Governance and Youth Participation in local policy making

DEFF Research Database (Denmark)

Eklund Karlsson, Leena; Haaber Pettersen, Charlotte Louise; Aro, Arja R.

2016-01-01

research strategy was applied to examine these two case studies. Data was collected under the REPOPA Project (Research into Policy to enhance Physical Activity) though semi-structures interviews (N=11), analysed through content analysis and supported by analysis of 123 background documents. Results: Youth...... was involved in policy making only through adult representation. These adult stakeholders became part of participatory governance in developing the healthy public policies in both Odense and Esbjerg municipalities. Conclusion: Youth participation in local HEPA policy making in Esbjerg and Odense did not meet...... the Danish principle of participatory policy process and good health system governance. Main messages: Mechanisms to facilitate youth participation in policy making in the study communities were lacking. The Danish goal of improved participatory policy making at the local level was not met....

Aarhus and Espoo Conventions: The role in promoting effective public participation in nuclear decision-making. The role of the Aarhus and Espoo Conventions in promoting effective public participation in nuclear decision-making

International Nuclear Information System (INIS)

Yanush, Maryna; Jendroska, Jerzy

2017-01-01

Ms Yanush and Mr Jendroska highlighted the role and importance of the Convention on Access to Information, Public Participation in Decision-Making and Access to Justice in Environmental Matters (the Aarhus Convention) and that of the Convention on Environmental Impact Assessment in a Transboundary Context (the Espoo Convention). These two conventions are open for global accession and, at present, have been ratified mainly by European and Central Asian countries within the United Nations Economic Commission for Europe (UNECE) region. Those two conventions, which apply to a wide range of activities including nuclear, are the only two binding international instruments setting minimum standards for public access to environmental information and public participation in decision making. The Maastricht Recommendations on Promoting Effective Public Participation in Decision-Making in Environmental Matters under the Aarhus Convention and the Good Practice Recommendations on the Application of the Convention to Nuclear Energy-related Activities under the Espoo Convention are instrumental in advancing the implementation in this area. Public participation under the Aarhus Convention goes beyond information or consultation: the decision maker must take into account the views of the 'public concerned' (i.e. the members of the public affected or likely to be affected by the decision making or having an interest in it). As the 'public concerned' is assessed through the potential impact of the proposed activity, including in the case of an accident, the obligation to notify and provide opportunity for public participation is not limited to the territory of the country hosting the proposed activity. Mr Jendroska indicated a particular finding of the Espoo Convention Implementation Committee that decisions regarding modifications, upgrades or extensions to the lifetime/operation of a nuclear installation would be subject to these obligations even though the activity remains exactly

Factors and outcomes of decision making for cancer clinical trial participation.

Science.gov (United States)

Biedrzycki, Barbara A

2011-09-01

To describe factors and outcomes related to the decision-making process regarding participation in a cancer clinical trial. Cross-sectional, descriptive. Urban, academic, National Cancer Institute-designated comprehensive cancer center in the mid-Atlantic United States. 197 patients with advanced gastrointestinal cancer. Mailed survey using one investigator-developed instrument, eight instruments used in published research, and a medical record review. disease context, sociodemographics, hope, quality of life, trust in healthcare system, trust in health professional, preference for research decision control, understanding risks, and information. decision to accept or decline research participation and satisfaction with this decision. All of the factors within the Research Decision Making Model together predicted cancer clinical trial participation and satisfaction with this decision. The most frequently preferred decision-making style for research participation was shared (collaborative) (83%). Multiple factors affect decision making for cancer clinical trial participation and satisfaction with this decision. Shared decision making previously was an unrecognized factor and requires further investigation. Enhancing the process of research decision making may facilitate an increase in cancer clinical trial enrollment rates. Oncology nurses have unique opportunities as educators and researchers to support shared decision making by those who prefer this method for deciding whether to accept or decline cancer clinical trial participation.

Need for public participation in decision-making on energy

International Nuclear Information System (INIS)

Norte Gomez, M. D.

2014-01-01

This paper outlines the need to expand and improve public participation in decision-making on energy. In an advanced society like ours you can not continue using the same tools they used a century ago. Provide and transmit by the scientific community to society, information science and technology in an appropriate language that comes to them, giving them opportunities and enabling them to participate objectively in this decision making. There must be a legitimate, honest, sincere and plural debate where the participation of all the actors involved and from all strata of society. (Author)

Participatory Risk Assessment for Environmental Decision-Making

International Nuclear Information System (INIS)

Homan, Jacqueline; Petts, Judith

2001-01-01

Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in practice, decision

Participatory Risk Assessment for Environmental Decision-Making

Energy Technology Data Exchange (ETDEWEB)

Homan, Jacqueline; Petts, Judith [Univ. of Birmingham (United Kingdom). Centre for Environmental Research and Training; Pollard, Simon; Twigger-Ross, Clare [National Centre for Risk Analysis and Options Appraisal, London (United Kingdom)

2001-07-01

Recent research, discussion and practice in the role environmental decision-making as an integral part of a democratic society have resulted in legislation, policy and guidance that encourage, and indeed may require, greater participation. The focus of this research paper is to explore these participatory ideas in the context of environmental risk assessment. Participation methods have generic application. However, the importance of fitting method to purpose requires that different contexts and issues relative to the objectives be addressed. In relation to environmental risk assessment these issues include: the complexity of risk issues per se; the inherent uncertainty that dominates any risk assessment; the quantitative nature of many risk assessments and the difficulty of dealing with low probability-high consequence outconies; the possibility of controversy in relation to decisions involving risk and thus the careful attention needed to the process and identification of participants; the traditional role and culture of experts in risk decisions and the challenge of reconciling this with the role of lay knowledge and the potential for the public to act as quality assurers in the risk decision process; the tendency for people to need reassurance when confronted with risk, even during a participation process; the need to acknowledge the public's ability to deal with complex technical issues and the need for information and data to respond to their questions, and the fact that 'risk' per se will often not be the only issue of public concern. The contributions to the risk debate from the social sciences are having considerable influence on the practice of environmental decision-making. Calls for increased stakeholder involvement in risk decisions are requiring greater access to and engagement with environmental risk assessments. Mechanisms for this level of involvement, however, are not well defined. For these aspirational calls to be realised in

Community sensitization and decision-making for trial participation: a mixed-methods study from The Gambia.

Science.gov (United States)

Dierickx, Susan; O'Neill, Sarah; Gryseels, Charlotte; Immaculate Anyango, Edna; Bannister-Tyrrell, Melanie; Okebe, Joseph; Mwesigwa, Julia; Jaiteh, Fatou; Gerrets, René; Ravinetto, Raffaella; D'Alessandro, Umberto; Peeters Grietens, Koen

2017-08-16

Ensuring individual free and informed decision-making for research participation is challenging. It is thought that preliminarily informing communities through 'community sensitization' procedures may improve individual decision-making. This study set out to assess the relevance of community sensitization for individual decision-making in research participation in rural Gambia. This anthropological mixed-methods study triangulated qualitative methods and quantitative survey methods in the context of an observational study and a clinical trial on malaria carried out by the Medical Research Council Unit Gambia. Although 38.7% of the respondents were present during sensitization sessions, 91.1% of the respondents were inclined to participate in the trial when surveyed after the sensitization and prior to the informed consent process. This difference can be explained by the informal transmission of information within the community after the community sensitization, expectations such as the benefits of participation based on previous research experiences, and the positive reputation of the research institute. Commonly mentioned barriers to participation were blood sampling and the potential disapproval of the household head. Community sensitization is effective in providing first-hand, reliable information to communities as the information is cascaded to those who could not attend the sessions. However, further research is needed to assess how the informal spread of information further shapes people's expectations, how the process engages with existing social relations and hierarchies (e.g. local political power structures; permissions of heads of households) and how this influences or changes individual consent. © 2017 The Authors Developing World Bioethics Published by John Wiley & Sons Ltd.

Knowledge, attitudes and decision-making preferences of men considering participation in the TROG RAVES Prostate Cancer Trial (TROG 08.03).

Science.gov (United States)

Tesson, Stephanie; Sundaresan, Puma; Ager, Brittany; Butow, Phyllis; Kneebone, Andrew; Costa, Daniel; Woo, Henry; Pearse, Maria; Juraskova, Ilona; Turner, Sandra

2016-04-01

The RAVES (Trans-Tasman Radiation Oncology Group 08.03) randomised controlled trial (RCT), compares adjuvant radiotherapy with early salvage radiotherapy in men with high risk histopathological features at prostatectomy. The RAVES Decision Aid study evaluates the utility of a decision aid for men considering participation in the RAVES RCT. We report the RAVES Decision Aid study participants' attitudes and knowledge regarding RCTs, decision-making preferences and decisional-conflict. Baseline questionnaires assessed knowledge and attitudes towards RCTs and RAVES RCT. Sociodemographic and clinical predictors of knowledge were examined. Involvement in decision-making and difficulties with the decision-making process were assessed using validated tools. 127 men (median age=63years) were recruited through urologists (n=91) and radiation oncologists (n=36). Men preferred collaborative (35%) or semi-active (35%) decision-making roles. Most (>75%) felt the RAVES RCT was worthwhile and important with participation being wise. However, nearly half had high decisional-conflict regarding participation. Scores of objective knowledge regarding RCTs and RAVES RCT were low. Most men with high-risk histopathological features at prostatectomy desire active involvement in decision-making regarding further management. Despite positive attitudes towards RCTs and the RAVES RCT, there were gaps in knowledge and high decisional-conflict surrounding participation. Crown Copyright © 2016. Published by Elsevier Ireland Ltd. All rights reserved.

Adolescent decision making about participation in a hypothetical HIV vaccine trial.

Science.gov (United States)

Alexander, Andreia B; Ott, Mary A; Lally, Michelle A; Sniecinski, Kevin; Baker, Alyne; Zimet, Gregory D

2015-03-10

The purpose of this study was to examine the process of adolescent decision-making about participation in an HIV vaccine clinical trial, comparing it to adult models of informed consent with attention to developmental differences. As part of a larger study of preventive misconception in adolescent HIV vaccine trials, we interviewed 33 male and female 16-19-year-olds who have sex with men. Participants underwent a simulated HIV vaccine trial consent process, and then completed a semistructured interview about their decision making process when deciding whether or not to enroll in and HIV vaccine trial. An ethnographic content analysis approach was utilized. Twelve concepts related to adolescents' decision-making about participation in an HIV vaccine trial were identified and mapped onto Appelbaum and Grisso's four components of decision making capacity including understanding of vaccines and how they work, the purpose of the study, trial procedures, and perceived trial risks and benefits, an appreciation of their own situation, the discussion and weighing of risks and benefits, discussing the need to consult with others about participation, motivations for participation, and their choice to participate. The results of this study suggest that most adolescents at high risk for HIV demonstrate the key abilities needed to make meaningful decisions about HIV vaccine clinical trial participation. Published by Elsevier Ltd.

How do persons with dementia participate in decision making related to health and daily care? a multi-case study.

Science.gov (United States)

Smebye, Kari Lislerud; Kirkevold, Marit; Engedal, Knut

2012-08-07

Many countries have passed laws giving patients the right to participate in decisions about health care. People with dementia cannot be assumed to be incapable of making decisions on their diagnosis alone as they may have retained cognitive abilities.The purpose of this study was to gain a better understanding of how persons with dementia participated in making decisions about health care and how their family carers and professional caregivers influenced decision making. This Norwegian study had a qualitative multi-case design. The triad in each of the ten cases consisted of the person with dementia, the family carer and the professional caregiver, in all 30 participants. Inclusion criteria for the persons with dementia were: (1) 67 years or older (2) diagnosed with dementia (3) Clinical Dementia Rating score 2, moderate dementia; (3) able to communicate verbally. The family carers and professional caregivers were then asked to participate.A semi-structured interview guide was used in interviews with family carers and professional caregivers. Field notes were written after participant observation of interactions between persons with dementia and professional caregivers during morning care or activities at a day centre. How the professional caregivers facilitated decision making was the focus of the observations that varied in length from 30 to 90 minutes. The data were analyzed using framework analysis combined with a hermeneutical interpretive approach. Professional caregivers based their assessment of mental competence on experience and not on standardized tests. Persons with dementia demonstrated variability in how they participated in decision making. Pseudo-autonomous decision making and delegating decision making were new categories that emerged. Autonomous decision making did occur but shared decision making was the most typical pattern. Reduced mental capacity, lack of available choices or not being given the opportunity to participate led to non

Service users' experiences of participation in decision making in mental health services.

Science.gov (United States)

Dahlqvist Jönsson, P; Schön, U-K; Rosenberg, D; Sandlund, M; Svedberg, P

2015-11-01

Despite the potential positive impact of shared decision making on service users knowledge and experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. This study highlights the desire of users to participate more actively in decision making and demonstrates that persons with SMI struggle to be seen as competent and equal partners in decision-making situations. Those interviewed did not feel that their strengths, abilities and needs were being recognized, which resulted in a feeling of being omitted from involvement in decision-making situations. The service users describe some essential conditions that could work to promote participation in decision making. These included having personal support, having access to knowledge, being involved in a dialogue and clarity about responsibilities. Mental health nurses can play an essential role for developing and implementing shared decision making as a tool to promote recovery-oriented mental health services. Service user participation in decision making is considered an essential component of recovery-oriented mental health services. Despite the potential of shared decision making to impact service users knowledge and positively influence their experience of decisional conflict, there is a lack of qualitative research on how participation in decision making is promoted from the perspective of psychiatric service users. In order to develop concrete methods that facilitate shared decision making, there is a need for increased knowledge regarding the users' own perspective. The aim of this study was to explore users' experiences of participation in decisions in mental health services in Sweden, and the kinds of support that may promote participation. Constructivist Grounded Theory (CGT) was utilized to analyse group and individual interviews with 20 users with experience of serious mental illness. The core

Environmental decision making: what does public participation add?

International Nuclear Information System (INIS)

Beierle, T.C.; Cayford, J.

2004-01-01

The role of public participation in environmental policy making has led to much discussion in recent years, accompanied by some cheering, some hand-wringing, a great deal of speculation, and always recognition of its growing importance. Over the past 30 years, participation has moved to centre stage in the play of influences that determine how the environment will be protected and managed. In doing so, it has evolved considerably. Traditional public hearings and public comment procedures have been joined by a broad array of more intensive approaches to participation that emphasize face-to-face deliberation, problem solving, and consensus building. Policy dialogues, stakeholder advisory committees, citizen juries, formal mediations, and a variety of other processes are now familiar components of the public participation mix. The amount of influence the public can wield has changed as well. In the United States, agreements made among interest groups in regulatory negotiations, for example, actually determine the content of proposed environmental regulations. Describing how well public participation has performed in its central role in environmental policy-making is the topic of our book, Democracy in Practice: Public Participation in Environmental Decisions. In the book, we evaluate the success of 239 cases of public participation undertaken in the United States over the last 30 years. Our primary objective was to develop an understanding of the social value of public participation by evaluating cases against a set of social goals, such as conflict resolution, trust formation, and education. Our second objective was to understand what made some processes successful and others not. We were particularly interested in how different approaches to public participation - from public hearings to formal mediations differed in their accomplishments. (author)

Patient participation in clinical decision-making in nursing: A comparative study of nurses' and patients' perceptions.

Science.gov (United States)

Florin, Jan; Ehrenberg, Anna; Ehnfors, Margareta

2006-12-01

The aim of this study was to compare the degree of concordance between patients and Registered Nurses' perceptions of the patients' preferences for participation in clinical decision-making in nursing care. A further aim was to compare patients' experienced participation with their preferred participatory role. Patient participation in clinical decision-making is valuable and has an effect on quality of care. However, there is limited knowledge about patient preferences for participation and how nurses perceive their patients' preferences. A comparative design was adopted with a convenient sample of 80 nurse-patient dyads. A modified version of the Control Preference Scale was used in conjunction with a questionnaire developed to elicit the experienced participation of the patient. A majority of the Registered Nurses perceived that their patients preferred a higher degree of participation in decision-making than did the patients. Differences in patient preferences were found in relation to age and social status but not to gender. Patients often experienced having a different role than what was initially preferred, e.g. a more passive role concerning needs related to communication, breathing and pain and a more active role related to activity and emotions/roles. Registered Nurses are not always aware of their patients' perspective and tend to overestimate patients' willingness to assume an active role. Registered Nurses do not successfully involve patients in clinical decision-making in nursing care according to their own perceptions and not even to the patients' more moderate preferences of participation. A thorough assessment of the individual's preferences for participation in decision-making seems to be the most appropriate approach to ascertain patient's involvement to the preferred level of participation. The categorization of patients as preferring a passive role, collaborative role or active role is seen as valuable information for Registered Nurses to

Disentangling participation power and decision-making in participatory design

CERN Document Server

Bratteteig, Tone

2014-01-01

Providing a critical view on user participation in design, disentangling decision making and power in design, this book uses fieldwork material from two large participatory design projects: one experimental in the field of urban planning, the other a product development project within health care. Addressing power issues in participatory design is critical to providing a realistic view of the possibilities and limitations of participation. Design is decision-making: during a design process a huge number of decisions?taken before the designers end up with a design result - an artefact or system

Patient participation in decision making on biomedical research: changing the network

NARCIS (Netherlands)

Caron - Flinterman, J.F.; Broerse, J.E.W.; Bunders - Aelen, J.G.F.

2007-01-01

Participation of end users in decision-making on science is increasingly practiced, as witnessed by the growing body of scientific literature on case evaluations. In the biomedical field, however, end-user participation in decision-making is rare. Some scholars argue that because patients are

Public participation in energy-related decision making: workshop proceedings

International Nuclear Information System (INIS)

1977-01-01

This document contains edited transcripts of presentations and discussion at plenary sessions of a workshop on Public Participation in Energy Related Decision Making sponsored by the National Science Foundation and held at The MITRE Corporation in McLean, Virginia, on September 21 and 22, 1976. The Emergency Core Cooling System rulemaking, the consideration of Energy Parks in Pennsylvania, and the Seabrook, New Hampshire Nuclear Station decisions are summarized, and the process of public participation in each decision is analyzed by actual participants in the respective cases. Also summarized are the North Anna decision, the Sears Island decision, and the Big Rock Point decision. The conclusions and recommendations from working group discussions on the role and process of public participation are presented. An overall summary is provided, along with the final report of the National Academy of Public Administration Panel which was convened to assist in the design and conduct of the workshop. A companion volume to these proceedings, Public Participation in Energy Related Decision Making: Six Case Studies, M76-53, was distributed to participants prior to the workshop and includes complete case studies of the above six decisions

The plethora of publics and their participation in policy making: How can they properly participate?

Energy Technology Data Exchange (ETDEWEB)

Carnes, S.A.

1995-07-01

This paper examines the theoretical bases of publics and stakeholder participation in decision making, with special attention to mixed issues, including federal government actions such as remedial action programs and hazardous facility sitings. Empowerment associated with participation is addressed, focusing on differences between power and authority.

Promoting women’s participation in decision-making at the local level.

OpenAIRE

Anwar, Ibrahim A.

2012-01-01

This study was carried out in the context of participation in decision-making in the Barzan sub-district in the Kurdistan region of Iraq. It focused on women’s participation in decision-making from the perspective of gender and development. Democratic governance and decentralisation served as the main theoretical framework and pre-condition for analyzing participation. Though the Kurdistan region has been moving towards democracy, decentralisation and participatory governance since 1992, ther...

A Model for Making Decisions about Ethical Dilemmas in Student Assessment

Science.gov (United States)

Johnson, Robert L.; Liu, Jin; Burgess, Yin

2017-01-01

In this mixed-methods study we investigated the development of a generalized ethics decision-making model that can be applied in considering ethical dilemmas related to student assessment. For the study, we developed five scenarios that describe ethical dilemmas associated with student assessment. Survey participants (i.e., educators) completed an…

Impact of Participation in Decision Making on Job Satisfaction: An Organizational Communication Perspective.

Science.gov (United States)

Xia, Ying; Zhang, Li; Zhao, Ning

2016-09-20

Participation in organizational decision-making has received considerable attention from scholars. Beyond the perspectives proposed in past studies, we offer a new account, based upon a communication perspective, to explain why and when participation in decision-making can influence job satisfaction. Drawing from social capital theory, we examine whether communication openness mediates the relationship between participation in decision-making and job satisfaction. We also investigate how information adequacy moderates this mediated process. Results from a sample of 184 employees in China showed that the four-factor model was the best fitting solution (CFI = .91, GFI = .90, RMSEA = .09). The analyses indicated that employees' participation in decision-making positively affected their job satisfaction (β = .32, p communication openness (direct effect became non-significant when communication openness was included: β = .06, n.s.). Results also found that decision-making information adequacy positively moderated the relationship between participation in decision-making and communication openness (β = .13, p communication and the free flow of information within organizations should be encouraged.

Heuristic decision-making about research participation in children with cystic fibrosis.

Science.gov (United States)

Christofides, Emily; Dobson, Jennifer A; Solomon, Melinda; Waters, Valerie; O'Doherty, Kieran C

2016-08-01

Traditional perspectives on informed consent assume that when faced with decisions about whether to participate in research, individuals behave according to principles of classical rationality, taking into account all available information to weigh risks and benefits to come to a decision that is optimal for them. However, theoretical and empirical research in psychology suggests that people may not make decisions in this way. Less is known about decision-making processes as they pertain to participating in biomedical research, particularly when the participants are children. We sought to better understand research decision processes especially in children who tend to participate extensively in research due to chronic illness. To learn more about children's decision-making in this context, we interviewed 19 young patients with cystic fibrosis (male n = 7; female n = 12) aged 8-18 years (M = 13 years) at a children's hospital in Canada between April and August 2013. We found that participants generally had a default approach to participation decisions, which they attributed to their parents' attitudes to research, experiences of having grown up participating in research, trusting the researchers, and wanting to help. Most of our participants made the decision to participate in research based on a heuristic with a baseline to say "yes", subject to change based on aspects of the research or particular preferences. In particular, concerns with the procedure, unwillingness to talk about cystic fibrosis, logistical challenges, and perceptions of risk all influenced the decision, as did the perceived importance or personal relevance of the research. Our study illustrates that rather than conducting risk/benefit analyses, participants tended to adopt a heuristic-like approach, consistent with decision theories that view heuristic decision-making as ecologically rational. Copyright © 2016 Elsevier Ltd. All rights reserved.

The Effects of Scenario Planning on Participant Decision-Making Style

Science.gov (United States)

Chermack, Thomas J.; Nimon, Kim

2008-01-01

This research examines changes in decision-making styles as a result of participation in scenario planning. A quasi-experimental pretest-posttest design and several nonparametric tests were used to analyze data gathered from research participants in a technology firm in the Northeastern United States. Results show that participants tend to…

Legitimacy and institutional response strategies of public participation in nuclear policy-making

International Nuclear Information System (INIS)

Lee, J. H.; Ahn, S. K.; Yun, Y. J.

2004-01-01

This paper proposes that the approach to nuclear policy system should be changed to the participatory and resilient way from the managerial and anticipatory way. This change is surely reasonable in the point that, firstly, the managerial and anticipatory approach contains the internal weakness of not allowing trials and errors due to its centralized decision making and, secondly, active participation of general public can give a great contribution to the course of decision-making in science and technology as well. However, the expansion of public participation has the risk of falling into the deadlock of unreasonable populism, so the course and procedures of public participation need to be included in the process of decision making in the matter of science and technology systematically. Accordingly, this paper shows the research result on the process of public participation in Europe and suggests the possibility that there can be a balanced and effective system of public participation in nuclear policy making

Public participation in decision-making for contaminated sites

International Nuclear Information System (INIS)

Till, J.E.; Sharp, S.L.

2000-01-01

Public participation is critical in environmental decision-making. This paper provides three examples of public participation in the decision making process. The first example illustrates the effectiveness of public involvement when incorporated at the beginning of a project. The second example shows the loss of trust by a community resulting from the lack of public involvement. The third example demonstrates public involvement in making risk-based decisions for corrective action in a non-radiological situation. The first site is the Los Alamos National Laboratory where a lawsuit filed by local citizens led to an independent audit of the laboratory's compliance with the Clean Air Act for radionuclides. The audit team involved the public extensively, resulting in close interaction during the audit and a better understanding by the public of the regulations. The second site is the Rocky Flats Plant nuclear weapons facility, which is being decommissioned and the surrounding property will ultimately be available for public use. The Department of Energy proposed a cleanup level but the level was developed with little public input and has been criticized widely by local residents. As a result, the target cleanup levels are being reevaluated by an independent contractor with oversight from a panel of local members of the public. Working with the independent contractor, the panel proposed new cleanup standards to the Department of Energy. The third site is a bulk oil and terminal where chemicals have migrated offsite into a residential area. Facility owners have initiated a public involvement program to help the community understand the potential risks involved and alternatives for remedial action. The public is playing a key role in the risk-based decision making process. Each of these examples illustrates the importance of public participation in different situations. (author)

The effects of scientific literacy on participation to political decision making

Directory of Open Access Journals (Sweden)

Süerdem Ahmet

2016-01-01

Full Text Available The low levels of scientific literacy among the general public in a society where technology penetrates all aspects of everyday life creates major citizenship problems. One of the main goals of education is increasing the civic scientific literacy of the citizens besides preparing students for science based vocations. Well educated human capital stock is important for informed decision making as well as the development of research and development activities. The quality of policy decisions is highly dependent on the level of interest, information and attitudes towards S&T. Making conscious decisions about S&T related developments is substantial for democratic participation of the public to policy making. Increasing complexity of science and technology related issues creates a gap between expert and citizen knowledge. Scientific literacy decreases this gap in terms of creating a knowledgeable approach to the controversies around scientific issues. The aim of this study is to make an operational model for explaining how civic scientific literacy affects public understanding of science and these in turn influence participation to political decision making. We analyse the effects of scientific literacy and other public understanding of science variables on participation to political decision making.

Community participation and environmental decision-making in the Niger Delta

International Nuclear Information System (INIS)

Adomokai, Rosemary; Sheate, William R.

2004-01-01

The participation of communities in the process of environmental decision-making in Nigeria and the Niger Delta region in particular is a relatively new process. There are many practical problems ranging from financial support, methods used and the willingness of identified stakeholders to participate. This paper seeks to highlight recent developments in community participation and environmental decision-making in the Niger Delta, using the EIA Decree of 1992 as a reference point. The EIA Decree of 1992 is the only legislation that refers to participation of the communities when environmental decisions are being made. The study reported here aimed to examine differences and similarities between the identified stakeholders interviewed in the research, in order to highlight areas of improvement that will encourage positive changes to the process and foster better relations between the stakeholders. The paper provides a brief background to community participation in the Niger Delta region and reports on the research approach adopted. Interviews with stakeholders in the EIA process were undertaken to provide a better understanding of public participation in practice under the EIA Decree. While participation was found to be now firmly on the agenda, there is still much to do to engender greater awareness of EIA and the potential benefits participation can hold

Why do Participation in Decision Making Enhance Creativity in Work Groups?

DEFF Research Database (Denmark)

Christensen, Bo Thomas; Jønsson, Thomas

It seems to be an established fact in the organizational psychological literature that participation in decision making leads to creativity and innovation in work groups and organizations. A quite extensive amount of research has claimed that the link exists, although only a somewhat smaller amount...... of research has established that there is a link between the two constructs of participation in decision making and creativity. But although this link has been clearly documented theories with clearly stated causal explanations of why participation in decision making (pdm) would lead to creativity...... factors include such different models as enhanced intrinsic motivation (Amabile, 2001; Conti & Amabile, 1999), reduction in resistance to change (De Dreu & West, 2001), pooling of unshared knowledge (Latham, Winters, & Locke, 1994) and better utilization of individual differences in cognitive style...

Why does Participation in Decision Making Enhance Creativity in Work Groups?

DEFF Research Database (Denmark)

Christensen, Bo T.; Jønsson, Thomas S.

It seems to be an established fact in the organizational psychological literature that participation in decision making leads to creativity and innovation in work groups and organizations. A quite extensive amount of research has claimed that the link exists, although only a somewhat smaller amount...... of research has established that there is a link between the two constructs of participation in decision making and creativity. But although this link has been clearly documented theories with clearly stated causal explanations of why participation in decision making (pdm) would lead to creativity...... factors include such different models as enhanced intrinsic motivation (Amabile, 2001; Conti & Amabile, 1999), reduction in resistance to change (De Dreu & West, 2001), pooling of unshared knowledge (Latham, Winters, & Locke, 1994) and better utilization of individual differences in cognitive style...

Civil Society Participation in EU Gender Policy-Making

DEFF Research Database (Denmark)

Agustin, Lise Rolandsen

2008-01-01

The participation of transnational advocacy networks (TANs) in the policy processes of the European Union (EU) is a potential site of substantial representation of women (SRW). In the article, it is argued that the institutional context can both enable and constrain civil society actors’ claims......-making. TANs employ framing strategies to make their claims resonate with or challenge the dominant discourse of the EU policies. The institutions use contested frames to constitute legitimate claims-makers, by recognising certain claims as more valid than others. The possibilities of SRW are delimited, since...

Measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective.

Science.gov (United States)

Heggland, Liv-Helen; Mikkelsen, Aslaug; Øgaard, Torvald; Hausken, Kjell

2014-02-01

To develop, empirical test, and validate an instrument measuring patient participation in surgical treatment decision-making from healthcare professionals' perspective. Since the advent of New Public Management in many Western countries, patient participation in healthcare decision-making has been considered to be a best practice. A common notion is that well-educated and well-informed public want to choose their own treatments and providers and want to ask questions about the quality of their health services. Survey. A self-report-measuring instrument was designed and administered to 620 healthcare professionals. Items were developed, validated and tested by 451 nurses and physicians working in six surgical wards in a University Hospital in Norway. A 16-item scale with the following four dimensions was developed: information dissemination, formulation of options, integration of information and control. Factor analysis procedures and reliability testing were performed. A one-way, between-groups analysis of variance was conducted to compare doctors' and nurses' opinions on four dimensions of patient participation in surgical treatment decision-making. This article shows that patient participation in surgical treatment decision-making can be measured by a 16-item scale and four distinct dimensions. The analysis demonstrated a reasonable level of construct validity and reliability. Nurses and physicians have a positive attitude towards patient participation overall, but the two groups differ in the extent to which they accept the idea of patient participation in treatment decision-making. The instrument can be a tool for managers and healthcare professionals in the implementation of patient participation in clinical practice. Data from the instrument can be useful to identify health services being provided and what areas that could strengthen patient participation. © 2013 Blackwell Publishing Ltd.

Women Participation In Agricutural Decision-Making In Aguata Local ...

African Journals Online (AJOL)

Madukwe

formulation and decision-making process, even in the issues that affect them ... information, workshop/conferences attendance and rate/level of participation in .... Appropriate Technology in “Women in Nigeria Economy”, ACENA Publishers,.

The reliability and validity of a child and adolescent participation in decision-making questionnaire.

Science.gov (United States)

O'Hare, L; Santin, O; Winter, K; McGuinness, C

2016-09-01

There is a growing impetus across the research, policy and practice communities for children and young people to participate in decisions that affect their lives. Furthermore, there is a dearth of general instruments that measure children and young people's views on their participation in decision-making. This paper presents the reliability and validity of the Child and Adolescent Participation in Decision-Making Questionnaire (CAP-DMQ) and specifically looks at a population of looked-after children, where a lack of participation in decision-making is an acute issue. The participants were 151 looked after children and adolescents between 10-23 years of age who completed the 10 item CAP-DMQ. Of the participants 113 were in receipt of an advocacy service that had an aim of increasing participation in decision-making with the remaining participants not having received this service. The results showed that the CAP-DMQ had good reliability (Cronbach's alpha = 0.94) and showed promising uni-dimensional construct validity through an exploratory factor analysis. The items in the CAP-DMQ also demonstrated good content validity by overlapping with prominent models of child and adolescent participation (Lundy 2007) and decision-making (Halpern 2014). A regression analysis showed that age and gender were not significant predictors of CAP-DMQ scores but receipt of advocacy was a significant predictor of scores (effect size d = 0.88), thus showing appropriate discriminant criterion validity. Overall, the CAP-DMQ showed good reliability and validity. Therefore, the measure has excellent promise for theoretical investigation in the area of child and adolescent participation in decision-making and equally shows empirical promise for use as a measure in evaluating services, which have increasing the participation of children and adolescents in decision-making as an intended outcome. © 2016 John Wiley & Sons Ltd.

Clinician and cancer patient views on patient participation in treatment decision-making: a quantitative and qualitative exploration

Science.gov (United States)

Pieterse, A H; Baas-Thijssen, M C M; Marijnen, C A M; Stiggelbout, A M

2008-01-01

Patient participation in treatment decision-making is being increasingly advocated, although cancer treatments are often guideline-driven. Trade-offs between benefits and side effects underlying guidelines are made by clinicians. Evidence suggests that clinicians are inaccurate at predicting patient values. The aim was to assess what role oncologists and cancer patients prefer in deciding about treatment, and how they view patient participation in treatment decision-making. Seventy disease-free cancer patients and 60 oncologists (surgical, radiation, and medical) were interviewed about their role preferences using the Control Preferences Scale (CPS) and about their views on patient participation using closed- and open-ended questions. Almost all participants preferred treatment decisions to be the outcome of a shared process. Clinicians viewed participation more often as reaching an agreement, whereas 23% of patients defined participation exclusively as being informed. Of the participants, ⩾81% thought not all patients are able to participate and ⩾74% thought clinicians are not always able to weigh the pros and cons of treatment for patients, especially not quality as compared with length of life. Clinicians seemed reluctant to share probability information on the likely impact of adjuvant treatment. Clinicians should acknowledge the legitimacy of patients' values in treatment decisions. Guidelines should recommend elicitation of patient values at specific decision points. PMID:18781148

Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

Science.gov (United States)

Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

2014-01-01

Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

Toward Motivating Participants to Assess Peers' Work More Fairly: Taking Programing Language Learning as an Example

Science.gov (United States)

Wang, Yanqing; Ai, Wenguo; Liang, Yaowen; Liu, Ying

2015-01-01

Peer assessment is an efficient and effective learning assessment method that has been used widely in diverse fields in higher education. Despite its many benefits, a fundamental problem in peer assessment is that participants lack the motivation to assess others' work faithfully and fairly. Nonconsensus is a common challenge that makes the…

The public participation handbook: making better decisions through citizen involvement

National Research Council Canada - National Science Library

Creighton, James L

2005-01-01

"Internationally renowned facilitator and consultant James L. Creighton offers a practical guide to designing and facilitating public participation in environmental and public policy decision making...

Participation in decision-making process, incentives and training as ...

African Journals Online (AJOL)

Participation in decision-making process, incentives and training as predictors of organizational commitment among industrial workers. ... African Journal for the Psychological Study of Social Issues ... Results indicated that the three motivational factors jointly and significantly predicted organizational commitment. Also, each ...

Stakeholder participation in health impact assessment: A multicultural approach

International Nuclear Information System (INIS)

Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

2013-01-01

The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

Stakeholder participation in health impact assessment: A multicultural approach

Energy Technology Data Exchange (ETDEWEB)

Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

2013-11-15

The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA.

The Extent of Teacher Participation in Decision-Making in Secondary Schools in Zimbabwe

Science.gov (United States)

Wadesango, Newman

2010-01-01

In Zimbabwe, there have been some debates on democratisation and decentralisation, which led to the development of policies meant to increase teacher participation in decision-making in schools. However, despite these developments, teacher participation in decision-making in Zimbabwean schools is regarded as insignificant. Teachers work closely…

Free-Choice Learning Suited to Women's Participation Needs in Environmental Decision-Making Processes

Science.gov (United States)

Skanavis, Constantina; Sakellari, Maria

2012-01-01

United Nations mandates recognize the need to promote the full participation of women in environmental decision-making processes on the basis of gender equality. But, there remains a profound lack of effective women's participation in some sectors of environmental decision-making. Free-choice environmental learning offers an effective educational…

Public participation in strategic environmental assessment (SEA): Critical review and the Quebec (Canada) approach

International Nuclear Information System (INIS)

Gauthier, Mario; Simard, Louis; Waaub, Jean-Philippe

2011-01-01

It is widely accepted that public participation must be a part of strategic environmental assessment (SEA) procedures, and yet few studies have been conducted on the implementation of SEA public participation procedures. Accordingly, the theoretical and practical aspects of public participation in SEA remain research priorities for environmental policy-making. This paper presents a review of the Quebec (Canada) model of public participation in SEA through an evaluation of six public hearings on proposed directions and policies concerning, respectively, hazardous waste, forest protection, residual materials, energy, water management and pig farming. First, the authors examine the theoretical dimensions of SEA and public participation in the process. Second, they give a summary of the lessons that can be learned from the few Canadian and international experiences. Third, they outline the Quebec experience. Finally, they conclude by evaluating the opportunities and limitations of the Quebec experience and make some recommendations to improve its application.

Risk assessment and clinical decision making for colorectal cancer screening.

Science.gov (United States)

Schroy, Paul C; Caron, Sarah E; Sherman, Bonnie J; Heeren, Timothy C; Battaglia, Tracy A

2015-10-01

Shared decision making (SDM) related to test preference has been advocated as a potentially effective strategy for increasing adherence to colorectal cancer (CRC) screening, yet primary care providers (PCPs) are often reluctant to comply with patient preferences if they differ from their own. Risk stratification advanced colorectal neoplasia (ACN) provides a rational strategy for reconciling these differences. To assess the importance of risk stratification in PCP decision making related to test preference for average-risk patients and receptivity to use of an electronic risk assessment tool for ACN to facilitate SDM. Mixed methods, including qualitative key informant interviews and a cross-sectional survey. PCPs at an urban, academic safety-net institution. Screening preferences, factors influencing patient recommendations and receptivity to use of a risk stratification tool. Nine PCPs participated in interviews and 57 completed the survey. Despite an overwhelming preference for colonoscopy by 95% of respondents, patient risk (67%) and patient preferences (63%) were more influential in their decision making than patient comorbidities (31%; P decision making, yet few providers considered risk factors other than age for average-risk patients. Providers were receptive to the use of a risk assessment tool for ACN when recommending an appropriate screening test for select patients. © 2013 John Wiley & Sons Ltd.

Social-Cultural Factors Affecting Maasai Women Participation In Decision Making In Tanzania. A Case Study Of Longido District

Directory of Open Access Journals (Sweden)

Carolyn Kandusi

2015-06-01

Full Text Available Abstract Throughout history participation in decision making through processes like voting vying for leadership position and participation in decision making meetings has been blinded by discrimination to certain groups of community members including women. This study assessed the social cultural factors affecting Maasai womens participation in decision making a case of Longido district. Purposive sampling was used to select the districts under the study. Decision to select Longido was based on the inhabitance of pastoral community. A total of 115 respondents were obtained through simple random selection. Data were collected through a questionnaire and analyzed using SPSS. Simple descriptive statistics and cross tabulation were used in the analysis. The results show that majority would you vote for a woman to be an MP Councilor Village Chairman in your community. A considerable proportion of men refused to be led by a woman. Furthermore women were found not to effectively participate in politics through vying for leadership positions as many respondents voted for male contestant main reasons being no female contestant. Situations in which women are involved in decision making were found mainly to be on issues pertaining women development and family matters. Findings show that women are allowed to vote in the community but often the decision for a woman to vote was found to be determined by men. The study further found that women are not regarded elders and females ideas were not taken into account as male ideas in village meetings. The main barriers for women participation in leadership were found that men do not want women to compete in leadership and women ideas not accepted by most men. The study concluded that Maasai women participation in decision making is limited by social cultural factors like social identity social acceptance social roles and limiting cultural practices. It is recommended that civic education strategy and appropriate

From the communication to participation in decision making

International Nuclear Information System (INIS)

Alonso, A.

2004-01-01

In the modern democratic societies there have appeared individuals and associations interested in and concerned with the risks proper to the use of ionising radiation and nuclear power. In the use of their democratic rights, they have requested and obtained from those responsible information on such activities and there has been established a fruitful communication process involving the interchange of facts and circumstances that is contributing to make the perceived risk more objective. At the moment, those societies are moving from information, through interactive communication, to participation in the decision.making processes with major social impacts or social sensitivity. This significant movement is analysed, as well as its causes and consequences. (Author)

Productivity and turnover in PCPs: the role of staff participation in decision-making.

Science.gov (United States)

Hung, Dorothy Y; Rundall, Thomas G; Cohen, Deborah J; Tallia, Alfred F; Crabtree, Benjamin F

2006-10-01

Efforts to redesign primary care practices are beginning to address how decisions are made in the practice setting. This study contributes to these efforts by examining associations between staff participation in decision-making, productivity, and turnover in primary care practices. The study is informed by organizational theories of participation that emphasize cognitive and affective influences on employee output and behavior. This research used data collected from primary care practices involved in a national initiative sponsored by the Robert Wood Johnson Foundation. Cross-sectional survey data on organizational structures and attributes among 49 practices were analyzed. Regression analysis was used to examine associations among practice productivity, staff participation in decision-making, and formal structures such as staff meetings. Associations between staff turnover and participative decision-making were also examined. Staff participation in decisions regarding quality improvement, practice change, and clinical operations was positively associated with practice productivity, whereas formal structures such as staff meetings were not. In addition, higher levels of participation in decision-making were associated with reduced turnover among nonclinicians and administrative staff. Examination of organizational features is increasingly recognized as a key to improving primary care performance. Study findings suggest that one important strategy may be implementation of a participative model emphasizing greater staff involvement in practice decisions. This may enhance information-sharing, work satisfaction, and commitment to organizational decisions, all of which can lead to beneficial outcomes such as increased productivity and stability in primary care practices.

Citizen participation in local policy making: design and democracy

NARCIS (Netherlands)

Michels, A.M.B.|info:eu-repo/dai/nl/11124501X

2012-01-01

Embedding democratic innovations that increase and deepen citizen participation in decision making has become a common policy of local governments in many countries. This article focuses on the role of the design of these innovations and seeks to establish the effects of their design on democracy.

Decision-making capacity for research participation among addicted people: a cross-sectional study.

Science.gov (United States)

Morán-Sánchez, Inés; Luna, Aurelio; Sánchez-Muñoz, Maria; Aguilera-Alcaraz, Beatriz; Pérez-Cárceles, Maria D

2016-01-13

Informed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research. 53 subjects with DSM-5 diagnoses of a Substance Use Disorder (SUD) and 50 non psychiatric comparison subjects (NPCs) participated in the survey from December 2014 to March 2015. This cross-sectional study was carried out at a community-based Outpatient Treatment Center and at an urban-located Health Centre in Spain. A binary judgment of capacity/incapacity was made guided by the MacArthur Competence Assessment Tool for Clinical Research (MacCAT-CR) and a clinical interview. Demographics and clinical characteristics were assessed by cases notes and the Mini-Mental State Examination, the Global Assessment Functional Scale and the Clinical Global Impression Scale. NPCs performed the best on the MacCAT-CR, and patients with SUD had the worst performance, particularly on the Understanding and Appreciation subscales. 32.7% SUD people lacked research-related decisional capacity. There were no statistically significant differences between the groups in terms of capacity to consent to research. The findings of our study provide evidence that a large proportion of individuals with SUD had decisional capacity for consent to research. It is therefore inappropriate to draw conclusions about capacity to make research decisions on the basis of a SUD diagnosis. In the absence of advanced cognitive impairment, acute withdrawal or intoxication, we should assume that addicted persons possess decision-making capacity. Thus, the view that people with SUD would ipso facto lose decision-making power for research consent is flawed and stigmatizing.

Interventions for promoting participation in shared decision-making for children with cancer.

Science.gov (United States)

Coyne, Imelda; O'Mathúna, Dónal P; Gibson, Faith; Shields, Linda; Leclercq, Edith; Sheaf, Greg

2016-11-29

Conference of the International Society for Paediatric Oncology (SIOP) and Annual Scientific Meeting of the Society for Medical Decision Making (SMDM). We scanned the ISRCTN (International Standard Randomised Controlled Trial Number) register and the National Institutes of Health (NIH) Register for ongoing trials on 29 February 2016. For this update, we included randomised controlled trials (RCTs) and controlled clinical trials (CCTs) of SDM interventions for children with cancer aged four to 18 years. The types of decisions included were: treatment, health care and research participation decisions. The primary outcome was SDM as measured with any validated scale. Two review authors undertook the searches, and three review authors independently assessed the studies obtained. We contacted study authors for additional information. No studies met the inclusion criteria, and hence no analysis could be undertaken. No conclusions can be made on the effects of interventions to promote SDM for children with cancer aged four to 18 years. This review has highlighted the dearth of high-quality quantitative research on interventions to promote participation in SDM for children with cancer. There are many potential reasons for the lack of SDM intervention studies with children. Attitudes towards children's participation are slowly changing in society and such changes may take time to be translated or adopted in healthcare settings. The priority may be on developing interventions that promote children's participation in communication interactions since information-sharing is a prerequisite for SDM. Restricting this review to RCTs was a limitation and extending the review to non-randomised studies (NRS) may have produced more evidence. For this update, we included only RCTs and CCTs. Clearly more research is needed.

Women\\'s participation in political leadership and decision-making ...

African Journals Online (AJOL)

Women\\'s participation in political leadership and decision-making in Ethiopia: A research note. B Mesfin. Abstract. No Abstract. Ethiopian Journal of the Social Sciences and Humanities Vol. 2 (2) 2004: pp.80-99. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

Sense-making and Impact Assessment

DEFF Research Database (Denmark)

Lyhne, Ivar

The poster integrates knowledge about how we make sense of situations into SEA methodology to strengthen the staging of impact assessments and the process of scoping impacts.......The poster integrates knowledge about how we make sense of situations into SEA methodology to strengthen the staging of impact assessments and the process of scoping impacts....

Data for Participation and Participation as Data: Supporting Incremental Participatory Decision-Making in Urban Planning

DEFF Research Database (Denmark)

Ddamba, Joshua; Dittrich, Yvonne

2015-01-01

Current literature on urban planning explores how to use ICT to support citizen participation. Advances in open data and its possibility to easily represent data on maps, opens up new opportunities to support participation and decision making in urban projects. This article investigates how spatial...... process and the decisions that are part of it. The paper concludes with design implications for decision support for urban planning. In future research, the intention is to explore these implications in a Participatory Design process....... of an urban renewal project, the article investigates the use of structured and unstructured data for participation. The fieldwork is conducted using ethnographically inspired methods, based on participatory observations, interviews and document analysis. As a result, the incremental decisions, the resulting...

