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Background: Low- and middle-income countries (LMICs), including South Africa, are currently experiencing multiple epidemics: HIV and the rising burden of non-communicable diseases (NCDs), leading to different patterns of multimorbidity (the occurrence of two or more chronic conditions) than experienced in high income settings. These adversely affect health outcomes, increase patients' perceived burden of treatment, and impact the workload of self-management. This paper outlines the methods used in a qualitative study exploring burden of treatment among people living with HIV/NCD multimorbidity in South Africa. Methods: We undertook a comparative qualitative study to examine the interaction between individuals' treatment burden (self-management workload) and their capacity to take on this workload, using the dual lenses of Burden of Treatment Theory (BoTT) and Cumulative Complexity Model (CuCoM) to aid conceptualisation of the data. We interviewed 30 people with multimorbidity and 16 carers in rural Eastern Cape and urban Cape Town between February-April 2021. Data was analysed through framework analysis. Findings: This paper discusses the methodological procedures considered when conducting qualitative research among people with multimorbidity in low-income settings in South Africa. We highlight the decisions made when developing the research design, recruiting participants, and selecting field-sites. We also explore data analysis processes and reflect on the positionality of the research project and researchers. Conclusion: This paper illustrates the decision-making processes conducting this qualitative research and may be helpful in informing future research aiming to qualitatively investigate treatment burden among patients in LMICs. [ABSTRACT FROM AUTHOR]

This research note addresses a significant gap in the literature regarding the underlying mechanisms of purchase decision-making that lead to unplanned and impulse purchases. Although several papers have highlighted the differences between the two purchase types, recent academic publications continue to use those terms interchangeably. Through a systematic literature review, this study identified six high-level constructs, in line the Theoretical Domains Framework, that effectively differentiate unplanned from impulse purchase types. Overall, impulse (vs. unplanned) purchases have a primary association with automatic (vs. reflective) motivation. With these findings, academic researchers can better define the types of purchase they are investigating, including the main constructs and underlying psychological mechanisms that are associated with these purchases. As a result, this study substantially improves the reliability of knowledge in this domain. Additionally, this study may encourage marketers to expand their existing toolkits with a broader set of activities that can drive these different purchase types. For instance, marketers could appeal to different underlying purchase decision-making mechanisms: for unplanned purchases, they could offer reminders of related products; for impulse purchases, they could focus on immediate gratification. [ABSTRACT FROM AUTHOR]

Background: Shared responsibility is an essential part of family-centred care and it characterizes the relationship between parents and healthcare professionals. Despite this, little is known about their shared responsibility for decision-making in neonatal intensive care units. Aim: The aim of this scoping review was to identify previous studies on the subject and to summarize the knowledge that has been published so far. Method: The review was conducted using electronic searches in the CINAHL, PubMed, Scopus and PsycINFO databases and manual searches of the reference lists of the selected papers. The searches were limited to peer-reviewed papers that had been published in English from 2010 to September 2021. The data were selected based on inclusion and exclusion criteria and the findings were inductively summarized. We identified eight papers that met the inclusion criteria. Ethical considerations: The scoping review was conducted according to good scientific practice by respecting authorship and reporting the study processes accurately, honestly and transparently. Results: The results showed that shared responsibility for decision-making was based on the parents' intentions, but the degree to which they were willing to take responsibility varied. The facilitating and inhibiting factors for shared responsibility for decision-making were related to the communication between parents and professionals. The impact was related to the parents' emotions. Conclusion: It is essential that parents and professionals negotiate how both parties will contribute to their shared responsibility for decision-making. This will enable them to reach a mutual understanding of what is in the infants' best interests and to mitigate the emotional burden of decisions in neonatal intensive care units. More research is needed to clarify the concept of shared responsibility for decision-making in this intensive care context. [ABSTRACT FROM AUTHOR]