Looking for a more participative healthcare: sharing medical decision making

OpenAIRE

Bravo, Paulina; Escuela de Enfermería, Pontificia Universidad Católica de Chile, Chile. School of Medicine, Cardiff University. Reino Unido. Enfermera, doctora en Salud Pública.; Contreras, Aixa; Escuela de Enfermería, Pontificia Universidad Católica de Chile, Chile. enfermera matrona, magister en Psicología Social Comunitaria.; Perestelo-Pérez, Lilisbeth; Servicio de Evaluación del Servicio Canario de la Salud, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC). España. psicóloga, doctora en Psicología Clínica y de la Salud.; Pérez-Ramos, Jeanette; Fundación Canaria de Investigación y Salud (FUNCIS). España. psicóloga.; Málaga, Germán; Conocimiento y Evidencia (CONEVID), Universidad Peruana Cayetano Heredia. Lima, Perú. médico internista, magister en Medicina.

2014-01-01

The healthcare model is shifting from a paternalistic towards a more inclusive and participative approach, such as shared decision making (SDM). SDM considers patients as autonomous and responsible agents. SDM is a therapeutic approach where healthcare providers and patients share the best evidence available to make a decision according to the values and preferences of the patient. Decision aids are tools that can facilitate this information exchange. These tools help patients to increase kno...

Investigating the Decision-Making Process of Standard Setting Participants

Science.gov (United States)

Papageorgiou, Spiros

2010-01-01

Despite the growing interest of the language testing community in standard setting, primarily due to the use of the Common European Framework of Reference (CEFR-Council of Europe, 2001), the participants' decision-making process in the CEFR standard setting context remains unexplored. This study attempts to fill in this gap by analyzing these…

Teacher Participation in the Decision-Making Process: Reality and Repercussions in Indian Higher Education

Science.gov (United States)

Mehta, Deepa; Gardia, Alok; Rathore, H. C. S.

2010-01-01

The study reported here focused on comparing teachers' actual and desired participation in different decision-making situations and examined how participation in decision making differs in Indian higher educational institutions. The paper provides a comparison of findings with similar studies conducted in Western settings regarding the…

Setting boundaries of participation in environmental impact assessment

Energy Technology Data Exchange (ETDEWEB)

Salomons, Geoffrey H., E-mail: gsalomon@ualberta.ca [University of Alberta, Department of Political Science, 10-16 Henry Marshall Tory Building, University of Alberta, Edmonton, AB T6G 2H4 (Canada); Hoberg, George, E-mail: george.hoberg@ubc.ca [University of British Columbia, Faculty of Forestry, Forest Sciences Centre 2045, 2424 Main Mall, Vancouver, British Columbia V6T 1Z4 (Canada)

2014-02-15

Public participation processes are touted as an effective way to increase the capacity and legitimacy of environmental assessment and the regulatory process that rely on them. Recent changes to the Canadian environmental assessment process narrowed the criteria for who can participate in environmental assessments from any who were interested to those who were most directly affected. This article examines the potential consequences of this change by exploring other areas of Canadian regulatory law where a similar directed affected test has been applied. This new standard risks institutionalizing the long-understood representational bias confronted by more diffuse interest like environmental protection. Restricting participation to the “directly affected” is far too narrow a test for processes like environmental assessment that are designed to determine the public interest. -- Highlights: • Public participation can improve the legitimacy of environmental assessments. • New Canadian rules narrow the range of eligible participants. • Similar rules in Alberta have excluded environmental representation. • The new rules may institutionalize bias against more diffuse interests. • Restricting participation to the “directly affected” is far too narrow.

Setting boundaries of participation in environmental impact assessment

International Nuclear Information System (INIS)

Salomons, Geoffrey H.; Hoberg, George

2014-01-01

Public participation processes are touted as an effective way to increase the capacity and legitimacy of environmental assessment and the regulatory process that rely on them. Recent changes to the Canadian environmental assessment process narrowed the criteria for who can participate in environmental assessments from any who were interested to those who were most directly affected. This article examines the potential consequences of this change by exploring other areas of Canadian regulatory law where a similar directed affected test has been applied. This new standard risks institutionalizing the long-understood representational bias confronted by more diffuse interest like environmental protection. Restricting participation to the “directly affected” is far too narrow a test for processes like environmental assessment that are designed to determine the public interest. -- Highlights: • Public participation can improve the legitimacy of environmental assessments. • New Canadian rules narrow the range of eligible participants. • Similar rules in Alberta have excluded environmental representation. • The new rules may institutionalize bias against more diffuse interests. • Restricting participation to the “directly affected” is far too narrow

Minority dissent and team innovation: the importance of participation in decision making

NARCIS (Netherlands)

de Dreu, C.K.W.; Beersma, B.

2001-01-01

This study integrates research on minority dissent and individual creativity, as well as team diversity and the quality of group decision making, with research on team participation in decision making. From these lines of research, it was proposed that minority dissent would predict innovation in

Minority dissent and team innovation : the importance of participation in decision making

NARCIS (Netherlands)

Dreu, de C.K.W.; West, M.A.

2001-01-01

This study integrates research on minority dissent and individual creativity, as well as team diversity and the quality of group decision making, with research on team participation in decision making. From these lines of research, it was proposed that minority dissent would predict innovation in

Participation of employees in the making of marketing decisions in enterprises in Serbia

OpenAIRE

Ravić Nenad; Kirin Snežana; Filipović Predrag

2016-01-01

Contemporary approaches to the analysis of business activities of modern organizational systems are focusing on human resources and considering them the most important property. Participation of employees in the decision-making process contributes to the improvement of company's performances, and also to the satisfaction and motivation of employees. Objective of this research paper is to point out to the significance of employees' participation in the making of strategic decisions in an enter...

38 CFR 52.110 - Participant assessment.

Science.gov (United States)

2010-07-01

... nurse with responsibility for the participant, social worker, recreational therapist and other... in the participant's physical, mental, or social condition. (3) Review of assessments. Program... plan related to changes in service needs and changes in functional status that prompted another level...

Career Development Strivings: Assessing Goals and Motivation in Career Decision-Making and Planning

Science.gov (United States)

Dik, Bryan J.; Sargent, Adam M.; Steger, Michael F.

2008-01-01

This article describes and demonstrates a novel approach to assessing goals and motives among individuals engaged in the career decision-making and planning process. Participants generated five career development strivings, rated each striving along several dimensions (self-efficacy, outcome expectations, sense of calling, spiritual significance,…

Factors That Influence Students to Participate in Team Decision Making

Science.gov (United States)

Forrester, William R.; Tashchian, Armen

2011-01-01

This study investigated the effects of personality on participation in decision making in a sample of 225 business students. The Neo-FFI scale was used to measure the five personality dimensions of openness, agreeableness, extroversion, conscientiousness and neuroticism. Analysis indicated that personality dimensions, extroversion and…

The participation of the German Länder in the EU decision-making process

Directory of Open Access Journals (Sweden)

Carlo Panara

2012-09-01

Full Text Available This article sketches out the main features of the German system of regional participation in the EU decision-making process with the aim of identifying the key strengths and weaknesses of that system. The author will be examining whether the model currently in place allows for a sufficiently rapid and effective response to the EU decision-making process, and whether there is a sufficiently balanced representation of regional and federal interests at the EU level. The article will also contain a proposal as to how the German model of regional participation in the EU decision-making process could be further improved.

A Spatially Intelligent Public Participation System for the Environmental Impact Assessment Process

Directory of Open Access Journals (Sweden)

Lei Lei

2013-05-01

Full Text Available An environmental impact assessment (EIA is a decision-making process that evaluates the possible significant effects that a proposed project may exert on the environment. The EIA scoping and reviewing stages often involve public participation. Although its importance has long been recognized, public participation in the EIA process is often regarded as ineffective, due to time, budget, resource, technical and procedural constraints, as well as the complexity of environmental information. Geographic Information System (GIS and Volunteer Geographic Information (VGI have the potential to contribute to data collection, sharing and presentation, utilize local user-generated content to benefit decision-making and increase public outreach. This research integrated GIS, VGI, social media tools, data mining and mobile technology to design a spatially intelligent framework that presented and shared EIA information effectively to the public. A spatially intelligent public participative system (SIPPS was also developed as a proof-of-concept of the framework. The research selected the Tehachapi Renewable Transmission Project (TRTP as the pilot study area. Survey questionnaires were designed to collect feedback and conduct evaluation. Results show that SIPPS was able to improve the effectiveness of public participation, promote environmental awareness and achieve good system usability.

African Mask-Making Workshop: Professional Development Experiences of Diverse Participants

Science.gov (United States)

Rule, Audrey C.; Montgomery, Sarah E.; Kirkland-Holmes, Gloria; Watson, Dwight C.; Ayesiga, Yvonne

2015-01-01

Diverse education professionals learned about African cultures in a workshop experience by making African masks using authentic symbolism. Analysis of reflections to evaluate the workshop for applicability to participants with and without African heritage showed that both groups expanded their cultural knowledge of traditional African ethnic…

Patient participation in decision-making about cardiovascular preventive drugs - resistance as agency.

Science.gov (United States)

Hultberg, Josabeth; Rudebeck, Carl Edvard

2017-09-01

The aim of the study was to describe and explore patient agency through resistance in decision-making about cardiovascular preventive drugs in primary care. Six general practitioners from the southeast of Sweden audiorecorded 80 consultations. From these, 28 consultations with proposals from GPs for cardiovascular preventive drug treatments were chosen for theme-oriented discourse analysis. The study shows how patients participate in decision-making about cardiovascular preventive drug treatments through resistance in response to treatment proposals. Passive modes of resistance were withheld responses and minimal unmarked acknowledgements. Active modes were to ask questions, contest the address of an inclusive we, present an identity as a non-drugtaker, disclose non-adherence to drug treatments, and to present counterproposals. The active forms were also found in anticipation to treatment proposals from the GPs. Patients and GPs sometimes displayed mutual renouncement of responsibility for decision-making. The decision-making process appeared to expand both beyond a particular phase in the consultations and beyond the single consultation. The recognition of active and passive resistance from patients as one way of exerting agency may prove valuable when working for patient participation in clinical practice, education and research about patient-doctor communication about cardiovascular preventive medication. We propose particular attentiveness to patient agency through anticipatory resistance, patients' disclosures of non-adherence and presentations of themselves as non-drugtakers. The expansion of the decision-making process beyond single encounters points to the importance of continuity of care. KEY POINTS Guidelines recommend shared decision-making about cardiovascular preventive treatment. We need an understanding of how this is accomplished in actual consultations.This paper describes how patient agency in decision-making is displayed through different forms

Assessment of primary school students’ decision-making related to tactical contexts

Directory of Open Access Journals (Sweden)

David Guitiérrez

2012-07-01

Full Text Available The purpose of this study was to assess and understand prior tactical knowledge and game performance as well as the relationship between the different components of game performance in invasion games. The participants (N = 22; girls: 13; boys: 9 were Physical Education students (ages: 11-12 with a low expertise in invasion games (they were selected among those with no other background in invasion games than PE lessons. Their game performance was videotaped, after which measures of motor execution and cognitive components were developed from observational analysis. Decision- making was measured on two levels: a decision-making restricted to the performance of technical-tactical skills; and b decision-making focused on adapting to the offensive tactical contexts of the game. Participants played an eight-minute-long 4-versus-4 generic invasion game. The latter was designed to meet both developmental needs and previous learning, so interference between motor execution ability and decision-making performance was minimized. The findings revealed that these students already had a basic concept of offensive and defensive game situations, both on-the-ball and off-the-ball. No significant differences were found between players’ performance in penetrating-the-defense contexts and in those where they kept ball possession. The findings additionally highlighted the existence of significant relationships between decision-making and skill execution in getting open, tackling, marking off-ball and double teaming. Other links between game performance components are discussed throughout the paper. The importance of assessing game performance taking into account tactical contexts is also supported (Gutiérrez, González, García-López, & Mitchell, 2011, as well as some of the GCA pedagogical principles, e.g. the use of modified games (Oslin & Mitchell, 2006.

Public participation in Strategic Environmental Assessment: A practitioners' perspective

International Nuclear Information System (INIS)

Rega, Carlo; Baldizzone, Giorgio

2015-01-01

Public participation is considered a distinguished feature of Strategic Environmental Assessment (SEA), and the SEA literature has traditionally identified several benefits attached to it, from more open and transparent decision-making to greater acceptance of plans/programmes' output by the affected population. However, relatively little empirical evidence has been collected so far on the extent and outcomes of public engagement as it is being carried out in current SEA practice. In this article, we present the results of a study on this theme based on a direct survey of 47 SEA practitioners and scholars from different countries. Respondents were asked to report their experience about a number of items including: the frequency of SEA process featuring deep public participation; its overall influence on plan/programmme-making; the identification of the main factors impeding it; the correlation of public involvement with environmental outcomes; and the increase of costs. Results indicate that public engagement in current SEA practice is still relatively limited and with limited influence on decision-making. The main impeding factors seem to be: lack of political willingness by proponents; insufficient information on the SEA process by the public; and weakness of the legal frames. However, respondents also report that when effective public engagement takes place, benefits do arise and identify a positive correlation between the degree of public involvement and the environmental performance of plans and programmes. Overall, findings suggest that public involvement has indeed the potential to positively influence both SEA and decision-making, although this should be supported from the policy side by stronger legal frames, higher requirements and improved technical guidance. - Highlights: • 47 SEA scholars and practitioners were surveyed about public participation in SEA. • Current public involvement in SEA is still limited. • Lack of information, political

Public participation in Strategic Environmental Assessment: A practitioners' perspective

Energy Technology Data Exchange (ETDEWEB)

Rega, Carlo, E-mail: carlo.rega@jrc.ec.europa.eu [Interuniversity Department of Regional and Urban Studies and Planning, Politecnico di Torino, Torino (Italy); Baldizzone, Giorgio [GB Studio consultancy, Via della Colla 3, 18100 Andora, SV (Italy)

2015-01-15

Public participation is considered a distinguished feature of Strategic Environmental Assessment (SEA), and the SEA literature has traditionally identified several benefits attached to it, from more open and transparent decision-making to greater acceptance of plans/programmes' output by the affected population. However, relatively little empirical evidence has been collected so far on the extent and outcomes of public engagement as it is being carried out in current SEA practice. In this article, we present the results of a study on this theme based on a direct survey of 47 SEA practitioners and scholars from different countries. Respondents were asked to report their experience about a number of items including: the frequency of SEA process featuring deep public participation; its overall influence on plan/programmme-making; the identification of the main factors impeding it; the correlation of public involvement with environmental outcomes; and the increase of costs. Results indicate that public engagement in current SEA practice is still relatively limited and with limited influence on decision-making. The main impeding factors seem to be: lack of political willingness by proponents; insufficient information on the SEA process by the public; and weakness of the legal frames. However, respondents also report that when effective public engagement takes place, benefits do arise and identify a positive correlation between the degree of public involvement and the environmental performance of plans and programmes. Overall, findings suggest that public involvement has indeed the potential to positively influence both SEA and decision-making, although this should be supported from the policy side by stronger legal frames, higher requirements and improved technical guidance. - Highlights: • 47 SEA scholars and practitioners were surveyed about public participation in SEA. • Current public involvement in SEA is still limited. • Lack of information, political

Competence for Democracy: Participation and Decision-Making in Classroom Interaction

Science.gov (United States)

Manzel, Sabine

2016-01-01

In this keynote address given at the International Association for Citizenship, Social and Economics Education (IACSEE) Conference in July 2015, Sabine Manzel focused on participation and decision-making as key competences for democracy. She analysed with standardized videography how both of these competences are realized in classroom interaction.

Justice in and through Education? Students' Participation in Decision-Making

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Rönnlund, Maria

2014-01-01

Drawing on one year of ethnographic work in three Swedish lower secondary schools, this article problematizes students' participation in decision-making in everyday school life in the perspective of social justice. In order to extend the traditional liberal understanding of justice and include also relational, procedurial, social and cultural…

Children's Decision-Making Involvement About Research Participation: Associations With Perceived Fairness and Self-Efficacy.

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Miller, Victoria A; Feudtner, Chris; Jawad, Abbas F

2017-04-01

The primary objective of this study was to examine the associations of children's involvement in decisions about research participation with their perceptions of the decision-making process and self-efficacy. Participants were children (ages 8-17) who enrolled in research studies in the prior 2 months. Children completed a questionnaire that yielded three decision-making involvement subscales: Researcher Engages Child, Researcher Supports Autonomy, and Child Participates. Children reported on fairness of the decision-making process and health-related decision self-efficacy. After adjusting for age, higher scores on Researcher Engages Child were associated with greater self-efficacy, and higher scores on Researcher Supports Autonomy were associated with greater perceived fairness. These data underscore the potential importance of researcher-child interactions about research participation when assent is sought, including proactively involving children in the decision by asking for their opinions and communicating their central role in the decision, which are likely to be more meaningful to children than receiving information or signing a form.

Unleashing Student Potential through Democratic Participation in Decision Making: Controversies and Prospects

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Nthontho, Maitumeleng Albertina

2017-01-01

The idea of students participating in decisions that affect them as individuals, organisations and/or communities is recent and urgent. The participation of students in decision making has gained global support, yet it does not seem to be regarded as a main vehicle for promoting democracy in educational institutions. This conceptual paper aims at…

Developing and Validating a Tool to Assess Ethical Decision-Making Ability of Nursing Students, Using Rubrics

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Indhraratana, Apinya; Kaemkate, Wannee

2012-01-01

The aim of this paper is to develop a reliable and valid tool to assess ethical decision-making ability of nursing students using rubrics. A proposed ethical decision making process, from reviewing related literature was used as a framework for developing the rubrics. Participants included purposive sample of 86 nursing students from the Royal…

Evaluating the effectiveness of British Columbia's environmental assessment process for first nations' participation in mining development

International Nuclear Information System (INIS)

Baker, Douglas C.; McLelland, James N.

2003-01-01

This paper applies effectiveness as a criterion to measure the participation of First Nations' participation in British Columbia's environmental assessment process. Effectiveness is reviewed as a means to measure policy implementation and an expanded framework is proposed to measure effectiveness. The framework is applied to three case studies in north-central British Columbia to measure the effectiveness of First Nations' participation in the EA process for mining development. All three cases failed to achieve procedural, substantive, and transactive efficacy and thereby failed to meet overall policy effectiveness. The policies used by the British Columbia government, including the relatively recent Environmental Assessment Act (1995), reflect a poor integration of First Nations people in the EA decision-making process with respect to mine development

Conformity and Internalisation in a Participative Decision Making Process

International Nuclear Information System (INIS)

Bombaerts, Gunter

2003-01-01

This paper reflects upon the stretching concept of the RISCOM model. We agree with the Habermassian point of departure that a competent speaker makes validity claims on truth, legitimacy and authenticity and partially with the Dialogue Project's conclusions that opening the black box of science is not possible in a decision making process (DMP) on a highly technical issue. Accordingly, we see an important role for a regulator to stretch the implementer, i.e. balance commercial and guardian ethics in the DMP. However, some caution is needed. Conformity studies indicate the large influence of group norms on individuals. When individuals lack personal reference frames of a particular issue they are prone to conform. The more values are shared, the more group members are convinced of the correctness. And social psychology shows more. In studies on persuasion, a difference between compliance and internalisation is made. Compliance is attained from rewards and coercive sources of power, whereas internalisation originates from expertise, legitimacy and credibility. Because of the shift to legitimacy and authenticity in the DMP, alignment of the norms and internalisation of discussed values becomes more apparent in the RISCOM participation model. Conformity reactions and possible internalisation are normal aspect of human interaction and not necessarily a negative aspect of public involvement. But keeping the importance of conformity in mind, a few consequences can be mentioned with regard to the relation implementer-regulator, the non-participation majority, and non-participating critics. The new role of the regulator and the involved public in the RISCOM mode] cannot absolutely avoid the risks due to conformity, it can only decrease the conformity influence

Assessing Cycling Participation in Australia

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Chris Rissel

2013-01-01

Full Text Available Planning and evaluating cycling programs at a national or state level requires accurate measures of cycling participation. However, recent reports of cycling participation have produced very different estimates. This paper examines the reported rates of cycling in five recent population surveys of cycling. Three surveys (one national and two from Sydney asking respondents when they last rode a bicycle generated cycling participation (cycled in the past year estimates of 29.7%, 34.1% and 28.9%. Two other national surveys which asked participants to recall (unprompted any physical activity done for exercise, recreation or sport in the previous 12 months, estimated cycling in the past year as 11.1% and 6.5%. While unprompted recall of cycling as a type of physical activity generates lower estimates of cycling participation than specific recall questions, both assessment approaches produced similar patterns of cycling by age and sex with both approaches indicating fewer women and older adults cycling. The different question styles most likely explain the substantial discrepancies between the estimates of cycling participation. Some differences are to be expected due to sampling variability, question differences, and regional variation in cycling.

Whose decision is it anyway? How clinicians support decision-making participation after acquired brain injury.

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Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2013-01-01

To raise professional awareness of factors that may influence the support offered by clinicians to people with acquired brain injury (ABI), and to consider the potential implications of these factors in terms of post-injury rehabilitation and living. A review of the literature was conducted to identify factors that determine how clinicians provide support and influence opportunities for individuals with ABI to participate in decision making across the rehabilitation continuum. Clinical case studies are used to highlight two specific issues: (1) hidden assumptions on the part of the practitioner, and (2) perceptions of risk operating in clinical practice. There are a range of factors which may influence the decision-making support provided by clinicians and, ultimately, shape lifetime outcomes for individuals with ABI. A multidimensional framework may assist clinicians to identify relevant factors and consider their potential implications including those that influence how clinicians involved in supporting decision making approach this task. Participation in decision making is an undisputed human right and central to the provision of person-centred care. Further research is required to understand how clinical practice can maximise both opportunities and support for increased decision-making participation by individuals with ABI. There is an increasing focus on the rights of all individuals to be supported to participate in decision making about their life. A number of changes associated with ABI mean that individuals with ABI will require support with decision making. Clinicians have a critical role in providing this support over the course of the rehabilitation continuum. Clinicians need to be aware of the range of factors that may influence the decision-making support they provide. A multidimensional framework may be used by clinicians to identify influences on the decision-making support they provide.

Policy making structures in the EU and participating countries. Deliverable D2

International Nuclear Information System (INIS)

Andersson, Kjell; Lidberg, Maria; Falck, Eberhard

2008-10-01

The point of departure for the ARGONA project is that participation and transparency are key elements of effective risk governance. The acronym ARGONA stands for 'Arenas for Risk Governance' and the project investigates how approaches of transparency and deliberation relate to each other and also how they relate to the political system in which decisions, for example on the final disposal of nuclear waste, are ultimately taken. The project then turns to study the role played by mediators, who facilitate public engagement with nuclear waste management issues, and the 'conduct of the conduct' of public consultations. By the latter is meant the communication of models used for deliberation and transparency. Furthermore, the project investigates how good risk communication can be organized taking cultural aspects and different arenas into account. In a central part of the project major efforts are made to test and apply approaches to transparency and participation by making explicit what it would mean to use the RISCOM model and other approaches within different cultural and organizational settings. Finally, the ARGONA partners develop guidelines for the application of novel approaches that will enhance real progress in nuclear waste management programmes. The project consists of six work packages that logically starts with a description of the policy making structures that exist within the EU and in the participating countries, including EU Directives, such as Strategic Environmental Assessment and Environmental Impact Assessment Directives, as well as national nuclear safety and environmental legislation. This work package (WP 1) forms the point of departure for the project, in determining the framework within which new arenas can be formed and within which the mediators are acting. A questionnaire was issued and sent to key organizations at national and local levels. The intention was that the work package should be focused on issues that set the scene for e.g. site

Assessment of parental decision-making in neonatal cardiac research: a pilot study.

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Nathan, Aruna T; Hoehn, K Sarah; Ittenbach, Richard F; Gaynor, J William; Nicolson, Susan; Wernovsky, Gil; Nelson, Robert M

2010-02-01

To assess parental permission for a neonate's research participation using the MacArthur competence assessment tool for clinical research (MacCAT-CR), specifically testing the components of understanding, appreciation, reasoning and choice. Quantitative interviews using study-specific MacCAT-CR tools. Parents of critically ill newborns would produce comparable MacCAT-CR scores to healthy adult controls despite the emotional stress of an infant with critical heart disease or the urgency of surgery. Parents of infants diagnosed prenatally would have higher MacCAT-CR scores than parents of infants diagnosed postnatally. There would be no difference in MacCAT-CR scores between parents with respect to gender or whether they did or did not permit research participation. Parents of neonates undergoing cardiac surgery who had made decisions about research participation before their neonate's surgery. The MacCAT-CR. 35 parents (18 mothers; 17 fathers) of 24 neonates completed 55 interviews for one or more of three studies. Total scores: magnetic resonance imaging (mean 36.6, SD 7.71), genetics (mean 38.8, SD 3.44), heart rate variability (mean 37.7, SD 3.30). Parents generally scored higher than published subject populations and were comparable to published control populations with some exceptions. The MacCAT-CR can be used to assess parental permission for neonatal research participation. Despite the stress of a critically ill neonate requiring surgery, parents were able to understand study-specific information and make informed decisions to permit their neonate's participation.

Risk assessment and multi-criteria decision-making

International Nuclear Information System (INIS)

Segerstaahl, Boris

1989-01-01

Risk assessment and analysis is connected to the policy framework used in decision-making on issues concerning technological risk. A review of the problems created by different views concerning the fundamental structure of risk concepts is used as a way to describe the structure of risk assessment studies as used in decision-making. The fundamental difference between judgments based on assessments and on perceptions is analyzed in order to explain the dynamics of the decision making process. A proposed effort to study the energy sector as a dynamic endless game implementing a mixed strategy is suggested. (author)

Mechanisms of public participation in the decision-making process

International Nuclear Information System (INIS)

Corner, J.

1993-01-01

Public inquiries, hearings, referenda and government reviews are among a number of commonly mechanisms through which the public in the relevant OECD countries participate in the decision-making process in respect of nuclear power and its development. The scope, application and effectiveness of these procedures appear to vary from country to country; differences which may result from styles of government, history, national interest and other factors. We listen to each OECD member in turn, explaining how is the situation in his country

Teacher Unions' Participation in Policy Making: A South African Case Study

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Govender, Logan

2015-01-01

This article contends that teacher unions' participation in policy making during South Africa's political transition was characterised by assertion of ideological identity (unionism and professionalism) and the cultivation of policy networks and alliances. It is argued that, historically, while teacher unions were divided along political and…

Lessons learnt from the DECI project on different processes for public participation and transparency in decision making

International Nuclear Information System (INIS)

Andersson, K.

2000-01-01

This study emanates from the work in Oskarshamn to build a process for public participation related to the site selection for a nuclear waste repository (the 'Oskarshamn model'). The idea was to see how these experiences could be useful in a broader context of decision making in complex issues, especially considering issues of common interest in the Baltic Sea Region. A pre-study for a 'Decision Institute', DECI, was initiated to describe problems in today's society that DECI would address, explore methods for the enhancement of transparency and public participation, and to suggest approaches for research and application. The study was financed by Swebaltcop (a EU Baltic Sea Co-operation Programme), the Regional Council in Kalmar County, and the Municipality of Oskarshamn. It was conducted by an interdisciplinary research group from Karinta-Konsult, the Royal Institute of Technology and the University of Gothenburg. Besides the work in Oskarshamn, results from the RISCOM Pilot project and current developments in Environmental Impact Assessment (EIA) and Strategic Environmental Assessment (SEA) were in particular taken into account. This presentation: - Addresses problems with decisions on complex issues. - Discusses reasons for public participation. - Gives a framework for transparency. - Describes a number procedures aimed at public participation and transparency. - Gives a framework for how procedures can be structured. - Gives some conclusions with regard to present status and future work. (author)

Patient Participation in Decision Making During Nursing Care in Greece--A Comparative Study.

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Kolovos, Petros; Kaitelidou, Daphne; Lemonidou, Chrysoula; Sachlas, Athanasios; Sourtzi, Panayota

2015-01-01

To describe patient participation in decision making during nursing care from patients' and nursing staff' perspectives. The sample consisted of medical and surgical patients (n = 300) and the nursing staff (n = 118) working in the respective wards in three general hospitals. A questionnaire was used for the study; data were collected from April 2009 to September 2010. Data were analyzed by an exploratory factor analysis. Patient participation was recorded at a medium level during nursing care, although it was rated as important from both patients and nursing staff. Exploratory factor analysis revealed the factor structure for the planning and implementation of the nursing care. Providers and receivers of nursing care perceived participation in a similar way. Interpersonal interaction was supported from older and less educated patients, as well as from university-educated nurses. Patient participation was greater in practical aspects of care and limited in technical medical issues and supportive services. Patient participation, although moderate, was evident during nursing care in hospital settings. Paternalism in the decision-making process was the dominant trend, whereas interpersonal interaction between the parties was recognized as a prerequisite for planning nursing care. © 2014 Wiley Periodicals, Inc.

Improving family satisfaction and participation in decision making in an intensive care unit.

Science.gov (United States)

Huffines, Meredith; Johnson, Karen L; Smitz Naranjo, Linda L; Lissauer, Matthew E; Fishel, Marmie Ann-Michelle; D'Angelo Howes, Susan M; Pannullo, Diane; Ralls, Mindy; Smith, Ruth

2013-10-01

Background Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together. Objectives To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families. Methods A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm. Results Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation. Conclusions Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together.

Assessing an Adolescent's Capacity for Autonomous Decision-Making in Clinical Care.

Science.gov (United States)

Michaud, Pierre-André; Blum, Robert Wm; Benaroyo, Lazare; Zermatten, Jean; Baltag, Valentina

2015-10-01

The purpose of this article is to provide policy guidance on how to assess the capacity of minor adolescents for autonomous decision-making without a third party authorization, in the field of clinical care. In June 2014, a two-day meeting gathered 20 professionals from all continents, working in the field of adolescent medicine, neurosciences, developmental and clinical psychology, sociology, ethics, and law. Formal presentations and discussions were based on a literature search and the participants' experience. The assessment of adolescent decision-making capacity includes the following: (1) a review of the legal context consistent with the principles of the Convention on the Rights of the Child; (2) an empathetic relationship between the adolescent and the health care professional/team; (3) the respect of the adolescent's developmental stage and capacities; (4) the inclusion, if relevant, of relatives, peers, teachers, or social and mental health providers with the adolescent's consent; (5) the control of coercion and other social forces that influence decision-making; and (6) a deliberative stepwise appraisal of the adolescent's decision-making process. This stepwise approach, already used among adults with psychiatric disorders, includes understanding the different facets of the given situation, reasoning on the involved issues, appreciating the outcomes linked with the decision(s), and expressing a choice. Contextual and psychosocial factors play pivotal roles in the assessment of adolescents' decision-making capacity. The evaluation must be guided by a well-established procedure, and health professionals should be trained accordingly. These proposals are the first to have been developed by a multicultural, multidisciplinary expert panel. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Public participation in Malawi's environmental impact assessment ...

African Journals Online (AJOL)

Since the adoption of the Environmental Management Act of 1996, Malawi has been using environmental impact assessment (EIA) as a tool for predicting and assessing the impact of development projects on the environment. This study assessed the extent of public participation in Malawi's EIA process. Desktop study of ...

Scheduling participants of Assessment Centres

DEFF Research Database (Denmark)

Lysgaard, Jens; Løber, Janni

  Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant...... Centres usually last two days and involve 3-6 psychologists or trained coaches as assessors. An entire course is composed of a number of rounds, with each round having its individual duration. In each round, the participants are divided into a number of groups with prespecifed pairing of group sizes...

Two studies on participation in decision-making and equity among FAA personnel.

Science.gov (United States)

1991-07-01

Study 1 Moderated multiple regression analyses on data collected from 2,177 FAA air traffic controller specialists indicated that equity perceptions moderated the relationship between participation in decision-making and level of job satisfaction. Sp...

Aggregate assessments support improved operational decision making

International Nuclear Information System (INIS)

Bauer, R.

2003-01-01

At Darlington Nuclear aggregate assessment of plant conditions is carried out in support of Operational Decision Making. This paper discusses how aggregate assessments have been applied to Operator Workarounds leading to improved prioritisation and alignment of work programs in different departments. As well, aggregate assessment of plant and human performance factors has been carried out to identify criteria which support conservative decision making in the main control room during unit transients. (author)

Business Students' Views of Peer Assessment on Class Participation

Science.gov (United States)

Tiew, Fidella

2010-01-01

The purpose of this project was to introduce peer and self assessment on tutorial class participation to a marketing unit at Curtin Sarawak. This assessment strategy was introduced with desire to improve class participation and increase student involvement in assessment. At the end of semester, a questionnaire was used to gather responses from a…

Assessing socially situated participation: a way of integrating communication and social assessment approaches.

Science.gov (United States)

Duchan, J F

2000-01-01

We have long treated communication and social assessment as related but separate domains. Theorizing by George Herbert Mead on "the social self" offers an alternative to this conceptual separation and a means of evaluating children's social interaction, social participation, and communication simultaneously. This article describes Mead's thinking and presents a framework for assessing children's social reciprocity, interactive stances, and role participation as they participate in everyday life contexts.

Parent participation in decision-making in health-care services for children: an integrative review.

Science.gov (United States)

Aarthun, Antje; Akerjordet, Kristin

2014-03-01

To describe and synthesize previous research on parents' perceptions of their participation in decision making in child health-care services. Health policy in the area of user involvement emphasizes parent participation in decision-making (DM), thus ensuring that services are provided in accordance with their child's needs and enhancing parents' control over their child's health-care services. A systematic literature search, covering the period January 2000 to February 2011, found 18 studies that met the inclusion criteria. The analysis process involved data extraction, reduction, comparison and synthesizing. Three themes emerged: (1) relational factors and interdependence, (2) personal factors and attitudes and (3) organisational factors. Parents highlighted the importance of the parent-health professional relationship, professionals' competence and the possibility of varying the degree of participation in decision making. Challenges involved asymmetry in authority and power, professionals' attitudes and competence and organisational shortcomings in health-care services. Health professionals need to become more aware of their critical role and responsibility in involving parents in DM. Health professionals' attitudes and competence can be improved by knowledge of user involvement and research and facilitating the inclusion of parents in decision making by influencing the culture, routines and resources in the health service. © 2012 John Wiley & Sons Ltd.

Clinical decision making for a tooth with apical periodontitis: the patients' preferred level of participation.

Science.gov (United States)

Azarpazhooh, Amir; Dao, Thuan; Ungar, Wendy J; Chaudry, Faiza; Figueiredo, Rafael; Krahn, Murray; Friedman, Shimon

2014-06-01

To effectively engage patients in clinical decisions regarding the management of teeth with apical periodontitis (AP), there is a need to explore patients' perspectives on the decision-making process. This study surveyed patients for their preferred level of participation in making treatment decisions for a tooth with AP. Data were collected through a mail-out survey of 800 University of Toronto Faculty of Dentistry patients, complemented by a convenience sample of 200 patients from 10 community practices. The Control Preferences Scale was used to evaluate the patients' preferences for active, collaborative, or passive participation in treatment decisions for a tooth with AP. Using bivariate and logistic regression analyses, the Gelberg-Andersen Behavioral Model for Vulnerable Populations was applied to the Control Preferences Scale questions to understand the influential factors (P ≤ .05). Among 434 of 1,000 respondents, 44%, 40%, and 16% preferred an active, collaborative, and passive participation, respectively. Logistic regression showed a significant association (P ≤ .025) between participants' higher education and preference for active participation compared with a collaborative role. Also, immigrant status was significantly associated with preference for passive participation (P = .025). The majority of patients valued an active or collaborative participation in deciding treatment for a tooth with AP. This pattern implied a preference for a patient-centered practice mode that emphasizes patient autonomy in decision making. Copyright © 2014 American Association of Endodontists. Published by Elsevier Inc. All rights reserved.

Contestations and complexities of nurses’ participation in policy-making in South Africa

Directory of Open Access Journals (Sweden)

Prudence Ditlopo

2014-12-01

Full Text Available Background: There has been increased emphasis globally on nurses’ involvement in health policy and systems development. However, there has been limited scholarly attention on nurses’ participation in policy-making in South Africa. Objective: This paper analyses the dynamics, strengths, and weaknesses of nurses’ participation in four national health workforce policies: the 2008 Nursing Strategy, revision of the Scope of Practice for nurses, the new Framework for Nursing Qualifications, and the Occupation-Specific Dispensation (OSD remuneration policy. Design: Using a policy analysis framework, we conducted in-depth interviews with 28 key informants and 73 frontline nurses in four South African provinces. Thematic content analysis was done using the Atlas.ti software. Results: The study found that nurses’ participation in policy-making is both contested and complex. The contestation relates to the extent and nature of nurses’ participation in nursing policies. There was a disjuncture between nursing leadership and frontline nurses in their levels of awareness of the four policies. The latter group was generally unaware of these policies with the exception of the OSD remuneration policy as it affected them directly. There was also limited consensus on which nursing group legitimately represented nursing issues in the policy arena. Shifting power relationships influenced who participated, how the participation happened, and the degree to which nurses’ views and inputs were considered and incorporated. Conclusions: The South African health system presents major opportunities for nurses to influence and direct policies that affect them. This will require a combination of proactive leadership, health policy capacity and skills development among nurses, and strong support from the national nursing association.

Participative Decision-Making and Job Satisfaction for Teachers in the UAE

Science.gov (United States)

Al Nuaimi, Samira; Chowdhury, Hossan; Eleftheriou, Konstantinos; Katsioloudes, Marios I.

2015-01-01

Purpose: Knowledge of teachers' participative decision making (PDM) and job satisfaction (JS) is important, as teachers comprise most of a school's staff. The purpose of this paper is to examine the effect of teacher gender, nationality and school type on teachers' PDM and JS in Abu Dhabi's schools and to determine whether there any significant…

Pediatric oncologists' attitudes towards involving adolescents in decision-making concerning research participation.

NARCIS (Netherlands)

Vries, M.C. de; Wit, J.M.; Engberts, D.P.; Kaspers, G.J.L.; Leeuwen, E. van

2010-01-01

BACKGROUND: Various regulations and guidelines stipulate the importance of involving adolescents in decision-making concerning research participation. Several studies have shown that in the context of pediatric oncology this involvement is difficult to achieve due to emotional stress, the complexity

Enhancing decision making about participation in cancer clinical trials: development of a question prompt list

Science.gov (United States)

Brown, Richard F.; Shuk, Elyse; Leighl, Natasha; Butow, Phyllis; Ostroff, Jamie; Edgerson, Shawna; Tattersall, Martin

2016-01-01

Purpose Slow accrual to cancer clinical trials impedes the progress of effective new cancer treatments. Poor physician–patient communication has been identified as a key contributor to low trial accrual. Question prompt lists (QPLs) have demonstrated a significant promise in facilitating communication in general, surgical, and palliative oncology settings. These simple patient interventions have not been tested in the oncology clinical trial setting. We aimed to develop a targeted QPL for clinical trials (QPL-CT). Method Lung, breast, and prostate cancer patients who either had (trial experienced) or had not (trial naive) participated in a clinical trial were invited to join focus groups to help develop and explore the acceptability of a QPL-CT. Focus groups were audio-recorded and transcribed. A research team, including a qualitative data expert, analyzed these data to explore patients’ decision-making processes and views about the utility of the QPL-CT prompt to aid in trial decision making. Results Decision making was influenced by the outcome of patients’ comparative assessment of perceived risks versus benefits of a trial, and the level of trust patients had in their doctors’ recommendation about the trial. Severity of a patient’s disease influenced trial decision making only for trial-naive patients. Conclusion Although patients were likely to prefer a paternalistic decision-making style, they expressed valuation of the QPL as an aid to decision making. QPL-CT utility extended beyond the actual consultation to include roles both before and after the clinical trial discussion. PMID:20593202

Comparing assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool.

Science.gov (United States)

Aydin Er, Rahime; Sehiralti, Mine

2014-07-01

To compare assessments of the decision-making competencies of psychiatric inpatients as provided by physicians, nurses, relatives and an assessment tool. This study was carried out at the psychiatry clinic of Kocaeli University Hospital from June 2007 to February 2008. The decision-making competence of the 83 patients who participated in the study was assessed by physicians, nurses, relatives and MacCAT-T. Of the 83 patients, the relatives of 73.8% of them, including the parents of 47.7%, were interviewed during the study. A moderately good consistency between the competency assessments of the nurses versus those of the physicians, but a poor consistency between the assessments of the physicians and nurses versus those of the patients' relatives, was determined. The differences in the competency assessment obtained with the MacCAT-T versus the evaluations of the physicians, nurses and patients' relatives were statistically significant. Our findings demonstrate those physicians, nurses and the patients' relatives have difficulty in identifying patients lacking decision-making competence. Therefore, an objective competence assessment tool should be used along with the assessments of physicians and nurses, both of whom can provide clinical data, as well as those of relatives, who can offer insights into the patient's moral values and expectations. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Congruence between patients’ preferred and perceived participation in medical decision-making: a review of the literature

Science.gov (United States)

2014-01-01

Background Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients’ preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. Methods A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Results Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. Conclusion This review suggests that a similar approach to all patients is not likely to meet patients’ wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients’ participation wishes on a regular basis during their illness trajectory. PMID:24708833

Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature.

Science.gov (United States)

Brom, Linda; Hopmans, Wendy; Pasman, H Roeline W; Timmermans, Danielle R M; Widdershoven, Guy A M; Onwuteaka-Philipsen, Bregje D

2014-04-03

Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients' preferences and their perceived participation in medical decision-making. We also explore the direction of mismatched and outline factors associated with congruence. A systematic review was performed on patient participation in medical decision-making. Medline, PsycINFO, CINAHL, EMBASE and the Cochrane Library databases up to September 2012, were searched and all studies were rigorously critically appraised. In total 44 papers were included, they sampled contained 52 different patient samples. Mean of congruence between preference for and perceived participation in decision-making was 60% (49 and 70 representing 25th and 75th percentiles). If no congruence was found, of 36 patient samples most patients preferred more involvement and of 9 patient samples most patients preferred less involvement. Factors associated with preferences the most investigated were age and educational level. Younger patients preferred more often an active or shared role as did higher educated patients. This review suggests that a similar approach to all patients is not likely to meet patients' wishes, since preferences for participation vary among patients. Health care professionals should be sensitive to patients individual preferences and communicate about patients' participation wishes on a regular basis during their illness trajectory.

Meaningful and efficient? Enduring challenges to Aboriginal participation in environmental assessment

International Nuclear Information System (INIS)

Udofia, Aniekan; Noble, Bram; Poelzer, Greg

2017-01-01

This paper explores the underlying practice-based challenges to meaningful and efficient Aboriginal participation in environmental assessment (EA) - participation that provides meaningful opportunities for Aboriginal communities to shape EA, yet assures a degree of efficiency for project proponents who need to obtain EA approvals in a timely and financially viable manner. We do so based on an analysis of the EA policy community's experience with uranium exploration and mining in Saskatchewan, Canada. Many of the challenges to meaningful and efficient Aboriginal participation that emerged are multi-dimensional, often concerning participation processes, decision-making, and relationships. Although scholars have explored many of these issues and have proposed numerous solutions, challenges persist in practice. Several other issues also emerged from our study that have received limited attention, including the non-commitment to early and ongoing participation by smaller project proponents, and the EA exemption of exploration projects; the limited availability of information to project developers on local right holders and Aboriginal interests; expectations about the integration of traditional knowledge and land use in EA not aligning with the information that is available to proponents; confusion about who is responsible for initiating early participation and consultation processes; the lack of early relationship building with potentially affected communities, particularly by governments; and the lack of other viable avenues, outside EA, for Aboriginal communities to raise more strategic issues of concern that affect traditional lands and treaty rights.

"I've never been a yes person": Decision-making participation and self-conceptualization after severe traumatic brain injury.

Science.gov (United States)

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2017-11-01

Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved. Self-conceptualization emerged as a complex and multifaceted process, as individuals with TBI aimed to reestablish a sense of autonomy. We describe a recursive relationship in which decision-making participation assists the dynamic construction of self, and self-concept contributes to the experience of making decisions. The role of an individual's social support network in acting as a bridge between participation and self-conceptualization is presented. Findings emphasize that contributing to decisions about one's own goals across a range of life areas can reinforce a positive self-concept. It is vital that supporters understand that participation in decision making provides a pathway to conceptualizing self and aim to maximize the person's participation in the decision-making process. Implications for Rehabilitation Previous research has identified that the experience of sustaining TBI has a significant impact on a person's conceptualization of self. This study identified that decision-making experiences play an important role in the ongoing process of self-conceptualization after injury. Decision-making experiences can reinforce a person's self-concept or lead them to revise (positively or negatively) their sense of self. By maximizing the person's decision-making participation, those around them can support them to develop positive self-attributes and contribute to shaping their future goals.

Assessing Women's Preferences and Preference Modeling for Breast Reconstruction Decision-Making.

Science.gov (United States)

Sun, Clement S; Cantor, Scott B; Reece, Gregory P; Crosby, Melissa A; Fingeret, Michelle C; Markey, Mia K

2014-03-01

Women considering breast reconstruction must make challenging trade-offs amongst issues that often conflict. It may be useful to quantify possible outcomes using a single summary measure to aid a breast cancer patient in choosing a form of breast reconstruction. In this study, we used multiattribute utility theory to combine multiple objectives to yield a summary value using nine different preference models. We elicited the preferences of 36 women, aged 32 or older with no history of breast cancer, for the patient-reported outcome measures of breast satisfaction, psychosocial well-being, chest well-being, abdominal well-being, and sexual wellbeing as measured by the BREAST-Q in addition to time lost to reconstruction and out-of-pocket cost. Participants ranked hypothetical breast reconstruction outcomes. We examined each multiattribute utility preference model and assessed how often each model agreed with participants' rankings. The median amount of time required to assess preferences was 34 minutes. Agreement among the nine preference models with the participants ranged from 75.9% to 78.9%. None of the preference models performed significantly worse than the best performing risk averse multiplicative model. We hypothesize an average theoretical agreement of 94.6% for this model if participant error is included. There was a statistically significant positive correlation with more unequal distribution of weight given to the seven attributes. We recommend the risk averse multiplicative model for modeling the preferences of patients considering different forms of breast reconstruction because it agreed most often with the participants in this study.

Quality control in public participation assessments of water quality: the OPAL Water Survey.

Science.gov (United States)

Rose, N L; Turner, S D; Goldsmith, B; Gosling, L; Davidson, T A

2016-07-22

Public participation in scientific data collection is a rapidly expanding field. In water quality surveys, the involvement of the public, usually as trained volunteers, generally includes the identification of aquatic invertebrates to a broad taxonomic level. However, quality assurance is often not addressed and remains a key concern for the acceptance of publicly-generated water quality data. The Open Air Laboratories (OPAL) Water Survey, launched in May 2010, aimed to encourage interest and participation in water science by developing a 'low-barrier-to-entry' water quality survey. During 2010, over 3000 participant-selected lakes and ponds were surveyed making this the largest public participation lake and pond survey undertaken to date in the UK. But the OPAL approach of using untrained volunteers and largely anonymous data submission exacerbates quality control concerns. A number of approaches were used in order to address data quality issues including: sensitivity analysis to determine differences due to operator, sampling effort and duration; direct comparisons of identification between participants and experienced scientists; the use of a self-assessment identification quiz; the use of multiple participant surveys to assess data variability at single sites over short periods of time; comparison of survey techniques with other measurement variables and with other metrics generally considered more accurate. These quality control approaches were then used to screen the OPAL Water Survey data to generate a more robust dataset. The OPAL Water Survey results provide a regional and national assessment of water quality as well as a first national picture of water clarity (as suspended solids concentrations). Less than 10 % of lakes and ponds surveyed were 'poor' quality while 26.8 % were in the highest water quality band. It is likely that there will always be a question mark over untrained volunteer generated data simply because quality assurance is uncertain

Probabilistic safety assessment as a standpoint for decision making

International Nuclear Information System (INIS)

Cepin, M.

2001-01-01

This paper focuses on the role of probabilistic safety assessment in decision-making. The prerequisites for use of the results of probabilistic safety assessment and the criteria for the decision-making based on probabilistic safety assessment are discussed. The decision-making process is described. It provides a risk evaluation of impact of the issue under investigation. Selected examples are discussed, which highlight the described process. (authors)

Assessment of Two Desk-Top Computer Simulations Used to Train Tactical Decision Making (TDM) of Small Unit Infantry Leaders

National Research Council Canada - National Science Library

Beal, Scott A

2007-01-01

Fifty-two leaders in the Basic Non-Commissioned Officer Course (BNCOC) at Fort Benning, Georgia, participated in an assessment of two desk-top computer simulations used to train tactical decision making...

Pediatric oncologists' attitudes towards involving adolescents in decision-making concerning research participation.

Science.gov (United States)

de Vries, Martine C; Wit, Jan M; Engberts, Dirk P; Kaspers, Gertjan J L; van Leeuwen, Evert

2010-07-15

Various regulations and guidelines stipulate the importance of involving adolescents in decision-making concerning research participation. Several studies have shown that in the context of pediatric oncology this involvement is difficult to achieve due to emotional stress, the complexity of research protocols and limited time. Still, up to 80% of adolescents with cancer enter onto a trial during their illness. The aim of this study was to determine clinicians' views and attitudes towards enrolling adolescents in research, considering the difficulties surrounding their involvement in decision-making. A qualitative multicenter study was performed, using in-depth semi-structured interviews on the informed consent process with 15 pediatric hemato-oncologists. Four central themes emerged that characterize clinicians' attitudes towards involving adolescents in the decision-making process: (1) clinicians regard most adolescents as not capable of participating meaningfully in discussions regarding research; (2) clinicians do not always provide adolescents with all information; (3) proxy consent from parents is obtained and is deemed sufficient; (4) clinician-investigator integrity: clinicians judge research protocols as not being harmful and even in the best interest of the adolescent. Clinicians justify not involving adolescents in research discussions by referring to best interest arguments (adolescents' incompetence, proxy consent, and investigator integrity), although this is not in line with legal regulations and ethical guidelines.

Participation in treatment decision-making among Chinese-Australian women with breast cancer.

Science.gov (United States)

Kwok, Cannas; Koo, Fung Kuen

2017-03-01

Using Confucian philosophy as a conceptual framework, this article examines the extent to which cultural values and language affect the participation preferences and experiences of the breast cancer treatment decision-making (TDM) process among Chinese women with breast cancer in Australia. Three focus groups were conducted with 23 Chinese-Australian women diagnosed with breast cancer in their native language (Mandarin and Cantonese). Each interview was translated and transcribed. Content analysis was used to uncover the major themes. Four typologies emerged: the patient as an active decision maker, the patient as a passive decision maker, the patient as a reluctant decision maker and the patient as a reluctant passive decision maker. Language barriers, cultural expectation of doctor's role and family role in Chinese culture appear as influential factors in TDM process among this group of women. Intervention to improve doctors' cultural sensitivities in order to help them assess women's role preferences in TDM and the ability of doctors to communicate in a culturally appropriate manner, may improve the process of breast cancer TDM among women from Chinese background.

Children's participation in shared decision-making: children, adolescents, parents and healthcare professionals' perspectives and experiences.

Science.gov (United States)

Coyne, Imelda; Amory, Aislinn; Kiernan, Gemma; Gibson, Faith

2014-06-01

Despite decision-making featuring throughout the trajectory of cancer care, children's participation in decision-making remains an area much under-researched and complicated by conflicting opinions. This study explored children's participation in shared decision-making (SDM) from multiple perspectives from one haematology/oncology unit in Ireland. Qualitative research design was used to explore participants' experiences of children's decision-making. Interviews were conducted with children(1) aged 7-16 years (n = 20), their parents (n = 22) and healthcare professionals (n = 40). Data were managed with the aid of NVivo (version 8). Parents and children's roles in decision-making were significantly influenced by the seriousness of the illness. Cancer is a life-threatening illness and so the treatment 'had to be done'. Children were not involved in major decisions (treatment decisions) as refusal was not an option. They were generally involved in minor decisions (choices about care delivery) with the purpose of gaining their cooperation, making treatment more palatable, giving back a sense of control and building trusting relationships. These choices were termed 'small' decisions that would not compromise the child's welfare. Some adolescents were aware that choices were not 'real' decisions since they were not allowed to refuse and expressed feelings of frustration. Healthcare professionals and parents controlled the process of SDM and the children's accounts revealed that they held a minimal role. Children appeared content that adults held responsibility for the major treatment decisions. However, they desired and valued receiving information, voicing their preferences and choosing how treatments were administered to them. Copyright © 2014 Elsevier Ltd. All rights reserved.

A qualitative study of blood and marrow transplant patient experiences participating in art making and music listening.

Science.gov (United States)

Mische Lawson, Lisa; Wedan, Lindsay; Stock, Morgan; Glennon, Cathy

2016-06-01

To explore patient experiences of engaging in art making or music listening while receiving treatment in a blood and marrow transplant clinic. Researchers recruited 25 individuals receiving blood and marrow transplant (BMT) treatment, 12 men and 13 women aged 22 to 74, from a Midwestern outpatient BMT clinic. Participants engaged in a painting activity or listened to music on an iPad using an internet music application for one hour. Researchers interviewed participants after the one-hour activity to gain insight into participants' perceptions of the art making or music listening experience. Interviews were recorded, transcribed verbatim, and independently coded by members of the research team. Researchers met on several occasions to analyse codes and agree on emerging themes. Nine themes emerged from the data including, Engaging in Activity, Art and Music in Daily Life, Expression, Engaging with Equipment, Novelty, BMT Process, Activity Process, Social Support, and Living Situation. Participants enjoyed art making and music listening and found the activities beneficial during treatment. Participants benefited from art making and music listening because these activities increased the variety of options available during treatment, allowed for self-expression, and could be done alone or with caregivers. Copyright © 2016 Elsevier Ltd. All rights reserved.

Making participation accessible for vulnerable clients

Directory of Open Access Journals (Sweden)

Louis Anthony Iaquinto

2016-07-01

Full Text Available Despite forty years of research, community sector service providers still find operationalising participation in their practice confusing and difficult.  This paper presents the results of a preliminary study that begins to question why this is so and what can be done about it?  The study examines the meaning and importance of participation determined by a review of the academic literature, by soliciting feedback from a range of stakeholders in community sector organisations, including service users with complex barriers to participation, staff, and board members.  The participants’ perspectives, views and experience of participation were obtained through the use of semi-structured interviews.  The data generated a number of telling examples of the impact organisational culture has on service delivery and how the values of the leadership shape the organization, as well as illustrations of the principles that underpin participation expressed from the standpoints of the three participant groups.  Study findings underscore the critical importance for service providers to consider their culture and its influences.   Keywords: organisational culture, vulnerable clients, client participation

Barriers to participation in a hospital-based falls assessment clinicprogramme

DEFF Research Database (Denmark)

Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... of knowledge were expected, owing to accepters' participation in the programme. Interview transcriptions were thematically analysed. The analysis was directed towards identification of barriers to falls assessment. Results: Barriers to participation were categorized as being either within or outside the falls...

Assessing Professional Decision-Making Abilities.

Science.gov (United States)

McNergney, Robert; Hinson, Stephanie

1985-01-01

Describes Teacher Development Decision Exercises, a computer-based method of diagnosing abilities of elementary and secondary school supervisors (principals, staff developers, curriculum coordinators) to make professional preactive or planning decisions. This approval simulates assessment of supervisors' abilities to use professional knowledge to…

Electricity, health and the environment: Comparative assessment in support of decision making. Proceedings of a symposium

International Nuclear Information System (INIS)

1996-01-01

The main objective of the Symposium was to enhance and strengthen information sharing and co-operation between interested and affected parties in the field of electricity demand analysis and supply planning, aiming at implementing sustainable policies in the power sector, taking into account economic, social, health and environmental aspects. To meet this objective, the Symposium sessions addressed the following topics: key issues in the decision making process; assessment of health and environmental impacts; integrated framework for comparative assessment; implementation of comparative assessment; country case studies; and comparative assessment in decision making. A closing round table focused on challenges for international co-operation aiming at implementation of sustainable electricity policies. In addition to the main sessions, poster presentations illustrated results from comparative assessment studies carried out in different countries, and software demonstration provided opportunities for participants to gain information about state of the art computer tools, databases and analytical models that are available for use in decision support studies. Refs, figs, tabs

Reconceptualizing public participation in environmental assessment as EA civics

Energy Technology Data Exchange (ETDEWEB)

Sinclair, A. John, E-mail: jsincla@umanitoba.ca [Natural Resources Institute, University of Manitoba, Winnipeg, MB R3T 2N2 (Canada); Diduck, Alan P., E-mail: a.diduck@uwinnipeg.ca [Department of Environmental Studies and Sciences, University of Winnipeg, 515 Portage Avenue, Winnipeg R3B 2E9 (Canada)

2017-01-15

Notwithstanding the considerable attention placed on creating meaningful opportunities for public participation in environmental assessment (EA), many participants and those who have reviewed participation processes often find practice sorely wanting. This reality stands in stark juxtaposition to future environmental governance needs, which will require increased openness, deliberation and transdisciplinary knowledge in order to deal with environmental change that is ever more uncertain, complex and conflictual. In this paper, our purpose was to consider how to meet those needs through reconceptualizing public participation as EA civics, founded on an active citizen base, deliberative in nature and orientated toward learning. We do this through developing a new conceptual model of next generation participation processes that is relevant at multiple spatial scales and institutional levels, is applicable to the entire assessment cycle and spans temporal scales through feedback loops. Our EA civics model builds on the “civics approach” to environmental governance and “action civics” by extending their core ideas to participation in EA. We did this by conducting an integrative literature review (including numerous papers we have contributed over the years) and reflecting on our own experiences as EA participants. We apply current thinking on public participation design to our EA civics conceptualization and highlight important design features that have received scant attention. We conclude that EA civics holds promise for fairer and more robust participation processes if all aspects of the model are considered and the actions related to each are implemented. - Highlights: • Consideration of the ‘civics approach’ and ‘action civics’ in an EA context • Conceptualization of public participation as EA civics • Reflection on the EA civics as a model of participation suitable for next generation assessment.

Reconceptualizing public participation in environmental assessment as EA civics

International Nuclear Information System (INIS)

Sinclair, A. John; Diduck, Alan P.

2017-01-01

Notwithstanding the considerable attention placed on creating meaningful opportunities for public participation in environmental assessment (EA), many participants and those who have reviewed participation processes often find practice sorely wanting. This reality stands in stark juxtaposition to future environmental governance needs, which will require increased openness, deliberation and transdisciplinary knowledge in order to deal with environmental change that is ever more uncertain, complex and conflictual. In this paper, our purpose was to consider how to meet those needs through reconceptualizing public participation as EA civics, founded on an active citizen base, deliberative in nature and orientated toward learning. We do this through developing a new conceptual model of next generation participation processes that is relevant at multiple spatial scales and institutional levels, is applicable to the entire assessment cycle and spans temporal scales through feedback loops. Our EA civics model builds on the “civics approach” to environmental governance and “action civics” by extending their core ideas to participation in EA. We did this by conducting an integrative literature review (including numerous papers we have contributed over the years) and reflecting on our own experiences as EA participants. We apply current thinking on public participation design to our EA civics conceptualization and highlight important design features that have received scant attention. We conclude that EA civics holds promise for fairer and more robust participation processes if all aspects of the model are considered and the actions related to each are implemented. - Highlights: • Consideration of the ‘civics approach’ and ‘action civics’ in an EA context • Conceptualization of public participation as EA civics • Reflection on the EA civics as a model of participation suitable for next generation assessment

Enhancing Public Participation to Improve Natural Resources Science and its Use in Decision Making

Science.gov (United States)

Glynn, P. D.; Shapiro, C. D.; Liu, S. B.

2015-12-01

The need for broader understanding and involvement in science coupled with social technology advances enabling crowdsourcing and citizen science have created greater opportunities for public participation in the gathering, interpretation, and use of geospatial information. The U.S. Geological Survey (USGS) is developing guidance for USGS scientists, partners, and interested members of the public on when and how public participation can most effectively be used in the conduct of scientific activities. Public participation can provide important perspectives and knowledge that cannot be obtained through traditional scientific methods alone. Citizen engagement can also provide increased efficiencies to USGS science and additional benefits to society including enhanced understanding, appreciation, and interest in geospatial information and its use in decision making.The USGS guidance addresses several fundamental issues by:1. Developing an operational definition of citizen or participatory science.2. Identifying the circumstances under which citizen science is appropriate for use and when its use is not recommended. 3. Describing structured processes for effective use of citizen science. 4. Defining the successful application of citizen science and identifying useful success metrics.The guidance is coordinated by the USGS Science and Decisions Center and developed by a multidisciplinary team of USGS scientists and managers. External perspectives will also be incorporated, as appropriate to align with other efforts such as the White House Office of Science and Technology Policy (OSTP) Citizen Science and Crowdsourcing Toolkit for the Federal government. The guidance will include the development of an economic framework to assess the benefits and costs of geospatial information developed through participatory processes. This economic framework considers tradeoffs between obtaining additional perspectives through enhanced participation with costs associated from obtaining

The role of women in nuclear - attracting public participation in regulatory decision-making process

Science.gov (United States)

Mohamad Jais, Azlina; Hassan, Najwa

2018-01-01

Public participation is vital in demonstrating transparency and enhancing effectiveness of a nuclear regulatory process. As such, it is necessary for nuclear practitioners to involve the public in key nuclear delivery milestones. This paper specifically discusses challenges faced in attracting public participation throughout the nuclear regulatory decision-making process, and highlights the roles of women in nuclear (WiN) in initiating the said public discourse.

Dementia, Decision Making, and Capacity.

Science.gov (United States)

Darby, R Ryan; Dickerson, Bradford C

After participating in this activity, learners should be better able to:• Assess the neuropsychological literature on decision making and the medical and legal assessment of capacity in patients with dementia• Identify the limitations of integrating findings from decision-making research into capacity assessments for patients with dementia ABSTRACT: Medical and legal professionals face the challenge of assessing capacity and competency to make medical, legal, and financial decisions in dementia patients with impaired decision making. While such assessments have classically focused on the capacity for complex reasoning and executive functions, research in decision making has revealed that motivational and metacognitive processes are also important. We first briefly review the neuropsychological literature on decision making and on the medical and legal assessment of capacity. Next, we discuss the limitations of integrating findings from decision-making research into capacity assessments, including the group-to-individual inference problem, the unclear role of neuroimaging in capacity assessments, and the lack of capacity measures that integrate important facets of decision making. Finally, we present several case examples where we attempt to demonstrate the potential benefits and important limitations of using decision-making research to aid in capacity determinations.

Defining new standards on citizen participation in the Chilean environmental assessment

Directory of Open Access Journals (Sweden)

Pilar Moraga Sariego

2017-06-01

Full Text Available The Law 19,300 on the General Bases of the Environment (1994 provided the first legal framework for environmental protection in the country, in the context of the Rio Summit held two years earlier. Following the recommendations of OECD to strengthen environmental institutions (2005, the legislator passed Law No. 20,417 introducing environmental reform (2010 and Law No. 20,600 creating the Environmental Tribunals (2012. The first one extends the scope of citizen participation in the environmental impact assessment system, however, it is the jurisprudential work of the Second Environmental Court that will make it possible to understand the real scope of the legislative amendment. This specialized judiciary develops new standards of citizen participation in the framework of the project of the State Railway Company. This is a broad interpretation of the principle with a view to a real and not only formal application of it, which contributes to the strengthening of this institution in relation to the principle of access to information and justice in environmental matters.

Assessment of participation in higher education team working activities

OpenAIRE

Andreu Andrés, María Angeles; García-Casas, Miguel

2014-01-01

[EN] Since among the competences which are most valued by engineering corporations are the ability to make decisions, the capacity for teamwork, one’s initiative and the capacity for solving problems together with an efficient communication, an experience based on active learning and team-working in which participants had to put them into practice was carried out. Before starting the experience with an active learning strategy, students had to decide on what they understood by participation i...

Assessment of Factors Influencing Beneficiary Participation in ...

African Journals Online (AJOL)

ISSN 0794-5698. Assessment of Factors Influencing Beneficiary Participation in Fadama II Project ... project implementation (80%) in the stages of project development. Women .... the project as they appeared to have more family burden to ...

Barriers and Promoters to Participation in the Era of Shared Treatment Decision-Making.

Science.gov (United States)

McCarter, Sarah P; Tariman, Joseph D; Spawn, Nadia; Mehmeti, Enisa; Bishop-Royse, Jessica; Garcia, Ima; Hartle, Lisa; Szubski, Katharine

2016-10-01

This study aimed to identify the barriers and promoters for participation in cancer treatment decision in the era of shared decision-making (SDM) process. A qualitative design was utilized. Nineteen nurses and 11 nurse practitioners from oncology inpatient and outpatient settings participated in semi-structured interviews. Data were analyzed using directed content analysis. The findings include practice barrier, patient barrier, institutional policy barrier, professional barrier, scope of practice barrier, insurance coverage barrier, and administrative barrier. Multidisciplinary team approach, having a nursing voice during SDM, high level of knowledge of the disease and treatment, and personal valuation of SDM participation were perceived as promoters. Oncology nurses and nurse practitioners face many barriers to their participation during SDM. Organizational support and system-wide culture of SDM are essential to achieve better cancer treatment decisions outcome. Additional studies are needed to determine the factors that can promote more participation among nurses and nurse practitioners. © The Author(s) 2016.

Towards a better understanding of the link between participation in decision-making and organizational citizenship behaviour : A multilevel analysis

NARCIS (Netherlands)

Van Yperen, N.W.; van den Berg, A.E.; Willering, M.C

In the present study, two models were tested that can improve understanding of the link between participation in decision-making and organizational citizenship behaviour (OCB). In Model 1, it is assumed that perceived supervisory support mediates the link between participation in decision-making and

Towards a better understanding of the link between participation in decision-making and organizational citizenship behaviour: a multilevel analysis

NARCIS (Netherlands)

Yperen, van N.W.; Berg, van den A.E.; Willering, M.C.

1999-01-01

In the present study, two models were tested that can improve understanding of the link between participation in decision-making and organizational citizenship behaviour (OCB). In Model 1, it is assumed that perceived supervisory support mediates the link between participation in decision-making and

Participative business modelling to support strategic decision making in operations : a case study

NARCIS (Netherlands)

Akkermans, H.A.

1993-01-01

Describes a case study in which a consultancy method based on participative business modelling was used to support strategic decision making in the field of operations. In this case study the Dutch client company faced serious logical and financial problems after an attempt to attain competitive

Participation of Children in Medical Decision-Making: Challenges and Potential Solutions.

Science.gov (United States)

Jeremic, Vida; Sénécal, Karine; Borry, Pascal; Chokoshvili, Davit; Vears, Danya F

2016-12-01

Participation in healthcare decision-making is considered to be an important right of minors, and is highlighted in both international legislation and public policies. However, despite the legal recognition of children's rights to participation, and also the benefits that children experience by their involvement, there is evidence that legislation is not always translated into healthcare practice. There are a number of factors that may impact on the ability of the child to be involved in decisions regarding their medical care. Some of these factors relate to the child, including their capacity to be actively involved in these decisions. Others relate to the family situation, sociocultural context, or the underlying beliefs and practices of the healthcare provider involved. In spite of these challenges to including children in decisions regarding their clinical care, we argue that it is an important factor in their treatment. The extent to which children should participate in this process should be determined on a case-by-case basis, taking all of the potential barriers into account.

Children's Participation in Decision-Making in the Philippines: Understanding the Attitudes of Policy-Makers and Service Providers

Science.gov (United States)

Bessell, Sharon

2009-01-01

This article explores the ideas about children's participation in decision-making held by government officials and non-government representatives engaged in promoting children's participation in the Philippines. It suggests that the ideas that policy-makers and service deliverers hold about children's participation are heterogeneous, diverse and…

Women's participation in household decision-making and higher dietary diversity: findings from nationally representative data from Ghana.

Science.gov (United States)

Amugsi, Dickson A; Lartey, Anna; Kimani, Elizabeth; Mberu, Blessing U

2016-05-31

Low-quality monotonous diet is a major problem confronting resource-constrained settings across the world. Starchy staple foods dominate the diets in these settings. This places the population, especially women of reproductive age, at a risk of micronutrients deficiencies. This study seeks to examine the association between women's decision-making autonomy and women's achievement of higher dietary diversity (DD) and determine the socio-demographic factors that can independently predict women's attainment of higher DD. The study used data from the 2008 Ghana Demographic and Health Survey. The participants comprised of 2262 women aged 15-49 years and who have complete dietary data. The DD score was derived from a 24-h recall of intake of foods from nine groups. The score was dichotomized into lower DD (DD ≤4) and higher (DD ≥5). Logistic regression was used to assess the association between women decision-making autonomy (final say on how to spend money, making household purchases, own health care, opinions on wife-beating, and sexual intercourse with husband) and the achievement of higher DD. The logistic regression models were adjusted for covariates at the individual and household levels. The analysis showed that women participation in decision-making regarding household purchases was significantly associated with higher DD, after adjusting for individual and household level covariates. The odds of achieving higher DD were higher among women who had a say in deciding household purchases, compared to women who did not have a say (OR = 1.74, 95 % CI = 1.24, 2.42). Women who had more than primary education were 1.6 times more likely to achieve higher DD, compared to those with no education (95 % CI = 1.12, 2.20). Compared to women who lived in polygamous households, those who lived in monogamous households had higher odds of achieving higher DD (OR = 1.42, 95 % CI = 1.04, 1.93). Net other covariates, women who have a say in making

Participative decision-making and corporate reporting in the creation of new corporate governance frameworks

OpenAIRE

Dragičević-Radičević, Tatjana; Mitrović, Ranka; Mikuljević, Milica

2012-01-01

For the purpose of effective and efficient decision-making participation of employees in decision-making on important influences raise employee motivation, encouraging the creative potential of people and overall, improve the quality of decisions, and thus on the overall organizational performance. In order to meet this requirement that employees must have the relevant information regarding the status and position of the company they work for and that they know the proper usage. That's why pa...

Decision Making in the PICU: An Examination of Factors Influencing Participation Decisions in Phase III Randomized Clinical Trials

Science.gov (United States)

Slosky, Laura E.; Burke, Natasha L.; Siminoff, Laura A.

2014-01-01

Background. In stressful situations, decision making processes related to informed consent may be compromised. Given the profound levels of distress that surrogates of children in pediatric intensive care units (PICU) experience, it is important to understand what factors may be influencing the decision making process beyond the informed consent. The purpose of this study was to evaluate the role of clinician influence and other factors on decision making regarding participation in a randomized clinical trial (RCT). Method. Participants were 76 children under sedation in a PICU and their surrogate decision makers. Measures included the Post Decision Clinician Survey, observer checklist, and post-decision interview. Results. Age of the pediatric patient was related to participation decisions in the RCT such that older children were more likely to be enrolled. Mentioning the sponsoring institution was associated with declining to participate in the RCT. Type of health care provider and overt recommendations to participate were not related to enrollment. Conclusion. Decisions to participate in research by surrogates of children in the PICU appear to relate to child demographics and subtleties in communication; however, no modifiable characteristics were related to increased participation, indicating that the informed consent process may not be compromised in this population. PMID:25161672

Participative management in health care services.

Science.gov (United States)

Muller, M

1995-03-01

The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalization of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management. A continuum of interactive decision-making and problem-solving is described, the different role-players involved, as well as the levels of interactive decision-making and problem-solving. The most appropriate decision-making strategy should be employed in pro-active and reactive decision-making. Applicable principles and assumptions in each element of participative management is described. It is recommended that this proposed model for participative management be refined by means of a literature control, interactive dialogue with experts and a model case description or participative management, to ensure the trustworthiness of this research.

Challenges in assessment and decision making in intercountry adoption

OpenAIRE

O'Brien, Valerie

2006-01-01

This paper addresses the challenges facing ICA assessment and decision making in Irish adoption practice? The following questions are addressed •How can a balance be struck between legislative, procedural and best practice parameters in decision making? •Are the models used in assessment and decision making at variance or fitting with the balance required between these parameters? •In moving forward from 2008, what are there issues that need particular attention?

How to Assess Creative Thinking Skill in Making Products of Liquid Pressure?

Science.gov (United States)

Chasanah, L.; Kaniawati, I.; Hernani, H.

2017-09-01

The primary skills that must be possessed in the 21st century curriculum are learning and innovation skills. One of the learning strategies that can train students to innovate and improve creative thinking skills is by applying Science, Technology, Engineering and Mathematics (STEM) in learning. Based on an interview to one of the science teachers that learning that aims to train learning and innovation skills has not been applied to learning in the classroom because there is not enough time, learning materials and assessment instruments used. This study aims to determine the results of the implementation of performance assessment of creative thinking skills on STEM-based learning in junior high school for the material of liquid pressure. This research uses descriptive method. Participants in this study were junior high school students 8th in Kudus area. The research instrument consists of observation sheet, performance assessment and documentation. The result showed that creative thinking skills performance assessment can assess student’s creativity in making products of STEM-based learning for junior high school.

Assessing Participation in Secondary Education Quality Enhancement

African Journals Online (AJOL)

Assessing Participation in Secondary Education Quality Enhancement: Teachers, Parents and Communities in Cross River State. ... ailing economy, low moral values and philosophy of the end justifies the means were reasons for low parents and communities involvement in secondary education-quality improvement.

Effective Principals, Effective Schools: Arriving at Site-Based Decision-Making with Successful Principals and Teacher Participation.

Science.gov (United States)

Charles, Gregory Stewart; Karr-Kidwell, PJ

This paper reviews research on principals' and teachers' roles in site-based decision making (SBDM). Research examining teacher participation in SBDM is reviewed, finding that higher quality teaching behaviors and higher student academic attainment resulted from teacher participation. The review focuses on steps in implementing SBDM, means for…

Exploring older and younger adults' preferences for health information and participation in decision making using the Health Information Wants Questionnaire (HIWQ).

Science.gov (United States)

Xie, Bo; Wang, Mo; Feldman, Robert; Zhou, Le

2014-12-01

Existing measurements of patient preferences cover only a limited range of health information and participation in decision making. A broader approach is necessary to understand the breadth and variations in patient preferences. To explore the breadth and variances in patient preferences for health information and participation in decision making and to understand the relationship between age and each type of preference. The Health Information Wants Questionnaire (HIWQ) was administered during May-December 2010 to gather data about the information and corresponding decision-making autonomy participants would want in seven areas: diagnosis, treatment, laboratory tests, self-care, complementary and alternative medicine (CAM), psychosocial factors and health-care providers. A large state university, public libraries and senior centres in Maryland, USA. A convenience sample of 438 individuals, including 226 undergraduates (mean age = 20; SD = 2.15) and 212 community-dwelling older adults (mean age = 72; SD = 9.00). Ratings on the information and decision-making items of the HIWQ. Participants expressed higher levels of preference for information than for participation in decision making on six of seven subscales. On the psychosocial subscale, they expressed stronger desire for participation in decision making than for information. Age had no predictive effect on the overall preferences or specific preferences for information and participation in decision making about standard treatments and CAM. The predictive effect of age on the other types of preferences varied significantly. Physicians should take into account the breadth and variations in patient preferences. The predictive effect of age on patient preferences varied depending on the specific area of preferences. © 2012 John Wiley & Sons Ltd.

Commentary on a participatory inquiry paradigm used to assess EOL simulation participant outcomes and design.

Science.gov (United States)

Gannon, Jane M

2017-11-20

Care at the end-of-life has attracted global attention, as health care workers struggle with balancing cure based care with end-of-life care, and knowing when to transition from the former to the latter. Simulation is gaining in popularity as an education strategy to facilitate health care provider decision-making by improving communication skills with patients and family members. This commentary focuses on the authors' simulation evaluation process. When data were assessed using a participatory inquiry paradigm, the evaluation revealed far more than a formative or summative evaluation of participant knowledge and skills in this area of care. Consequently, this assessment strategy has ramifications for best practices for simulation design and evaluation.

Postnatal Psychosocial Assessment and Clinical Decision-Making, a Descriptive Study.

Science.gov (United States)

Sims, Deborah; Fowler, Cathrine

2018-05-18

The aim of this study is to describe experienced child and family health nurses' clinical decision-making during a postnatal psychosocial assessment. Maternal emotional wellbeing in the postnatal year optimises parenting and promotes infant development. Psychosocial assessment potentially enables early intervention and reduces the risk of a mental disorder occurring during this time of change. Assessment accuracy, and the interventions used are determined by the standard of nursing decision-making. A qualitative methodology was employed to explore decision-making behaviour when conducting a postnatal psychosocial assessment. This study was conducted in an Australian early parenting organisation. Twelve experienced child and family health nurses were interviewed. A detailed description of a postnatal psychosocial assessment process was obtained using a critical incident technique. Template analysis was used to determine the information domains the nurses accessed, and content analysis was used to determine the nurses' thinking strategies, to make clinical decisions from this assessment. The nurses described 24 domains of information and used 17 thinking strategies, in a variety of combinations. The four information domains most commonly used were parenting, assessment tools, women-determined issues and sleep. The seven thinking strategies most commonly used were searching for information, forming relationships between the information, recognising a pattern, drawing a conclusion, setting priorities, providing explanations for the information and judging the value of the information. The variety and complexity of the clinical decision-making involved in postnatal psychosocial assessment confirms that the nurses use information appropriately and within their scope of nursing practice. The standard of clinical decision-making determines the results of the assessment and the optimal access to care. Knowledge of the information domains and the decision-making strategies

Environmental assessment of nuclear projects in Canada - process, participation, lessons learned

International Nuclear Information System (INIS)

Underdown, G.A.; Brown, P.A.; Morrison, R.W.

1995-01-01

This paper documents public participation in decision-making for five cases of nuclear-based projects in Canada. Two cases involve the application of the Federal Environmental Assessment and Review Process (EARP), a formal, non-judicial process for public involvement in projects with a potential environmental impact. It is being applied to the development of new Uranium mines and the disposal of used nuclear fuels. The siting of radioactive waste facilities, generally unwanted by the communities, presents many difficult challenges which needs to be addressed before a project goes through the EARP process. An open, consultative, community-based approach to decision-making about siting is being applied in the three cases: Port Hope, Scarborough and Surrey. A number of lessons have been learned, the most important that there is a need to establish an acceptable process that includes 'getting the science right' on a project before attempting to find a site. The EARP, in most cases, provides a good mechanism for the sharing of information about a potential between the proponents and the public as long as there are no major unresolved contentious issues such as the unwanted siting of a waste facility in a particular community. 19 refs

Public participation in decision-making on the coverage of new antivirals for hepatitis C.

Science.gov (United States)

Kieslich, Katharina; Ahn, Jeonghoon; Badano, Gabriele; Chalkidou, Kalipso; Cubillos, Leonardo; Hauegen, Renata Curi; Henshall, Chris; Krubiner, Carleigh B; Littlejohns, Peter; Lu, Lanting; Pearson, Steven D; Rid, Annette; Whitty, Jennifer A; Wilson, James

2016-08-15

Purpose - New hepatitis C medicines such as sofosbuvir underline the need to balance considerations of innovation, clinical evidence, budget impact and equity in health priority-setting. The purpose of this paper is to examine the role of public participation in addressing these considerations. Design/methodology/approach - The paper employs a comparative case study approach. It explores the experience of four countries - Brazil, England, South Korea and the USA - in making coverage decisions about the antiviral sofosbuvir and involving the public and patients in these decision-making processes. Findings - Issues emerging from public participation ac tivities include the role of the universal right to health in Brazil, the balance between innovation and budget impact in England, the effect of unethical medical practices on public perception in South Korea and the legitimacy of priority-setting processes in the USA. Providing policymakers are receptive to these issues, public participation activities may be re-conceptualized as processes that illuminate policy problems relevant to a particular context, thereby promoting an agenda-setting role for the public. Originality/value - The paper offers an empirical analysis of public involvement in the case of sofosbuvir, where the relevant considerations that bear on priority-setting decisions have been particularly stark. The perspectives that emerge suggest that public participation contributes to raising attention to issues that need to be addressed by policymakers. Public participation activities can thus contribute to setting policy agendas, even if that is not their explicit purpose. However, the actualization of this contribution is contingent on the receptiveness of policymakers.

Mock Pages Are a Valid Construct for Assessment of Clinical Decision Making and Interprofessional Communication.

Science.gov (United States)

Boehler, Margaret L; Schwind, Cathy J; Markwell, Stephen J; Minter, Rebecca M

2017-01-01

Answering pages from nurses about patients in need of immediate attention is one of the most difficult challenges a resident faces during their first days as a physician. A Mock Page program has been developed and adopted into a national surgical resident preparatory curriculum to prepare senior medical students for this important skill. The purpose of this study is to assess standardized mock page cases as a valid construct to assess clinical decision making and interprofessional communication skills. Mock page cases (n = 16) were administered to 213 senior medical students from 12 medical schools participating in a national surgical resident preparatory curriculum in 2013 and 2014. Clinical decision making and interprofessional communication were measured by case-specific assessments evaluating these skills which have undergone rigorous standard-setting to determine pass/fail cut points. Students' performance improved in general for both communication and clinical decision making over the 4-week course. Cases have been identified that seem to be best suited for differentiating high- from low-performing students. Chest pain, pulmonary embolus, and mental status change cases posed the greatest difficulty for student learners. Simulated mock pages demonstrate an innovative technique for training students in both effective interprofessional communication and management of common postoperative conditions they will encounter as new surgical interns.

Assessing the relationship between the WNSSP and therapeutic participation in adolescents in low response states following severe traumatic brain injury.

Science.gov (United States)

Patrick, Peter D; Wamstad, Julia Buch; Mabry, Jennifer L; Smith-Janik, Shannan; Gurka, Matthew J; Buck, Marcia L; Blackman, James A

2009-06-01

This study examines the relationship between scores on the Western Neuro Sensory Stimulation Profile (WNSSP) and therapeutic participation as it relates to rehabilitation readiness (RR) in adolescents with low response following severe traumatic brain injury (TBI). This is a serial observational design using multiple measures of clinical status and participation. Ten children, mean age 16.7 years, who remained in a low response state (30 days or more) were assessed with the WNSSP and videotaped during physical and occupational therapy sessions. Associations were evaluated between WNSSP scores and participation scores related to arousal, awareness and communication. The WNSSP was only associated with the communication score (p < 0.0001). The arousal and awareness scores had no significant impact on the WNSSP score. These results suggest that scores on the WNSSP may be related to the return of communication skills in adolescents in low response states as one part of assessing their therapeutic participation and ultimate rehabilitation readiness. This ability may assist in making decisions regarding care planning.

Factors Affecting Women's Autonomous Decision Making In Research Participation Amongst Yoruba Women Of Western Nigeria.

Science.gov (United States)

Princewill, Chitu Womehoma; Jegede, Ayodele S; Nordström, Karin; Lanre-Abass, Bolatito; Elger, Bernice Simone

2017-04-01

Research is a global enterprise requiring participation of both genders for generalizable knowledge; advancement of science and evidence based medical treatment. Participation of women in research is necessary to reduce the current bias that most empirical evidence is obtained from studies with men to inform health care and related policy interventions. Various factors are assumed to limit autonomy amongst the Yoruba women of western Nigeria. This paper seeks to explore the experience and understanding of autonomy by the Yoruba women in relation to research participation. Focus is on factors that affect women's autonomous decision making in research participation. An exploratory qualitative approach comprising four focus group discussions, 42 in-depth interviews and 14 key informant interviews was used. The study permits a significant amount of triangulation, as opinions of husbands and religious leaders are also explored. Interviews and discussions were audiotaped and transcribed verbatim. Content analysis was employed for data analysis. Findings show that concepts of autonomy varied amongst the Yoruba women. Patriarchy, religion and culture are conceived to have negative impact on the autonomy of women in respect to research participation. Among the important findings are: 1) male dominance is strongly emphasized by religious leaders who should teach equality, 2) while men feel that by making decisions for women, they are protecting them, the women on the other hand see this protection as a way of limiting their autonomy. We recommend further studies to develop culturally appropriate and workable recruitment methods to increase women's participation in research. © 2016 John Wiley & Sons Ltd.

The Environmental Scanning Function of Public Relations Practitioners and Participation in Management Decision Making.

Science.gov (United States)

Dozier, David M.

Focusing on the concepts of scanning (gathering information about segments of the public, their reactions to the organization, and their opinions about issues important to the organization), decision making, and roles, a study examined the relationship between environmental scanning and the participation of public relations practitioners in…

US National Climate Assessment (NCA) Scenarios for Assessing Our Climate Future: Issues and Methodological Perspectives Background Whitepaper for Participants

Energy Technology Data Exchange (ETDEWEB)

Moss, Richard H.; Engle, Nathan L.; Hall, John; Jacobs, Kathy; Lempert, Rob; Mearns, L. O.; Melillo, Jerry; Mote, Phil; O' Brien, Sheila; Rosenzweig, C.; Ruane, Alex; Sheppard, Stephen; Vallario, Robert W.; Wiek, Arnim; Wilbanks, Thomas

2011-10-01

This whitepaper is intended to provide a starting point for discussion at a workshop for the National Climate Assessment (NCA) that focuses on the use and development of scenarios. The paper will provide background needed by participants in the workshop in order to review options for developing and using scenarios in NCA. The paper briefly defines key terms and establishes a conceptual framework for developing consistent scenarios across different end uses and spatial scales. It reviews uses of scenarios in past U.S. national assessments and identifies potential users of and needs for scenarios for both the report scheduled for release in June 2013 and to support an ongoing distributed assessment process in sectors and regions around the country. Because scenarios prepared for the NCA will need to leverage existing research, the paper takes account of recent scientific advances and activities that could provide needed inputs. Finally, it considers potential approaches for providing methods, data, and other tools for assessment participants. We note that the term 'scenarios' has many meanings. An important goal of the whitepaper (and portions of the workshop agenda) is pedagogical (i.e., to compare different meanings and uses of the term and make assessment participants aware of the need to be explicit about types and uses of scenarios). In climate change research, scenarios have been used to establish bounds for future climate conditions and resulting effects on human and natural systems, given a defined level of greenhouse gas emissions. This quasi-predictive use contrasts with the way decision analysts typically use scenarios (i.e., to consider how robust alternative decisions or strategies may be to variation in key aspects of the future that are uncertain). As will be discussed, in climate change research and assessment, scenarios describe a range of aspects of the future, including major driving forces (both human activities and natural processes

Trajectories of Depressive Symptoms Among Web-Based Health Risk Assessment Participants.

Science.gov (United States)

Bedrosian, Richard; Hawrilenko, Matt; Cole-Lewis, Heather

2017-03-31

Health risk assessments (HRAs), which often screen for depressive symptoms, are administered to millions of employees and health plan members each year. HRA data provide an opportunity to examine longitudinal trends in depressive symptomatology, as researchers have done previously with other populations. The primary research questions were: (1) Can we observe longitudinal trajectories in HRA populations like those observed in other study samples? (2) Do HRA variables, which primarily reflect modifiable health risks, help us to identify predictors associated with these trajectories? (3) Can we make meaningful recommendations for population health management, applicable to HRA participants, based on predictors we identify? This study used growth mixture modeling (GMM) to examine longitudinal trends in depressive symptomatology among 22,963 participants in a Web-based HRA used by US employers and health plans. The HRA assessed modifiable health risks and variables such as stress, sleep, and quality of life. Five classes were identified: A "minimal depression" class (63.91%, 14,676/22,963) whose scores were consistently low across time, a "low risk" class (19.89%, 4568/22,963) whose condition remained subthreshold, a "deteriorating" class (3.15%, 705/22,963) who began at subthreshold but approached severe depression by the end of the study, a "chronic" class (4.71%, 1081/22,963) who remained highly depressed over time, and a "remitting" class (8.42%, 1933/22,963) who had moderate depression to start, but crossed into minimal depression by the end. Among those with subthreshold symptoms, individuals who were male (PInternet Research (http://www.jmir.org), 31.03.2017.

Political governance and constitution-making in Kenya : in search of popular participation. / J.M. Mukuna.

OpenAIRE

Mukuna, J M

2012-01-01

This thesis examines the evolving ideal of popular participation in the context of Kenya's experience in the intertwined areas of political governance and constitution-making. The thesis is primarily motivated by the spirit and intent of the country's constitution-making initiatives which commenced in earnest after the 2007 post-election violence in which about 1,300 precious lives were lost, over 300,000 people displaced and property destroyed. The study adopts a qualitative a...

Impact of support system failure limitations on probabilistic safety assessment and in regulatory decision making

International Nuclear Information System (INIS)

Bickel, J.H.

1990-01-01

When used as a tool for safety decision making, Probabilistic Safety Assessment (PSA) is as effective as it realistically characterizes the overall frequency and consequences of various types of system and component failures. If significant support system failure events are omitted from consideration, the PSA process omits the characterization of possible unique contributors to core damage risk, possibly underestimates the frequency of core damage, and reduces the future utility of the PSA as a decision making tool for the omitted support system. This paper is based on a review of several recent US PSA studies and the author's participation in several International Atomic Energy Agency (IAEA) sponsored peer reviews. 21 refs., 2 figs., 1 tab

Web sites survey for electronic public participation

International Nuclear Information System (INIS)

Park, Moon Su; Lee, Young Wook; Kang, Chang Sun

2004-01-01

Public acceptance has been a key factor in nuclear industry as well as other fields. There are many ways to get public acceptance. Public participation in making a policy must be a good tool for this purpose. Moreover, the participation by means of internet may be an excellent way to increase voluntary participation. In this paper, the level of electronic public participation is defined and how easy and deep for lay public to participate electronically is assessed for some organization's web sites

[Health technology assessment for decision-making in Latin America: good practice principles].

Science.gov (United States)

Pichon-Riviere, Andrés; Soto, Natalie C; Augustovski, Federico Ariel; García Martí, Sebastián; Sampietro-Colom, Laura

2018-02-19

Identify the most relevant, applicable, and priority good practice principles in health technology assessment (HTA) in Latin America, and potential barriers to implementing them in the region. HTA good practice principles postulated worldwide were identified and then explored through a deliberative process in a forum of evaluators, funders, and technology producers. Forty-two representatives from ten Latin American countries participated in the forum. The good practice principles postulated at the international level were considered valid and potentially applicable in Latin America. Five principles were identified as priorities and as having greater potential to be expanded at this time: transparency in carrying out HTA; involvement of stakeholders in the HTA process; existence of mechanisms to appeal decisions; existence of clear mechanisms for HTA priority-setting; and existence of a clear link between assessment and decision-making. The main challenge identified was to find a balance between application of these principles and available resources, to prevent the planned improvements from jeopardizing report production times and failing to meet decision-makers' needs. The main recommendation was to gradually advance in improving HTA and its link to decision-making by developing appropriate processes for each country, without attempting to impose, in the short term, standards taken from examples at the international level without adequate adaptation to the local context.

Effects of Student Participation in Decision Making at School. A Systematic Review and Synthesis of Empirical Research

Science.gov (United States)

Mager, Ursula; Nowak, Peter

2012-01-01

This article reviews empirical research on the effects of student participation in school decision-making processes. Out of 3102 searched citations, a total of 32 publications met the inclusion criteria. The qualitative analyses employed in this review yielded a typology of student participation, a categorisation of the diverse effects of student…

Safety assessment as basis for the decision making process

International Nuclear Information System (INIS)

Ilie, P.; Didita, L.; Danchiv, A.

2005-01-01

This paper deals with the safety assessment for a new near surface repository, particularly for the early stage of repository development using ISAM (Improvement of Safety Assessment Methodologies for Near Surface Disposal Facilities) safety assessment methodology. In this stage of the repository life cycle the main purpose of the safety assessment is to demonstrate that the plant is capable to be constructed and operated safely. The paper is based on development of the ASAM (Application of the Safety Assessment Methodologies for Near-Surface Disposal Facilities) Decision Support Subgroup of the Common Aspects Working Group. The implications of decision making for the application of the ISAM methodology on post-closure safety assessment are analysed. Some important elements of the decision-making process with impact on key components of the ISAM process are described. Following the development of Decision Support Subgroup of the ASAM Common Aspects Working Group the proposed change of ISAM methodology is analysed. This approach puts all activities in a decision context where the first iteration of the safety assessment is based on the existing state of knowledge and the initial engineering design. Confidence in the process is accomplished through the direct inclusion of all decision makers and stakeholders in the formulation of decisions, the definition of the state of knowledge, and decision making activities. The decision process is developed in context of undertaking assessments with little site-specific information, this situation is specifically for new planned repository. Limited site-specific information can result in a high degree of uncertainty, therefore it is important first of all to identify the sources of uncertainty arising from the limited nature of the site-specific information and then to apply appropriate approaches to manage the uncertainties and to determine whether the uncertainties are important to the overall safety of the disposal facility

Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context.

Science.gov (United States)

Jefford, Elaine; Jomeen, Julie; Martin, Colin R

2016-04-28

The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general

Let us make impact assessment more accessible

International Nuclear Information System (INIS)

Alton, Charles C.; Underwood, P. Benjamin

2003-01-01

Impact assessment professionals have traditionally written documents for themselves. Often, their work appears to be received with indifference by business professionals and decision makers who have different needs and interests. The two groups conflict when they should be thinking and planning together at the 'big picture' level (including the understanding of the social factors at work in environmental impact assessment) and developing related and workable 'site-specific' implementation that characterizes socially acceptable decision making. To achieve this goal, the IA professional needs to rethink the approach. IA professionals often focus on the traditional 'physical' environment, confining the assessment to facts and figures about hard aspects of the environment. Reams of detailed data are compiled to demonstrate impact assessment and to achieve a degree of certainty and precision. However, the sheer bulk of data assures that it will not be read by those who most need to use it. The IA professional must learn to prepare assessments that effectively consider less quantifiable, 'softer' aspects of the environment. We advocate preparation of an impact analysis that management decision makers and environmental stewards can use as a reference tool. The goal is to reduce or eliminate the hundreds of unread pages containing lengthy modeling runs and obscure details, and instead to prepare documents that are useful in both courtroom and boardroom. This convenient and quick-study 'consumer report' style combines with a tiered decision making process that assures broad long-term thinking and planning, and focused short-term detailed implementation, using a level of detail appropriate to the decision at hand. This methodology integrates social factors into decision making, so as to provide meaningful discussion and analysis. These principles, which have been proven in US boardrooms and courtrooms, will be illustrated with actual examples from broad policy-level impact

Structuring and self-competence: How they can make a difference in assessing and managing risk

Directory of Open Access Journals (Sweden)

Virtu Chongtham

2015-01-01

Full Text Available Background: Assessing risk is a mandatory part of standard mental health practice in the West, but is fraught with difficulties. Structuring and self-efficacy are important factors, but there is near absence of work on this aspect from India. This study aimed to determine how these two concepts can make a difference in assessing and managing risk. Methods: A prospective cross-sectional study over 2 months was conducted with 35 participants (dealing with patients with mental illnesses from Department of Psychiatry, Government Medical College and Hospital-32, Chandigarh and 30 participants in comparison group (dealing with people with intellectual disabilities from Regional Institute of Mentally Handicapped-31, Chandigarh using Risk Assessment and Management Self-efficacy Scale (RAMSES. Results : In overall sample (n = 65, only 17% reported using a screening instrument while 62% reported use of screening questions thereby making the total prevalence of use of screening instruments and/or questions as 79%. Total RAMSES score and mean score for all three domains was 7.14 and between 7 and 8 respectively for the study group; while for the comparison group, the total RAMSES score was 7.92 and the mean score for all three domains was between 7 and 9 respectively indicating above average level of reported self-efficacy. For the individual RAMSES items, a lower competency (<7 for study group and (<8 for comparison group was reported for formal or written process related to synthesis of risk assessment and risk management. The study group showed lower self-efficacy scores on majority of individual RAMSES items, 2/3 domains and overall score. Conclusions: Indian mental health professionals of different backgrounds with varying duration of experience reported reasonable degree of competence regarding risk assessment (primarily for the risk toward self and others. Hence, we recommend that they embrace the western concept of "risk assessment" by incorporating

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style

Directory of Open Access Journals (Sweden)

Alex Ghanouni

2017-04-01

Full Text Available Abstract Background There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. Methods A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and ‘decision-making styles’ (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent. The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. Results After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009. Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively. Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008

A cross-sectional survey assessing factors associated with reading cancer screening information: previous screening behaviour, demographics and decision-making style.

Science.gov (United States)

Ghanouni, Alex; Renzi, Cristina; Waller, Jo

2017-04-18

There is broad agreement that cancer screening invitees should know the risks and benefits of testing before deciding whether to participate. In organised screening programmes, a primary method of relaying this information is via leaflets provided at the time of invitation. Little is known about why individuals do not engage with this information. This study assessed factors associated with reading information leaflets provided by the three cancer screening programmes in England. A cross-sectional survey asked screening-eligible members of the general population in England about the following predictor variables: uptake of previous screening invitations, demographic characteristics, and 'decision-making styles' (i.e. the extent to which participants tended to make decisions in a way that was avoidant, rational, intuitive, spontaneous, or dependent). The primary outcome measures were the amount of the leaflet that participants reported having read at their most recent invitation, for any of the three programmes for which they were eligible. Associations between these outcomes and predictor variables were assessed using binary or ordinal logistic regression. After exclusions, data from 275, 309, and 556 participants were analysed in relation to the breast, cervical, and bowel screening programmes, respectively. Notable relationships included associations between regularity of screening uptake and reading (more of) the information leaflets for all programmes (e.g. odds ratio: 0.16 for participants who never/very rarely attended breast screening vs. those who always attended previously; p = .009). Higher rational decision-making scores were associated with reading more of the cervical and bowel screening leaflets (OR: 1.13, p < .0005 and OR: 1.11, p = .045, respectively). Information engagement was also higher for White British participants compared with other ethnic groups for breast (OR: 3.28, p = .008) and bowel (OR: 2.58, p = .015) information; an

A qualitative identification of categories of patient participation in decision-making by health care professionals and patients during surgical treatment.

Science.gov (United States)

Heggland, Liv-Helen; Hausken, Kjell

2013-05-01

The aim of this article is to identify how health care professionals and patients experience patient participation in decision-making processes in hospitals. Eighteen semi-structured interviews with experts from different disciplines such as medicine and nursing in surgical departments as well as patients who have undergone surgical treatment constitute the data. By content analysis four categories of patient participation were identified: information dissemination, formulation of options, integration of information, and control. To meet the increasing demands of patient participation, this categorization with four identified critical areas for participation in decision-making has important implications in guiding information support for patients prior to surgery and during hospitalization.

Decision-making in multiple sclerosis consultations in Italy: third observer and patient assessments.

Science.gov (United States)

Pietrolongo, Erika; Giordano, Andrea; Kleinefeld, Monica; Confalonieri, Paolo; Lugaresi, Alessandra; Tortorella, Carla; Pugliatti, Maura; Radice, Davide; Goss, Claudia; Heesen, Christoph; Solari, Alessandra

2013-01-01

To assess decision-making in multiple sclerosis (MS) from third observer and patient perspectives. Audio recordings of first-ever consultations with a participating physician (88 outpatients, 10 physicians) at four tertiary MS care clinics in Italy, were rated by a third observer using the Observing Patient Involvement in Shared Decision Making (OPTION) and by patients using the Perceived Involvement in Care Scale (PICS). Mean patient age was 37.5, 66% were women, 72% had MS, and 28% had possible MS or other disease. Mean PICS subscale scores (range 0 poor, 100 best possible) were 71.9 (SD 24.3) for "physician facilitation" (PICS-F); 74.6 (SD 22.9) for "patient information exchange" (PICS-I); and only 22.5 (SD 16.2) for "patient decision making" (PICS-DM). Mean OPTION total score (0 poor, 100 best possible) was 29.6 (SD 10.3). Poorest OPTION scores were found for items assessing "preferred patient approach to receiving information" and "preferred patient level of involvement." Highest scores were for "clinician drawing attention to identified problem", "indicating need for decision making," and "need to review the decision." Consultation time, woman physician, patient-physician gender concordance and PICS-F were associated with higher OPTION total score; older physician and second opinion consultation were associated with lower OPTION score. In line with findings in other settings, our third observer findings indicated limited patient involvement abilities of MS physicians during first consultations. Patient perceptions of physician skills were better than third observers', although they correlated. Consultations with women physicians, and younger physicians, were associated with higher third observer and patient-based scores. Our findings reveal a need to empower Italian MS physicians with better communication and shared decision-making skills, and show in particular that attention to MS patient preferences for reception of information and involvement in health

A real-time internal dose assessment exercise

International Nuclear Information System (INIS)

Bingham, D.; Bull, R. K.

2013-01-01

A real-time internal dose assessment exercise has been conducted in which participants were required to make decisions about sampling requirements, seek relevant information about the 'incident' and make various interim dose assessments. At the end of the exercise, each participant was requested to make a formal assessment, providing statements of the methods, models and assumptions used in that assessment. In this paper we describe how the hypothetical assessment case was set up and the exercise was conducted, the responses of the participants and the assessments of dose that they made. Finally we discuss the lessons learnt from the exercise and suggest how the exercise may be adapted to a wider range of participants. (authors)

Teacher Participation in Decision Making and Its Impact on School and Teachers

Science.gov (United States)

Sarafidou, Jasmin-Olga; Chatziioannidis, Georgios

2013-01-01

Purpose: The purpose of this paper is to examine teacher involvement in different domains of decision making in Greek primary schools and explore associations with school and teacher variables. Design/methodology/approach: A survey employing self-administered questionnaires, with a Likert-type scale assessing teachers' actual and desired…

PUBLIC PARTICIPATION IN THE CHINESE ENVIRONMENTAL IMPACT ASSESSMENT (EIA) SYSTEM

OpenAIRE

SHANSHAN YANG

2008-01-01

This article was initiated by findings that public participation in the Chinese Environmental Impact Assessment (EIA) system has not been effectively carried out. The article first introduces the research rationale and theoretical basis. It then reviews and analyses public participation in the Chinese EIA system, including its history, legal and institutional requirements and problems. Thirdly it puts forward suggestions for promoting public participation in the Chinese EIA system taking into...

Decision making process and factors contributing to research participation among general practitioners: A grounded theory study.

Science.gov (United States)

Tong, Seng Fah; Ng, Chirk Jenn; Lee, Verna Kar Mun; Lee, Ping Yein; Ismail, Irmi Zarina; Khoo, Ee Ming; Tahir, Noor Azizah; Idris, Iliza; Ismail, Mastura; Abdullah, Adina

2018-01-01

The participation of general practitioners (GPs) in primary care research is variable and often poor. We aimed to develop a substantive and empirical theoretical framework to explain GPs' decision-making process to participate in research. We used the grounded theory approach to construct a substantive theory to explain the decision-making process of GPs to participate in research activities. Five in-depth interviews and four focus group discussions were conducted among 21 GPs. Purposeful sampling followed by theoretical sampling were used to attempt saturation of the core category. Data were collected using semi-structured open-ended questions. Interviews were recorded, transcribed verbatim and checked prior to analysis. Open line-by-line coding followed by focus coding were used to arrive at a substantive theory. Memoing was used to help bring concepts to higher abstract levels. The GPs' decision to participate in research was attributed to their inner drive and appreciation for primary care research and their confidence in managing their social and research environments. The drive and appreciation for research motivated the GPs to undergo research training to enhance their research knowledge, skills and confidence. However, the critical step in the GPs' decision to participate in research was their ability to align their research agenda with priorities in their social environment, which included personal life goals, clinical practice and organisational culture. Perceived support for research, such as funding and technical expertise, facilitated the GPs' participation in research. In addition, prior experiences participating in research also influenced the GPs' confidence in taking part in future research. The key to GPs deciding to participate in research is whether the research agenda aligns with the priorities in their social environment. Therefore, research training is important, but should be included in further measures and should comply with GPs' social

FACTORS AFFECTING WOMEN’S AUTONOMOUS DECISION MAKING IN RESEARCH PARTICIPATION AMONGST YORUBA WOMEN OF WESTERN NIGERIA

Science.gov (United States)

PRINCEWILL, CHITU WOMEHOMA; JEGEDE, AYODELE S.; NORDSTRöM, KARIN; LANRE-ABASS, BOLATITO; ELGER, BERNICE SIMONE

2016-01-01

Research is a global enterprise requiring participation of both genders for generalizable knowledge; advancement of science and evidence based medical treatment. Participation of women in research is necessary to reduce the current bias that most empirical evidence is obtained from studies with men to inform health care and related policy interventions. Various factors are assumed to limit autonomy amongst the Yoruba women of western Nigeria. This paper seeks to explore the experience and understanding of autonomy by the Yoruba women in relation to research participation. Focus is on factors that affect women’s autonomous decision making in research participation. An exploratory qualitative approach comprising four focus group discussions, 42 in-depth interviews and 14 key informant interviews was used. The study permits a significant amount of triangulation, as opinions of husbands and religious leaders are also explored. Interviews and discussions were audiotaped and transcribed verbatim. Content analysis was employed for data analysis. Findings show that concepts of autonomy varied amongst the Yoruba women. Patriarchy, religion and culture are conceived to have negative impact on the autonomy of women in respect to research participation. Among the important findings are: 1) male dominance is strongly emphasized by religious leaders who should teach equality, 2) while men feel that by making decisions for women, they are protecting them, the women on the other hand see this protection as a way of limiting their autonomy. We recommend further studies to develop culturally appropriate and workable recruitment methods to increase women’s participation in research. PMID:26871880

Gendered alternative to cyber fraud participation: an assessment of ...

African Journals Online (AJOL)

Gendered alternative to cyber fraud participation: an assessment of technological driven crime in Lagos State, Nigeria. Ajibade Ebenezer Jegede, Ayotunde Oluwadamilola Elegbeleye, Elizabeth Ibunkunoluwa Olowookere, Bankole Roberts Olorunyomi ...

Environmental Decision Making and Information Technology: Issues Assessment

Energy Technology Data Exchange (ETDEWEB)

Barg, S.; Fletcher, T.; Mechling, J.; Tonn, B.; Turner, R.

1999-05-01

This report presents a summary of the Information Technology and Environmental Decision Making Workshop that was held at Harvard University, October 1-3, 1998. Over sixty participants from across the US took part in discussions that focused on the current practice of using information technology to support environmental decision making and on future considerations of information technology development, information policies, and data quality issues in this area. Current practice is focusing on geographic information systems and visualization tools, Internet applications, and data warehousing. In addition, numerous organizations are developing environmental enterprise systems to integrate environmental information resources. Plaguing these efforts are issues of data quality (and public trust), system design, and organizational change. In the future, much effort needs to focus on building community-based environmental decision-making systems and processes, which will be a challenge given that exactly what needs to be developed is largely unknown and that environmental decision making in this arena has been characterized by a high level of conflict. Experimentation and evaluation are needed to contribute to efficient and effective learning about how best to use information technology to improve environmental decision making.

A framework for guiding sustainability assessment and on-farm strategic decision making

International Nuclear Information System (INIS)

Coteur, Ine; Marchand, Fleur; Debruyne, Lies; Dalemans, Floris; Lauwers, Ludwig

2016-01-01

Responding to future challenges and societal needs, various actions are taken in agriculture to evolve towards more sustainable farming practices. These actions imply strategic choices and suppose adequate sustainability assessments to identify, measure, evaluate and communicate sustainable development. However, literature is scarce on the link between strategic decision making and sustainability assessment. As questions emerge on how, what and when to measure, the objective of this paper is to construct a framework for guiding sustainability assessment and on-farm strategic decision making. Qualitative research on own experiences from the past and a recent project revealed four categories of actual needs farmers, advisors and experts have regarding sustainability assessment: context, flexibility, focus on farm and farmer and communication. These stakeholders' needs are then incorporated into a two-dimensional framework that marries the intrinsic complexity of sustainability assessment tools and the time frame of strategic decision making. The framework allows a farm-specific and flexible approach leading to harmonized actions towards sustainable farming. As this framework is mainly a procedural instrument to guide the use of sustainability assessment tools within strategic decision making, it fits to incorporate, even guide, future research on sustainability assessment tools themselves and on their adoption on farms. - Highlights: • How to link sustainability assessment and on-farm strategic decision making is unclear. • Two-dimensional framework incorporating stakeholders' needs regarding sustainability assessment • Linking complexity of sustainability assessment tools and the time frame of strategic decision making • Farm-specific and flexible approach to harmonize action towards sustainable farming

A framework for guiding sustainability assessment and on-farm strategic decision making

Energy Technology Data Exchange (ETDEWEB)

Coteur, Ine, E-mail: ine.coteur@ilvo.vlaanderen.be [Institute for Agricultural and Fisheries Research (ILVO)-Social sciences Unit, Burg. Van Gansberghelaan 115, box 2, 9820 Merelbeke (Belgium); Marchand, Fleur [Institute for Agricultural and Fisheries Research (ILVO)-Social sciences Unit, Burg. Van Gansberghelaan 115, box 2, 9820 Merelbeke (Belgium); University of Antwerp, Ecosystem Management Research Group and IMDO, Universiteitsplein 1, 2610 Wilrijk (Belgium); Debruyne, Lies; Dalemans, Floris [Institute for Agricultural and Fisheries Research (ILVO)-Social sciences Unit, Burg. Van Gansberghelaan 115, box 2, 9820 Merelbeke (Belgium); Lauwers, Ludwig [Institute for Agricultural and Fisheries Research (ILVO)-Social sciences Unit, Burg. Van Gansberghelaan 115, box 2, 9820 Merelbeke (Belgium); University of Ghent, Department of Agricultural Economics, Coupure Links 53, 9000 Ghent (Belgium)

2016-09-15

Responding to future challenges and societal needs, various actions are taken in agriculture to evolve towards more sustainable farming practices. These actions imply strategic choices and suppose adequate sustainability assessments to identify, measure, evaluate and communicate sustainable development. However, literature is scarce on the link between strategic decision making and sustainability assessment. As questions emerge on how, what and when to measure, the objective of this paper is to construct a framework for guiding sustainability assessment and on-farm strategic decision making. Qualitative research on own experiences from the past and a recent project revealed four categories of actual needs farmers, advisors and experts have regarding sustainability assessment: context, flexibility, focus on farm and farmer and communication. These stakeholders' needs are then incorporated into a two-dimensional framework that marries the intrinsic complexity of sustainability assessment tools and the time frame of strategic decision making. The framework allows a farm-specific and flexible approach leading to harmonized actions towards sustainable farming. As this framework is mainly a procedural instrument to guide the use of sustainability assessment tools within strategic decision making, it fits to incorporate, even guide, future research on sustainability assessment tools themselves and on their adoption on farms. - Highlights: • How to link sustainability assessment and on-farm strategic decision making is unclear. • Two-dimensional framework incorporating stakeholders' needs regarding sustainability assessment • Linking complexity of sustainability assessment tools and the time frame of strategic decision making • Farm-specific and flexible approach to harmonize action towards sustainable farming.

The emergency patient's participation in medical decision-making.

Science.gov (United States)

Wang, Li-Hsiang; Goopy, Suzanne; Lin, Chun-Chih; Barnard, Alan; Han, Chin-Yen; Liu, Hsueh-Erh

2016-09-01

The purpose of this research was to explore the medical decision-making processes of patients in emergency departments. Studies indicate that patients should be given enough time to acquire relevant information and receive adequate support when they need to make medical decisions. It is difficult to satisfy these requirements in emergency situations. Limited research has addressed the topic of decision-making among emergency patients. This qualitative study used a broadly defined grounded theory approach to explore decision-making in an emergency department in Taiwan. Thirty emergency patients were recruited between June and December 2011 for semi-structured interviews that were audio-taped and transcribed verbatim. The study identified three stages in medical decision-making by emergency patients: predecision (interpreting the problem); decision (a balancing act) and postdecision (reclaiming the self). Transference was identified as the core category and pattern of behaviour through which patients resolved their main concerns. This transference around decision-making represents a type of bricolage. The findings fill a gap in knowledge about the decision-making process among emergency patients. The results inform emergency professionals seeking to support patients faced with complex medical decision-making and suggest an emphasis on informed patient decision-making, advocacy, patient-centred care and in-service education of health staff. © 2016 John Wiley & Sons Ltd.

Effectiveness of teachers' training in assessment techniques: participants' perception.

Science.gov (United States)

Baral, N; Gautam, A; Lamsal, M; Paudel, B H; Lal Das, B K; Aryal, M

2011-01-01

Medical education has experienced a rapidly changing scenario especially during the past three decades. Teachers training programs have emerged in recent years as a more in depth and comprehensive mechanisms for strengthening instructional skills and formulating assessment techniques among faculty members. The present study was carried out with the aim of assessing effectiveness of teacher training workshop on assessment techniques at B.P. Koirala Institute of Health sciences (BPKIHS), Dharan, Nepal. Methods: In this prospective questionnaire based study, the 26 entry level teachers were enrolled. They were requested to fill the questionnaire before and after the workshop on the assessment techniques at BPKIHS, Dharan. Twenty six teachers majority of whom were entry level teachers comprising of medical, dental, nursing and allied sciences participated in pre- and post test analysis on the various components of written and oral examinations. A two and half days long training was conducted having 9 hours of teaching interactive sessions, 6 hours of group exercises, daily evaluation and 3 hours of presentation by participants. There was high degree of agreement with most topics of the assessment training. There was a significant gain in knowledge (p training being informative and learned new things about assessment. More practice session with longer duration with invited resource persons were also suggested for an effective session. Thereis an immense opportunity for a better and comprehensive training in evaluation techniques in medical education..

Mediating Education Policy: Making up the "Anti-Politics" of Third-Sector Participation in Public Education

Science.gov (United States)

Williamson, Ben

2014-01-01

This article examines the participation of "third-sector" organisations in public education in England. These organisations act as a cross-sectoral policy network made up of new kinds of policy experts: mediators and brokers with entrepreneurial careers in ideas. They have sought to make education reform thinkable, intelligible and…

Participation, public policy-making, and legitimacy in the EU Voluntary Partnership Agreement process

DEFF Research Database (Denmark)

Wodschow, Astrid; Nathan, Iben; Cerutti, Paolo

2016-01-01

This paper discusses how participatory policy-making processes such as the Voluntary Partnership Agreement (VPA) negotiations are and should be organised to foster political legitimacy and support. The VPAs are bilateral agreements between the European Union (EU) and timber producing countries....... VPAs constitute a cornerstone in EU's Forest Law Enforcement, Governance and Trade (FLEGT) programme, the most important tool for the EU to address illegal logging problems. The EU requires that national VPA negotiations include participation by the relevant stakeholders. Based on primary data, we...... compare the VPA negotiations in Cameroon (2006–2009) with three different ‘ideal’ models of participatory policy-making: the rationalist, the communicative incremental and the mixed model, which we expect have different implications for legitimacy. We conclude that the Cameroonian process is closest...

Parents' and Physicians' Perceptions of Children's Participation in Decision-making in Paediatric Oncology: A Quantitative Study.

Science.gov (United States)

Rost, Michael; Wangmo, Tenzin; Niggli, Felix; Hartmann, Karin; Hengartner, Heinz; Ansari, Marc; Brazzola, Pierluigi; Rischewski, Johannes; Beck-Popovic, Maja; Kühne, Thomas; Elger, Bernice S

2017-12-01

The goal is to present how shared decision-making in paediatric oncology occurs from the viewpoints of parents and physicians. Eight Swiss Pediatric Oncology Group centres participated in this prospective study. The sample comprised a parent and physician of the minor patient (decision-making on the part of the children. A patient's age and gender predicted involvement. Older children and girls were more likely to be involved. In the decision-making process, parents held a less active role than they actually wanted. Physicians should take measures to ensure that provided information is understood correctly. Furthermore, they should work towards creating awareness for systematic differences between parents and physicians with respect to the perception of the child, the disease, and shared decision-making.

Public Participation: Lessons from the Case Study Record

Energy Technology Data Exchange (ETDEWEB)

Beierle, Thomas C.; Cayford, Jerry [Resources for the Future, Washington, DC (United States)

2001-07-01

Public participation has received increasing attention in environmental policy making world wide. Yet research has been inadequate to answer fundamental questions about how successful past programs have been, what factors lead to success, and where efforts to improve public involvement should focus. To address these questions, we examine the case study record of public participation efforts in the United States over the last 30 years. We evaluate the success of numerous examples of public participation in environmental decision making and identify the factors that lead to success. The paper deals with a number of themes, including: The extent to which participation can incorporate public values into decision making, improve the substantive quality of decisions, reduce conflict, increase trust in institutions, and educate and inform the public; What can be expected from different approaches to public participation, such as public meetings, advisory committees, and mediation; The relative importance of the participatory process vs. the context in which participation takes place; Procedural features of particular importance; and The relationship between participation and implementation. The paper provides general results that can be used to guide the improvement of public participation programs, support assessment of innovative methods, and advance the theoretical understanding of public participation.

Public Participation: Lessons from the Case Study Record

International Nuclear Information System (INIS)

Beierle, Thomas C.; Cayford, Jerry

2001-01-01

Public participation has received increasing attention in environmental policy making world wide. Yet research has been inadequate to answer fundamental questions about how successful past programs have been, what factors lead to success, and where efforts to improve public involvement should focus. To address these questions, we examine the case study record of public participation efforts in the United States over the last 30 years. We evaluate the success of numerous examples of public participation in environmental decision making and identify the factors that lead to success. The paper deals with a number of themes, including: The extent to which participation can incorporate public values into decision making, improve the substantive quality of decisions, reduce conflict, increase trust in institutions, and educate and inform the public; What can be expected from different approaches to public participation, such as public meetings, advisory committees, and mediation; The relative importance of the participatory process vs. the context in which participation takes place; Procedural features of particular importance; and The relationship between participation and implementation. The paper provides general results that can be used to guide the improvement of public participation programs, support assessment of innovative methods, and advance the theoretical understanding of public participation

Patients' participation in decision-making in the medical field--'projectification' of patients in a neoliberal framed healthcare system.

Science.gov (United States)

Glasdam, Stinne; Oeye, Christine; Thrysoee, Lars

2015-10-01

This article focuses on patients' participation in decision-making in meetings with healthcare professionals in a healthcare system, based on neoliberal regulations and ideas. Drawing on two constructed empirical cases, primarily from the perspective of patients, this article analyses and discusses the clinical practice around decision-making meetings within a Foucauldian perspective. Patients' participation in decision-making can be seen as an offshoot of respect for patient autonomy. A treatment must be chosen, when patients consult physicians. From the perspective of patients, there is a tendency for healthcare professionals to supply the patients with the information that they think are necessary for them to make their own decision. But patients do not always want to be a 'customer' in the healthcare system; they want to be a patient, consulting an expert for help and advice, which creates resistance to some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal framework and medical logic. The decision-making competence in relation to the choice of treatment is placed away from the professionals and seen as belonging to the patient. A 'projectification' of the patient occurs, whereby the patient becomes responsible for his/her choices in treatment and care and the professionals support him/her with knowledge, preferences, and alternative views, out of which he/she must make his/her own choices, and the responsibility for those choices now and in the future. At the same time, there is a tendency towards de-professionalization. In that light, participation of patients in decision-making can be regarded as a tacit governmentality strategy that shapes the location of responsibility between individual and society, and independent patients and healthcare professionals, despite the basically desirable, appropriate, and necessary idea of involving patients in their own

Faculty in Faith-Based Institutions: Participation in Decision-Making and Its Impact on Job Satisfaction

Science.gov (United States)

Metheny, Glen A.; West, G. Bud; Winston, Bruce E.; Wood, J. Andy

2015-01-01

This study examined full-time faculty in Christian, faith-based colleges and universities and investigated the type of impact their participation in the decision-making process had on job satisfaction. Previous studies have examined relationships among faculty at state universities and community colleges, yet little research has been examined in…

Evolution of public participation in the assessment and management of environmental health risks: a brief history of developments in the United States.

Science.gov (United States)

Sexton, Ken

2013-09-02

Significance for public healthRisk-based decision making is a core feature of government actions aimed at protecting public health from the adverse effects of environmental hazards. In the past, it has often been an expert-driven, mostly obscure process used by federal agencies to justify and defend regulatory decisions made outside the public arena. But the nature of decision making has changed as it has become apparent that environmental health problems are more complicated, controversial, and costly to solve than originally thought. Meaningful public engagement is now an inherent component of all phases of the risk assessment - risk management paradigm because it promotes stakeholder buy in, taps into unique stakeholder knowledge, and promotes the concept of environmental democracy.In the United States, the risk assessment - risk management paradigm that underpins federal decisions about environmental health risks was first established in 1983. In the beginning, the importance of public participation was not explicitly recognized within the paradigm. Over time, however, it has become evident that not only must risk-based decisions be founded on the best available scientific knowledge and understanding, but also that they must take account of the knowledge, values, and preferences of interested and affected parties, including community members, business people, and environmental advocates. This article examines the gradually expanding role of public participation in risk-based decision making in the United States, and traces its evolution from a peripheral issue labeled as an external pressure to an integral element of the 21st century risk assessment - risk management paradigm. Today, and into the foreseeable future, public participation and stakeholder involvement are intrinsic features of the emerging American regulatory landscape, which emphasizes collaborative approaches for achieving cooperative and cost-effective solutions to complicated and often

Differential participation in formative assessment and achievement in introductory calculus

OpenAIRE

Dibbs, Rebecca-Anne

2015-01-01

International audience; Prior formative assessment research has shown positive achievement gains when classes using formative assessment are compared to classes that do not. However, little is known about what, if any, benefits of formative assessment occur within a class. The purpose of this study was to investigate the achievement of the students in introductory calculus using formative assessment at the two different participation levels observed in class. Although there was no significant...

Development of Public Participation in Strategic Environmental Impact Assessment%公众参与在战略环境影响评价中的发展研究

Institute of Scientific and Technical Information of China (English)

孙明宇; 张金荻

2016-01-01

公众参与是战略环境影响评价的一个显著的特点,公众参与使得决策制定过程具有更公开、更透明化的特点,同时也使得利益相关者和受影响的人群更容易接受规划和项目的实施.概述了公众参与在战略环境评价的理论发展过程,列举了近年来战略环境影响评价公众参与在国外的实践经验,讨论了中国公众参与在战略环境影响评价的研究成果,最后提出了完善中国战略环境影响评价公众参与制度的合理建议.%Public participation is a significant characteristic of Strategic Environmental Assessment. Public participation in the decision-making process has the characteristics of more open and more transparent. At the same time, public participation also makes the stakeholders and the affected people are more likely to accept the planning and project implementation. This paper summarizes development of public participation in strategic environmental assessment process on the theory, enumerates the public participation the practice experience of abroad in strategic environmental impact assessment in recent years, discusses the exist-ence question of the public participation in strategic environmental impact assessment in China. It finally proposes consummates Chinese strategic public participation in environmental impact assessment system of reasonable suggestions.

Decision-Making Process Related to Participation in Phase I Clinical Trials: A Nonsystematic Review of the Existing Evidence.

Science.gov (United States)

Gorini, Alessandra; Mazzocco, Ketti; Pravettoni, Gabriella

2015-01-01

Due to the lack of other treatment options, patient candidates for participation in phase I clinical trials are considered the most vulnerable, and many ethical concerns have emerged regarding the informed consent process used in the experimental design of such trials. Starting with these considerations, this nonsystematic review is aimed at analyzing the decision-making processes underlying patients' decision about whether to participate (or not) in phase I trials in order to clarify the cognitive and emotional aspects most strongly implicated in this decision. Considering that there is no uniform decision calculus and that many different variables other than the patient-physician relationship (including demographic, clinical, and personal characteristics) may influence patients' preferences for and processing of information, we conclude that patients' informed decision-making can be facilitated by creating a rigorously developed, calibrated, and validated computer tool modeled on each single patient's knowledge, values, and emotional and cognitive decisional skills. Such a tool will also help oncologists to provide tailored medical information that is useful to improve the shared decision-making process, thereby possibly increasing patient participation in clinical trials. © 2015 S. Karger AG, Basel.

'Walking the tightrope': The role of peer support workers in facilitating consumers' participation in decision-making.

Science.gov (United States)

Cleary, Michelle; Raeburn, Toby; Escott, Phil; West, Sancia; Lopez, Violeta

2018-05-09

In adult mental health services, the participation of consumers is essential. The aim of this study was to explore the challenges faced by peer support workers when involving mental health consumers in decision-making about their care and the strategies they employed to overcome these challenges so as to improve mental health consumers' participation in decision-making and recovery. Semi-structured individual interviews were conducted with six peer support workers currently employed in psychiatric hospitals and/or community mental health systems. Thematic analysis identified challenges related to role definition, power imbalance, doctor-centric medical approaches to care, and lack of resources. Strategies to overcome these challenges that were reported, included the following: facilitating meaningful involvement for service users, appropriate use of the lived experience, building relationships and communication, promoting rights and advocacy, and promoting professionalism of peer support workers (PSWs). Nursing staff need ongoing support and education to understand and value the varied roles of PSWs and thereby empower PSWs to engage in enhancing consumer decision-making. The roles of the PSWs should be viewed as complementary, and greater appreciation and understanding of roles would better support recovery-oriented care. © 2018 Australian College of Mental Health Nurses Inc.

Public preferences for engagement in Health Technology Assessment decision-making: protocol of a mixed methods study.

Science.gov (United States)

Wortley, Sally; Tong, Allison; Lancsar, Emily; Salkeld, Glenn; Howard, Kirsten

2015-07-14

Much attention in recent years has been given to the topic of public engagement in health technology assessment (HTA) decision-making. HTA organizations spend substantial resources and time on undertaking public engagement, and numerous studies have examined challenges and barriers to engagement in the decision-making process however uncertainty remains as to optimal methods to incorporate the views of the public in HTA decision-making. Little research has been done to ascertain whether current engagement processes align with public preferences and to what extent their desire for engagement is dependent on the question being asked by decision-makers or the characteristics of the decision. This study will examine public preferences for engagement in Australian HTA decision-making using an exploratory mixed methods design. The aims of this study are to: 1) identify characteristics about HTA decisions that are important to the public in determining whether public engagement should be undertaken on a particular topic, 2) determine which decision characteristics influence public preferences for the extent, or type of public engagement, and 3) describe reasons underpinning these preferences. Focus group participants from the general community, aged 18-70 years, will be purposively sampled from the Australian population to ensure a wide range of demographic groups. Each focus group will include a general discussion on public engagement as well as a ranking exercise using a modified nominal group technique (NGT). The NGT will inform the design of a discrete choice study to quantitatively assess public preferences for engagement in HTA decision-making. The proposed research seeks to investigate under what circumstances and how the public would like their views and preferences to be considered in health technology assessments. HTA organizations regularly make decisions about when and how public engagement should occur but without consideration of the public's preferences on

Congruence between patients' preferred and perceived participation in medical decision-making: a review of the literature

NARCIS (Netherlands)

Brom, L.; Hopmans, W.; Pasman, H.R.W.; Timmermans, D.R.M.; Widdershoven, G.A.M.; Onwuteaka-Philipsen, B.D.

2014-01-01

Background: Patients are increasingly expected and asked to be involved in health care decisions. In this decision-making process, preferences for participation are important. In this systematic review we aim to provide an overview the literature related to the congruence between patients'

Assessing choice making among children with multiple disabilities.

OpenAIRE

Sigafoos, J; Dempsey, R

1992-01-01

Some learners with multiple disabilities display idiosyncratic gestures that are interpreted as a means of making choices. In the present study, we assessed the validity of idiosyncratic choice-making behaviors of 3 children with multiple disabilities. Opportunities for each child to choose between food and drink were provided under two conditions. In one condition, the children were given the food or drink item corresponding to their prior choice. In the other condition, the teacher delivere...

Making Intercultural Language Learning Visible and Assessable

Science.gov (United States)

Moloney, Robyn; Harbon, Lesley

2010-01-01

While languages education (Liddicoat, 2002) is being transformed by intercultural language learning theory, there is little illustration of either how students are achieving intercultural learning or how to assess it. This article reports on a study of high school language students in Sydney, Australia. Its findings make visible student…

"The Dose Makes the Poison": Informing Consumers About the Scientific Risk Assessment of Food Additives.

Science.gov (United States)

Bearth, Angela; Cousin, Marie-Eve; Siegrist, Michael

2016-01-01

Intensive risk assessment is required before the approval of food additives. During this process, based on the toxicological principle of "the dose makes the poison,ˮ maximum usage doses are assessed. However, most consumers are not aware of these efforts to ensure the safety of food additives and are therefore sceptical, even though food additives bring certain benefits to consumers. This study investigated the effect of a short video, which explains the scientific risk assessment and regulation of food additives, on consumers' perceptions and acceptance of food additives. The primary goal of this study was to inform consumers and enable them to construct their own risk-benefit assessment and make informed decisions about food additives. The secondary goal was to investigate whether people have different perceptions of food additives of artificial (i.e., aspartame) or natural origin (i.e., steviolglycoside). To attain these research goals, an online experiment was conducted on 185 Swiss consumers. Participants were randomly assigned to either the experimental group, which was shown a video about the scientific risk assessment of food additives, or the control group, which was shown a video about a topic irrelevant to the study. After watching the video, the respondents knew significantly more, expressed more positive thoughts and feelings, had less risk perception, and more acceptance than prior to watching the video. Thus, it appears that informing consumers about complex food safety topics, such as the scientific risk assessment of food additives, is possible, and using a carefully developed information video is a successful strategy for informing consumers. © 2015 Society for Risk Analysis.

Decision making in healthy participants on the Iowa Gambling Task: new insights from an operant approach.

Science.gov (United States)

Bull, Peter N; Tippett, Lynette J; Addis, Donna Rose

2015-01-01

The Iowa Gambling Task (IGT) has contributed greatly to the study of affective decision making. However, researchers have observed high inter-study and inter-individual variability in IGT performance in healthy participants, and many are classified as impaired using standard criteria. Additionally, while decision-making deficits are often attributed to atypical sensitivity to reward and/or punishment, the IGT lacks an integrated sensitivity measure. Adopting an operant perspective, two experiments were conducted to explore these issues. In Experiment 1, 50 healthy participants completed a 200-trial version of the IGT which otherwise closely emulated Bechara et al.'s (1999) original computer task. Group data for Trials 1-100 closely replicated Bechara et al.'s original findings of high net scores and preferences for advantageous decks, suggesting that implementations that depart significantly from Bechara's standard IGT contribute to inter-study variability. During Trials 101-200, mean net scores improved significantly and the percentage of participants meeting the "impaired" criterion was halved. An operant-style stability criterion applied to individual data revealed this was likely related to individual differences in learning rate. Experiment 2 used a novel operant card task-the Auckland Card Task (ACT)-to derive quantitative estimates of sensitivity using the generalized matching law. Relative to individuals who mastered the IGT, persistent poor performers on the IGT exhibited significantly lower sensitivity to magnitudes (but not frequencies) of rewards and punishers on the ACT. Overall, our findings demonstrate the utility of operant-style analysis of IGT data and the potential of applying operant concurrent-schedule procedures to the study of human decision making.

Neonatologists can impede or support parents' participation in decision-making during medical rounds in neonatal intensive care units.

Science.gov (United States)

Axelin, Anna; Outinen, Jyri; Lainema, Kirsi; Lehtonen, Liisa; Franck, Linda S

2018-05-03

We explored the dynamics of neonatologist-parent communication and decision-making during medical rounds in a level three neonatal intensive care unit. This was a qualitative study, with an ethnographic approach, that was conducted at Turku University Hospital, Finland, from 2013-2014. We recruited eight mothers and seven couples, their 11 singletons and four sets of twins and two neonatologists and observed and video recorded 15 medical rounds. The infants were born at 23+5 to 40+1 weeks and the parents were aged 24-47. The neonatologists and parents were interviewed separately after the rounds. Four patterns of interaction emerged. The collaborative pattern was most consistent, with the ideal of shared decision-making, as the parents' preferences were genuinely and visibly integrated into the treatment decisions. In the neonatologist-led interactional pattern, the decision-making process was only somewhat inclusive of the parents' observations and preferences. The remaining two patterns, emergency and disconnected, were characterised by a paternalistic decision-making model where the parents' observations and preferences had minimal to no influence on the communication or decision-making. The neonatologists played a central role in facilitating parental participation and their interaction during medical rounds were characterised by the level of parent participation in decision-making. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Scoping and public participation in the environmental impact assessment: Finnish experiences

International Nuclear Information System (INIS)

Leskinen, A.

2002-01-01

Environmental Impact Assessment (EIA) is a process that produces information for decision making. Therefore it can be described as planning. It is also a systematic way to compare alternative options. One major lesson learned during the early years of EIA was that everything cannot and should not be assessed. The first reports of the assessments in the US were massive documents that were of very limited use in decision making. Therefore the scoping-phase was adopted. The aim of scoping is to focus on important issues at the beginning of the EIA-process. I try to shed some light to the importance of the scoping or programming phase of the process. (author)

Relationship of Teachers' Readiness for Change with Their Participation in Decision Making and School Culture

Science.gov (United States)

Inandi, Yusuf; Giliç, Fahrettin

2016-01-01

The aim of this research is to study the relationship between primary school teachers' level of participation in decision making, school culture and their level of readiness for change. The data in the study were collected from 597 primary school teachers (304 men and 293 women) in central districts of Mersin in 2014 spring semester. Participation…

Making assessments while taking repeated risks: a pattern of multiple response pathways.

Science.gov (United States)

Pleskac, Timothy J; Wershbale, Avishai

2014-02-01

Beyond simply a decision process, repeated risky decisions also require a number of cognitive processes including learning, search and exploration, and attention. In this article, we examine how multiple response pathways develop over repeated risky decisions. Using the Balloon Analogue Risk Task (BART) as a case study, we show that 2 different response pathways emerge over the course of the task. The assessment pathway is a slower, more controlled pathway where participants deliberate over taking a risk. The 2nd pathway is a faster, more automatic process where no deliberation occurs. Results imply the slower assessment pathway is taken as choice conflict increases and that the faster automatic response is a learned response. Based on these results, we modify an existing formal cognitive model of decision making during the BART to account for these dual response pathways. The slower more deliberative response process is modeled with a sequential sampling process where evidence is accumulated to a threshold, while the other response is given automatically. We show that adolescents with conduct disorder and substance use disorder symptoms not only evaluate risks differently during the BART but also differ in the rate at which they develop the more automatic response. More broadly, our results suggest cognitive models of judgment decision making need to transition from treating observed decisions as the result of a single response pathway to the result of multiple response pathways that change and develop over time.

Role of Informed Consent in a Decision-making on Participation in The Clinical Trial: Multicenter study in Russia “Face to Face”

Directory of Open Access Journals (Sweden)

O. I. Zvonareva

2016-01-01

Full Text Available Introduction. Currently, clinical trials (CT remain the only technology, which provides proof of efficacy and safety of new drugs and their subsequent release to the market. Medical researcher and informed consent (IC are the main (and often the only source of information for the patient about the upcoming clinical trials, and thus have a direct impact on the perception of clinical trials, and on the patient’s decision about participation. However, the degree of influence of these factors on the clinical trials participants still remains unclear.Materials and methods. A multicenter cross-sectional study was conducted in different cities of the Russian Federation. Patients who had previous experience in CTs (or were enrolled in a CT at the time of this study were asked to complete a questionnaire.Results. To assess the impact of researcher, all respondents were divided into 2 groups: patients that acquainted with IC in collaboration with the researcher, and the other group, which reviewed IC form independently. We evaluated the importance of the factors influencing the decision-making process on participation in clinical trials. According to our data, the most important factors were professional monitoring services (3,72 ± 1,00, regular condition monitoring (3,66 ± 0,98, and better medical care (3,62 ± 1,00. These factors were evaluated at significantly lower score by group of patients that acquainted with IC together with the researcher (3,55 ±0,94, vs 4,01 ± 0,90, p = 0,002; 3,52 ± 1,01 vs 3,87 ± 0,90, p = 0,040; 3,49 ± 0,94, vs 3,83 ± 1,06, p = 0,020 respectively. In assessing the factors that had negative impact on the interest in participating in a clinical trial, the most significant were risk of side effects (3,01 ± 1,27, study of new medication (2,68 ± 1,21, and the risk of getting into the placebo group (2,64 ± 1,34 (so-called “objective” risk factors. At the same time, risk of side effects and risk of

Decision-making by adolescents and parents of children with cancer regarding health research participation.

Science.gov (United States)

Read, Kate; Fernandez, Conrad Vincent; Gao, Jun; Strahlendorf, Caron; Moghrabi, Albert; Pentz, Rebecca Davis; Barfield, Raymond Carlton; Baker, Justin Nathaniel; Santor, Darcy; Weijer, Charles; Kodish, Eric

2009-09-01

Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer. This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their own research participation and cited factors that would influence their own decision to participate in, or to provide parental authorization for their child to participate in health research. Completed questionnaire rates for AYAs and parents were 86 (46.5%) of 185 and 409 (65.2%) of 627, respectively. AYAs (n = 86 [67%]) and parents (n = 409 [85%]) cited that they would participate in research because it would help others. AYAs perceived pressure by their family and friends (16%) and their physician (19%). Having too much to think about at the time of accrual was an impediment to both groups (36% AYAs and 47% parents). The main deterrent for AYAs was that research would take up too much time (45%). Nonwhite parents (7 of 56 [12.5%]) were more apt to decline than white parents (12 of 32 [3.7%]; P < .01). AYAs identified time commitment and having too much to think about as significant impediments to research participation. Addressing these barriers by minimizing time requirements and further supporting decision-making may improve informed consent and impact on enrollment in trials.

Balancing Optimal Assessment with Part-Time Faculty Participation: A Discipline's Dilemma

Science.gov (United States)

Danley-Scott, Jennifer; Tompsett-Makin, Deborah

2013-01-01

Part-time faculty need to be brought into the student learning outcomes assessment loop not only to help accreditation, but because they, like full-time faculty, can benefit from assessment. When part-time faculty are not participating in assessment, a sizable percentage of courses are being less effectively taught than they could be. In an…

Evaluation and selection of decision-making methods to assess landfill mining projects.

Science.gov (United States)

Hermann, Robert; Baumgartner, Rupert J; Vorbach, Stefan; Ragossnig, Arne; Pomberger, Roland

2015-09-01

For the first time in Austria, fundamental technological and economic studies on recovering secondary raw materials from large landfills have been carried out, based on the 'LAMIS - Landfill Mining Austria' pilot project. A main focus of the research - and the subject of this article - was to develop an assessment or decision-making procedure that allows landfill owners to thoroughly examine the feasibility of a landfill mining project in advance. Currently there are no standard procedures that would sufficiently cover all the multiple-criteria requirements. The basic structure of the multiple attribute decision making process was used to narrow down on selection, conceptual design and assessment of suitable procedures. Along with a breakdown into preliminary and main assessment, the entire foundation required was created, such as definitions of requirements to an assessment method, selection and accurate description of the various assessment criteria and classification of the target system for the present 'landfill mining' vs. 'retaining the landfill in after-care' decision-making problem. Based on these studies, cost-utility analysis and the analytical-hierarchy process were selected from the range of multiple attribute decision-making procedures and examined in detail. Overall, both methods have their pros and cons with regard to their use for assessing landfill mining projects. Merging these methods or connecting them with single-criteria decision-making methods (like the net present value method) may turn out to be reasonable and constitute an appropriate assessment method. © The Author(s) 2015.

European Portuguese adaptation and validation of dilemmas used to assess moral decision-making.

Science.gov (United States)

Fernandes, Carina; Gonçalves, Ana Ribeiro; Pasion, Rita; Ferreira-Santos, Fernando; Paiva, Tiago Oliveira; Melo E Castro, Joana; Barbosa, Fernando; Martins, Isabel Pavão; Marques-Teixeira, João

2018-03-01

Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are "morally acceptable" elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments.

European Portuguese adaptation and validation of dilemmas used to assess moral decision-making

Directory of Open Access Journals (Sweden)

Carina Fernandes

2018-04-01

Full Text Available Abstract Objective To adapt and validate a widely used set of moral dilemmas to European Portuguese, which can be applied to assess decision-making. Moreover, the classical formulation of the dilemmas was compared with a more focused moral probe. Finally, a shorter version of the moral scenarios was tested. Methods The Portuguese version of the set of moral dilemmas was tested in 53 individuals from several regions of Portugal. In a second study, an alternative way of questioning on moral dilemmas was tested in 41 participants. Finally, the shorter version of the moral dilemmas was tested in 137 individuals. Results Results evidenced no significant differences between English and Portuguese versions. Also, asking whether actions are “morally acceptable” elicited less utilitarian responses than the original question, although without reaching statistical significance. Finally, all tested versions of moral dilemmas exhibited the same pattern of responses, suggesting that the fundamental elements to the moral decision-making were preserved. Conclusions We found evidence of cross-cultural validity for moral dilemmas. However, the moral focus might affect utilitarian/deontological judgments.

Making and maintaining lifestyle changes after participating in group based type 2 diabetes self-management educations: a qualitative study.

Directory of Open Access Journals (Sweden)

Marit B Rise

Full Text Available BACKGROUND: Disease management is crucial in type 2 diabetes. Diabetes self-management education aims to provide the knowledge necessary to make and maintain lifestyle changes. However, few studies have investigated the processes after such courses. The aim of this study was to investigate how participants make and maintain lifestyle changes after participating in group-based type 2 diabetes self-management education. METHODS: Data was collected through qualitative semi-structured interviews with 23 patients who attended educational group programs in Central Norway. The participants were asked how they had used the advice given and what they had changed after the course. RESULTS: Knowledge was essential for making lifestyle changes following education. Three factors affected whether lifestyle changes were implemented: obtaining new knowledge, taking responsibility, and receiving confirmation of an already healthy lifestyle. Four factors motivated individuals to maintain changes: support from others, experiencing an effect, fear of complications, and the formation of new habits. CONCLUSION: Knowledge was used to make and maintain changes in diet, medication and physical activity. Knowledge also acted as confirmation of an already adequate lifestyle. Knowledge led to no changes if diabetes appeared "not that scary" or if changes appeared too time consuming. Those involved in diabetes education need to be aware of the challenges in convincing asymptomatic patients about the benefits of adherence to self-management behaviour.

Decision Making in Healthy Participants on the Iowa Gambling Task: New Insights from an Operant Approach

Directory of Open Access Journals (Sweden)

Peter eBull

2015-04-01

Full Text Available The Iowa Gambling Task (IGT has contributed greatly to the study of affective decision making. However, researchers have observed high inter-study and inter-individual variability in IGT performance in healthy participants, and many are classified as impaired using standard criteria. Additionally, while decision-making deficits are often attributed to atypical sensitivity to reward and/or punishment, the IGT lacks an integrated sensitivity measure. Adopting an operant perspective, two experiments were conducted to explore these issues. In Experiment 1, 50 healthy participants completed a 200-trial version of the IGT which otherwise closely emulated Bechara et al.’s (1999 original computer task. Group data for Trials 1-100 closely replicated Bechara et al.’s original findings of high net scores and preferences for advantageous decks, suggesting that implementations that depart significantly from Bechara’s standard IGT contribute to inter-study variability. During Trials 101-200, mean net scores improved significantly and the percentage of participants meeting the impaired criterion was halved. An operant-style stability criterion applied to individual data revealed this was likely related to individual differences in learning rate. Experiment 2 used a novel operant card task—the Auckland Card Test (ACT—to derive quantitative estimates of sensitivity using the generalized matching law. Relative to individuals who mastered the IGT, persistent poor performers on the IGT exhibited significantly lower sensitivity to magnitudes (but not frequencies of rewards and punishers on the ACT. Overall, our findings demonstrate the utility of operant-style analysis of IGT data and the potential of applying operant concurrent-schedule procedures to the study of human decision making.

Jordanian Physicians' Attitudes toward Disclosure of Cancer Information and Patient Participation in Treatment Decision-making.

Science.gov (United States)

Obeidat, Rana; Khrais, Huthaifah I

2016-01-01

This study aims to determine the attitude of Jordanian physicians toward disclosure of cancer information, comfort and use of different decision-making approaches, and treatment decision making. A descriptive, comparative research design was used. A convenience sample of 86 Jordanian medical and radiation oncologists and surgeons practicing mainly in oncology was recruited. A modified version of a structured questionnaire was used for data collection. The questionnaire is a valid measure of physicians' views of shared decision making. Almost 91% of all physicians indicated that the doctor should tell the patient and let him/her decide if the family should know of an early-stage cancer diagnosis. Physicians provide abundant information about the extent of the disease, the side effects and benefits of the treatment, and details of the treatment procedures. They also provided less information on the effects of treatment on the sexuality, mood, and family of the patient. Almost 48% of the participating physicians reported using shared decision making as their usual approach for treatment decision making, and 67% reported that they were comfortable with this approach. The main setting of clinical activity was the only factor associated with physicians' usual approach to medical decision making. Moreover, age, years of experience, and main setting of clinical activity were associated with physicians' comfort level with the shared approach. Although Jordanian physicians appreciate patient autonomy, self-determination, and right to information, paternalistic decision making and underuse of the shared decision-making approach persist. Strategies that target both healthcare providers and patients must be employed to promote shared decision making in the Jordanian healthcare system.

The Participation and Decision Making of "At Risk" Youth in Community Music Projects: An Exploration of Three Case Studies

Science.gov (United States)

Rimmer, Mark

2012-01-01

In the UK, recent years have witnessed a considerable growth in youth participation activities that seek to involve children and young people in various forms of decision-making. One such form of youth participation to benefit from increased government support since the late 1990s concerns community arts activities, especially those targeting…

Need for public participation in decision-making on energy; Necesidad de la participacion publica en la toma de decisiones en materia energetica

Energy Technology Data Exchange (ETDEWEB)

Norte Gomez, M. D.

2014-07-01

This paper outlines the need to expand and improve public participation in decision-making on energy. In an advanced society like ours you can not continue using the same tools they used a century ago. Provide and transmit by the scientific community to society, information science and technology in an appropriate language that comes to them, giving them opportunities and enabling them to participate objectively in this decision making. There must be a legitimate, honest, sincere and plural debate where the participation of all the actors involved and from all strata of society. (Author)

Participation of the elderly after vision loss

NARCIS (Netherlands)

Alma, M.A.; Mei, van der S.F.; Melis-Dankers, B.J.M.; Tilburg, van T.G.; Groothoff, J.W.; Suurmeijer, T.P.B.M.

2011-01-01

Purpose. To assess the degree of participation of the visually impaired elderly and to make a comparison with population-based reference data. Method. This cross-sectional study included visually impaired elderly persons (≥55 years; n=173) who were referred to a low-vision rehabilitation centre.

Multiple factors, including non-motor impairments, influence decision making with regard to exercise participation in Parkinson's disease: a qualitative enquiry.

Science.gov (United States)

O'Brien, Christine; Clemson, Lindy; Canning, Colleen G

2016-01-01

To explore how the meaning of exercise and other factors interact and influence the exercise behaviour of individuals with Parkinson's disease (PD) enrolled in a 6-month minimally supervised exercise program to prevent falls, regardless of whether they completed the prescribed exercise or not. This qualitative study utilised in-depth semi-structured interviews analysed using grounded theory methodology. Four main themes were constructed from the data: adapting to change and loss, the influence of others, making sense of the exercise experience and hope for a more active future. Participation in the PD-specific physiotherapy program involving group exercise provided an opportunity for participants to reframe their identity of their "active" self. Three new influences on exercise participation were identified and explored: non-motor impairments of apathy and fatigue, the belief in a finite energy quota, and the importance of feedback. A model was developed incorporating the themes and influences to explain decision-making for exercise participation in this group. Complex and interacting issues, including non-motor impairments, need to be considered in order to enhance the development and ongoing implementation of effective exercise programmes for people with PD. Exercise participation can assist individuals to reframe their identity as they are faced with losses associated with Parkinson's disease and ageing. Non-motor impairments of apathy and fatigue may influence exercise participation in people with Parkinson's disease. Particular attention needs to be paid to the provision of feedback in exercise programs for people with Parkinson's disease as it important for their decision-making about continuing exercise.

[Social participation in mental health: space of construction of citizenship, policy formulation and decision making].

Science.gov (United States)

Guimarães, José Maria Ximenes; Jorge, Maria Salete Bessa; Maia, Regina Claudia Furtado; de Oliveira, Lucia Conde; Morais, Ana Patrícia Pereira; Lima, Marcos Paulo de Oliveira; Assis, Marluce Maria Araújo; dos Santos, Adriano Maia

2010-07-01

The article approaches the comprehension of professionals that act in the mental health area about the movement of construction of social participation in the health system of Fortaleza, Ceará State. The methodology adopted is based upon qualitative approach. The study was developed with semi-structured interviews with 17 mental health professionals of the city above mentioned. The empirical data was analyzed through the technique of thematic content analysis, where it was identified three cores of analysis: social participation as space of citizenship and policy formulation; oriented to attention of collective needs; and decision taking. The study reveals that social participation represents a possibility of amplifying X the relations between the Civil Society and the State, which makes possible the social intervention in proposals of the health policies. It is highlighted the right to health linked to the consolidation of democracy in the attention to the needs and collective edification.

Worker participation - the Netherlands

OpenAIRE

Kwantes, J.H.

2014-01-01

Worker participation relates to the involvement of workers in the management decision-making processes. In this article attention is focused on worker participation related to occupational safety and health in the Netherlands. Worker participation can refer either to direct or indirect participation by the worker. Indirect participation involves employee representation, while direct participation relates to individual involvement in management’s decision-making processes. In the Framework Dir...

Assessing Stakeholder Participation in Sub-Arctic Co-Management: Administrative Rulemaking and Private Agreements

Directory of Open Access Journals (Sweden)

Sari M. Graben

2011-02-01

Full Text Available This paper argues that participatory governance initiatives like co-management can be made effective through agency rulemaking. Using the Mackenzie Valley Environmental Impact Review Board as a case study, this paper affirms that it is possible for marginalized stakeholders to participate in co-management and alter decision-making. By using its formal authority to generate rules that reflect community perspectives, this board contextualized environmental assessment in community-based perspectives. The study of participation presented here illustrates: 1 that a high level of agency support for community participation in rule-making can lead to rules which reflect community perspectives; and 2 that agency implementation of community perspectives has led to the increased use of stakeholder collaboration through private agreement. Nonetheless, the paper also addresses limitations on the ability to translate social needs into privately negotiated agreements where negotiations depart from highly commoditized terms. Consequently, this paper questions the use of negotiated agreements to meet the goals of stakeholder participation, as conceived by deliberative democratic strands of new governance. Dans cet article, l’auteure soutient que le pouvoir de règlementation d’un organisme peut rendre plus efficace de nouvelles initiatives en matière de gouvernance telles que la cogestion. Prenant l’Office d’examen des répercussions environnementales de la vallée du Mackenzie comme exemple, elle affirme que des parties prenantes marginalisées ont la possibilité de participer à de nouvelles modalités de gouvernance comme la cogestion et d’influer sur la prise de décision. En exerçant son pouvoir d’adopter des règles inspirées des valeurs communautaires, l’Office a procédé à une évaluation environnementale en tenant compte du contexte communautaire. L’étude de participation présentée ici démontre: 1 que, lorsqu’un organisme

Assessments of the extent to which health-care providers involve patients in decision making: a systematic review of studies using the OPTION instrument.

Science.gov (United States)

Couët, Nicolas; Desroches, Sophie; Robitaille, Hubert; Vaillancourt, Hugues; Leblanc, Annie; Turcotte, Stéphane; Elwyn, Glyn; Légaré, France

2015-08-01

We have no clear overview of the extent to which health-care providers involve patients in the decision-making process during consultations. The Observing Patient Involvement in Decision Making instrument (OPTION) was designed to assess this. To systematically review studies that used the OPTION instrument to observe the extent to which health-care providers involve patients in decision making across a range of clinical contexts, including different health professions and lengths of consultation. We conducted online literature searches in multiple databases (2001-12) and gathered further data through networking. (i) OPTION scores as reported outcomes and (ii) health-care providers and patients as study participants. For analysis, we only included studies using the revised scale. Extracted data included: (i) study and participant characteristics and (ii) OPTION outcomes (scores, statistical associations and reported psychometric results). We also assessed the quality of OPTION outcomes reporting. We found 33 eligible studies, 29 of which used the revised scale. Overall, we found low levels of patient-involving behaviours: in cases where no intervention was used to implement shared decision making (SDM), the mean OPTION score was 23 ± 14 (0-100 scale). When assessed, the variables most consistently associated with higher OPTION scores were interventions to implement SDM (n = 8/9) and duration of consultations (n = 8/15). Whatever the clinical context, few health-care providers consistently attempt to facilitate patient involvement, and even fewer adjust care to patient preferences. However, both SDM interventions and longer consultations could improve this. © 2013 John Wiley & Sons Ltd.

Assessment and decision making for R and D programmes

Energy Technology Data Exchange (ETDEWEB)

Berg, P.; Lindberg, R.

1997-12-31

Tampere University of Technology (TUT) and Technology Development Centre (TEKES) has since 1993 been developing a new method for assessment and decision making for R and D programmes. The method has been adapted in several Finnish technology programmes. The method enables separate parties of R and D programme to specify their projects in relation with the entire programme. It also links objectives with a measurable assessment procedure and produces objective information for decision making. The method has been developed in co-operation with the University of Manchester. The method is divided into the following four parts: (1) preparation of the assessment strategy; (2) implementation of appraisal, (3) monitoring in the implementation phase, and (4) implementation and evaluation. The preparation of assessment strategy is divided into five parts: selection of strategy makers, determination of the scope of the strategy, selection of main assessment criteria, selection of main data collection methods and data sources, and output of assessment strategy. The implementation of appraisal is divided into six parts, which are mapping of the problems, selection of criteria to be assessed, selection of data sources, follow-up procedures, preparing the assessment plan for future, and analysis of results and reporting. The emphasis of the phase is on the appraisal of appropriateness of the goals. Monitoring in the implementation phase follows the same systematic procedure as previous part as well as implementation and evaluation. The emphasis in the last phase is on the evaluation of fulfilled outputs and impacts. (orig.)

Effects of subordinate feedback to the supervisor and participation in decision-making in the prediction of organizational support.

Science.gov (United States)

1992-03-01

The present study tested the hypothesis that participation in decision-making (PDM) and perceived effectiveness of subordinate feedback to the supervisor would contribute unique variance in the prediction of perceptions of organizational support. In ...

Attentional Filter Training but Not Memory Training Improves Decision-Making

OpenAIRE

Schmicker, Marlen; M?ller, Patrick; Schwefel, Melanie; M?ller, Notger G.

2017-01-01

Decision-making has a high practical relevance for daily performance. Its relation to other cognitive abilities such as executive control and memory is not fully understood. Here we asked whether training of either attentional filtering or memory storage would influence decision-making as indexed by repetitive assessments of the Iowa Gambling Task (IGT). The IGT was developed to assess and simulate real-life decision-making (Bechara et al., 2005). In this task, participants gain or lose money...

Students' and Teachers' Participation in Decision-Making and ...

African Journals Online (AJOL)

Results showed that students and teachers, irrespective of sex, indicated alike a low level of participation in administrative creative decisions which influenced their attitude to school work and school internal discipline. Furthermore, low level of participation was found to have significant unwholesome impact on their attitude ...

Management and Encouragement of Pupil Participation in Primary Education: A Qualitative Case Study

Directory of Open Access Journals (Sweden)

Daniel García-Pérez

2014-06-01

Full Text Available Our work focuses on the participation of students of primary education in decision-making. We carried out a qualitative case study of two public Primary schools with the aim of illustrating good models of student participation. On the one hand, our results highlight the opportunities resulting from the creation of specific structures of student participation, such as class and student councils, because they allow students to participate in collective rule-making, conflict management and the planning and evaluation of school and class activities. On the other hand, the results emphasize the contributions derived from the use of teaching methods that enhance student participation in decision making on academic issues by selecting contents, the inclusion of self-assessment processes and the self-organization of work time. Overall, the results obtained point out that it is feasible to organize the activity of a Primary Education center encouraging students to participate in decision making and they add evidence supported in the practice of two schools to progress in the study and promotion of school participation.

How to make participatory technology assessment in agriculture more 'participatory'

DEFF Research Database (Denmark)

Tavella, Elena

2016-01-01

the cultivation of new GM plants in Denmark. Furthermore, through this illustration, the term Participatory Technology Assessment (PTA) is redefined, thereby suggesting two additional aspects to assessing new technologies – following and evaluating policy making – to be considered in the conduct of PTA....

Patients' need for information provision and perceived participation in decision making in doctor-patient consultation: Micro-cultural differences between French- and Italian-speaking Switzerland.

Science.gov (United States)

Camerini, Anne-Linda; Schulz, Peter J

2016-03-01

To explore micro-cultural differences in patients' need for information provision, perceived participation in decision making, and related concepts during the doctor-patient consultation between French- and Italian-speaking patients in Switzerland. In 2012, 153 French- and 120 Italian-speaking patients with chronic low back pain (cLBP) were surveyed on their need for information provision, perceived participation in decision making, cLBP knowledge, psychological empowerment, and trust in their doctor. T-tests and regression analyses with interaction terms were performed. Results show that French- and Italian-speaking patients significantly differed in their participation in decision making, with French-speaking patients reporting higher involvement. Need for information provision was related to empowerment among French- and to trust among Italian-speaking patients. For participation in decision making, trust was the only related concept among French-, and cLBP knowledge among Italian-speaking patients. Significant interaction terms indicate a moderation of micro-cultural background. Findings point towards differences in the relationships between individual patient characteristics (i.e. knowledge, empowerment) and relational doctor-patient characteristics (i.e. trust) and patients' need for information provision and participation in decision making between French- and Italian-speaking patients in Switzerland. Doctors should be aware of these differences when dealing with patients of different micro-cultural backgrounds. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

5 CFR 892.207 - Can I make changes to my FEHB enrollment while I am participating in premium conversion?

Science.gov (United States)

2010-01-01

... OF PERSONNEL MANAGEMENT (CONTINUED) CIVIL SERVICE REGULATIONS (CONTINUED) FEDERAL FLEXIBLE BENEFITS PLAN: PRE-TAX PAYMENT OF HEALTH BENEFITS PREMIUMS Eligibility and Participation § 892.207 Can I make...

Measurement properties of instruments that assess participation in young people with autism spectrum disorder: a systematic review.

Science.gov (United States)

Lami, Francesca; Egberts, Kristine; Ure, Alexandra; Conroy, Rowena; Williams, Katrina

2018-03-01

To systematically review the measurement properties of instruments assessing participation in young people with autism spectrum disorder (ASD). A search was performed in MEDLINE, PsycINFO, and PubMed combining three constructs ('ASD', 'test of participation', 'measurement properties'). Results were restricted to articles including people aged 6 to 29 years. The 2539 identified articles were independently screened by two reviewers. For the included articles, data were extracted using standard forms and their risk of bias was assessed. Nine studies (8 cross-sectional) met the inclusion criteria, providing information on seven different instruments. The total sample included 634 participants, with sex available for 600 (males=494; females=106) and age available for 570, with mean age for these participants 140.58 months (SD=9.11; range=36-624). Included instruments were the school function assessment, vocational index, children's assessment of participation and enjoyment/preferences for activities of children, experience sampling method, Pediatric Evaluation of Disability Inventory, Computer Adaptive Test, adolescent and young adult activity card sort, and Patient-Reported Outcomes Measurement Information System parent-proxy peer relationships. Seven studies assessed reliability and validity; good properties were reported for half of the instruments considered. Most studies (n=6) had high risk of bias. Overall the quality of the evidence for each tool was limited. Validation of these instruments, or others that comprehensively assess participation, is needed. Future studies should follow recommended methodological standards. Seven instruments have been used to assess participation in young people with autism. One instrument, with excellent measurement properties in one study, does not comprehensively assess participation. Studies of three instruments that incorporate a more comprehensive assessment of participation have methodological limitations. Overall, limited

Do People Really Want Freedom of Choice? Assessing preferences of pension participants

NARCIS (Netherlands)

van Dalen, H.P.; Henkens, K.

2017-01-01

Reforms in private pension plans across the world are opening up more options for pension participants to make choices to suit their preferences. Freedom of choice is however not a unidimensional concept as it is commonly perceived by policy makers. People can value both the freedom to choose as

Value-based decision-making battery: A Bayesian adaptive approach to assess impulsive and risky behavior.

Science.gov (United States)

Pooseh, Shakoor; Bernhardt, Nadine; Guevara, Alvaro; Huys, Quentin J M; Smolka, Michael N

2018-02-01

Using simple mathematical models of choice behavior, we present a Bayesian adaptive algorithm to assess measures of impulsive and risky decision making. Practically, these measures are characterized by discounting rates and are used to classify individuals or population groups, to distinguish unhealthy behavior, and to predict developmental courses. However, a constant demand for improved tools to assess these constructs remains unanswered. The algorithm is based on trial-by-trial observations. At each step, a choice is made between immediate (certain) and delayed (risky) options. Then the current parameter estimates are updated by the likelihood of observing the choice, and the next offers are provided from the indifference point, so that they will acquire the most informative data based on the current parameter estimates. The procedure continues for a certain number of trials in order to reach a stable estimation. The algorithm is discussed in detail for the delay discounting case, and results from decision making under risk for gains, losses, and mixed prospects are also provided. Simulated experiments using prescribed parameter values were performed to justify the algorithm in terms of the reproducibility of its parameters for individual assessments, and to test the reliability of the estimation procedure in a group-level analysis. The algorithm was implemented as an experimental battery to measure temporal and probability discounting rates together with loss aversion, and was tested on a healthy participant sample.

Why is it hard to make progress in assessing children's decision-making competence?

Science.gov (United States)

Hein, Irma M; Troost, Pieter W; Broersma, Alice; de Vries, Martine C; Daams, Joost G; Lindauer, Ramón J L

2015-01-10

For decades, the discussion on children's competence to consent to medical issues has concentrated around normative concerns, with little progress in clinical practices. Decision-making competence is an important condition in the informed consent model. In pediatrics, clinicians need to strike a proper balance in order to both protect children's interests when they are not fully able to do so themselves and to respect their autonomy when they are. Children's competence to consent, however, is currently not assessed in a standardized way. Moreover, the correlation between competence to give informed consent and age in children has never been systematically investigated, nor do we know which factors exactly contribute to children's competence.This article aims at identifying these gaps in knowledge and suggests options for dealing with the obstacles in empirical research in order to advance policies and practices regarding children's medical decision-making competence. Understanding children's competency is hampered by the law. Legislative regulations concerning competency are established on a strong presumption that persons older than a certain age are competent, whereas younger persons are not. Furthermore, a number of contextual factors are believed to be of influence on a child's decision-making competence: the developmental stage of children, the influence of parents and peers, the quality of information provision, life experience, the type of medical decision, and so on. Ostensibly, these diverse and extensive barriers hinder any form of advancement in this conflicted area. Addressing these obstacles encourages the discussion on children's competency, in which the most prominent question concerns the lack of a clear operationalization of children's competence to consent. Empirical data are needed to substantiate the discussion. The empirical approach offers an opportunity to give direction to the debate. Recommendations for future research include: studying a

The Choice Project: Peer Workers Promoting Shared Decision Making at a Youth Mental Health Service.

Science.gov (United States)

Simmons, Magenta Bender; Batchelor, Samantha; Dimopoulos-Bick, Tara; Howe, Deb

2017-08-01

In youth mental health services, consumer participation is essential, but few implementation strategies exist to engage young consumers. This project evaluated an intervention implemented in an Australian youth mental health service that utilized peer workers to promote shared decision making via an online tool. All new clients ages 16-25 were invited to participate in this nonrandomized comparative study, which used a historical comparison group (N=80). Intervention participants (N=149) engaged with a peer worker and used the online tool before and during their intake assessment. Pre- and postintake data were collected for both groups; measures included decisional conflict, perceived shared decision making, and satisfaction. A series of paired t tests, analyses of variance, and multiple regressions were conducted to assess differences in scores across intervention and comparison groups and pre- and postintake assessments. Ratings of perceived shared decision making with intake workers were higher in the intervention group than in the comparison group (p=.015). In both groups, decisional conflict scores were significantly lower after the intake assessment (pdecision making and lower decisional conflict were associated with satisfaction (pdecision making reported feeling more involved in their assessment. Feeling involved and having lower decisional conflict after seeing an intake worker were important for client satisfaction. These findings demonstrate the importance of both peer work and shared decision making for promoting optimal outcomes in youth mental health services.

'The biggest thing is trying to live for two people': Spousal experiences of supporting decision-making participation for partners with TBI.

Science.gov (United States)

Knox, Lucy; Douglas, Jacinta M; Bigby, Christine

2015-01-01

To understand how the spouses of individuals with severe TBI experience the process of supporting their partners with decision-making. This study adopted a constructivist grounded theory approach, with data consisting of in-depth interviews conducted with spouses over a 12-month period. Data were analysed through an iterative process of open and focused coding, identification of emergent categories and exploration of relationships between categories. Participants were four spouses of individuals with severe TBI (with moderate-severe disability). Spouses had shared committed relationships (marriage or domestic partnerships) for at least 4 years at initial interview. Three spouses were in relationships that had commenced following injury. Two main themes emerged from the data. The first identified the saliency of the relational space in which decision-making took place. The second revealed the complex nature of decision-making within the spousal relationship. Spouses experience decision-making as a complex multi-stage process underpinned by a number of relational factors. Increased understanding of this process can guide health professionals in their provision of support for couples in exploring decision-making participation after injury.

Communication Skills assessed at OSCE are not affected by Participation in the Adolescent Healthy Sexuality Program

Directory of Open Access Journals (Sweden)

Deborah Penava

2002-12-01

Full Text Available We proposed that first year medical students who voluntarily participated in the Healthy Sexuality adolescent program would perform better than their peers on an adolescent counseling station at the year-end OSCE (Objective Structured Clinical Examination. In addition we compared medical students’ communication skills at the time of the program as assessed by self, peers and participating adolescents. Methods: Nineteen first year medical students voluntarily participated in the ongoing Healthy Sexuality program. Adolescent participants, medical student peer participants and medical students assessed communication components on a 7-point Likert scale at the end of the program. At the year-end OSCE, all first year medical students at the University of Western Ontario were assessed at an adolescent counseling station by a standardized patient (SP and a physician examiner. Statistical analysis examined differences between the two groups. Results: Students who participated in the Healthy Sexuality program did not perform better than their colleagues on the year-end OSCE. A statistically significant correlation between physician examiner and SP evaluations was found (r = 0.62. Adolescent participants communication skills assessments in the Healthy Sexuality Program demonstrated no significant correlation with medical student assessments (self or peer. Conclusions:Voluntary intervention with adolescents did not result in improved communication skills at the structured year-end examination. Further investigation will be directed towards delineating differences between SP and physician examiner assessments.

Probabilistic assessment methods as a tool for developing nations to make safety decisions

International Nuclear Information System (INIS)

Gumley, P.; Inamdar, S.V.

1985-01-01

This paper advocates the use of probabilistic safety assessment methods in making safety decisions. It discusses the question of adequate safety - what it means to a country buying a nuclear power plant, and how probabilistic safety assessment studies of the reference plant can be used for ensuring this adequate safety. It is proposed that adequate safety means ensuring that the plant would behave, in accident conditions, in a manner similar to the way it is expected to behave were it in the country of origin. For this one needs to know how the plant responds under somewhat altered conditions. These altered conditions can arise from such factors as varying reliability of electrical grids, different manufacturing technology, local systems design and operator capability. In the design of nuclear power plants, the traditional approach to safety has led to the belief that availability and effectiveness of safety systems alone are all that is required to ensure plant safety. This belief can result in design oversights leading to potential problems arising from the power production systems and the service systems. Participation by the buying country in the design of such systems, and understanding the safety implications thereof, can be facilitated by probabilistic safety assessment methods. This philosophy is illustrated in this paper by examples. (author)

The use of comparative risk assessment in decision making

International Nuclear Information System (INIS)

Chicken, J.C.; Hayns, M.R.; Tolley, B.

1989-01-01

This paper justifies: 1) Comparative risk assessment provides a way of establishing whether or not the risks associated with a novel proposal are likely to satisfy current norms. 2) Comparative risk assessment is an aid to decision making when for some reason there is inadequate quantitative data about the risks associated with a project. 3) One problem is that there is no single universally acceptable norm. Norms vary both with time and from activity to activity. The spread of acceptable norms spans at least two orders of magnitude. 4) For any comparative risk assessment to be considered more than a suggestion on how acceptable a risk is, the risks that are compared must be similar and located in similar cultural and geographical environments. 5) Ulitmately justification of the acceptability of a project must be based on data generated directly by the project itself and any opinion based on comparative evidence must be iteratively revised as direct hard evidence becomes available. 6) Comparative risk assessment has a useful role in presentations to the lay public about the acceptability of a particular risk. 7) There may be more problems in making a comparative assessment of risk acceptability in socio-political terms than in technical or economic terms. The central requirement that the comparison must be based on data from similar cultural backgrounds is often hard to satisfy in relation to socio-political considerations

'What do I know? Should I participate?' Considerations on participation in HIV related research among HIV infected adults in Bangalore, South India.

Science.gov (United States)

Rodrigues, Rashmi J; Antony, Jimmy; Krishnamurthy, Shubha; Shet, Anita; De Costa, Ayesha

2013-01-01

India has the highest number of HIV infected persons in the world after South Africa. Much HIV related behavioral, clinical and laboratory based research is ongoing in India. Yet little is known on Indian HIV patients' knowledge of research, their processes of decision making and motives for participation. We aimed to explore these areas among HIV infected individuals to understand their reasons for participating in research. This is a cross sectional survey among 173 HIV infected adults at a tertiary level hospital in Bangalore, India, done between October 2010 and January 2011. A pre-tested questionnaire was administered to the participants by trained research assistants to assess their knowledge regarding research, willingness to participate, decision making and determinants of participation. Participants were presented with five hypothetical HIV research studies. Each study had a different level of intervention and time commitment. Of respondents, 103(60%), said that research meant 'to discover something new' and 138(80%) were willing to participate in research. A third of the respondents were unaware of their right to refuse participation. Willingness to participate in research varied with level of intervention. It was the lowest for the hypothetical study involving sensitive questions followed by the hypothetical drug trial; and was the highest for the hypothetical cross sectional questionnaire based study (pWomen were less likely to make autonomous decisions for participation in interventional studies. Despite a majority willing to participate, over a third of respondents did not have any knowledge of research or the voluntary nature of participation. This has ethical implications. Researchers need to focus on enabling potential research participants understand the concepts of research, promote autonomous decisions, especially by women and restrict therapeutic misconception.

Democratic Theory and Citizen Participation

DEFF Research Database (Denmark)

Biegelbauer, Peter; Hansen, Janus

2011-01-01

Citizen participation in terms of participatory technology assessment (PTA) has caused a lot of debate in science and technology policy. However, there are still many open questions: What is the actual impact of PTA on policy-making? On which normative theory of democracy is the evaluation of PTA...... based and does it make a difference which theory is used? Which framework is appropriate to evaluate the often fuzzy impact of PTA on policy-making? Is PTA actually a central element for policy-making or are other factors much more relevant such as politicians' involvement or the presence of industry...... interests? What is the ‘nature’ of the public in different national and institutional contexts? How are expectations of policy-makers played out in the perceived need for regulation? These issues are addressed in a series of comparative papers in this issue which focus on the regulation...

Assessing testamentary and decision-making capacity: Approaches and models.

Science.gov (United States)

Purser, Kelly; Rosenfeld, Tuly

2015-09-01

The need for better and more accurate assessments of testamentary and decision-making capacity grows as Australian society ages and incidences of mentally disabling conditions increase. Capacity is a legal determination, but one on which medical opinion is increasingly being sought. The difficulties inherent within capacity assessments are exacerbated by the ad hoc approaches adopted by legal and medical professionals based on individual knowledge and skill, as well as the numerous assessment paradigms that exist. This can negatively affect the quality of assessments, and results in confusion as to the best way to assess capacity. This article begins by assessing the nature of capacity. The most common general assessment models used in Australia are then discussed, as are the practical challenges associated with capacity assessment. The article concludes by suggesting a way forward to satisfactorily assess legal capacity given the significant ramifications of getting it wrong.

[The federal participation law : New requirements for needs assessment with special emphasis on medical rehabilitation services].

Science.gov (United States)

Schubert, Michael; Schian, Marcus; Viehmeier, Sarah

2016-09-01

The federal participation law (Bundesteilhabegesetz - BTHG) is one of the largest efforts in the last 15 years to reform the legal participation rights of people with disabilities. In particular, a number of enhancements are planned in the overall benefits law in Part 1 of Book IX in the Social Code (Sozialgesetzbuch - SGB), which applies to all rehabilitation carriers including general provisions and standards for needs assessment. This paper deals with the implications of these provisions and interacting standards, based on the draft bill of April 2016.The discussion takes place against the background of the regulatory objectives formulated in the ministerial draft itself, jurisprudential expertise on the effects of the current legal norms of the SGB IX as well as relevant professional political developments and statements by various stakeholders.The analysis shows a clear political commitment to increase the requirements for needs assessment in the overall law of the SGB IX and to express these more effectively. The draft bill seeks not only to modify procedures subsequent to the application for rehabilitation benefits, but also to precisely set out provisions on instruments for needs assessment in a new § 13. Common principles for these instruments of needs assessment should increase the cooperation, coordination and convergence among rehabilitation carriers.Nevertheless, with regard to the proposed regulatory texts, there is doubt that the objectives set by the draft bill itself will be achieved. For example, the required common principles for needs assessment are to be agreed upon based on the existing special legislation for the different rehabilitation carriers, without the SGB IX setting its own binding standards or framework principles. In addition, it lacks clear legal guidelines for the professional practice to make use of the bio-psycho-social model of the WHO and the ICF in the process of needs assessment. As a consequence the ICF cannot

ParticipACTION: Baseline assessment of the 'new ParticipACTION': A quantitative survey of Canadian organizational awareness and capacity

Directory of Open Access Journals (Sweden)

Bauman Adrian

2009-12-01

Full Text Available Abstract Background ParticipACTION is a Canadian physical activity (PA communications and social marketing organization that was relaunched in 2007 after a six-year hiatus. This study assesses the baseline awareness and capacity of Canadian organizations that promote physical activity, to adopt, implement and promote ParticipACTION's physical activity campaign. The three objectives were: (1 to determine organizational awareness of both the 'original' and 'new' ParticipACTION; (2 to report baseline levels of three organizational capacity domains (i.e., to adopt, implement and externally promote physical activity initiatives; and, (3 to explore potential differences in those domains based on organizational size, sector and primary mandate. Methods Organizations at local, provincial/territorial, and national levels were sent an invitation via email prior to the official launch of ParticipACTION to complete an on-line survey. The survey assessed their organization's capacity to adopt, implement and externally promote a new physical activity campaign within their organizational mandates. Descriptive statistics were employed to address the first two study objectives. A series of one-way analysis of variance were conducted to examine the third objective. Results The response rate was 29.7% (268/902. The majority of responding organizations had over 40 employees and had operated for over 10 years. Education was the most common primary mandate, followed by sport and recreation. Organizations were evenly distributed between government and not-for-profits. Approximately 96% of respondents had heard of the 'original' ParticipACTION while 54.6% had heard of the 'new' ParticipACTION (Objective 1. Findings indicate good organizational capacity in Canada to promote physical activity (Objective 2 based on reported means of approximately 4.0 (on 5-point scales for capacity to adopt, implement, and externally promote new physical activity campaigns. Capacity to

Incentives and other factors associated with employee participation in health risk assessments.

Science.gov (United States)

Taitel, Michael S; Haufle, Vincent; Heck, Debi; Loeppke, Ronald; Fetterolf, Donald

2008-08-01

Investigate factors associated with employee participation rates in health risk assessments. This cross-sectional study using multiple regression analyzed data from 124 employers with 882,275 eligible employees who completed 344,825 health and productivity assessments (HPAs). Incentive value and Communications and Organizational Commitment Level (Com/Org Level) were the strongest predictors of HPA completion rates. Employer size and a Gateway Model were also significant predictors. In addition, a correlation of variables showed other important relationships. To achieve a 50% HPA completion rate, employers with a low Com/Org Level will need an incentive value of approximately $120 whereas employers with a high Com/Org Level only need approximately $40--a difference of $80 dollars. This applied study offers empirical evidence to help employers increase their employees' participation in health risk assessments.

Participative management in health care services

Directory of Open Access Journals (Sweden)

M. Muller

1995-03-01

Full Text Available The need and demand for the highest-quality management of all health care delivery activities requires a participative management approach. The purpose with this article is to explore the process of participative management, to generate and describe a model for such management, focusing mainly on the process of participative management, and to formulate guidelines for operationalisation of the procedure. An exploratory, descriptive and theory-generating research design is pursued. After a brief literature review, inductive reasoning is mainly employed to identify and define central concepts, followed by the formulation of a few applicable statements and guidelines. Participative management is viewed as a process of that constitutes the elements of dynamic interactive decision-making and problem-solving, shared governance, empowerment, organisational transformation, and dynamic communication within the health care organisation. The scientific method of assessment, planning, implementation and evaluation is utilised throughout the process of participative management.

Health technology assessment, value-based decision making, and innovation.

Science.gov (United States)

Henshall, Chris; Schuller, Tara

2013-10-01

Identifying treatments that offer value and value for money is becoming increasingly important, with interest in how health technology assessment (HTA) and decision makers can take appropriate account of what is of value to patients and to society, and in the relationship between innovation and assessments of value. This study summarizes points from an Health Technology Assessment International (HTAi) Policy Forum discussion, drawing on presentations, discussions among attendees, and background papers. Various perspectives on value were considered; most place patient health at the core of value. Wider elements of value comprise other benefits for: patients; caregivers; the health and social care systems; and society. Most decision-making systems seek to take account of similar elements of value, although they are assessed and combined in different ways. Judgment in decisions remains important and cannot be replaced by mathematical approaches. There was discussion of the value of innovation and of the effects of value assessments on innovation. Discussion also included moving toward "progressive health system decision making," an ongoing process whereby evidence-based decisions on use would be made at various stages in the technology lifecycle. Five actions are identified: (i) development of a general framework for the definition and assessment of value; development by HTA/coverage bodies and regulators of (ii) disease-specific guidance and (iii) further joint scientific advice for industry on demonstrating value; (iv) development of a framework for progressive licensing, usage, and reimbursement; and (v) promoting work to better adapt HTA, coverage, and procurement approaches to medical devices.

Participatory research, people with intellectual disabilities and ethical approval: making reasonable adjustments to enable participation.

Science.gov (United States)

Northway, Ruth; Howarth, Joyce; Evans, Lynne

2015-02-01

The aim of this paper is to explore how making reasonable adjustments to the process of securing ethical approval for research can facilitate the meaningful involvement of people with intellectual disabilities as members of a research team. This is achieved through critical reflection upon the approach taken within one participatory research study whose objective was to explore how people with intellectual disabilities understand abuse. Internationally participatory research studies (in which active involvement of community members in all stages of the research process is sought) are becoming increasingly common in the context of health care and, more specifically, within research involving people with intellectual disabilities. However, whilst it is acknowledged that participatory research gives rise to specific ethical challenges, how (or if) involvement in securing ethical approval is facilitated, is not discussed in most research reports. The significance of this paper is that it seeks to address this gap by exploring how meaningful participation can be promoted by making reasonable adjustments. Within the study, the research team worked in collaboration with the ethics committee to identify potential barriers that could prevent the participation of members of the research team who had intellectual disabilities. Reasonable adjustments (such as redesigning forms) were made to the processes involved in securing ethical approval. This study demonstrated that it is possible to ensure that ethical standards are upheld and the requirements of ethics committees met whilst also facilitating the meaningful involvement of people with intellectual disabilities. The reasonable adjustments approach explored within this paper can be translated into the context of clinical practice: making changes to the way that services are delivered can promote greater involvement of people with intellectual disabilities in their own health care. © 2014 John Wiley & Sons Ltd.

'What do I know? Should I participate?' Considerations on participation in HIV related research among HIV infected adults in Bangalore, South India.

Directory of Open Access Journals (Sweden)

Rashmi J Rodrigues

Full Text Available BACKGROUND: India has the highest number of HIV infected persons in the world after South Africa. Much HIV related behavioral, clinical and laboratory based research is ongoing in India. Yet little is known on Indian HIV patients' knowledge of research, their processes of decision making and motives for participation. We aimed to explore these areas among HIV infected individuals to understand their reasons for participating in research. METHODOLOGY/PRINCIPAL FINDINGS: This is a cross sectional survey among 173 HIV infected adults at a tertiary level hospital in Bangalore, India, done between October 2010 and January 2011. A pre-tested questionnaire was administered to the participants by trained research assistants to assess their knowledge regarding research, willingness to participate, decision making and determinants of participation. Participants were presented with five hypothetical HIV research studies. Each study had a different level of intervention and time commitment. Of respondents, 103(60%, said that research meant 'to discover something new' and 138(80% were willing to participate in research. A third of the respondents were unaware of their right to refuse participation. Willingness to participate in research varied with level of intervention. It was the lowest for the hypothetical study involving sensitive questions followed by the hypothetical drug trial; and was the highest for the hypothetical cross sectional questionnaire based study (p<0.0015. Individual health benefits and altruism were the primary motives for participation in research and indicate the presence of therapeutic misconception. Women were less likely to make autonomous decisions for participation in interventional studies. CONCLUSIONS/SIGNIFICANCE: Despite a majority willing to participate, over a third of respondents did not have any knowledge of research or the voluntary nature of participation. This has ethical implications. Researchers need to focus on

The willingness and actual situation of Chinese cancer patients and their family members participating in medical decision-making.

Science.gov (United States)

Zhang, Jie; Yang, Dan; Deng, Yaotiao; Wang, Ying; Deng, Lei; Luo, Xinmei; Zhong, Wuning; Liu, Jie; Wang, Yuqing; Jiang, Yu

2015-12-01

In China, not only patients and physicians are involved in medical decision-making (MDM) but also the patients' family members. The objective is to investigate the willingness and actual situation of cancer patients and their family members participating in the MDM process. In this cross-sectional study, questionnaires were administered to 247 pairs of cancer inpatients and their relatives. Information regarding participants' willingness and actual experience during the decision-making process was documented. Eligible participants were cancer inpatients or their relatives, 18 years of age or older, and informed of the cancer diagnosis. All the patients should have received chemotherapy. The effective response rate was 72.9% (180/247). Over half of the patients (53.3%) and family members (57.8%) were willing to be part of the MDM process. In contrast, only 35.0% of patients and 46.1% of family members actually experienced this process (p = 0.001 and p = 0.011, respectively). Fewer family members (42.2%) than patients (53.3%) believed that patients should be involved in the MDM process (p family (odds ratio 2.577, 95% CI 1.198-5.556, p = 0.015) experienced more involvement in MDM. Although more than half of Chinese cancer patients and family members wanted to be part of MDM, the actual participation was below their expectation. Majority of family members do not want the patients to be involved in the process of MDM. Copyright © 2015 John Wiley & Sons, Ltd.

HEALTH TECHNOLOGY ASSESSMENT FOR DECISION MAKING IN LATIN AMERICA: GOOD PRACTICE PRINCIPLES.

Science.gov (United States)

Pichon-Riviere, Andrés; Soto, Natalie C; Augustovski, Federico Ariel; García Martí, Sebastián; Sampietro-Colom, Laura

2018-06-11

The aim of this study was to identify good practice principles for health technology assessment (HTA) that are the most relevant and of highest priority for application in Latin America and to identify potential barriers to their implementation in the region. HTA good practice principles proposed at the international level were identified and then explored during a deliberative process in a forum of assessors, funders, and product manufacturers. Forty-two representatives from ten Latin American countries participated. Good practice principles proposed at the international level were considered valid and potentially relevant to Latin America. Five principles were identified as priority and with the greatest potential to be strengthened at this time: transparency in the production of HTA, involvement of relevant stakeholders in the HTA process, mechanisms to appeal decisions, clear priority-setting processes in HTA, and a clear link between HTA and decision making. The main challenge identified was to find a balance between the application of these principles and the available resources in a way that would not detract from the production of reports and adaptation to the needs of decision makers. The main recommendation was to progress gradually in strengthening HTA and its link to decision making by developing appropriate processes for each country, without trying to impose, in the short-term, standards taken from examples at the international level without adequate adaptation of these to local contexts.

Participation of ARN-Argentina in the quality assessment program, EML-USDOE since 200-2001

International Nuclear Information System (INIS)

Equillor, Hugo E.; Serdeiro, Nelida H.; Fernandez, Jorge A.; Gavini, Ricardo M.; Grinman, Ana D.R.; Lewis, Esther C.; Medici, Marcela A.; Palacios, Miguel A.; Diodati, Jorge M.

2002-01-01

The Nuclear Regulatory Authority (ARN) participates every six months in the Quality Assessment Program (QAP), carried out by the Environmental Measurements Laboratory - United States Department Of Energy (EML-USDOE). The aim of this participation is to assess the quality of the radiochemical determinations and alpha, beta, gamma measurements, that ARN realises routinely. The analysed matrix are: water, filter, soil and vegetable. In the present work, the results of the ARN participation in the last four intercomparisons, period 2000-2001, are detailed and analysed statistically. The results are compared with obtained ones by all the laboratories. (author)

A qualitative study of decision-making on Phase III randomized clinical trial participation in paediatric oncology

DEFF Research Database (Denmark)

Ingersgaard, Marianne Vie; Tulstrup, Morten; Schmiegelow, Kjeld

2018-01-01

AIM: To explore parents' and adolescents' motives for accepting/declining participation in the ALL2008 trials and adolescents' involvement in the decision-making process. BACKGROUND: Children and adolescents with acute lymphoblastic leukaemia treated on the Nordic Society of Paediatric Haematology...... the adolescents' decision. There were no differences between motivations of preferences held by parents of children or adolescents, respectively. Decisions were based on subjective values attributed to cure contra toxicity and individual preferences for either standard or experimental treatment. The possibility....... FINDINGS: Adolescents and parents emphasized the importance of adolescents' active participation in decisions regarding enrolment into clinical trials. A majority of adolescents were either final or collaborative decision-makers. Parents stated that in case of disagreement, they would overrule...

?Decision-making capacity for research participation among addicted people: a cross-sectional study?

OpenAIRE

Mor?n-S?nchez, In?s; Luna, Aurelio; S?nchez-Mu?oz, Maria; Aguilera-Alcaraz, Beatriz; P?rez-C?rceles, Maria D.

2016-01-01

Background Informed consent is a key element of ethical clinical research. Addicted population may be at risk for impaired consent capacity. However, very little research has focused on their comprehension of consent forms. The aim of this study is to assess the capacity of addicted individuals to provide consent to research. Methods 53 subjects with DSM-5 diagnoses of a Substance Use Disorder (SUD) and 50 non psychiatric comparison subjects (NPCs) participated in the survey from December 201...

Emotions in Risk Assessment and Decision Making Processes During Craft Practice

Directory of Open Access Journals (Sweden)

Camilla Groth

2015-12-01

Full Text Available Traditionally subjective experiences and emotions have been overlooked in the practice of scientific research. In the field of design and craft research too, feelings and emotions have been considered as interfering with the rigour of research. However, as a result of findings in neuroscience, a new understanding has emerged, providing emotions a central role in risk assessment and decision making processes. This has implications also for how we understand craft practice. In this practice-led research, a craft practitioner analysed five video-recordings of herself while throwing clay blindfolded. The researcher-practitioner specifically studied critical incidents in the throwing process and made a detailed analysis of how sensory experiences and emotions guided her in risk assessment, decision making, and problem solving during the clay-throwing sessions. She found that her tactile experience gave her important clues on the condition of the material and its consequent possibilities at different stages. These experiences in turn affected her emotions in either positive or negative ways, affecting her risk assessment, decision making, and problem solving activities. This research has shown that sensory experiences and emotions influence the craft making process and are thus important elements in the expertise of the craftsperson. The role of such emotions remains to be studied further in the expertise of researchers in general.

The Role of Integrated Modelling and Assessment for Decision-Making: Lessons from Water Allocation Issues in Australia

Science.gov (United States)

Jakeman, A. J.; Guillaume, J. H. A.; El Sawah, S.; Hamilton, S.

2014-12-01

Integrated modelling and assessment (IMA) is best regarded as a process that can support environmental decision-making when issues are strongly contested and uncertainties pervasive. To be most useful, the process must be multi-dimensional and phased. Principally, it must be tailored to the problem context to encompass diverse issues of concern, management settings and stakeholders. This in turn requires the integration of multiple processes and components of natural and human systems and their corresponding spatial and temporal scales. Modellers therefore need to be able to integrate multiple disciplines, methods, models, tools and data, and many sources and types of uncertainty. These dimensions are incorporated into iteration between the various phases of the IMA process, including scoping, problem framing and formulation, assessing options and communicating findings. Two case studies in Australia are employed to share the lessons of how integration can be achieved in these IMA phases using a mix of stakeholder participation processes and modelling tools. One case study aims to improve the relevance of modelling by incorporating stakeholder's views of irrigated viticulture and water management decision making. It used a novel methodology with the acronym ICTAM, consisting of Interviews to elicit mental models, Cognitive maps to represent and analyse individual and group mental models, Time-sequence diagrams to chronologically structure the decision making process, an All-encompassing conceptual model, and computational Models of stakeholder decision making. The second case uses a hydro-economic river network model to examine basin-wide impacts of water allocation cuts and adoption of farm innovations. The knowledge exchange approach used in each case was designed to integrate data and knowledge bearing in mind the contextual dimensions of the problem at hand, and the specific contributions that environmental modelling was thought to be able to make.

Examining Citizen Participation: Local Participatory Policy Making and Democracy

NARCIS (Netherlands)

Michels, A.M.B.|info:eu-repo/dai/nl/11124501X; de Graaf, L.J.

2010-01-01

Citizen participation is usually seen as a vital aspect of democracy. Many theorists claim that citizen participation has positive effects on the quality of democracy. This article examines the probability of these claims for local participatory policymaking projects in two municipalities in the

The impact of health technology assessment reports on decision making in Austria.

Science.gov (United States)

Zechmeister, Ingrid; Schumacher, Ines

2012-01-01

Health technology assessment (HTA) was established in Austria in the 1990s and, since then, it has gained considerable importance. In this study, we aim to analyze whether the HTA reports that have been produced at the Institute for Technology Assessment (ITA) and at the Ludwig Boltzmann Institute for HTA (LBI-HTA) have had an impact on decision making within the Austrian health care system. We selected all reports that were intended for supporting (i) reimbursement/investment or (ii) disinvestment decisions. Eleven full HTA reports and fifty-eight rapid assessments fulfilled the inclusion criteria. We used interview data and administrative data on volumes, tariffs and expenditure of products/services to analyze whether and how reports were in reality used in decision making and what the consequences for health care expenditure and resource distribution have been. Five full HTA reports and fifty-six rapid technology assessments were used for reimbursement decisions. Four full HTA reports and two rapid assessments were used for disinvestment decisions and resulted in reduced volumes and expenditure. Two full HTA reports showed no impact on decision making. Impact was most evident for hospital technologies. HTA has played some role in reducing volumes of over-supplied hospital technologies, resulting in reduced expenditure for several hospital providers. Additionally, it has been increasingly included in prospective planning and reimbursement decisions of late, indicating re-distribution of resources toward evidence-based technologies. However, further factors may have influenced the decisions, and the impact could be considerably increased by systematically incorporating HTA into the decision-making process in Austria.

Attitude and Behavior Factors Associated with Front-of-Package Label Use with Label Users Making Accurate Product Nutrition Assessments.

Science.gov (United States)

Roseman, Mary G; Joung, Hyun-Woo; Littlejohn, Emily I

2018-05-01

Front-of-package (FOP) labels are increasing in popularity on retail products. Reductive FOP labels provide nutrient-specific information, whereas evaluative FOP labels summarize nutrient information through icons. Better understanding of consumer behavior regarding FOP labels is beneficial to increasing consumer use of nutrition labeling when making grocery purchasing decisions. We aimed to determine FOP label format effectiveness in aiding consumers at assessing nutrient density of food products. In addition, we sought to determine relationships between FOP label use and attitude toward healthy eating, diet self-assessment, self-reported health and nutrition knowledge, and label and shopping behaviors. A between-subjects experimental design was employed. Participants were randomly assigned to one of four label conditions: Facts Up Front, Facts Up Front Extended, a binary symbol, and no-label control. One hundred sixty-one US primary grocery shoppers, aged 18 to 69 years. Participants were randomly invited to the online study. Participants in one of four label condition groups viewed three product categories (cereal, dairy, and snacks) with corresponding questions. Adults' nutrition assessment of food products based on different FOP label formats, along with label use and attitude toward healthy eating, diet self-assessment, self-reported health and nutrition knowledge, and label and shopping behaviors. Data analyses included descriptive statistics, χ 2 tests, and logistical regression. Significant outcomes were set to α=.05. Participants selected the more nutrient-dense product in the snack food category when it contained an FOP label. Subjective health and nutrition knowledge and frequency of selecting food for healthful reasons were associated with FOP label use (P<0.01 and P<0.05, respectively). Both Facts Up Front (reductive) and binary (evaluative) FOP labels appear effective for nutrition assessment of snack products compared with no label. Specific

Framework for Human Health Risk Assessment to Inform Decision Making

Science.gov (United States)

The purpose of this document is to describe a Framework for conducting human health risk assessments that are responsive to the needs of decision‐making processes in the U.S. Environmental Protection Agency (EPA).

The application of the assessment of nuclear accident status in emergency decision-making during nuclear accident

International Nuclear Information System (INIS)

Yang Ling

2011-01-01

Nuclear accident assessment is one of the bases for emergency decision-making in the situation of nuclear accident in NPP. Usually, the assessment includes accident status and consequence assessment. It is accident status assessment, and its application in emergency decision-making is introduced here. (author)

Mapping eParticipation

DEFF Research Database (Denmark)

Rose, Jeremy; Sanford, Clive Carlton

2007-01-01

The emerging research area of eParticipation can be characterized as the study of technology-facilitated citizen participation in (democratic) deliberation and decision-making. Using conventional literature study techniques, we identify 105 articles that are considered to be highly relevant to e......Participation. We develop a definitional schema that suggests different ways of understanding an emerging socio-technical research area and use this schema to map the research contributions identified. This allows us make an initial sketch of the scientific character of the area and its central concerns, theories......, and methods. We extend the analysis to define four central research challenges for the field: understanding technology and participation; the strategic challenge; the design challenge; and the evaluation challenge. This article thus contributes to a developing account of eParticipation, which will help future...

From the communication to participation in decision making; De la comunicacion a la participacion en la decisiones

Energy Technology Data Exchange (ETDEWEB)

Alonso, A. [Universidad Politecnica de Madrid (Spain)

2004-07-01

In the modern democratic societies there have appeared individuals and associations interested in and concerned with the risks proper to the use of ionising radiation and nuclear power. In the use of their democratic rights, they have requested and obtained from those responsible information on such activities and there has been established a fruitful communication process involving the interchange of facts and circumstances that is contributing to make the perceived risk more objective. At the moment, those societies are moving from information, through interactive communication, to participation in the decision.making processes with major social impacts or social sensitivity. This significant movement is analysed, as well as its causes and consequences. (Author)

Ethical decision-making climate in the ICU: theoretical framework and validation of a self-assessment tool.

Science.gov (United States)

Van den Bulcke, Bo; Piers, Ruth; Jensen, Hanne Irene; Malmgren, Johan; Metaxa, Victoria; Reyners, Anna K; Darmon, Michael; Rusinova, Katerina; Talmor, Daniel; Meert, Anne-Pascale; Cancelliere, Laura; Zubek, Làszló; Maia, Paolo; Michalsen, Andrej; Decruyenaere, Johan; Kompanje, Erwin J O; Azoulay, Elie; Meganck, Reitske; Van de Sompel, Ariëlla; Vansteelandt, Stijn; Vlerick, Peter; Vanheule, Stijn; Benoit, Dominique D

2018-02-23

Literature depicts differences in ethical decision-making (EDM) between countries and intensive care units (ICU). To better conceptualise EDM climate in the ICU and to validate a tool to assess EDM climates. Using a modified Delphi method, we built a theoretical framework and a self-assessment instrument consisting of 35 statements. This Ethical Decision-Making Climate Questionnaire (EDMCQ) was developed to capture three EDM domains in healthcare: interdisciplinary collaboration and communication; leadership by physicians; and ethical environment. This instrument was subsequently validated among clinicians working in 68 adult ICUs in 13 European countries and the USA. Exploratory and confirmatory factor analysis was used to determine the structure of the EDM climate as perceived by clinicians. Measurement invariance was tested to make sure that variables used in the analysis were comparable constructs across different groups. Of 3610 nurses and 1137 physicians providing ICU bedside care, 2275 (63.1%) and 717 (62.9%) participated respectively. Statistical analyses revealed that a shortened 32-item version of the EDMCQ scale provides a factorial valid measurement of seven facets of the extent to which clinicians perceive an EDM climate: self-reflective and empowering leadership by physicians; practice and culture of open interdisciplinary reflection; culture of not avoiding end-of-life decisions; culture of mutual respect within the interdisciplinary team; active involvement of nurses in end-of-life care and decision-making; active decision-making by physicians; and practice and culture of ethical awareness. Measurement invariance of the EDMCQ across occupational groups was shown, reflecting that nurses and physicians interpret the EDMCQ items in a similar manner. The 32-item version of the EDMCQ might enrich the EDM climate measurement, clinicians' behaviour and the performance of healthcare organisations. This instrument offers opportunities to develop tailored ICU

Science and environmental policy-making : bias-proofing the assessment process

International Nuclear Information System (INIS)

McKitrick, R.

2005-01-01

Politicians and policy-makers appeal to the concept of peer-reviewed research as a foundation for decision-making. However, peer review does not typically guarantee that data and methods are open to scrutiny or that results are reproducible. This paper argued that additional checks and balances are needed for scientific assessment reports when they are being used to justify major policy investments. The need for such mechanisms was examined with reference to the debate in climate change, which allowed the Intergovernmental Panel on Climate Change (IPCC) to downplay fundamental scientific uncertainties in research in order to claim that the 1990s were the warmest decade of the millennium. Two mechanisms were proposed to address biases in expert assessment panels. The creation of a scientific audit or permanent agency was recommended that would act independently of assessment panels to identify key studies influencing panel decisions to ensure that data are publicly available and that statistical methods are fully described and correctly implemented. The creation of a counterweight panel was also advised, which would then be convened to prepare the strongest possible counter argument to the conclusions of an assessment panel. It was concluded that, given the far-reaching implications of policy decisions that are based on expert assessments, audits and counterweight panels should be integrated into the process by which science is used to guide decision-making. 17 refs., 4 figs

Making the assessment right, or making the right assessment?

NARCIS (Netherlands)

Ritzen, M.J.; Rovers, R.; Vroon, Z.A.E.P.; Geurts, C.P.W.; Khan, A.; Allacker, K.

2015-01-01

While its design has significant impact on the sustainability of a building, assessment methods to measure sustainability in design phases are not widely used. If assessment methods are applied, it is debateable whether they can generate the insight that is needed to realize a truly sustainable

Self-esteem and risky decision-making: an ERP study.

Science.gov (United States)

Yang, Juan; Dedovic, Katarina; Zhang, Qinglin

2010-12-01

Self-esteem, a value one places on oneself, influences one's cognitive, emotional and behavioral responses across various situations. In the case of risky decision-making, high self-esteem (SE) individuals rely on their positive self-views and tend to be less defensive in response to a risky task; low SE individuals, on the contrary, tend to have fewer accessible positive resources and thus, are more prone to risk-aversion. While past studies have provided evidence for a link between self-esteem and a behaviorally-risky response, no study has explored the relation between self-esteem and the electrophysiological correlates of risky response. Therefore, the current study investigated the correlates of risky decision-making in high SE compared to low SE participants using event-related potentials (ERP) technology in 28 undergraduate students playing a blackjack game. The results showed that there was no difference between the high SE participants and the low SE participants with respect to the behavioral assessments of the risk-taking decision-making. However, for the electrophysiological data, we observed that the amplitude of P2 (150-300 ms) was more positive in the high SE participants compared to the low SE participants over the central-posterior scalp region. Dipole source analysis indicated that this positive component was generated in posterior cingulate cortex (PCC). These findings suggest that the high SE participants experienced more emotional signals than the low SE participants during decision-making.

Patient participation in collective healthcare decision making: the Dutch model

NARCIS (Netherlands)

van de Bovenkamp, H.; Trappenburg, M.J.; Grit, K.

2010-01-01

Objective To study whether the Dutch participation model is a good model of participation. Background Patient participation is on the agenda, both on the individual and the collective level. In this study, we focus on the latter by looking at the Dutch model in which patient organizations are

Patient participation in collective healthcare decision making: the Dutch model

NARCIS (Netherlands)

van de Bovenkamp, H.M.; Trappenburg, M.J.; Grit, K.J.

2010-01-01

Objective  To study whether the Dutch participation model is a good model of participation. Background  Patient participation is on the agenda, both on the individual and the collective level. In this study, we focus on the latter by looking at the Dutch model in which patient organizations are

Patient participation in collective healthcare decision making: the Dutch model

NARCIS (Netherlands)

Bovenkamp, H. van de; Trappenburg, M.J.; Grit, K. J.

2009-01-01

Objective To study whether the Dutch participation model is a good model of participation. Background Patient participation is on the agenda, both on the individual and the collective level. In this study, we focus on the latter by looking at the Dutch model in which patient organizations are

Usefulness of alternative integrative assessment methodologies in public decision making

Energy Technology Data Exchange (ETDEWEB)

Erickson, L. E.; Litchfield, J. W.; Currie, J. W.; McDonald, C. L.; Adams, R. C.

1978-07-01

Many diverse social, economic, and environmental effects are associated with each of the available energy development alternatives. The assessment of the costs, risks, and benefits of these energy development options is an important function of the U. S. Department of Energy. This task is more difficult when no single alternative is better than the others in all respects. This paper compares benefit-cost and multi-attribute utility analysis as decision aids for these more difficult and more common assessment cases. PNL has developed expertise in making these assessments through its involvement since the Calvert Cliffs decision in both the preparation of Environmental Impact Statements and the development of methods to make these statements more thorough and responsive to the spirit of the National Environmental Protection Act (NEPA). Since 1973 PNL has had continuing efforts to quantify, value, and compare all of the major factors which influence the overall impacts of energy development options. An important part of this work has been the measurement and incorporation of the relative values which community groups place on these conflicting factors. Such difficult assessment problems could be approached in many ways including the use of benefit-cost or multi-attribute utility analysis. This paper addresses the following questions: (1) Should an integrative assessment methodology be used for the overall assessment of these costs, risks, and benefits. (2) If an integrative assessment methodology is to be used, what alternative methods are available and what should be the basis for selecting a method. (3) Is it possible to use one of the available alternatives for one portion of the assessment and another for another portion of the assessment. The answers to these questions presented in this report are applicable to most public decision problems.

Ecological Momentary Assessment in Behavioral Research: Addressing Technological and Human Participant Challenges.

Science.gov (United States)

Burke, Lora E; Shiffman, Saul; Music, Edvin; Styn, Mindi A; Kriska, Andrea; Smailagic, Asim; Siewiorek, Daniel; Ewing, Linda J; Chasens, Eileen; French, Brian; Mancino, Juliet; Mendez, Dara; Strollo, Patrick; Rathbun, Stephen L

2017-03-15

Ecological momentary assessment (EMA) assesses individuals' current experiences, behaviors, and moods as they occur in real time and in their natural environment. EMA studies, particularly those of longer duration, are complex and require an infrastructure to support the data flow and monitoring of EMA completion. Our objective is to provide a practical guide to developing and implementing an EMA study, with a focus on the methods and logistics of conducting such a study. The EMPOWER study was a 12-month study that used EMA to examine the triggers of lapses and relapse following intentional weight loss. We report on several studies that informed the implementation of the EMPOWER study: (1) a series of pilot studies, (2) the EMPOWER study's infrastructure, (3) training of study participants in use of smartphones and the EMA protocol and, (4) strategies used to enhance adherence to completing EMA surveys. The study enrolled 151 adults and had 87.4% (132/151) retention rate at 12 months. Our learning experiences in the development of the infrastructure to support EMA assessments for the 12-month study spanned several topic areas. Included were the optimal frequency of EMA prompts to maximize data collection without overburdening participants; the timing and scheduling of EMA prompts; technological lessons to support a longitudinal study, such as proper communication between the Android smartphone, the Web server, and the database server; and use of a phone that provided access to the system's functionality for EMA data collection to avoid loss of data and minimize the impact of loss of network connectivity. These were especially important in a 1-year study with participants who might travel. It also protected the data collection from any server-side failure. Regular monitoring of participants' response to EMA prompts was critical, so we built in incentives to enhance completion of EMA surveys. During the first 6 months of the 12-month study interval, adherence to

Decision-Making Styles in the Workplace

Directory of Open Access Journals (Sweden)

Silvia Raffaldi

2012-05-01

Full Text Available Two procedures were adopted to assess decision-making styles in the workplace: (a the administration of traditional standardized self-report questionnaires and (b open-ended questions about the way respondents would take decisions in a critical business case. Seventy-four adults were given two questionnaires: the Preference for Intuition and Deliberation, which assesses “deliberative” or “intuitive” decision style, and the Style of Learning and Thinking, which assesses thinking styles as “left” (namely, analytical-systematic or “right” (that is, global-intuitive. Participants were also presented with a business case that involved taking a decision. Responses to the business case were used to classify approaches to decision making as “analytical-systematic” or “global-intuitive.” Results showed that the questionnaires correlated consistently with scores from the business case, thus supporting the notion that the assessment of decision style through self-report questionnaires is reliable and valid.

Public participation in environmental issues in Taiwan

International Nuclear Information System (INIS)

Li, K.K.

1994-01-01

It is natural in a democratic society that people request more participation in the decision making process. The once centralized government was however reluctant to open more room in this regard concerning the nuclear power industry and radioactive waste management. The environmental impact assessment provided the statuary ground, although limited, for public participation in the environmental issues. A comprehensive social communication program which consists of public information, public education, public relation, and public participation must be established to ensure the smooth realization of a development project. This paper described the relevant situations in Taiwan and recommended various practices to alleviate the NIMBY syndrome. These descriptions and recommendations would be useful particularly for the third world countries facing emerging environmental issues in the near future

Probabilistic Risk Assessment to Inform Decision Making: Frequently Asked Questions

Science.gov (United States)

General concepts and principles of Probabilistic Risk Assessment (PRA), describe how PRA can improve the bases of Agency decisions, and provide illustrations of how PRA has been used in risk estimation and in describing the uncertainty in decision making.

Using measurement uncertainty in decision-making and conformity assessment

Science.gov (United States)

Pendrill, L. R.

2014-08-01

Measurements often provide an objective basis for making decisions, perhaps when assessing whether a product conforms to requirements or whether one set of measurements differs significantly from another. There is increasing appreciation of the need to account for the role of measurement uncertainty when making decisions, so that a ‘fit-for-purpose’ level of measurement effort can be set prior to performing a given task. Better mutual understanding between the metrologist and those ordering such tasks about the significance and limitations of the measurements when making decisions of conformance will be especially useful. Decisions of conformity are, however, currently made in many important application areas, such as when addressing the grand challenges (energy, health, etc), without a clear and harmonized basis for sharing the risks that arise from measurement uncertainty between the consumer, supplier and third parties. In reviewing, in this paper, the state of the art of the use of uncertainty evaluation in conformity assessment and decision-making, two aspects in particular—the handling of qualitative observations and of impact—are considered key to bringing more order to the present diverse rules of thumb of more or less arbitrary limits on measurement uncertainty and percentage risk in the field. (i) Decisions of conformity can be made on a more or less quantitative basis—referred in statistical acceptance sampling as by ‘variable’ or by ‘attribute’ (i.e. go/no-go decisions)—depending on the resources available or indeed whether a full quantitative judgment is needed or not. There is, therefore, an intimate relation between decision-making, relating objects to each other in terms of comparative or merely qualitative concepts, and nominal and ordinal properties. (ii) Adding measures of impact, such as the costs of incorrect decisions, can give more objective and more readily appreciated bases for decisions for all parties concerned. Such

In it together: Organizational learning through participation in environmental assessment

Science.gov (United States)

Fitzpatrick, Patricia

2005-07-01

Can organizations learn through participation in environmental assessment (EA)? This was the central research question of a study that explored the linkages among sustainable development, EA, public participation, and learning. To address this question, the research design involved a comparative case study of two concurrent but geographically separate projects, the Wuskwatim generation station and transmission lines projects (Wuskwatim projects), and the Snap Lake Diamonds Project (Snap Lake project). The Wuskwatim projects involve the construction of a low head dam and three 230 kV transmission line segments in Northern Manitoba, Canada. The Snap Lake Project involves the construction and operation of a diamond mine 220 km northwest of Yellowknife, Northwest Territories, Canada, at the headwaters of the Lockhart River drainage system. The EAs of these proposed developments provided multiple opportunities for public (and organizational) involvement in the review, including comments on the scope of the assessment, information requests, and public hearings. Data collection included participant observation, semi-structured interviews with EA participants, and documentation generated through the course of the reviews. Data were organized using QSR Nvivo, a database software system. In this dissertation, three key contributions are made. The theoretical framework that draws together a number of separate but related fields of study---communicative action, discursive democracy, transformative learning, organizational learning---is the first contribution. The second is verification that organizations learn through participation in EA. Third, empirical support is presented far the assertion that transformative learning can address change beyond that experienced by the individual, to account for both policy-oriented and organizational learning. Related to the second contribution, results indicate that participants of EA engage in Teaming on multiple scales. Furthermore

Worker participation - the Netherlands

NARCIS (Netherlands)

Kwantes, J.H.

2014-01-01

Worker participation relates to the involvement of workers in the management decision-making processes. In this article attention is focused on worker participation related to occupational safety and health in the Netherlands. Worker participation can refer either to direct or indirect participation

Environmental impacts assessment: Instruments for environmental policy making and resource management

International Nuclear Information System (INIS)

Cavelli, C.M.; Sartori, S.

1993-06-01

This review of evaluation criteria for environmental impacts assessments in Italy covers the following aspects: the efficacy of current Italian normatives governing assessment methods, the current approach of regional public administrations, the necessity for the creation of a national regulating board, environmental impacts assessment for complex environmental systems, the application of impacts assessment recommendations to resource development modelling in the planning of integrated environmental-economic systems, the involvement of the general public in decision making, techniques to determine the monetary worth of environmental resources, the use of multi-criteria analysis techniques

Community participation in Health Impact Assessment. A scoping review of the literature

International Nuclear Information System (INIS)

Broeder, Lea den; Uiters, Ellen; Have, Wim ten; Wagemakers, Annemarie; Schuit, Albertine Jantine

2017-01-01

Currently, the engagement of local communities in Health Impact Assessment is becoming more and more important. A scoping review was performed to take stock of visions, methods and experiences in this field. A combined Scopus and Medline search yielded 100 articles in scientific journals. The final selection consisted of 43 papers, including case studies, evaluation studies, reviews, and opinion papers. After analysis, consultation of four experts was performed to check preliminary study outcomes. A grey literature web search was performed to check and complement the results. Results show that community participation is generally considered a core element in HIA. Views as expressed in the papers concern, firstly, the need for and value of local knowledge, secondly, the adherence to or application of democratic values and, thirdly, empowerment of communities. Three categories of methods are used in relation to community participation, often in combination: methods to facilitate knowledge elicitation, to ensure the inclusion of communities in the HIA process, and to build community capacity to participate in policy development. However, the theoretical or practical underpinning of the choice for specific methods is mostly not presented. The experiences described in the papers mainly focus on the access to local knowledge and its usability as a source of evidence in the HIA process. Described effects of community participation are (improved) relations between communities and local agencies, policy makers and professionals and the empowerment of community members. Although these effects are ascribed to community participation, many papers do not provide support for this conclusion beyond the retrospective perception of participants. Expert consultation and additional analysis of the grey literature supported the results derived from the scientific literature and provided more in-depth knowledge. In the grey literature theoretical frameworks, methods and tools for

Peer Assessment of Oral Presentations: Effects of Student Gender, University Affiliation and Participation in the Development of Assessment Criteria

Science.gov (United States)

Langan, Mark A.; Wheater, Philip C.; Shaw, Emma M.; Haines, Ben J.; Cullen, Rod W.; Boyle, Jennefer C.; Penney, David; Oldekop, Johan A.; Ashcroft, Carl; Lockey, Les; Preziosi, Richard F.

2005-01-01

Peer assessment provides a useful mechanism to develop many positive qualities in students studying in higher education (HE). Potential influences on peer-awarded marks include student qualities such as gender, HE background (e.g. university affiliation) and participation in the development of the assessment criteria. Many studies that have…

Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study.

Science.gov (United States)

Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit; Vedsted, Peter

2015-12-01

Population-based cancer screening is offered in many countries to detect early stages of cancer and reduce mortality. Screening efficiency and equality is susceptible due to a group of non-participants. We investigated associations between self-assessed health, perceived stress and subsequent non-participation in breast cancer screening. This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50-69 years) for the first organised breast cancer screening programme -3 years later in the Central Denmark Region in 2008-2009. A U-shaped association was observed for physical health assessment as women with the highest (PR=1.28, 95% CI: 1.06-1.55), and the lowest (PR=1.41, 95% CI: 1.18-1.68) physical health scores were less likely to participate in the programme than women with physical health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR=1.44, 95% CI: 1.22-1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores (PR=1.27, 95% CI: 1.07-1.51) compared with women scoring in the middle range. Women with highest and lowest self-assessed physical health, with lowest mental health or highest perceived stress were significantly more likely not to participate in breast cancer screening 2-3 years later than women who reported average health. Interventions targeting these groups may promote equal participation in future breast cancer screening programmes. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluating public participation in Chinese EIA. An integrated Public Participation Index and its application to the case of the New Beijing Airport

Energy Technology Data Exchange (ETDEWEB)

Brombal, Daniele [Department of Asian and North African Studies, University Ca' Foscari Venice (Italy); Moriggi, Angela [Department of Asian and North African Studies, University Ca' Foscari Venice (Italy); Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari Venice (Italy); Marcomini, Antonio, E-mail: marcom@unive.it [Department of Environmental Sciences, Informatics and Statistics, University Ca' Foscari Venice (Italy)

2017-01-15

In recent years, China's government authorities have devoted increasing attention to the role of public participation processes in Environmental Impact Assessment (EIA). The capacity of these processes to influence decision-making remains widely debated. This paper aims at appraising the institutional rationale informing the implementation of public participation in China's EIA, benchmarking it against three conceptualisations: (1) Normative, based on objectives of empowerment and democratisation; (2) Substantive, where participation is pursued mainly to improve quality of decisions; (3) Instrumental, seeking participation as an instrument to legitimise decision-making processes. The appraisal is carried out by means of a new integrated index (Public Participation Index, PPI), which is applied to a case study representative of latest advancements in EIA public participation practices in China, namely the “New Beijing Airport Project”. Located 46 km south of downtown Beijing, the project was approved in 2014 and it is currently under construction. Results of the PPI application to this case study indicate that, despite progress made in recent years, the implementation of public participation in Chinese EIA still largely responds to an instrumental rationale, with limited capacity for the public to affect decisions. - Highlights: • In recent years China has strengthened EIA public participation (PP) legislation. • Despite progress, implementation of PP remains informed by an instrumental rationale. • A large gap exists between principles enunciated in regulations and implementation. • The Public Participation Index can be used to monitor China's EIA PP development.

Evaluating public participation in Chinese EIA. An integrated Public Participation Index and its application to the case of the New Beijing Airport

International Nuclear Information System (INIS)

Brombal, Daniele; Moriggi, Angela; Marcomini, Antonio

2017-01-01

In recent years, China's government authorities have devoted increasing attention to the role of public participation processes in Environmental Impact Assessment (EIA). The capacity of these processes to influence decision-making remains widely debated. This paper aims at appraising the institutional rationale informing the implementation of public participation in China's EIA, benchmarking it against three conceptualisations: (1) Normative, based on objectives of empowerment and democratisation; (2) Substantive, where participation is pursued mainly to improve quality of decisions; (3) Instrumental, seeking participation as an instrument to legitimise decision-making processes. The appraisal is carried out by means of a new integrated index (Public Participation Index, PPI), which is applied to a case study representative of latest advancements in EIA public participation practices in China, namely the “New Beijing Airport Project”. Located 46 km south of downtown Beijing, the project was approved in 2014 and it is currently under construction. Results of the PPI application to this case study indicate that, despite progress made in recent years, the implementation of public participation in Chinese EIA still largely responds to an instrumental rationale, with limited capacity for the public to affect decisions. - Highlights: • In recent years China has strengthened EIA public participation (PP) legislation. • Despite progress, implementation of PP remains informed by an instrumental rationale. • A large gap exists between principles enunciated in regulations and implementation. • The Public Participation Index can be used to monitor China's EIA PP development.

Leisure participation-preference congruence of children with cerebral palsy: a Children's Assessment of Participation and Enjoyment International Network descriptive study.

Science.gov (United States)

Imms, Christine; King, Gillian; Majnemer, Annette; Avery, Lisa; Chiarello, Lisa; Palisano, Robert; Orlin, Margo; Law, Mary

2017-04-01

To examine participation-preference congruence, regional differences in participation-preference congruence, and predictors of whether children with cerebral palsy participate in preferred activities. The sample (n=236) included 148 males and 88 females aged 10 to 13 years, living in Victoria, Australia (n=110), Ontario (n=80), or Quebec (n=46), Canada. Ninety-nine (41.9%) were classed at Gross Motor Function Classification System (GMFCS) level I; 89 (37.7%) at GMFCS level II/III; and 48 (20.3%) at GMFCS level IV/V. Participants completed the Children's Assessment of Participation and Enjoyment and Preferences for Activity of Children questionnaires. Regional comparisons were performed using one-way analyses of variance and factors influencing participation-preference congruence were explored using multiple linear regression. The proportion of children doing non-preferred activities in each activity type was generally low (2-17%), with only one regional difference. Higher proportions were not doing preferred active physical (range 23.2-29.1% across regions), skill-based (range 21.7-27.9% across regions), and social activities (range 12.8-14.5% across regions). GMFCS level was the most important predictor associated with not doing preferred activities. Children with cerebral palsy did not always participate in preferred active physical and skill-based activities. Understanding discrepancies between preferences and actual involvement may allow families and rehabilitation professionals to address participation barriers. © 2016 Mac Keith Press.

Risk Assessment and Decision-Making under Uncertainty in Tunnel and Underground Engineering

Directory of Open Access Journals (Sweden)

Yuanpu Xia

2017-10-01

Full Text Available The impact of uncertainty on risk assessment and decision-making is increasingly being prioritized, especially for large geotechnical projects such as tunnels, where uncertainty is often the main source of risk. Epistemic uncertainty, which can be reduced, is the focus of attention. In this study, the existing entropy-risk decision model is first discussed and analyzed, and its deficiencies are improved upon and overcome. Then, this study addresses the fact that existing studies only consider parameter uncertainty and ignore the influence of the model uncertainty. Here, focus is on the issue of model uncertainty and differences in risk consciousness with different decision-makers. The utility theory is introduced in the model. Finally, a risk decision model is proposed based on the sensitivity analysis and the tolerance cost, which can improve decision-making efficiency. This research can provide guidance or reference for the evaluation and decision-making of complex systems engineering problems, and indicate a direction for further research of risk assessment and decision-making issues.

Association of Wage With Employee Participation in Health Assessments and Biometric Screening.

Science.gov (United States)

Sherman, Bruce W; Addy, Carol

2018-02-01

To understand differences in health risk assessment (HRA) and biometric screening participation rates among benefits-enrolled employees in association with wage category. Cross-sectional analysis of employee eligibility file and health benefits (wellness and claims) data. Data from self-insured employers participating in the RightOpt private exchange (Conduent HR Services) during 2014. Active employees from 4 companies continuously enrolled in health insurance for which wage data were available. Measures included HRA and biometric screening participation rates and wage status, with employee age, sex, employer, job tenure, household income, geographic location, and health benefits deductible as a percentage of total wages serving as covariates. Employees were separated into 5 groups based on wage status. Logistic regression analysis incorporated other measures as covariates to adjust for differences between groups, with HRA and biometric screening participation rates determined as binary outcomes. Participation rates for HRA and biometric screening were 90% and 87%, respectively, in the highest wage category, decreasing to 67% and 60%, respectively, among the lowest wage category. Employee wage status is associated with significant differences in HRA and biometric participation rates. Generalizing the results generated by modest participation in these offerings to entire populations may risk misinterpretation of results based on variable participation rates across wage categories.

Assessment of participation bias in cohort studies: systematic review and meta-regression analysis

Directory of Open Access Journals (Sweden)

Sérgio Henrique Almeida da Silva Junior

2015-11-01

Full Text Available Abstract The proportion of non-participation in cohort studies, if associated with both the exposure and the probability of occurrence of the event, can introduce bias in the estimates of interest. The aim of this study is to evaluate the impact of participation and its characteristics in longitudinal studies. A systematic review (MEDLINE, Scopus and Web of Science for articles describing the proportion of participation in the baseline of cohort studies was performed. Among the 2,964 initially identified, 50 were selected. The average proportion of participation was 64.7%. Using a meta-regression model with mixed effects, only age, year of baseline contact and study region (borderline were associated with participation. Considering the decrease in participation in recent years, and the cost of cohort studies, it is essential to gather information to assess the potential for non-participation, before committing resources. Finally, journals should require the presentation of this information in the papers.

Computer Simulation as a Tool for Assessing Decision-Making in Pandemic Influenza Response Training

Directory of Open Access Journals (Sweden)

James M Leaming

2013-05-01

Full Text Available Introduction: We sought to develop and test a computer-based, interactive simulation of a hypothetical pandemic influenza outbreak. Fidelity was enhanced with integrated video and branching decision trees, built upon the 2007 federal planning assumptions. We conducted a before-and-after study of the simulation effectiveness to assess the simulations’ ability to assess participants’ beliefs regarding their own hospitals’ mass casualty incident preparedness.Methods: Development: Using a Delphi process, we finalized a simulation that serves up a minimum of over 50 key decisions to 6 role-players on networked laptops in a conference area. The simulation played out an 8-week scenario, beginning with pre-incident decisions. Testing: Role-players and trainees (N=155 were facilitated to make decisions during the pandemic. Because decision responses vary, the simulation plays out differently, and a casualty counter quantifies hypothetical losses. The facilitator reviews and critiques key factors for casualty control, including effective communications, working with external organizations, development of internal policies and procedures, maintaining supplies and services, technical infrastructure support, public relations and training. Pre- and post-survey data were compared on trainees.Results: Post-simulation trainees indicated a greater likelihood of needing to improve their organization in terms of communications, mass casualty incident planning, public information and training. Participants also recognized which key factors required immediate attention at their own home facilities.Conclusion: The use of a computer-simulation was effective in providing a facilitated environment for determining the perception of preparedness, evaluating general preparedness concepts and introduced participants to critical decisions involved in handling a regional pandemic influenza surge. [West J Emerg Med. 2013;14(3:236–242.

Environmental Assessments and Stakeholder Involvement

International Nuclear Information System (INIS)

Wesolowski, Cassandra

2006-01-01

Directives and legislation on EIA and SEA need to provide more guidance on how and when public participation should be used. There are now several examples of how well public participation can be performed and the methods are becoming more proactive and innovative. By increasing the role of public participation within the Environmental Assessment process, plans, programmes and projects will become more publicly acceptable. There does need to be a balance as to where public participation is performed in the system, as too much can be a stress on resources and time, as well as producing ineffective results. Key stages such as scoping, preparing the environmental statement or report and decision-making need to be highlighted for the benefits public participation can have. The Aarhus Convention is certainly making a difference in the UK; however it is difficult to judge exactly how much difference yet. It was only fully implemented in the UK in 2005 although some Authorities were applying the three pillars prior to implementation. It is not clear how aware the general public are of the Convention and their rights. Empowering communities in the UK. will communities for decision-making in Environmental Assessments? Providing the public with resources to enable them to fully engage in the process will improve the participation and increase their confidence, but how will this increase their influence within the decision-making process? Ultimately, should the stakeholders and public just influence the incremental decisions made in Environmental Assessments or have more responsibility within the major decisions taken? It will be interesting to see how these issues are addressed over the coming years

Environmental Assessments and Stakeholder Involvement

Energy Technology Data Exchange (ETDEWEB)

Wesolowski, Cassandra [Univ. of Manchester, School of Environment and Development (United Kingdom). Planning and Landscape

2006-09-15

Directives and legislation on EIA and SEA need to provide more guidance on how and when public participation should be used. There are now several examples of how well public participation can be performed and the methods are becoming more proactive and innovative. By increasing the role of public participation within the Environmental Assessment process, plans, programmes and projects will become more publicly acceptable. There does need to be a balance as to where public participation is performed in the system, as too much can be a stress on resources and time, as well as producing ineffective results. Key stages such as scoping, preparing the environmental statement or report and decision-making need to be highlighted for the benefits public participation can have. The Aarhus Convention is certainly making a difference in the UK; however it is difficult to judge exactly how much difference yet. It was only fully implemented in the UK in 2005 although some Authorities were applying the three pillars prior to implementation. It is not clear how aware the general public are of the Convention and their rights. Empowering communities in the UK. will communities for decision-making in Environmental Assessments? Providing the public with resources to enable them to fully engage in the process will improve the participation and increase their confidence, but how will this increase their influence within the decision-making process? Ultimately, should the stakeholders and public just influence the incremental decisions made in Environmental Assessments or have more responsibility within the major decisions taken? It will be interesting to see how these issues are addressed over the coming years.

Preventing School Employee Sexual Misconduct: An Outcome Survey Analysis of Making Right Choices.

Science.gov (United States)

Lipson, Glenn; Grant, Billie-Jo; Mueller, Jessica; Sonnich, Steve

2018-05-30

This treatment-only study examines the impact of Making Right Choices, an online course prevention program designed to promote the knowledge, awareness, and prevention of school employee sexual misconduct. The sample included 13,007 school employee participants who took the Making Right Choices course between May 6, 2011, and March 12, 2017, in California and New York. The 20-item measure, Preventing Misconduct Assessment, was administered to participants at the end of the online course; completion of the measure was voluntary. Descriptive statistics revealed that a large majority of participants reported increasing their knowledge and awareness of school employee sexual misconduct because of their participation in the Making Right Choices online course. This study yields important findings regarding the impact of a sexual misconduct prevention program and, specifically, the difference it may make for non-licensed school employees. These findings indicate that school employees are accepting of sexual misconduct training programs and rate them as having value.

Students' and Teachers' Participation in Decision-Making and ...

African Journals Online (AJOL)

User

2011-04-19

Apr 19, 2011 ... responsibility of school leaders, and the way and manner in which they .... bearing to his being is fundamental to our democratic way of life and must be ... school administrators, then, the decision-making style of the school ...

Ethical implications of democratic theory for U.S. public participation in environmental impact assessment

Science.gov (United States)

Marion Hourdequin; Peter Landres; Mark J. Hanson; David R. Craig

2012-01-01

Traditional mechanisms for public participation in environmental impact assessment under U.S. federal law have been criticized as ineffective and unable to resolve conflict. As these mechanisms are modified and new approaches developed, we argue that participation should be designed and evaluated not only on practical grounds of cost-effectiveness and efficiency, but...

[Citizens' participation in health: education and shared decision-making. SESPAS Report 2012].

Science.gov (United States)

Ruiz-Azarola, Ainhoa; Perestelo-Pérez, Lilisbeth

2012-03-01

In recent decades, citizen's participation has become increasingly important in the field of public health, with the new role of the patient as an active agent, manager and producer of his or her own health, and the paradigm of patient-centered care. These changes have represented some of the most important milestones in the continuous improvement of healthcare. The involvement of patients is a new way of understanding the relationship between patients, health professionals and health systems, not only in terms of knowledge management and patients' control of their own health, individually or collectively, but also in terms of the influence that patients may have in health policy planning. Increased life expectancy and the consequent rise in the prevalence of chronic diseases, which already account for 80% of primary care consultations, is one of the key factors changing the role of patients. The place traditionally occupied by professional consultations given any symptoms or signs of alarm is beginning to be occupied by self-care and information and health education resources within the reach of patients and citizens. Internet access is an inexhaustible source of health information resources aimed at patients and provides participation tools. Social networks are places to exchange information and practical advice among patients, families and health professionals. Patients may be experts in their own illnesses and may thus take a more active role in decisions about their health, such as in shared decision making, as part of initiatives, and as part of evaluation of public health activities and health services. Copyright © 2011 SESPAS. Published by Elsevier Espana. All rights reserved.

Participation of ARN-Argentina in the quality assessment program, EML-USDOE since 1995 to 1999

International Nuclear Information System (INIS)

Equillor, Hugo E.; Serdeiro, Nelida H.; Bonino, Nestor O.; Fernandez, Jorge A.; Gavini, Ricardo M.; Grinman, Ana D.R.; Lewis, E. Cecilia; Palacios, Miguel A.; Bomben, Ana M.; Diodati, Jorge M.

2000-01-01

A radiochemical laboratory must apply optimized analytical techniques and calibrated measurement systems so as to obtain accurate results. In order to achieve this, it is necessary to participate in intercomparison programs with specialized laboratories, as well as to have internal controls that must routinely be done, like efficiencies, backgrounds and chemical yields. The Nuclear Regulatory Authority, in charge of the radiological protection in the Argentine Republic, participates since 1995 in the Quality Assessment Program (QAP) carried out by the Environmental Measurements Laboratory-United States Department of Energy. The aim of this participation is to assess the quality of the reported measurements. The results of these ten partaking are detailed and analyzed in this work. (authors)

Considerations of informed consent and decision-making competence in older adults with cognitive impairment.

Science.gov (United States)

Mayo, Ann M; Wallhagen, Margaret I

2009-04-01

Including older adults with cognitive impairment in research studies is necessary to ensure that interventions designed to improve care are effective for all older adults. However, issues related to capacity to consent raise many difficult questions that nurse researchers must address. Protecting vulnerable participants while simultaneously maintaining autonomy and moving important research forward can be challenging. Assessing the decision-making abilities of understanding, appreciation, reasoning, and expressing a choice is an important aspect of determining decision-making capacity. Yet although this is the prominent rational method for judging decision-making competence, it does not take into consideration the importance of culture, values, and emotions. This article focuses on the assessment of decision-making capacity to consent, recommendations for obtaining informed consent in older adults with cognitive impairment, the use of surrogate decision makers, strategies to maximize research participation, and directions for future research. Copyright 2009, SLACK Incorporated.

States' Participation Guidelines for Alternate Assessments Based on Modified Academic Achievement Standards (AA-MAS) in 2010. Synthesis Report 82

Science.gov (United States)

Lazarus, Sheryl S.; Hodgson, Jennifer R.; Price, Lynn M.; Thurlow, Martha L.

2011-01-01

Federal legislation requires that all students participate in state accountability systems. Most students with disabilities participate in the regular assessment, with or without accommodations. Students with more significant cognitive disabilities participate in the Alternate Assessment based on Alternate Achievement Standards (AA-AAS). A few…

Intelligent Aircraft Damage Assessment, Trajectory Planning, and Decision-Making under Uncertainty

Science.gov (United States)

Lopez, Israel; Sarigul-Klijn, Nesrin

Situational awareness and learning are necessary to identify and select the optimal set of mutually non-exclusive hypothesis in order to maximize mission performance and adapt system behavior accordingly. This paper presents a hierarchical and decentralized approach for integrated damage assessment and trajectory planning in aircraft with uncertain navigational decision-making. Aircraft navigation can be safely accomplished by properly addressing the following: decision-making, obstacle perception, aircraft state estimation, and aircraft control. When in-flight failures or damage occur, rapid and precise decision-making under imprecise information is required in order to regain and maintain control of the aircraft. To achieve planned aircraft trajectory and complete safe landing, the uncertainties in system dynamics of the damaged aircraft need to be learned and incorporated at the level of motion planning. The damaged aircraft is simulated via a simplified kinematic model. The different sources and perspectives of uncertainties in the damage assessment process and post-failure trajectory planning are presented and classified. The decision-making process for an emergency motion planning and landing is developed via the Dempster-Shafer evidence theory. The objective of the trajectory planning is to arrive at a target position while maximizing the safety of the aircraft given uncertain conditions. Simulations are presented for an emergency motion planning and landing that takes into account aircraft dynamics, path complexity, distance to landing site, runway characteristics, and subjective human decision.

Objective classification of scapular kinematics in participants with movement faults of the scapula on clinical assessment.

Science.gov (United States)

Warner, Martin B; Whatling, Gemma; Worsley, Peter R; Mottram, Sarah; Chappell, Paul H; Holt, Catherine A; Stokes, Maria J

2015-01-01

The aim of this study was to assess the potential of employing a classification tool to objectively classify participants with clinically assessed movement faults (MFs) of the scapula. Six participants with a history of shoulder pain with MFs of the scapula and 12 healthy participants with no movement faults (NMFs) performed a flexion movement control test of the scapula, while scapular kinematic data were collected. Principal component scores and discrete kinematic variables were used as input into a classifier. Five out of the six participants with a history of pain were successfully classified as having scapular MFs with an accuracy of 72%. Variables related to the upward rotation of the scapula had the most influence on the classification. The results of the study demonstrate the potential of adopting a multivariate approach in objective classification of participants with altered scapular kinematics in pathological groups.

Risk-informed decision making a keystone in advanced safety assessment

International Nuclear Information System (INIS)

Reinhart, M.

2007-01-01

Probabilistic Safety Assessment (PSA) has provided extremely valuable complementary insight, perspective, comprehension, and balance to deterministic nuclear reactor safety assessment. This integrated approach of risk-informed management and decision making has been called Risk-Informed Decision Making (RIDM). RIDM provides enhanced safety, reliability, operational flexibility, reduced radiological exposure, and improved fiscal economy. Applications of RIDM continuously increase. Current applications are in the areas of design, construction, licensing, operations, and security. Operational phase safety applications include the following: technical specifications improvement, risk-monitors and configuration control, maintenance planning, outage planning and management, in-service inspection, inservice testing, graded quality assurance, reactor oversight and inspection, inspection finding significance determination, operational events assessment, and rulemaking. Interestingly there is a significant spectrum of approaches, methods, programs, controls, data bases, and standards. The quest of many is to assimilate the full compliment of PSA and RIDM information and to achieve a balanced international harmony. The goal is to focus the best of the best, so to speak, for the benefit of all. Accordingly, this presentation will address the principles, benefits, and applications of RIDM. It will also address some of the challenges and areas to improve. Finally it will highlight efforts by the IAEA and others to capture the international thinking, experience, successes, challenges, and lessons in RIDM. (authors)

Making Sense of Data from Complex Assessments. CSE Technical Report.

Science.gov (United States)

Mislevy, Robert J.; Steinberg, Linda S.; Almond, Russell G.; Breyer, F. Jay; Johnson, Lynn

Advances in cognitive psychology deepen the understanding of how students gain and use knowledge and broaden the range of performances and situations researchers want to see to acquire evidence about students' developing knowledge. Advances in technology make it possible to capture more complex performances in assessment settings by including, as…

“Making our job hospitable” – Assessment of job-crafting behavior among dental academic faculty in South India

Directory of Open Access Journals (Sweden)

V Siva Kalyan

2018-01-01

Full Text Available Introduction: Employees are regularly offered opportunities to make their work more appealing and rewarding. These opportunities might be as simple as making fine changes to their daily tasks to boost happiness and to connect with more people at vocation. Hence, an attempt is made to assess job-crafting behavior among the dental academic faculty. Materials and Methods: A cross-sectional study was conducted among dental academic faculty from five dental colleges. Job Crafting Questionnaire (JCQ was used to assess the job-crafting behavior. Mean scores were calculated for different domains of JCQ. Gender differences were analyzed using Student's “t-” test and one-way ANOVA to test the difference between different academic positions of the faculty members. Results: A total of 228 dental faculty members with a mean age of 34.43 ± 6.13 years participated in the study. The mean value of job-crafting behavior was found to be highest among female faculty (60.07 ± 8.38 and professors (61.35 ± 8.30. Male faculty scored higher in task-crafting domain and female faculty scored higher in both cognitive- and relational-crafting domains. The professors scored highest in all the three domains of job-crafting behavior as compared to that of senior lecturers and readers. Conclusion: Job crafting is an effectual workplace intervention, where employees assume an active role in shaping their work experience to enhance their job satisfaction and well-being. The overall score of job-crafting behavior was found to be highest among both professors and female faculty members. Male faculty members scored higher in task-crafting domain. With regard to individual domains, the participants scored highest in cognitive crafting followed by task and relational crafting.

Anticipatory stress influences decision making under explicit risk conditions.

Science.gov (United States)

Starcke, Katrin; Wolf, Oliver T; Markowitsch, Hans J; Brand, Matthias

2008-12-01

Recent research has suggested that stress may affect memory, executive functioning, and decision making on the basis of emotional feedback processing. The current study examined whether anticipatory stress affects decision making measured with the Game of Dice Task (GDT), a decision-making task with explicit and stable rules that taps both executive functioning and feedback learning. The authors induced stress in 20 participants by having them anticipate giving a public speech and also examined 20 comparison subjects. The authors assessed the level of stress with questionnaires and endocrine markers (salivary cortisol and alpha-amylase), both revealing that speech anticipation led to increased stress. Results of the GDT showed that participants under stress scored significantly lower than the comparison group and that GDT performance was negatively correlated with the increase of cortisol. Our results indicate that stress can lead to disadvantageous decision making even when explicit and stable information about outcome contingencies is provided.

Public participation at Fernald: FERMCO's evolving role

International Nuclear Information System (INIS)

Williams, J.B.; Fellman, R.W.; Brettschneider, D.J.

1995-01-01

In an effort to improve public involvement in the site restoration decision making process, the DOE has established site specific advisory boards, of which the Fernald Citizens Task Force is one. The Fernald Task Force is focused on making recommendations in four areas: (1) What should be the future use of the site? (2) Determinations of cleanup levels (how clean is clean?) (3) Where should the wastes be disposed of? (4) What should be the cleanup priorities? Because these questions are being asked very early in the decision-making process, the answers are necessarily qualified, and are based on a combination of preliminary data, assumptions, and professional judgment. The requirement to make progress in the absence of accurate data has necessitated FERMCO and the Task Force to employ an approach similar to sensitivity analysis, in which a range of possible data values are evaluated and the relative importance of the various factors is assessed. Because of its charter to provide recommendations of future site use, the Task Force has developed a sitewide perspective, compared to the more common operable unit specific focus of public participation under CERCLA. The relationship between FERMCO and the Task Force is evolving toward one of partnership with DOE in managing the obstacles and hidden opportunities for success. The Task Force likely will continue to participate in the Fernald project long after its initial recommendations have been made. DOE already has made the commitment that the process of public participation will extend into the Remedial Design phase. There is substantial reason for optimism that continuing the Task Force process through the design phase will assist in developing the appropriate balance of cost and engineered protectiveness

Patients' participation in decision-making in the medical field

DEFF Research Database (Denmark)

Glasdam, Stinne; Oeye, Christine; Thrysøe, Lars

2015-01-01

is going to happen in his life. Both professionals and patients have an underlying, tacit preconception that every medical treatment is better than no treatment. Patients do not always want to be a ‘customer’ in the healthcare system; they want to be a patient, consulting an expert for help and advice......, which creates resistance to the some parts of the decision-making process. Both professionals and patients are subject to the structural frame of the medical field, formed of both neoliberal frame and medical logic. The decision-making competence in relation to the choice of treatment is placed away...

Does Participative Decision Making Affect Lecturer Performance in Higher Education?

Science.gov (United States)

Sukirno, D. S.; Siengthai, Sununta

2011-01-01

Purpose: The relationship between participation and job performance has captured the interest of not only business researchers but also education researchers. However, the topic has not gained significant attention in the educational management research arena. The purpose of this paper is to empirically examine the impact of participation in…

Making Sense of Voluntary Participation: A Theoretical Synthesis

Science.gov (United States)

Ryan, Vernon D.; Agnitsch, Kerry A.; Zhao, Lijun; Mullick, Rehan

2005-01-01

This paper examines the influence of community attachment on voluntary citizen participation in rural community improvement projects. We do so by modifying the original systemic model of community attachment (Kasarda and Janowitz 1974) and combining it with tenets of rational choice and social embeddedness theories. The modified model is then…

Planning for Student Assessment: Participant's Handbook. Bilingual Evaluation Technical Assistance, Workshop III.

Science.gov (United States)

California Univ., Los Angeles. Center for the Study of Evaluation.

This participant's handbook is designed to be used in conjunction with a workshop for planning bilingual student assessment. The following materials are included: (1) simulation materials, including descriptions of simulated programs, tests, test manuals, and printouts; (2) checklists, diagrams, and charts illustrating important points of the…

Do People Really Want Freedom of Choice? Assessing preferences of pension participants

OpenAIRE

van Dalen, H.P.; Henkens, K.

2017-01-01

Reforms in private pension plans across the world are opening up more options for pension participants to make choices to suit their preferences. Freedom of choice is however not a unidimensional concept as it is commonly perceived by policy makers. People can value both the freedom to choose as well as the freedom not to choose This observation can have far-reaching implications for pension policy design. By using a unique panel survey among Dutch employees we are able to offer a more refine...

Companies Credit Risk Assessment Methods for Investment Decision Making

Directory of Open Access Journals (Sweden)

Dovilė Peškauskaitė

2017-06-01

Full Text Available As the banks have tightened lending requirements, companies look for alternative sources of external funding. One of such is bonds issue. Unfortunately, corporate bonds issue as a source of funding is rare in Lithuania. This occurs because companies face with a lack of information, investors fear to take on credit risk. Credit risk is defined as a borrower’s failure to meet its obligation. Investors, in order to avoid credit risk, have to assess the state of the companies. The goal of the article is to determine the most informative methods of credit risk assessment. The article summarizes corporate lending sources, analyzes corporate default causes and credit risk assessment methods. The study based on the SWOT analysis shows that investors before making an investment decision should evaluate both the business risk,using qualitative method CAMPARI, and the financial risk, using financial ratio analysis.

End-of-life decision making is more than rational.

Science.gov (United States)

Eliott, Jaklin A; Olver, Ian N

2005-01-01

Most medical models of end-of-life decision making by patients assume a rational autonomous adult obtaining and deliberating over information to arrive at some conclusion. If the patient is deemed incapable of this, family members are often nominated as substitutes, with assumptions that the family are united and rational. These are problematic assumptions. We interviewed 23 outpatients with cancer about the decision not to resuscitate a patient following cardiopulmonary arrest and examined their accounts of decision making using discourse analytical techniques. Our analysis suggests that participants access two different interpretative repertoires regarding the construct of persons, invoking a 'modernist' repertoire to assert the appropriateness of someone, a patient or family, making a decision, and a 'romanticist' repertoire when identifying either a patient or family as ineligible to make the decision. In determining the appropriateness of an individual to make decisions, participants informally apply 'Sanity' and 'Stability' tests, assessing both an inherent ability to reason (modernist repertoire) and the presence of emotion (romanticist repertoire) which might impact on the decision making process. Failure to pass the tests respectively excludes or excuses individuals from decision making. The absence of the romanticist repertoire in dominant models of patient decision making has ethical implications for policy makers and medical practitioners dealing with dying patients and their families.

Informed Decision-Making in the Context of Prenatal Chromosomal Microarray.

Science.gov (United States)

Baker, Jessica; Shuman, Cheryl; Chitayat, David; Wasim, Syed; Okun, Nan; Keunen, Johannes; Hofstedter, Renee; Silver, Rachel

2018-03-07

The introduction of chromosomal microarray (CMA) into the prenatal setting has involved considerable deliberation due to the wide range of possible outcomes (e.g., copy number variants of uncertain clinical significance). Such issues are typically discussed in pre-test counseling for pregnant women to support informed decision-making regarding prenatal testing options. This research study aimed to assess the level of informed decision-making with respect to prenatal CMA and the factor(s) influencing decision-making to accept CMA for the selected prenatal testing procedure (i.e., chorionic villus sampling or amniocentesis). We employed a questionnaire that was adapted from a three-dimensional measure previously used to assess informed decision-making with respect to prenatal screening for Down syndrome and neural tube defects. This measure classifies an informed decision as one that is knowledgeable, value-consistent, and deliberated. Our questionnaire also included an optional open-ended question, soliciting factors that may have influenced the participants' decision to accept prenatal CMA; these responses were analyzed qualitatively. Data analysis on 106 participants indicated that 49% made an informed decision (i.e., meeting all three criteria of knowledgeable, deliberated, and value-consistent). Analysis of 59 responses to the open-ended question showed that "the more information the better" emerged as the dominant factor influencing both informed and uninformed participants' decisions to accept prenatal CMA. Despite learning about the key issues in pre-test genetic counseling, our study classified a significant portion of women as making uninformed decisions due to insufficient knowledge, lack of deliberation, value-inconsistency, or a combination of these three measures. Future efforts should focus on developing educational approaches and counseling strategies to effectively increase the rate of informed decision-making among women offered prenatal CMA.

Assessing the Relationship between Youth Sport Participation Settings and Creativity in Adulthood

Science.gov (United States)

Bowers, Matthew T.; Green, B. Christine; Hemme, Florian; Chalip, Laurence

2014-01-01

This article presents an assessment of the relative influences of time spent participating in organized sports and informal sports during childhood with respect to the development of general creativity. In this study, 99 upper-division undergraduate and graduate students completed a comprehensive childhood leisure activities questionnaire and the…

PRA (Probabilistic Risk Assessments) Participation versus Validation

Science.gov (United States)

DeMott, Diana; Banke, Richard

2013-01-01

Probabilistic Risk Assessments (PRAs) are performed for projects or programs where the consequences of failure are highly undesirable. PRAs primarily address the level of risk those projects or programs posed during operations. PRAs are often developed after the design has been completed. Design and operational details used to develop models include approved and accepted design information regarding equipment, components, systems and failure data. This methodology basically validates the risk parameters of the project or system design. For high risk or high dollar projects, using PRA methodologies during the design process provides new opportunities to influence the design early in the project life cycle to identify, eliminate or mitigate potential risks. Identifying risk drivers before the design has been set allows the design engineers to understand the inherent risk of their current design and consider potential risk mitigation changes. This can become an iterative process where the PRA model can be used to determine if the mitigation technique is effective in reducing risk. This can result in more efficient and cost effective design changes. PRA methodology can be used to assess the risk of design alternatives and can demonstrate how major design changes or program modifications impact the overall program or project risk. PRA has been used for the last two decades to validate risk predictions and acceptability. Providing risk information which can positively influence final system and equipment design the PRA tool can also participate in design development, providing a safe and cost effective product.

Self-assessed health, perceived stress and non-participation in breast cancer screening: A Danish cohort study

DEFF Research Database (Denmark)

Jensen, Line Flytkjær; Pedersen, Anette Fischer; Andersen, Berit

2015-01-01

and subsequent non-participation in breast cancer screening. Methods This population-based cohort study included 4512 women who had participated in a Health Survey in 2006 and who were also the target group (aged 50–69 years) for the first organised breast cancer screening programme -3 years later in the Central...... Denmark Region in 2008–2009. Results A U-shaped association was observed for physical health assessment as women with the highest (PR = 1.28, 95% CI: 1.06–1.55), and the lowest (PR = 1.41, 95% CI: 1.18–1.68) physical health scores were less likely to participate in the programme than women with physical...... health scores in the middle range. Women with low mental health assessment were more likely not to participate than women with mental health scores in the middle range (PR = 1.44, 95% CI: 1.22–1.69). Higher non-participation propensity was also observed for women with the highest perceived stress scores...

Assessing the multidimensionality of coastal erosion risks: public participation and multicriteria analysis in a Mediterranean coastal system.

Science.gov (United States)

Roca, Elisabet; Gamboa, Gonzalo; Tàbara, J David

2008-04-01

The complex and multidimensional nature of coastal erosion risks makes it necessary to move away from single-perspective assessment and management methods that have conventionally predominated in coastal management. This article explores the suitability of participatory multicriteria analysis (MCA) for improving the integration of diverse expertises and values and enhancing the social-ecological robustness of the processes that lead to the definition of relevant policy options to deal with those risks. We test this approach in the Mediterranean coastal locality of Lido de Sète in France. Results show that the more adaptive alternatives such as "retreating the shoreline" were preferred by our selected stakeholders to those corresponding to "protecting the shoreline" and the business as usual proposals traditionally put forward by experts and policymakers on these matters. Participative MCA contributed to represent coastal multidimensionality, elicit and integrate different views and preferences, facilitated knowledge exchange, and allowed highlighting existing uncertainties.

Frailty assessment in vascular surgery and its utility in preoperative decision making.

Science.gov (United States)

Kraiss, Larry W; Beckstrom, Julie L; Brooke, Benjamin S

2015-06-01

The average patient requiring vascular surgery has become older, as life expectancy within the US population has increased. Many older patients have some degree of frailty and reside near the limit of their physiological reserve with restricted ability to respond to stressors such as surgery. Frailty assessment is an important part of the preoperative decision-making process, in order to determine whether patients are fit enough to survive the vascular surgery procedure and live long enough to benefit from the intervention. In this review, we will discuss different measures of frailty assessment and how they can be used by vascular surgery providers to improve preoperative decision making and the quality of patient care. Copyright © 2015 Elsevier Inc. All rights reserved.

Gender Differences in Bladder Cancer Treatment Decision Making.

Science.gov (United States)

Pozzar, Rachel A; Berry, Donna L

2017-03-01

To explore gender differences in bladder cancer treatment decision making.
. Secondary qualitative analysis of interview transcripts.
. One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews. Participants were primarily Caucasian, and most had at least some college education.
. Word frequency reports were used to identify thematic differences between the men's and women's statements. Line-by-line coding of constructs prevalent among women was then performed on all participants in NVivo 9. Coding results were compared between genders using matrix coding queries.
. The role of family in the decision-making process was found to be a dominant theme for women but not for men. Women primarily described family members as facilitators of bladder cancer treatment-related decisions, but men were more likely to describe family in a nonsupportive role.
. The results suggest that influences on the decision-making process are different for men and women with bladder cancer. Family may play a particularly important role for women faced with bladder cancer treatment-related decisions.
. Clinical nurses who care for individuals with bladder cancer should routinely assess patients' support systems and desired level of family participation in decision making. For some people with bladder cancer, family may serve as a stressor. Nurses should support the decision-making processes of all patients and be familiar with resources that can provide support to patients who do not receive it from family.

Environmental risk assessment of chemicals and nanomaterials--The best foundation for regulatory decision-making?

Science.gov (United States)

Syberg, Kristian; Hansen, Steffen Foss

2016-01-15

Environmental risk assessment (ERA) is often considered as the most transparent, objective and reliable decision-making tool for informing the risk management of chemicals and nanomaterials. ERAs are based on the assumption that it is possible to provide accurate estimates of hazard and exposure and, subsequently, to quantify risk. In this paper we argue that since the quantification of risk is dominated by uncertainties, ERAs do not provide a transparent or an objective foundation for decision-making and they should therefore not be considered as a "holy grail" for informing risk management. We build this thesis on the analysis of two case studies (of nonylphenol and nanomaterials) as well as a historical analysis in which we address the scientific foundation for ERAs. The analyses show that ERAs do not properly address all aspects of actual risk, such as the mixture effect and the environmentally realistic risk from nanomaterials. Uncertainties have been recognised for decades, and assessment factors are used to compensate for the lack of realism in ERAs. The assessment factors' values were pragmatically determined, thus lowering the scientific accuracy of the ERAs. Furthermore, the default choice of standard assay for assessing a hazard might not always be the most biologically relevant, so we therefore argue that an ERA should be viewed as a pragmatic decision-making tool among several, and it should not have a special status for informing risk management. In relation to other relevant decision-making tools we discuss the use of chemical alternative assessments (CAAs) and the precautionary principle. Copyright © 2015 Elsevier B.V. All rights reserved.

The effects of critical thinking instruction on training complex decision making

NARCIS (Netherlands)

Helsdingen, A.S.; Bosch, K. van den; Gog, T. van; Merriënboer, J.J.G. van

2010-01-01

Objective : Two field studies assessed the effects of critical thinking instruction on training and transfer of a complex decision-making skill. Background : Critical thinking instruction is based on studies of how experienced decision makers approach complex problems. Method : Participants

The Characteristics of Older People Who Engage in Community Music Making, Their Reasons for Participation and the Barriers They Face

Science.gov (United States)

Hallam, Susan; Creech, Andrea; Varvarigou, Maria; McQueen, Hilary

2012-01-01

There is now an accepted need for initiatives that support older people's health and well-being. There is increasing evidence that active engagement with music has the potential to contribute to this. This research aimed to explore the characteristics of older people who participated in active music making with a view to identifying the groups…

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania.

Science.gov (United States)

Shayo, Elizabeth H; Norheim, Ole F; Mboera, Leonard E G; Byskov, Jens; Maluka, Stephen; Kamuzora, Peter; Blystad, Astrid

2012-06-07

Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people's needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual's opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Existing challenges related to individuals' influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all individuals to participate in decision-making processes. This

Challenges to fair decision-making processes in the context of health care services: a qualitative assessment from Tanzania

Directory of Open Access Journals (Sweden)

Shayo Elizabeth H

2012-06-01

Full Text Available Abstract Background Fair processes in decision making need the involvement of stakeholders who can discuss issues and reach an agreement based on reasons that are justifiable and appropriate in meeting people’s needs. In Tanzania, the policy of decentralization and the health sector reform place an emphasis on community participation in making decisions in health care. However, aspects that can influence an individual’s opportunity to be listened to and to contribute to discussion have been researched to a very limited extent in low-income settings. The objective of this study was to explore challenges to fair decision-making processes in health care services with a special focus on the potential influence of gender, wealth, ethnicity and education. We draw on the principle of fairness as outlined in the deliberative democratic theory. Methods The study was carried out in the Mbarali District of Tanzania. A qualitative study design was used. In-depth interviews and focus group discussion were conducted among members of the district health team, local government officials, health care providers and community members. Informal discussion on the topics was also of substantial value. Results The study findings indicate a substantial influence of gender, wealth, ethnicity and education on health care decision-making processes. Men, wealthy individuals, members of strong ethnic groups and highly educated individuals had greater influence. Opinions varied among the study informants as to whether such differences should be considered fair. The differences in levels of influence emerged most clearly at the community level, and were largely perceived as legitimate. Conclusions Existing challenges related to individuals’ influence of decision making processes in health care need to be addressed if greater participation is desired. There is a need for increased advocacy and a strengthening of responsive practices with an emphasis on the right of all

A method to assess how interactive water simulation tools influence transdisciplinary decision-making processes in water management

Science.gov (United States)

Leskens, Johannes

2015-04-01

In modern water management, often transdisciplinary work sessions are organized in which various stakeholders participate to jointly define problems, choose measures and divide responsibilities to take actions. Involved stakeholders are for example policy analysts or decision-makers from municipalities, water boards or provinces, representatives of pressure groups and researchers from knowledge institutes. Parallel to this increasing attention for transdisciplinary work sessions, we see a growing availability of interactive IT-tools that can be applied during these sessions. For example, dynamic flood risk maps have become recently available that allow users during a work sessions to instantaneously assess the impact of storm surges or dam breaches, displayed on digital maps. Other examples are serious games, realistic visualizations and participatory simulations. However, the question is if and how these interactive IT-tools contribute to better decision-making. To assess this, we take the process of knowledge construction during a work session as a measure for the quality of decision-making. Knowledge construction can be defined as the process in which ideas, perspectives and opinions of different stakeholders, all having their own expertise and experience, are confronted with each other and new shared meanings towards water management issues are created. We present an assessment method to monitor the process of knowledge construction during work sessions in water management in which interactive IT tools are being used. The assessment method is based on a literature review, focusing on studies in which knowledge construction was monitored in other contexts that water management. To test the applicability of the assessment method, we applied it during a multi-stakeholder work session in Westland, located in the southwest of the Netherlands. The discussions during the work session were observed by camera. All statements, expressed by the various members of a

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making

Science.gov (United States)

Toupin April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E.; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter

2015-01-01

Objective Despite the importance of shared decision making for delivering patient-centred care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this OMERACT working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspective of patients, health professionals and researchers. Methods We followed the OMERACT Filter 2.0 to develop a draft core domain set, which consisted of: (i) forming an OMERACT working group; (ii) conducting a review of domains of shared decision making; and (iii) obtaining the opinions of stakeholders using a modified nominal group process held at a session activity at the OMERACT 2014 meeting. Results 26 stakeholders from Europe, North America and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the Draft Core Set: 1) Identifying the decision; 2) Exchanging Information; 3) Clarifying views; 4) Deliberating; 5) Making the decision; 6) Putting the decision into practice; and 7) Assessing the impact of the decision. Contextual factors were also suggested. Conclusion We propose a Draft Core Set of shared decision making domains for OA intervention research studies. Next steps include a workshop at OMERACT 2016 to reach consensus on these proposed domains in the wider OMERACT group, as well as detail sub-domains and assess instruments to develop a Core Outcome Measurement Set. PMID:25877502

Development of a Draft Core Set of Domains for Measuring Shared Decision Making in Osteoarthritis: An OMERACT Working Group on Shared Decision Making.

Science.gov (United States)

Toupin-April, Karine; Barton, Jennifer; Fraenkel, Liana; Li, Linda; Grandpierre, Viviane; Guillemin, Francis; Rader, Tamara; Stacey, Dawn; Légaré, France; Jull, Janet; Petkovic, Jennifer; Scholte-Voshaar, Marieke; Welch, Vivian; Lyddiatt, Anne; Hofstetter, Cathie; De Wit, Maarten; March, Lyn; Meade, Tanya; Christensen, Robin; Gaujoux-Viala, Cécile; Suarez-Almazor, Maria E; Boonen, Annelies; Pohl, Christoph; Martin, Richard; Tugwell, Peter S

2015-12-01

Despite the importance of shared decision making for delivering patient-centered care in rheumatology, there is no consensus on how to measure its process and outcomes. The aim of this Outcome Measures in Rheumatology (OMERACT) working group is to determine the core set of domains for measuring shared decision making in intervention studies in adults with osteoarthritis (OA), from the perspectives of patients, health professionals, and researchers. We followed the OMERACT Filter 2.0 method to develop a draft core domain set by (1) forming an OMERACT working group; (2) conducting a review of domains of shared decision making; and (3) obtaining opinions of all those involved using a modified nominal group process held at a session activity at the OMERACT 12 meeting. In all, 26 people from Europe, North America, and Australia, including 5 patient research partners, participated in the session activity. Participants identified the following domains for measuring shared decision making to be included as part of the draft core set: (1) identifying the decision, (2) exchanging information, (3) clarifying views, (4) deliberating, (5) making the decision, (6) putting the decision into practice, and (7) assessing the effect of the decision. Contextual factors were also suggested. We proposed a draft core set of shared decision-making domains for OA intervention research studies. Next steps include a workshop at OMERACT 13 to reach consensus on these proposed domains in the wider OMERACT group, as well as to detail subdomains and assess instruments to develop a core outcome measurement set.

Emotional and Social Factors influence Poker Decision Making Accuracy.

Science.gov (United States)

Laakasuo, Michael; Palomäki, Jussi; Salmela, Mikko

2015-09-01

Poker is a social game, where success depends on both game strategic knowledge and emotion regulation abilities. Thus, poker provides a productive environment for studying the effects of emotional and social factors on micro-economic decision making. Previous research indicates that experiencing negative emotions, such as moral anger, reduces mathematical accuracy in poker decision making. Furthermore, various social aspects of the game—such as losing against "bad players" due to "bad luck"—seem to fuel these emotional states. We designed an Internet-based experiment, where participants' (N = 459) mathematical accuracy in five different poker decision making tasks were assessed. In addition, we manipulated the emotional and social conditions under which the tasks were presented, in a 2 × 2 experimental setup: (1) Anger versus neutral emotional state—participants were primed either with an anger-inducing, or emotionally neutral story, and (2) Social cue versus non-social cue—during the tasks, either an image of a pair of human eyes was "following" the mouse cursor, or an image of a black moving box was presented. The results showed that anger reduced mathematical accuracy of decision making only when participants were "being watched" by a pair of moving eyes. Experienced poker players made mathematically more accurate decisions than inexperienced ones. The results contribute to current understanding on how emotional and social factors influence decision making accuracy in economic games.

Using cognitive referents in making sense of teaching: A chemistry teacher's struggle to change assessment practices

Science.gov (United States)

Briscoe, Carol

This qualitative case study focused on the role of cognitive referents in the sense-making process of one teacher as he attempted to change his classroom science assessment. The interpretations identify cultural myths, conceptual metonymys, as well as personally constructed beliefs as referents that constrained change. The teacher's cognitive struggle to make sense of assessment and his role as assessor are linked to conflicting referents he used in varying contexts including day-to-day assessment and summative assessment settings. The results of the study suggest that cognitive referents are important influences in driving how a teacher thinks about assessment and may constrain an individual teacher's implementation of innovative practices. Accordingly, identification of referents such as myths, their associated beliefs, and metonymic conceptual models that teachers use to make sense of their actions is an important first step in developing an understanding of constraints to educational change.

PUBLIC PARTICIPATION AND WATER USE RIGHTS

Directory of Open Access Journals (Sweden)

Phillipa King

2015-11-01

Full Text Available The conservation and protection of water resources is paramount in the safeguarding of environmental rights and the attainment of sustainable development in South Africa. Although the National Water Act 36 of 1998 (the NWA seeks to provide a framework for ensuring the sustainable use of water resources, its application has been hindered by capacity and enforcement constraints, a legacy of water pollution (primarily as a result of mining and industrial activities, and poor resource management. To aggravate this situation, the difficulties in effectively implementing the NWA are exacerbated by inadequate public participation in water use licensing processes. Public participation in environmental decision-making has increasingly received recognition for its role in ensuring administrative justice and the protection of environmental rights. While environmental legislation (in many cases sets out procedures for ensuring that public views are taken into account in environmental decision-making processes, the judiciary has also recognised the pivotal role of public engagement in ensuring administrative justice where environmental rights are at stake. Sound public participation practices play an important role in identifying issues requiring consideration in the context of environmental assessment processes, as well as in ensuring that communities are empowered to monitor, identify and report on potential contraventions of environmental legislation. Water is a vital natural resource which is under significant pressure in South Africa. In the circumstances, effective public participation is crucial to ensuring the protection and equitable use of water resources. It follows that provision for comprehensive public engagement in water use licensing processes is integral to ensuring the sustainable management of water resources. While provision is made in the NWA for public engagement in the context of water use licensing processes, such participation is

Regional soil erosion assessment in Slovakia using modelling and farmer's participation

DEFF Research Database (Denmark)

Kenderessy, Pavol; Veihe, Anita

with cereals, sunflowers and corn and is characterised by poor cultivation practices and use of fertilizers leading to land degradation. As a first step, the initial raster-based modelling of soil loss and deposition has provided acceptable and realistic values. The predicted spatial patterns of erosion...... for erosion risk assessments at the landscape scale in Slovakia using a combination of quantitative and qualitative methods for assessing spatial prediction patterns. The model was set up for the Paríž catchment (239.93 km2) in south-western Slovakia. The area has been intensively cultivated primarily...... are now being identified using farmer participation to ensure that the ‘correct’ hot spot areas are being identified. In the end, scenarios will be set up to assess the effect of farming practices and/or conservation measures on soil erosion rates in the area....

Assessment of the national school lunch program in a subset of schools in San Juan, Puerto Rico: participants vs. non-participants.

Science.gov (United States)

Preston, Alan M; Venegas, Heidi; Rodríguez, Cindy A; Vélez-Rodríguez, Rose M

2013-03-01

Extensive evaluations of the national school lunch program (NSLP) have been carried out on the U.S. mainland. Puerto Rico, a commonwealth of the U.S. is a participant in this program, but has never been included in assessment studies. Herein, we present assessment information and compare results with comparable mainland studies. Multiple 24-hr recall questionnaires were administered to groups of participating (P) and non-participating (NP) children in the lunch program at 3 educational levels. Comparisons were made for children within the study as well as between comparable children in mainland studies for total intake of several macro- and micro-nutrients, contribution of the lunch to the total daily intake and adherence to U.S. Recommended Dietary Allowances (RDA's) or to Dietary Reference Intakes (DRI's) including acceptable macronutrient distribution ranges (AMDR's). Target intakes were met by P for % of the RDA of energy from protein, for all water soluble vitamins, iron, zinc and cholesterol. P did not achieve target intakes for total energy, energy from carbohydrates and fat nor for fat soluble vitamins, calcium, magnesium, phosphorus, potassium and fiber. Recommended levels were exceeded for sodium, total fat and saturated fat. Comparing P vs NP, the vast majority of both groups fell within AMDR recommendations for macronutrients but not all micronutrients. For the most part, our results parallel those obtained in the National sample however, results suggest that P in the lunch program in Puerto Rico have a healthier intake of several nutrients than NP students. The unique feature of this study is that it is the first assessment of the NSLP in a completely Hispanic population.

Do neurocognitive deficits in decision making differentiate conduct disorder subtypes?

Science.gov (United States)

Fanti, Kostas A; Kimonis, Eva R; Hadjicharalambous, Maria-Zoe; Steinberg, Laurence

2016-09-01

The present study aimed to test whether neurocognitive deficits involved in decision making underlie subtypes of conduct-disorder (CD) differentiated on the basis of callous-unemotional (CU) traits. Eighty-five participants (M age = 10.94 years) were selected from a sample of 1200 children based on repeated assessment of CD and CU traits. Participants completed a multi-method battery of well-validated measures of risky decision making and associated constructs of selective attention and future orientation (Stroop, Stoplight, and Delay-Discounting Tasks). Findings indicated that impaired decision making, selective attention, and future orientation contribute to the antisocial presentations displayed by children with CD, irrespective of level of CU traits. Youth high on CU traits without CD showed less risky decision making, as indicated by their performance on the Stoplight laboratory task, than those high on both CD and CU traits, suggesting a potential protective factor against the development of antisocial behavior.

The Negative Impact of Legislation Pitfalls on Meaningful Public Participation, Efficient Policy-Making and Effective Governance

Directory of Open Access Journals (Sweden)

Oana ALMĂȘAN

2009-02-01

Full Text Available This article focuses on emphasizing howa variety of apparently irrelevant legislationimperfections may induce significant misunderstandingsregarding the real spirit of democraticgovernance, corrupting the practice of activecitizenship in the policy-making processes anddepriving the Romanian public administration ofan important and valuable instrument for efficientgovernance and implementation of sustainabledecisions. The authors chose to analyze aspectsof the related legislation, as it represents afundamental element needed for the developmentof active citizenship. This article is the result of alarger on-going research on the phenomena ofpublic participation and policy dialogue that aimsto provide a more accurate understanding ofactive citizenship mechanisms and to investigatethe existence of a deliberative conscience at thelevel of the Romanian society.

The interaction between state and dispositional emotions in decision making: An ERP study.

Science.gov (United States)

Wang, Yingying; Gu, Ruolei; Luo, Yue-Jia; Zhou, Chenglin

2017-02-01

In this study, to investigate the influence of incidental emotions on decision making in high-anxious individuals, participants were required to perform a monetary gambling task. Behavioral and electroencephalography responses were recorded to explore the stages of option assessment and outcome evaluation during decision making, respectively. Incidental emotions were elicited by facial expression pictures presented on the background, which included four conditions (control, neutral, fearful, and happy). Results showed smaller feedback-related negativity (FRN) amplitudes in high-anxious participants than low-anxious participants in the control, neutral, and fearful conditions, but not in the happy condition, for small outcomes. The P3 amplitudes were larger in high-anxious participants compared to their counterparts in the fearful and happy conditions, but not in the other conditions. In short, the interaction effects between trait anxiety and facial emotions manifested on the outcome evaluation stage of decision making. Copyright © 2016 Elsevier B.V. All rights reserved.

A Tutorial on Probablilistic Risk Assessement and its Role in Risk-Informed Decision Making

Science.gov (United States)

Dezfuli, Homayoon

2010-01-01

This slide presentation reviews risk assessment and its role in risk-informed decision making. It includes information on probabilistic risk assessment, typical risk management process, origins of risk matrix, performance measures, performance objectives and Bayes theorem.

Barriers to participation in a hospital-based falls assessment clinic programme: an interview study with older people

DEFF Research Database (Denmark)

Evron, L.; Schultz-Larsen, K.; Fristrup, T.

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Thos...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare Udgivelsesdato: 2009/9......Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...

Barriers to participation in a hospital-based falls assessment clinic programme: an interview study with older people

DEFF Research Database (Denmark)

Evron, Lotte; Schultz-Larsen, Kirsten; Fristrup, Tine

2009-01-01

Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Thos...... the findings of this study to a public health message, we have to consider moving the focus of falls prevention strategies from disease control to the domain of health promotion in order to engage older adults in preventive healthcare.......Aims: To gain new knowledge about barriers to participation in hospital-based falls assessment. Methods: Semi-structured interviews with 20 older people referred to falls assessment at a hospital-based clinic were conducted. A convenience sample of 10 refusers and 10 accepters was collected. Those...... system taking over their life. Conclusions: This study indicates that older at-risk patients acknowledge their falls problem, but refuse to participate in hospital-based assessment programmes because they expect to lose their authority and to be caught up in the healthcare system. In order to transform...

Integrated assessment and environmental policy making. In pursuit of usefulness

International Nuclear Information System (INIS)

Parson, E.A.

1995-01-01

Current integrated assessment projects primarily seek end to end integration through formal models at a national to global scale, and show three significant representational weaknesses: determinants of decadal-scale emissions trends; valuing impacts and adaptive response; and the formation and effects of policies. Meeting the needs of policy audiences may require other forms of integration; may require integration by formal modeling or by other means; and may require representing decisions of other actors through political and negotiating processes. While rational global environmental policy making requires integrated assessment, current practice admits no single vision of how to do it, so understanding will be best advanced by a diverse collection of projects pursuing distinct methods and approaches. Further practice may yield some consensus on best practice, possibly including generic assessment skills generalizable across issues. (Author)

Methodical principles of assessment of financial compensation for clinical trial volunteer participants

Directory of Open Access Journals (Sweden)

V. Ye. Dobrova

2013-10-01

participation in clinical trials by patients and healthy volunteers has been rationalized, whereas methods of calculating monetary compensation for such participation have been suggested. The two methods of calculating of the financial compensation were proposed: first - hourly compensation for the time which was spent on clinical trials, the second - hourly-bonus compensation for the possible discomfort and inconvenience of participation in clinical trials in accordance with the ethical rules for research involving people as objects of observation. Conclusion. Achievement of the organizational and financial constituent ensuring participation of volunteers in a clinical trial on the one hand should assure the appropriate experimental foundation for reliable research conducting and on other hand should focus attention on the fulfillment of mental and ethical rules for investigations involving human as a studied object. Basing on the results of an analysis and the survey performed which involved qualified experts regarding aspects affecting volunteers enrollment in a clinical trial, the scientifically substantiated system of the volunteers discomfort and inconvenience assessment in a clinical trial has been proposed, which includes criteria: study duration, adverse events/adverse reactions possibility, blood sampling during study, discomfort caused by study design, inconvenience to participate in a clinical trial. Two techniques for calculation of the financial compensation for healthy volunteers participation in a clinical trial have been proposed: the first one is the payment by the hour spent for participation in a study, and the second one is the hourly pay with bonus for possible discomfort caused by involvement in a clinical trial. In the further study authors plan to research the aspects of risk assessment associated with volunteers participation in a clinical trial and its considering as an additional constituent in the process of the calculation of financial incentives

Transparency and Public Participation in Radioactive Waste Management. RISCOM II Final report

Energy Technology Data Exchange (ETDEWEB)

Andersson, Kjell [Karinta-Konsult, Taeby (Sweden); Westerling, Magnus [Swedish Nuclear Power Inspectorate, Stockholm (Sweden); Atherton, Elizabeth [UK Nirex Ltd (United Kingdom)] [and others

2003-10-01

The RISCOM II project was initiated to support the participating organisations in developing transparency in their radioactive waste programmes by developing a greater degree of public participation.The project has clarified how the RISCOM Model can best be used in radioactive waste management programmes, as well as which are the most important areas of further testing an improvement. The methodology used for designing hearings included active involvement of the hearing actors at the preparatory stage - an element that contributed to the fairness of the entire process. We have also seen how the RISCOM Model can support the development of criteria for public participation processes. To enhance transparency, such processes should have the capacity to evaluate claims of fact, legitimacy and authenticity, and they need to have stretching capacity. Above all, in parallel with possible further development and refinement of the RISCOM Model, its theoretical grounds in combination with its already proven applicability make it ready for further use directly in radioactive waste management programmes for the design of decision processes and means for citizen participation. The model can also be used for the analysis of organisational systems ability to provide transparency. One of the cores issues addressed in the study has been how performance assessment can be made more transparent and what needs to be done to make it more accessible to the general public: Arrangements should be made to make visible where values enter the performance assessment and how uncertainties are taken care of. Performance assessment should not be communicated by information departments - the real experts need to engage themselves so that people can see that they are honest, open about uncertainties and address the concerns of ordinary people. Clearly regulatory standards and criteria are one important area where the principles of transparent decision-making should be applied. Successful citizen

Transparency and Public Participation in Radioactive Waste Management. RISCOM II Final report

Energy Technology Data Exchange (ETDEWEB)

Andersson, Kjell [Karinta-Konsult, Taeby (Sweden); Westerling, Magnus [Swedish Nuclear Power Inspectorate, Stockholm (Sweden); Atherton, Elizabeth [UK Nirex Ltd (United Kingdom); and others

2003-10-01

The RISCOM II project was initiated to support the participating organisations in developing transparency in their radioactive waste programmes by developing a greater degree of public participation.The project has clarified how the RISCOM Model can best be used in radioactive waste management programmes, as well as which are the most important areas of further testing an improvement. The methodology used for designing hearings included active involvement of the hearing actors at the preparatory stage - an element that contributed to the fairness of the entire process. We have also seen how the RISCOM Model can support the development of criteria for public participation processes. To enhance transparency, such processes should have the capacity to evaluate claims of fact, legitimacy and authenticity, and they need to have stretching capacity. Above all, in parallel with possible further development and refinement of the RISCOM Model, its theoretical grounds in combination with its already proven applicability make it ready for further use directly in radioactive waste management programmes for the design of decision processes and means for citizen participation. The model can also be used for the analysis of organisational systems ability to provide transparency. One of the cores issues addressed in the study has been how performance assessment can be made more transparent and what needs to be done to make it more accessible to the general public: Arrangements should be made to make visible where values enter the performance assessment and how uncertainties are taken care of. Performance assessment should not be communicated by information departments - the real experts need to engage themselves so that people can see that they are honest, open about uncertainties and address the concerns of ordinary people. Clearly regulatory standards and criteria are one important area where the principles of transparent decision-making should be applied. Successful citizen

Persons with Alzheimer's Disease Make Phone Calls Independently Using a Computer-Aided Telephone System

Science.gov (United States)

Perilli, Viviana; Lancioni, Giulio E.; Singh, Nirbhay N.; O'Reilly, Mark F.; Sigafoos, Jeff; Cassano, Germana; Cordiano, Noemi; Pinto, Katia; Minervini, Mauro G.; Oliva, Doretta

2012-01-01

This study assessed whether four patients with a diagnosis of Alzheimer's disease could make independent phone calls via a computer-aided telephone system. The study was carried out according to a non-concurrent multiple baseline design across participants. All participants started with baseline during which the telephone system was not available,…

Decision-making impairment in anorexia nervosa: New insights into the role of age and decision-making style.

Science.gov (United States)

Giannunzio, Valeria; Degortes, Daniela; Tenconi, Elena; Collantoni, Enrico; Solmi, Marco; Santonastaso, Paolo; Favaro, Angela

2018-07-01

Patients with anorexia nervosa (AN) often report difficulties in decision making, which may interfere with treatment. The aim of this study was to investigate decision making in a large sample of adolescent and adult patients with AN, by using the Iowa gambling task. Participants were 611 female individuals (310 patients and 301 controls) who underwent neuropsychological and clinical assessment. Significantly poorer decision-making performance was observed in adult patients, whereas no difference emerged between affected and nonaffected adolescents. Both adolescent and adult patients were characterized by trends for higher levels of attention to losses in comparison with healthy controls. Although healthy adult women exhibited better decision-making performance than healthy adolescents, in AN, there was no improvement of decision making with age. A cluster analysis identified 2 different styles of decision making in both patients and controls: a conservative style and an impulsive style. Our study provides evidence of dysfunctional decision making in adult patients with AN and reveals an association between poor decision making and excessive punishment sensitivity in AN. The clinical and scientific implications of these findings merit further exploration. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Assessing the relevance of ecotoxicological studies for regulatory decision making.

Science.gov (United States)

Rudén, Christina; Adams, Julie; Ågerstrand, Marlene; Brock, Theo Cm; Poulsen, Veronique; Schlekat, Christian E; Wheeler, James R; Henry, Tala R

2017-07-01

Regulatory policies in many parts of the world recognize either the utility of or the mandate that all available studies be considered in environmental or ecological hazard and risk assessment (ERA) of chemicals, including studies from the peer-reviewed literature. Consequently, a vast array of different studies and data types need to be considered. The first steps in the evaluation process involve determining whether the study is relevant to the ERA and sufficiently reliable. Relevance evaluation is typically performed using existing guidance but involves application of "expert judgment" by risk assessors. In the present paper, we review published guidance for relevance evaluation and, on the basis of the practical experience within the group of authors, we identify additional aspects and further develop already proposed aspects that should be considered when conducting a relevance assessment for ecotoxicological studies. From a regulatory point of view, the overarching key aspect of relevance concerns the ability to directly or indirectly use the study in ERA with the purpose of addressing specific protection goals and ultimately regulatory decision making. Because ERA schemes are based on the appropriate linking of exposure and effect estimates, important features of ecotoxicological studies relate to exposure relevance and biological relevance. Exposure relevance addresses the representativeness of the test substance, environmental exposure media, and exposure regime. Biological relevance deals with the environmental significance of the test organism and the endpoints selected, the ecological realism of the test conditions simulated in the study, as well as a mechanistic link of treatment-related effects for endpoints to the protection goal identified in the ERA. In addition, uncertainties associated with relevance should be considered in the assessment. A systematic and transparent assessment of relevance is needed for regulatory decision making. The relevance

Falls Assessment Clinical Trial (FACT: design, interventions, recruitment strategies and participant characteristics

Directory of Open Access Journals (Sweden)

Lawton Beverley

2007-07-01

Full Text Available Abstract Background Guidelines recommend multifactorial intervention programmes to prevent falls in older adults but there are few randomised controlled trials in a real life health care setting. We describe the rationale, intervention, study design, recruitment strategies and baseline characteristics of participants in a randomised controlled trial of a multifactorial falls prevention programme in primary health care. Methods Participants are patients from 19 primary care practices in Hutt Valley, New Zealand aged 75 years and over who have fallen in the past year and live independently. Two recruitment strategies were used – waiting room screening and practice mail-out. Intervention participants receive a community based nurse assessment of falls and fracture risk factors, home hazards, referral to appropriate community interventions, and strength and balance exercise programme. Control participants receive usual care and social visits. Outcome measures include number of falls and injuries over 12 months, balance, strength, falls efficacy, activities of daily living, quality of life, and physical activity levels. Results 312 participants were recruited (69% women. Of those who had fallen, 58% of people screened in the practice waiting rooms and 40% when screened by practice letter were willing to participate. Characteristics of participants recruited using the two methods are similar (p > 0.05. Mean age of all participants was 81 years (SD 5. On average participants have 7 medical conditions, take 5.5 medications (29% on psychotropics with a median of 2 falls (interquartile range 1, 3 in the previous year. Conclusion The two recruitment strategies and the community based intervention delivery were feasible and successful, identifying a high risk group with multiple falls. Recruitment in the waiting room gave higher response rates but was less efficient than practice mail-out. Testing the effectiveness of an evidence based intervention in a

Testing decision-making competency of schizophrenia participants in clinical trials. A meta-analysis and meta-regression.

Science.gov (United States)

Hostiuc, Sorin; Rusu, Mugurel Constantin; Negoi, Ionut; Drima, Eduard

2018-01-05

The process of assessing the decision-making capacity of potential subjects before their inclusion in clinical trials is a legal requirement and a moral obligation, as it is essential for respecting their autonomy. This issue is especially important in psychiatry patients (such as those diagnosed with schizophrenia). The primary purpose of this article was to evaluate the degree of impairment in each dimension of decision-making capacity in schizophrenia patients compared to non-mentally-ill controls, as quantified by the (MacCAT-CR) instrument. Secondary objectives were (1) to see whether enhanced consent forms are associated with a significant increase in decision-making capacity in schizophrenia patients, and (2) if decision-making capacity in schizophrenia subjects is dependent on the age, gender, or the inpatient status of the subjects. We systematically reviewed the results obtained from three databases: ISI Web of Science, Pubmed, Scopus. Each database was scrutinised using the following keywords: "MacCAT-CR + schizophrenia", "decision-making capacity + schizophrenia", and "informed consent + schizophrenia." We included 13 studies in the analysis. The effect size between the schizophrenia and the control group was significant, with a difference in means of -4.43 (-5.76; -3.1, p reasoning, and -0.05 (-0.9, -0.01, p = 0.022) for expressing a choice. Even if schizophrenia patients have a significantly decreased decision-making capacity compared to non-mentally-ill controls, they should be considered as competent unless very severe changes are identifiable during clinical examination. Enhanced informed consent forms decrease the differences between schizophrenia patients and non-mentally-ill controls (except for the reasoning dimension) and should be used whenever the investigators want to include more ill patients in their clinical trials. Increased age, men gender and an increased percentage of inpatients might increase the differential of decision-making

Assessing Students' Performances in Decision-Making: Coping Strategies of Biology Teachers

Science.gov (United States)

Steffen, Benjamin; Hößle, Corinna

2017-01-01

Decision-making in socioscientific issues (SSI) constitutes a real challenge for both biology teachers and learners. The assessment of students' performances in SSIs constitutes a problem, especially for biology teachers. The study at hand was conducted in Germany and uses a qualitative approach following the research procedures of grounded theory…

Public participation in the environmental impact assessment: one alternative of involvement

International Nuclear Information System (INIS)

Hokkanen, P.

2002-01-01

Posiva's EIA for the disposal of nuclear waste covered four candidate municipalities, Eurajoki, Kuhmo, Loviisa and Aeaekoski, where the possibilities of final disposal of spent fuel were being investigated. The implementation of the EIA was a comprehensive process in many ways, when considering the history of EIA in Finland. There was an 'EIA era' for almost three years in all candidate municipalities. The EIA process was seen in the everyday life of the municipalities. The EIA process has been dubbed of 'the EIA of the century' in Finland. The central political aim of the EIA - to increase participation - moreover brings the question of nuclear waste into a new arena. The Environmental Impact Assessment Act underlines public participation. There are many ways of public participation available at the local level. Some are 'direct and some 'representative' in nature. For example, in the case of the final disposal of nuclear waste, local inhabitants have had a number of opportunities to take part in and to influence the ongoing process. In the EIA process of the final disposal there were three ways to participate: Public hearings (and other meetings) before and after the EIA programme and report; written opinions to the competent authority (KTM) after the EIA programme and report; and direct contacts to the EIA contact persons of the candidate municipalities. (authors)

Decision-making in people who relapsed to driving under the influence of alcohol.

Science.gov (United States)

Kasar, Muzaffer; Gleichgerrcht, Ezequiel; Keskinkilic, Cahit; Tabo, Abdulkadir; Manes, Facundo F

2010-12-01

Alcohol use has been previously associated with neurocognitive impairments, especially in decision-making cognition. However, some studies have shown little to no decision-making deficits in relation to different characteristics of people with drinking problems. Relapsing to driving under the influence (DUI) of alcohol is an important issue with legal and psychosocial aspects. We evaluated decision-making performance in second-time DUI offenders by using the Iowa Gambling Task (IGT). Thirty-four male second-time DUI offenders who had been selected for an official psychoeducational rehabilitation program and 31 healthy controls that were matched for age, education, and alcohol use were included. Along with psychiatric assessment, we applied conventional neuropsychological testing comprising cognitive set-shifting, response inhibition, attention, and visuospatial abilities. Also, we used the Temperament and Character Inventory (TCI) to assess personality patterns. A computerized version of IGT was used. No significant differences were found between the groups in regard to sociodemographics and conventional neuropsychological testing. DUI participants had significantly higher scores only in "self-transcendence" subdomain of TCI. On the fifth block of the IGT, DUI participants had significantly lower net scores than controls (U = 380.0, p decision-making deficits in DUI participants, which goes undetected on conventional neuropsychological testing and which is not correlated with TCI subdomains related with impulsivity patterns. Copyright © 2010 by the Research Society on Alcoholism.

The IDEA Assessment Tool: Assessing the Reporting, Diagnostic Reasoning, and Decision-Making Skills Demonstrated in Medical Students' Hospital Admission Notes.

Science.gov (United States)

Baker, Elizabeth A; Ledford, Cynthia H; Fogg, Louis; Way, David P; Park, Yoon Soo

2015-01-01

Construct: Clinical skills are used in the care of patients, including reporting, diagnostic reasoning, and decision-making skills. Written comprehensive new patient admission notes (H&Ps) are a ubiquitous part of student education but are underutilized in the assessment of clinical skills. The interpretive summary, differential diagnosis, explanation of reasoning, and alternatives (IDEA) assessment tool was developed to assess students' clinical skills using written comprehensive new patient admission notes. The validity evidence for assessment of clinical skills using clinical documentation following authentic patient encounters has not been well documented. Diagnostic justification tools and postencounter notes are described in the literature (1,2) but are based on standardized patient encounters. To our knowledge, the IDEA assessment tool is the first published tool that uses medical students' H&Ps to rate students' clinical skills. The IDEA assessment tool is a 15-item instrument that asks evaluators to rate students' reporting, diagnostic reasoning, and decision-making skills based on medical students' new patient admission notes. This study presents validity evidence in support of the IDEA assessment tool using Messick's unified framework, including content (theoretical framework), response process (interrater reliability), internal structure (factor analysis and internal-consistency reliability), and relationship to other variables. Validity evidence is based on results from four studies conducted between 2010 and 2013. First, the factor analysis (2010, n = 216) yielded a three-factor solution, measuring patient story, IDEA, and completeness, with reliabilities of .79, .88, and .79, respectively. Second, an initial interrater reliability study (2010) involving two raters demonstrated fair to moderate consensus (κ = .21-.56, ρ =.42-.79). Third, a second interrater reliability study (2011) with 22 trained raters also demonstrated fair to moderate agreement

Organizational politics, participation in decision-making, and job satisfaction.

Science.gov (United States)

1992-04-01

The study tested two hypotheses: (a) that organizational politics as measured by the Kacmar and Ferris (1991) Perceptions of Organizational Politics Scale would be negatively related to feelings of job satisfaction; and (b) that participation in deci...

Promoting Participation Through the Universal Design of Built Environments: Making it Happen

Directory of Open Access Journals (Sweden)

Valerie Watchorn

2014-12-01

Full Text Available Environmental design is a determinant of social inclusion and people’s participation in life roles. Design that does not cater for a diverse range of ages, abilities and cultures restricts people’s access to, and use of, domestic or public premises. Universal design is an approach that acknowledges diversity of populations and encourages designers to create objects and places that are usable by the greatest majority of users. Although there are potential benefits to the widest application of universal design within society, such application is not mandatory within Australia. This paper presents findings from an Australian qualitative study that explored universal design as a means of facilitating greater environmental access for all. The views of experts working within the field of architecture and environmental access were explored regarding factors that restrict or facilitate application of universal design to the design of built environments. Study findings revealed a number of themes relating to factors that may restrain, ‘what’s holding us back?’ and factors that may facilitate application of universal design, ‘making it happen’. These findings have direct relevance to those involved in the planning and design of built environments, policy developers and educators. Keywords: Universal design, architecture, occupational therapy, built environments, barriers, facilitators, inter-professional education

Decision-making deficits in normal elderly persons associated with executive personality disturbances.

Science.gov (United States)

Nguyen, Christopher M; Barrash, Joseph; Koenigs, Anna L; Bechara, Antoine; Tranel, Daniel; Denburg, Natalie L

2013-11-01

The problems that some community-dwelling elderly persons develop in real-world decision-making may have disastrous consequences for their health and financial well-being. Investigations across the adult life span have identified personality as an important individual differences variable that is related to decision-making ability. The aim of this study was to investigate the relationship between personality characteristics, as rated by an informant, and complex decision-making performance among elderly persons. It was hypothesized that deficits in decision-making would be associated with personality characteristics reflecting weak executive functioning (Lack of Planning, Poor Judgment, Lack of Persistence, Perseveration, Lack of Initiative, Impulsivity, and Indecisiveness). Fifty-eight elderly persons participated. Their health and cognitive status were deemed intact via comprehensive neuropsychological evaluation. The Iowa Scales of Personality, completed by an informant, was used to assess personality characteristics, and the Iowa Gambling Task, completed by the participant, was used to assess complex decision-making abilities. Longstanding disturbances in executive personality characteristics were found to be associated with poor decision-making, and these disturbances remained predictive of poor decision-making even after taking into consideration demographic, neuropsychological, and mood factors. Acquired personality disturbances did not add significantly to prediction after longstanding disturbances were taken into account. Disturbances in other dimensions of personality were not significantly associated with poor decision-making. Our study suggests that attentiveness to the personality correlates of difficulties with aspects of executive functioning over the adult years could enhance the ability to identify older individuals at risk for problems with real-world decision-making.

Participation of distributed generation in balance management

NARCIS (Netherlands)

Frunt, J.; Kechroud, A.; Kling, W.L.; Myrzik, J.M.A.

2009-01-01

Distributed generation is not yet considered to participate in balance management in power systems. Low marginal costs and poor predictability make them less attractive for this application. However, further integration of distributed generation will make participation in balance management a

Wishful Thinking? Inside the Black Box of Exposure Assessment.

Science.gov (United States)

Money, Annemarie; Robinson, Christine; Agius, Raymond; de Vocht, Frank

2016-05-01

Decision-making processes used by experts when undertaking occupational exposure assessment are relatively unknown, but it is often assumed that there is a common underlying method that experts employ. However, differences in training and experience of assessors make it unlikely that one general method for expert assessment would exist. Therefore, there are concerns about formalizing, validating, and comparing expert estimates within and between studies that are difficult, if not impossible, to characterize. Heuristics on the other hand (the processes involved in decision making) have been extensively studied. Heuristics are deployed by everyone as short-cuts to make the often complex process of decision-making simpler, quicker, and less burdensome. Experts' assessments are often subject to various simplifying heuristics as a way to reach a decision in the absence of sufficient data. Therefore, investigating the underlying heuristics or decision-making processes involved may help to shed light on the 'black box' of exposure assessment. A mixed method study was conducted utilizing both a web-based exposure assessment exercise incorporating quantitative and semiqualitative elements of data collection, and qualitative semi-structured interviews with exposure assessors. Qualitative data were analyzed using thematic analysis. Twenty-five experts completed the web-based exposure assessment exercise and 8 of these 25 were randomly selected to participate in the follow-up interview. Familiar key themes relating to the exposure assessment exercise emerged; 'intensity'; 'probability'; 'agent'; 'process'; and 'duration' of exposure. However, an important aspect of the detailed follow-up interviews revealed a lack of structure and order with which participants described their decision making. Participants mostly described some form of an iterative process, heavily relying on the anchoring and adjustment heuristic, which differed between experts. In spite of having undertaken

Participation and social participation: are they distinct concepts?

Science.gov (United States)

Piškur, Barbara; Daniëls, Ramon; Jongmans, Marian J; Ketelaar, Marjolijn; Smeets, Rob J E M; Norton, Meghan; Beurskens, Anna J H M

2014-03-01

The concept of participation has been extensively used in health and social care literature since the World Health Organization introduced its description in the International Classification of Functioning, Disability and Health (ICF) in 2001. More recently, the concept of social participation is frequently used in research articles and policy reports. However, in the ICF, no specific definition exists for social participation, and an explanation of differences between the concepts is not available. The central question in this discussion article is whether participation, as defined by the ICF, and social participation are distinct concepts. This article illustrates the concepts of participation and social participation, presents a critical discussion of their definitions, followed by implications for rehabilitation and possible future directions. A clear definition for participation or social participation does not yet exist. Definitions for social participation differ from each other and are not sufficiently distinct from the ICF definition of participation. Although the ICF is regarded an important conceptual framework, it is criticised for not being comprehensive. The relevance of societal involvement of clients is evident for rehabilitation, but the current ICF definition of participation does not sufficiently capture societal involvement. Changing the ICF's definition of participation towards social roles would overcome a number of its shortcomings. Societal involvement would then be understood in the light of social roles. Consequently, there would be no need to make a distinction between social participation and participation.

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland

Science.gov (United States)

McDermott, T. K. J.; Surminski, S.

2018-06-01

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting `acceptable risk levels' and identifying `adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of

How normative interpretations of climate risk assessment affect local decision-making: an exploratory study at the city scale in Cork, Ireland.

Science.gov (United States)

McDermott, T K J; Surminski, S

2018-06-13

Urban areas already suffer substantial losses in both economic and human terms from climate-related disasters. These losses are anticipated to grow substantially, in part as a result of the impacts of climate change. In this paper, we investigate the process of translating climate risk data into action for the city level. We apply a commonly used decision-framework as our backdrop and explore where in this process climate risk assessment and normative political judgements intersect. We use the case of flood risk management in Cork city in Ireland to investigate what is needed for translating risk assessment into action at the local city level. Evidence presented is based on focus group discussions at two stakeholder workshops, and a series of individual meetings and phone-discussions with stakeholders involved in local decision-making related to flood risk management and adaptation to climate change, in Ireland. Respondents were chosen on the basis of their expertise or involvement in the decision-making processes locally and nationally. Representatives of groups affected by flood risk and flood risk management and climate adaptation efforts were also included. The Cork example highlights that, despite ever more accurate data and an increasing range of theoretical approaches available to local decision-makers, it is the normative interpretation of this information that determines what action is taken. The use of risk assessments for decision-making is a process that requires normative decisions, such as setting 'acceptable risk levels' and identifying 'adequate' protection levels, which will not succeed without broader buy-in and stakeholder participation. Identifying and embracing those normative views up-front could strengthen the urban adaptation process-this may, in fact, turn out to be the biggest advantage of climate risk assessment: it offers an opportunity to create a shared understanding of the problem and enables an informed evaluation and discussion of

[Adapting and validating the generic instrument CollaboRATE™ to measure women's participation in health related decision-making during the reproductive process].

Science.gov (United States)

Bravo, Paulina; Contreras, Aixa; Dois, Angelina; Villarroel, Luis

2018-05-01

There is a worldwide interest in involving patients in health related decisions, so patients can actively search for therapeutic options and choose course of action that allows them to have better quality of life and wellbeing. The majority of the instruments available to capture the degree of participation in medical decision-making are in English and have been developed in high income countries. To adapt and validate for the Chilean context the instrument CollaboRATE™, to measure women's participation in medical decisions during the reproductive process. Cross-sectional study to adapt and validate the instrument CollaboRATE™. Maternity units in Santiago, Chile. Puerperal women in maternity units of three public hospitals. Translation and back-translation, cultural and linguistic relevance with service users and final revision by experts. Study for validation with 90 puerperal women. The Chilean version of CollaboRATE™ demonstrated to be a reliable instrument to capture the degree of patients' participation in medical decision-making. Cronbach alpha was above 0.89. This study provides the first instrument to capture the prevalence of SDM in a Latin American country. This instrument will be critical in future research efforts that seek to explore to what extent people are being involved in the decisions related to their healthcare. Copyright © 2017. Publicado por Elsevier España, S.L.U.

Health technology assessment and primary data collection for reducing uncertainty in decision making.

Science.gov (United States)

Goeree, Ron; Levin, Les; Chandra, Kiran; Bowen, James M; Blackhouse, Gord; Tarride, Jean-Eric; Burke, Natasha; Bischof, Matthias; Xie, Feng; O'Reilly, Daria

2009-05-01

Health care expenditures continue to escalate, and pressures for increased spending will continue. Health care decision makers from publicly financed systems, private insurance companies, or even from individual health care institutions, will continue to be faced with making difficult purchasing, access, and reimbursement decisions. As a result, decision makers are increasingly turning to evidence-based platforms to help control costs and make the most efficient use of existing resources. Most tools used to assist with evidence-based decision making focus on clinical outcomes. Health technology assessment (HTA) is increasing in popularity because it also considers other factors important for decision making, such as cost, social and ethical values, legal issues, and factors such as the feasibility of implementation. In some jurisdictions, HTAs have also been supplemented with primary data collection to help address uncertainty that may still exist after conducting a traditional HTA. The HTA process adopted in Ontario, Canada, is unique in that assessments are also made to determine what primary data research should be conducted and what should be collected in these studies. In this article, concerns with the traditional HTA process are discussed, followed by a description of the HTA process that has been established in Ontario, with a particular focus on the data collection program followed by the Programs for Assessment of Technology in Health Research Institute. An illustrative example is used to show how the Ontario HTA process works and the role value of information analyses plays in addressing decision uncertainty, determining research feasibility, and determining study data collection needs.

Pressure ulcer risk assessment and prevention: what difference does a risk scale make? A comparison between Norway and Ireland.

Science.gov (United States)

Johansen, E; Moore, Z; van Etten, M; Strapp, H

2014-07-01

To explore similarities and differences in nurses' views on risk assessment practices and preventive care activities in a context where patients' risk of developing pressure ulcers is assessed using clinical judgment (Norway) and a context where patients' risk of developing pressure ulcers is assessed using a formal structured risk assessment combined with clinical judgement (Ireland). A descriptive, qualitative design was employed across two different care settings with a total of 14 health care workers, nine from Norway and five from Ireland. Regardless of whether risk assessment was undertaken using clinical judgment or formal structured risk assessment, identified risk factors, at risk patients and appropriate preventive initiatives discussed by participant were similar across care settings. Furthermore, risk assessment did not necessarily result in the planning and implementation of appropriate pressure ulcer prevention initiatives. Thus, in this instance, use of a formal risk assessment tool does not seem to make any difference to the planning, initiation and evaluation of pressure ulcer prevention strategies. Regardless of the method of risk assessment, patients at risk of developing pressure ulcers are detected, suggesting that the practice of risk assessment should be re-evaluated. Moreover, appropriate preventive interventions were described. However, the missing link between risk assessment and documented care planning is of concern and barriers to appropriate pressure ulcer documentation should be explored further. This work is partly funded by a research grant from the Norwegian Nurses Organisation (NNO) (Norsk Sykepleierforbund NSF) in 2012. The authors have no conflict of interest to declare.

Fear of falling and self-perception of health in older participants and non-participants of physical activity programs

Directory of Open Access Journals (Sweden)

Carolina Kruleske da Silva

2013-12-01

Full Text Available Fear of falling, self-perception of health, and participation in physical activity programs have been associated with several variables related to health and performance in older adults. The purpose of this study was to evaluate self-perception of health and fear of falling in older adult participants and non-participants of physical activity programs, and to verify the relationship between these variables. A total of 40 healthy but sedentary older adults, and 45 physically active older adults were assessed through the Falls Efficacy Scale International-Brazil (FES-I and a questionnaire that measured their self-perception of health. The older adults that did not participate in regular physical activity programs presented higher scores of fear of falling, which, in turn, is associated with an increase of risk for falls. Moreover, older adults, participants in regular physical activity programs exhibited a more positive health perception than did the non-participants. Also, non-participants of physical activity programs perceived their health status as being poor or very poor as well as expressing great concern about falling compared to those who considered their health as excellent, good or regular. The results of this study have important implications for making clinical decisions in prevention or rehabilitation of older people, and they justify recommendations to the public health system.

Exploring the link between environmental identity, behaviors and decision making

Science.gov (United States)

Freed, Allison

This study was conducted with undergraduate students at a large university to investigate the association between environmental identity, pro-environmental behaviors and environmental decision-making. This study explored how environmental identity as defined by Clayton (2003) influenced the type of pro-environmental behaviors individuals choose to participate in. Environmental decision-making based on Kahneman's (2003, 2011) System 1 and System 2 framework was also assessed in association with environmental identity. A survey including the Environmental Identity Survey (Clayton, 2003), the Environmentally Responsible Behaviors Index (Smith-Sebasto & D'Acosta, 1995), and a Decision Making Questionnaire were administered. After administering the surveys, eight participants were chosen for a 60-minute interview. The quantitative results of the study showed there was a significant relationship between environmental identity and participating in environmental behaviors more often. There was also a significant relation between environmental identity and making the decision to recycle in a fast and automatic way. The interview results showed that participants with both a strong and a weak environmental identity recycled often and thought it was a fast decision. The results of this study show that certain components of environmental identity are important, but other factors like the physical environment and social norms influence the thinking that goes into recycling more than environmental identity alone. This study provides evidence of the importance of social norms and environmental structures in fostering pro-environmental behaviors and influencing the type of thinking that goes into making environmental decisions. Keywords: environmental identity, environmental behaviors, System 1, System 2, recycling.

Accuracy assessment of planimetric large-scale map data for decision-making

Directory of Open Access Journals (Sweden)

Doskocz Adam

2016-06-01

Full Text Available This paper presents decision-making risk estimation based on planimetric large-scale map data, which are data sets or databases which are useful for creating planimetric maps on scales of 1:5,000 or larger. The studies were conducted on four data sets of large-scale map data. Errors of map data were used for a risk assessment of decision-making about the localization of objects, e.g. for land-use planning in realization of investments. An analysis was performed for a large statistical sample set of shift vectors of control points, which were identified with the position errors of these points (errors of map data.

A typology of preferences for participation in healthcare decision making.

Science.gov (United States)

Flynn, Kathryn E; Smith, Maureen A; Vanness, David

2006-09-01

Classifying patients as "active" or "passive" with regard to healthcare decision making is misleading, since patients have different desires for different components of the decision-making process. Distinguishing patients' desired roles is an essential step towards promoting care that respects and responds to individual patients' preferences. We included items on the 2004 Wisconsin Longitudinal Study mail survey measuring preferences for four components of the decision-making process: physician knowledge of patient medical history, physician disclosure of treatment choices, discussion of treatment choices, and selection of treatment choice. We characterized preference types for 5199 older adults using cluster analysis. Ninety-six percent of respondents are represented by four preference types, all of which prefer maximal information exchange with physicians. Fifty-seven percent of respondents wanted to retain personal control over important medical decisions ("autonomists"). Among the autonomists, 81% preferred to discuss treatment choices with their physician. Thirty-nine percent of respondents wanted their physician to make important medical decisions ("delegators"). Among the delegators, 41% preferred to discuss treatment choices. Female gender, higher educational attainment, better self-rated health, fewer prescription medications, and having a shorter duration at a usual place of care predicted a significantly higher probability of the most active involvement in discussing and selecting treatment choices. The overwhelming majority of older adults want to be given treatment options and have their physician know everything about their medical history; however, there are substantial differences in how they want to be involved in discussing and selecting treatments.

Protocol for the Quick Clinical study: a randomised controlled trial to assess the impact of an online evidence retrieval system on decision-making in general practice

Directory of Open Access Journals (Sweden)

Kidd Michael R

2006-08-01

Full Text Available Abstract Background Online information retrieval systems have the potential to improve patient care but there are few comparative studies of the impact of online evidence on clinicians' decision-making behaviour in routine clinical work. Methods/design A randomized controlled parallel design is employed to assess the effectiveness of an online evidence retrieval system, Quick Clinical (QC in improving clinical decision-making processes in general practice. Eligible clinicians are randomised either to receive access or not to receive access to QC in their consulting rooms for 12 months. Participants complete pre- and post trial surveys. Two-hundred general practitioners are recruited. Participants must be registered to practice in Australia, have a computer with Internet access in their consulting room and use electronic prescribing. Clinicians planning to retire or move to another practice within 12 months or participating in any other clinical trial involving electronic extraction of prescriptions data are excluded from the study. The primary end-points for the study is clinician acceptance and use of QC and the resulting change in decision-making behaviour. The study will examine prescribing patterns related to frequently prescribed medications where there has been a recent significant shift in recommendations regarding their use based upon new evidence. Secondary outcome measures include self-reported changes in diagnosis, patient education, prescriptions written, investigations and referrals. Discussion A trial under experimental conditions is an effective way of examining the impact of using QC in routine general practice consultations.

Interventions for promoting participation in shared decision-making for children with cancer.

LENUS (Irish Health Repository)

Coyne, Imelda

2013-01-01

Children\\'s rights to have their views heard in matters that affect their lives are now well established since the publication of the UN Convention treaty (1989). Children with cancer generally prefer to be involved in decision-making and consider it important that they have the opportunity to take part in decision-making concerning their health care, even in end-of-life decisions. There is considerable support for involving children in healthcare decision-making at a level commensurate with their experience, age and abilities. Thus healthcare professionals and parents need to know how they should involve children in decision-making and what interventions are most effective in promoting shared decision-making (SDM) for children with cancer.

Transparency and Public Participation in Radioactive Waste Management. RISCOM II Final report

International Nuclear Information System (INIS)

Andersson, Kjell; Westerling, Magnus; Atherton, Elizabeth

2003-10-01

The RISCOM II project was initiated to support the participating organisations in developing transparency in their radioactive waste programmes by developing a greater degree of public participation.The project has clarified how the RISCOM Model can best be used in radioactive waste management programmes, as well as which are the most important areas of further testing an improvement. The methodology used for designing hearings included active involvement of the hearing actors at the preparatory stage - an element that contributed to the fairness of the entire process. We have also seen how the RISCOM Model can support the development of criteria for public participation processes. To enhance transparency, such processes should have the capacity to evaluate claims of fact, legitimacy and authenticity, and they need to have stretching capacity. Above all, in parallel with possible further development and refinement of the RISCOM Model, its theoretical grounds in combination with its already proven applicability make it ready for further use directly in radioactive waste management programmes for the design of decision processes and means for citizen participation. The model can also be used for the analysis of organisational systems ability to provide transparency. One of the cores issues addressed in the study has been how performance assessment can be made more transparent and what needs to be done to make it more accessible to the general public: Arrangements should be made to make visible where values enter the performance assessment and how uncertainties are taken care of. Performance assessment should not be communicated by information departments - the real experts need to engage themselves so that people can see that they are honest, open about uncertainties and address the concerns of ordinary people. Clearly regulatory standards and criteria are one important area where the principles of transparent decision-making should be applied. Successful citizen

Exposure to Acute Stress Enhances Decision-Making Competence: Evidence for the Role of DHEA

Science.gov (United States)

Shields, Grant S.; Lam, Jovian C. W.; Trainor, Brian C.; Yonelinas, Andrew P.

2016-01-01

Exposure to acute stress can impact performance on numerous cognitive abilities, but little is known about how acute stress affects real-world decision-making ability. In the present study, we induced acute stress with a standard laboratory task involving uncontrollable socio-evaluative stress and subsequently assessed decision-making ability using the Adult Decision Making Competence index. In addition, we took baseline and post-test saliva samples from participants to examine associations between decision-making competence and adrenal hormones. Participants in the stress induction group showed enhanced decision-making competence, relative to controls. Further, although both cortisol and dehydroepiandrosterone (DHEA) reactivity predicted decision-making competence when considered in isolation, DHEA was a significantly better predictor than cortisol when both hormones were considered simultaneously. Thus, our results show that exposure to acute stress can have beneficial effects on the cognitive ability underpinning real-world decision-making and that this effect relates to DHEA reactivity more than cortisol. PMID:26874561

Exposure to acute stress enhances decision-making competence: Evidence for the role of DHEA.

Science.gov (United States)

Shields, Grant S; Lam, Jovian C W; Trainor, Brian C; Yonelinas, Andrew P

2016-05-01

Exposure to acute stress can impact performance on numerous cognitive abilities, but little is known about how acute stress affects real-world decision-making ability. In the present study, we induced acute stress with a standard laboratory task involving uncontrollable socio-evaluative stress and subsequently assessed decision-making ability using the Adult Decision Making Competence index. In addition, we took baseline and post-test saliva samples from participants to examine associations between decision-making competence and adrenal hormones. Participants in the stress induction group showed enhanced decision-making competence, relative to controls. Further, although both cortisol and dehydroepiandrosterone (DHEA) reactivity predicted decision-making competence when considered in isolation, DHEA was a significantly better predictor than cortisol when both hormones were considered simultaneously. Thus, our results show that exposure to acute stress can have beneficial effects on the cognitive ability underpinning real-world decision-making and that this effect relates to DHEA reactivity more than cortisol. Copyright © 2016 Elsevier Ltd. All rights reserved.

A novel sustainable decision making model for municipal solid waste management

International Nuclear Information System (INIS)

Hung, M.-L.; Ma Hwongwen; Yang, W.-F.

2007-01-01

This paper reviews several models developed to support decision making in municipal solid waste management (MSWM). The concepts underlying sustainable MSWM models can be divided into two categories: one incorporates social factors into decision making methods, and the other includes public participation in the decision-making process. The public is only apprised or takes part in discussion, and has little effect on decision making in most research efforts. Few studies have considered public participation in the decision-making process, and the methods have sought to strike a compromise between concerned criteria, not between stakeholders. However, the source of the conflict arises from the stakeholders' complex web of value. Such conflict affects the feasibility of implementing any decision. The purpose of this study is to develop a sustainable decision making model for MSWM to overcome these shortcomings. The proposed model combines multicriteria decision making (MCDM) and a consensus analysis model (CAM). The CAM is built up to aid in decision-making when MCDM methods are utilized and, subsequently, a novel sustainable decision making model for MSWM is developed. The main feature of CAM is the assessment of the degree of consensus between stakeholders for particular alternatives. A case study for food waste management in Taiwan is presented to demonstrate the practicality of this model

Patient understanding of diabetes self-management: participatory decision-making in diabetes care.

Science.gov (United States)

Quinn, Charlene C; Royak-Schaler, Renee; Lender, Dan; Steinle, Nanette; Gadalla, Shahinaz; Zhan, Min

2011-05-01

Our aim was to determine whether patient participation in decision-making about diabetes care is associated with understanding of diabetes self-management and subsequent self-care practices. We also identified issues that would impact messaging for use in mobile diabetes communication. A cross-sectional observational study was conducted with type 2 diabetes patients (n = 81) receiving their care at the University of Maryland Joslin Diabetes Center. A convenience sample of patients were eligible to participate if they were aged 25-85 years, had type 2 diabetes, spoke English, and visited their physician diabetes manager within the past 6 months. In-person patient interviews were conducted at the time of clinic visits to assess patient understanding of diabetes management, self-care practices, and perceptions of participation in decision-making about diabetes care. African Americans reported fewer opportunities to participate in decision-making than Caucasians, after controlling for education [mean difference (MD) = -2.4, p = .02]. This association became insignificant after controlling for patient-physician race concordance (MD = -1.5, p = .21). Patient understanding of self-care was predicted by having greater than high school education (MD = 3.6, p = .001) and having physicians who involved them in decision-making about their care. For each unit increase in understanding of diabetes self-care, the mean patient self-care practice score increased by 0.16 (p = .003), after adjustment for patient race and education. Patient participation in decision-making is associated with better understanding of care. Participation in decision-making plays a key role in patient understanding of diabetes self-management and subsequent self-care practices. Patients with limited education need specific instruction in foot care, food choices, and monitoring hemoglobin A1c. © 2011 Diabetes Technology Society.

Decision-making and planning in full recovery of anorexia nervosa.

Science.gov (United States)

Lindner, Susanne E; Fichter, Manfred M; Quadflieg, Norbert

2012-11-01

Based on findings of persisting neuropsychological impairments in women recovered from anorexia nervosa (rec AN), this study examined decision-making and planning, for achieving a desired goal, as central executive functions in a large sample of rec AN. The definition of recovery included physiological, behavioral, and psychological variables. A total of 100 rec AN women were compared to 100 healthy women, 1:1 matched for age and educational level. Decision-making was assessed with the Iowa Gambling Task and planning with the Tower of London. Expert interviews and self-ratings were used for assessing the inclusion/exclusion criteria and control variables. Compared to healthy controls, rec AN women were better in decision-making and worse in planning even after considering control variables. This study does not support results from other studies showing that rec AN participants perform better in decision-making. Results from this study show that planning is impaired even after full recovery from AN. Copyright © 2012 Wiley Periodicals, Inc.

Financial Participation of Employees in Estonia

DEFF Research Database (Denmark)

Eamets, Raul; Mygind, Niels; Spitsa, Natalia

2006-01-01

Presently, legal regulation of participation of employees - financial participation as well as participation in decision-making - is not well developed in Estonia. On the one hand, it is due to the fact that no tradition of employee participation could have been formed after Estonia became...

Assessment of the sunk-cost effect in clinical decision-making.

Science.gov (United States)

Braverman, Jennifer A; Blumenthal-Barby, J S

2012-07-01

Despite the current push toward the practice of evidence-based medicine and comparative effectiveness research, clinicians' decisions may be influenced not only by evidence, but also by cognitive biases. A cognitive bias describes a tendency to make systematic errors in certain circumstances based on cognitive factors rather than evidence. Though health care providers have been shown in several studies to be susceptible to a variety of types of cognitive biases, research on the role of the sunk-cost bias in clinical decision-making is extremely limited. The sunk-cost bias is the tendency to pursue a course of action, even after it has proved to be suboptimal, because resources have been invested in that course of action. This study explores whether health care providers' medical treatment recommendations are affected by prior investments in a course of treatment. Specifically, we surveyed 389 health care providers in a large urban medical center in the United States during August 2009. We asked participants to make a treatment recommendation based on one of four hypothetical clinical scenarios that varied in the source and type of prior investment described. By comparing recommendations across scenarios, we found that providers did not demonstrate a sunk-cost effect; rather, they demonstrated a significant tendency to over-compensate for the effect. In addition, we found that more than one in ten health care providers recommended continuation of an ineffective treatment. Copyright © 2012 Elsevier Ltd. All rights reserved.

Potential of life cycle assessment to support environmental decision making at commercial dairy farms

NARCIS (Netherlands)

Meul, M.; Middelaar, van C.E.; Boer, de I.J.M.; Passel, van S.; Fremaut, D.; Haesaert, G.

2014-01-01

In this paper, we evaluate the potential of life cycle assessment (LCA) to support environmental decision making at commercial dairy farms. To achieve this, we follow a four-step method that allows converting environmental assessment results using LCA into case-specific advice for farmers. This is

Financial Participation of Employees in Lithuania

DEFF Research Database (Denmark)

Darskuviené, Valdoné; Hanisch, Stefan; Mygind, Niels

2006-01-01

Participation of employees in decision-making in Lithuanian companies has its roots in trade union movement as well as in the practice of managing companies under Soviet rule. After Lithuania regained independence, employee ownership was used to facilitate privatization. A notable success...... as participation in decision-making - is not well developed and does not provide for stronger incentives. The solution of current employment and social problems by the Government, ruling parties as well as social partners is not associated with a higher level of participation of employees. Financial participation...... is viewed mainly as a way of employee motivation as initiated by managers and current owners of companies....

Exposure to Acute Stress Enhances Decision-Making Competence: Evidence for the Role of DHEA

OpenAIRE

Shields, Grant S.; Lam, Jovian C. W.; Trainor, Brian C.; Yonelinas, Andrew P.

2016-01-01

Exposure to acute stress can impact performance on numerous cognitive abilities, but little is known about how acute stress affects real-world decision-making ability. In the present study, we induced acute stress with a standard laboratory task involving uncontrollable socio-evaluative stress and subsequently assessed decision-making ability using the Adult Decision Making Competence index. In addition, we took baseline and post-test saliva samples from participants to examine associations b...

The Brain Health Registry: An internet-based platform for recruitment, assessment, and longitudinal monitoring of participants for neuroscience studies.

Science.gov (United States)

Weiner, Michael W; Nosheny, Rachel; Camacho, Monica; Truran-Sacrey, Diana; Mackin, R Scott; Flenniken, Derek; Ulbricht, Aaron; Insel, Philip; Finley, Shannon; Fockler, Juliet; Veitch, Dallas

2018-05-08

Recruitment, assessment, and longitudinal monitoring of participants for neuroscience studies and clinical trials limit the development of new treatments. Widespread Internet use allows data capture from participants in an unsupervised setting. The Brain Health Registry, a website and online registry, collects data from participants and their study partners. The Brain Health Registry obtains self and study partner report questionnaires and neuropsychological data, including the Cogstate Brief Battery, Lumos Labs Neurocognitive Performance Test, and MemTrax Memory Test. Participants provide informed consent before participation. Baseline and longitudinal data were obtained from nearly 57,000 and 28,000 participants, respectively. Over 18,800 participants were referred to, and nearly 1800 were enrolled in, clinical Alzheimer's disease and aging studies, including five observational studies and seven intervention trials. Online assessments of participants and study partners provide useful information at relatively low cost for neuroscience studies and clinical trials and may ultimately be used in routine clinical practice. Copyright © 2018 the Alzheimer's Association. All rights reserved.

The Meaningful Activity Participation Assessment: A Measure of Engagement in Personally Valued Activities

Science.gov (United States)

Eakman, Aaron M.; Carlson, Mike E.; Clark, Florence A.

2010-01-01

The Meaningful Activity Participation Assessment (MAPA), a recently developed 28-item tool designed to measure the meaningfulness of activity, was tested in a sample of 154 older adults. The MAPA evidenced a sufficient level of internal consistency and test-retest reliability and correlated as theoretically predicted with the Life Satisfaction…

The misleading of public participation in environmental assessment - exploring four infrastructure cases in Denmark

DEFF Research Database (Denmark)

Elling, Bo; Nielsen, Helle Nedergaard

2018-01-01

The article analyses the recent development of public participation in environmental assessment and indicates some unfortunate and unintended results. A number of Danish cases show how the tools involved are employed for a kind of ‘acceptance planning’, instead of actual environmental protection......, and that the legitimacy which public inclusion was supposed to bring to environmental assessment has instead been replaced by considerations of legality, which frees entrepreneurs and authorities from including real environmental considerations in their planning. Thus, the undesirable handling of public participation...... that the article analyses is not only due to the actual difficulties of practising inclusion and the indisputable complexity of the environmental issues but also to a very large extent due to considerations of economic efficiency and an unwillingness among investors – public as well as private – to take account...

Communication Games: Participant's Manual.

Science.gov (United States)

Krupar, Karen R.

Using a series of communicational games, the author leads the participant through self-awareness, verbal and nonverbal communication, decision-making, problem-solving, and skills in perception, listening, and small group, organizational, and cultural communications. The thesis behind the book is that model-making, role-playing, or other forms of…

43 CFR 46.315 - How to format an environmental assessment.

Science.gov (United States)

2010-10-01

... planning, decision-making, and appropriate public participation. (b) An environmental assessment may be accompanied by any other planning or decision-making document. The portion of the document that analyzes the...

Mild Cognitive Impairment is Associated with PoorerDecision Making in Community-Based Older Persons

Science.gov (United States)

Duke Han, S.; Boyle, Patricia A.; James, Bryan D.; Yu, Lei; Bennett, David A.

2015-01-01

Background/Objectives Financial and healthcare decision making are important for maintaining wellbeing and independence in old age. We tested the hypothesis that Mild Cognitive Impairment (MCI) is associated with poorer decision making in financial and healthcare matters. Design Community-based epidemiologic cohort study. Setting Communities throughout Northeastern Illinois. Participants Participants were 730 older nondemented persons from the Rush Memory and Aging Project. Measurements All participants underwent a detailed clinical evaluation and decision making assessment using a measure that closely approximates materials utilized in real world financial and healthcare settings. This allowed for measurement of total decision making, as well as financial and healthcare decision making. Regression models were used to examine whether the presence of MCI was associated with a lower level of decision making. In subsequent analyses, we explored the relation of specific cognitive systems (i.e., episodic memory, semantic memory, working memory, perceptual speed, and visuospatial ability) with decision making in those with MCI. Results Results showed that MCI was associated with lower decision making total scores as well as financial and healthcare scores, respectively, after accounting for the effects of age, education, and sex. The effect of MCI on total decision making was equivalent to the effect of more than 10 additional years of age. Additional models showed that when considering multiple cognitive systems, perceptual speed accounted for the most variance in decision making among participants with MCI. Conclusion Results suggest that persons with MCI may exhibit poorer financial and healthcare decision making in real world situations, and that perceptual speed may be an important contributor to poorer decision making among persons with MCI. PMID:25850350

Results of the ARN participation in the quality assessment program of the EML-DOE during period 2000-2001

International Nuclear Information System (INIS)

Equillor, Hugo E.; Serdeiro, Nelida H.; Fernandez, Jorge A.; Gavini, Ricardo M.; Grinman, Ana D.R.; Lewis, Esther C.; Medici, Marcela A.; Palacios, Miguel A.; Diodati, Jorge M.

2003-01-01

The Nuclear Regulatory Authority (ARN) participates every six months in the Quality Assessment Program (QAP), carried out by the Environmental Measurements Laboratory - United States Department Of Energy (EML-USDOE). The aim of this participation is to assess the quality of the radiochemical determinations and alpha, beta, gamma measurements, that ARN realises routinely. The analysed matrix are: water, filter, soil and vegetable. In the present work, the results of the ARN participation in the last four intercomparisons, period 2000-2001, are detailed and analysed statistically. The results are compared with obtained ones by all the laboratories. (author)

Employee Participation--A Practical Guide.

Science.gov (United States)

Wooden, Mark

1990-01-01

Despite the benefits of employee participation in decision making, it is not widespread. Making it work requires commitment, job security, training, access to information, communication channels, goal setting, flat organizational structures, and financial reinforcement. (SK)

Value assessment aid to complex decision making. Final report

International Nuclear Information System (INIS)

Humphress, G.; Lewis, E.

1982-07-01

Value assessment (VA) is a new decision aid that can improve the performance of decisionmakers confronted with multiple attributes and conflicting objectives. Managers who are not supported by formal decision aids turn to various ''satisficing'' or effort-reducing biases that can lead to serious errors in the decisionmaking process. Value assessment, on the other hand, is an optimizing approach to problem-solving behavior. VA helps decisionmakers overcome the tendency to turn to effort-reducing biases by reducing the complexity of making tradeoffs and weighing all available information. Many of the issues which confront modern electric utility managements are complex, multiple attribute problems which must be viewed from engineering, financial and socio-political perspectives simultaneously. Added to this are the complications contributed by factors like uncertainty, risk, incomplete information and conflicting objectives among the public it serves. This is the complex decisionmaking arena which VA is intended to support

Cultural influences on the physician-patient encounter: The case of shared treatment decision-making.

Science.gov (United States)

Charles, Cathy; Gafni, Amiram; Whelan, Tim; O'Brien, Mary Ann

2006-11-01

In this paper we discuss the influence of culture on the process of treatment decision-making, and in particular, shared treatment decision-making in the physician-patient encounter. We explore two key issues: (1) the meaning of culture and the ways that it can affect treatment decision-making; (2) cultural issues and assumptions underlying the development and use of treatment decision aids. This is a conceptual paper. Based on our knowledge and reading of the key literature in the treatment decision-making field, we looked for written examples where cultural influences were taken into account when discussing the physician-patient encounter and when designing instruments (decision aids) to help patients participate in making decisions. Our assessment of the situation is that to date, and with some recent exceptions, research in the above areas has not been culturally sensitive. We suggest that more research attention should be focused on exploring potential cultural variations in the meaning of and preferences for shared decision-making as well as on the applicability across cultural groups of decision aids developed to facilitate patient participation in treatment decision-making with physicians. Both patients and physicians need to be aware of the cultural assumptions underlying the development and use of decision aids and assess their cultural sensitivity to the needs and preferences of patients in diverse cultural groups.