Objectives: The number of anterior cruciate ligament (ACL) injuries and reconstructions observed in the adolescent population continues to rise. While the use of quadriceps tendon autograft has increased in popularity in this population, there remains no consensus on the ideal graft for pediatric ACL reconstruction. The objective of this study was to compare three commonly used ACL graft types with respect to i) performance on return to sport assessments and ii) timing to clearance for return to sports in an adolescent population. Methods: All patients, less than or equal to 19 years of age, who underwent reconstruction for ACL tears between 2016 and 2020 at a large, urban, academic institution were identified. Graft choice was made in a shared decision-making model with patient, parents, and surgeon. Patient demographics, laterality, graft type, time from surgery to clearance, number of physical therapy (PT) visits, and presence of concomitant meniscus injuries were collected from the electronic medical record. At a minimum of 6 months postoperatively, patients completed a formal return to sport test (RTS) including isometric strength assessments, Y- balance testing, and hop testing. Treatment cohorts based on graft type were compared with respect to RTS performance and timing to clearance. Associations between patient demographics and return to sport timing and performance were also assessed. Clearance for return to sport was determined by the treating surgeon with limb symmetry index of 90% on RTS as the goal for clearance. Results: A total of 110 adolescents, 44 female (40%), with a mean age of 16.3 years (SD, 1.7; range, 10-19) met our inclusion criteria (Table 1). Average time to first RTS assessment was 280 days (9.3 months) and average time to clearance was 371 days (12.2 months) after surgery. ACL grafts included 58 (52.7%) hamstring autografts, 26 (23.6%) bone-patellar tendon-bone (BPTB) autografts, 21 (19.1%) bone quadriceps (BQT) autografts, and 5 (4.6%) iliotibial band (ITB) autografts. ITB patients were younger on average (12.5 years old) than those receiving hamstring, BPTB or BQT grafts. There were no significant differences between groups with respect to laterality, number of physical therapy visits, or rate of concurrent meniscus surgery. Patients receiving BQT grafts were more likely to be cleared within 1 year of surgery compared to hamstring graft patients (82.4% vs. 39.6%, p=0.002) and had similar rates of clearance within 1 year compared to BPTB patients (82.4% vs. 65.2%, p=0.230). Patients with BQT and BPTB grafts both demonstrated significantly better hamstring strength symmetry compared to hamstring graft patients (5.8% strength deficit compared to healthy side vs. 1.3% vs. 29.3%, p<0.001) (Table 2). There were no differences in quadriceps strength or hop test asymmetry between graft types. Multivariate regression with age, gender, and number of PT sessions included as covariates demonstrated that hamstring graft choice was associated with decreased odds of clearance at 1 year. Conclusions: In this study of 110 adolescent ACL reconstruction patients who underwent return to sport evaluations, we found no significant difference between BPTB and BQT autografts with respect to RTS performance and time to clearance. Hamstring autograft was associated with significantly worse hamstring strength asymmetry and significantly lower rates of clearance within 1 year. Concurrent meniscus surgery, age, gender, and number of PT sessions completed prior to RTS evaluation were not significantly associated with timing of clearance or performance on the RTS assessment. Table 1. Patient Demographics and Surgical Characteristics Table 2. Patient Demographics and Performance by 3 Common Graft Types [ABSTRACT FROM AUTHOR]

Introduction: A National Cancer Information System is planned for phased implementation in Irish cancer centres to enable electronic prescribing (ePrescribing) of systemic anti-cancer therapy. This study aimed to capture the opinions of healthcare professionals in a hospital setting relating to the current paper-based workflow for systemic anti-cancer therapy prescribing and their attitudes and expectations of the new ePrescribing system to develop recommendations, which assist in the planning and implementation of future ePrescribing systems. Methods: A mixed methods study of concurrent design was conducted. Interviews with healthcare professionals primarily aimed to evaluate processes and identify areas requiring improvement within the current paper-based workflow for systemic anti-cancer therapy prescribing. An online questionnaire adapted from the Information Systems Expectations and Experiences tool primarily aimed to capture expectations of the new ePrescribing system and attitudes towards the transition. Results: Twelve healthcare professionals were interviewed, and 50 healthcare professionals responded to the online questionnaire (response rate: 33.3%). Eight major themes emerged from interview transcripts relating to opinions on the paper-based workflow. Questionnaire respondents reported positive attitudes towards ePrescribing implementation and had high expectations for workflow improvements and functionalities of the new system. Seven recommendations for ePrescribing implementation were developed: (1) prioritise specific processes; (2) plan for changes in communication; (3) repeat research in the post-implementation setting; (4) ensure good information technology infrastructure and system support; (5) ensure optimum training; (6) outline limitations of clinical decision support; (7) provide clear instructions on local configurability. Conclusion: This study identifies potential challenges in transitioning to ePrescribing and provides recommendations, which assist stakeholders in ensuring safe and effective transitions, thus informing future ePrescribing systems' implementation in haematology/oncology settings. [ABSTRACT FROM AUTHOR]

Background: Advance care planning discussions are crucial in the management and support of individuals with life-limiting or life-threatening conditions. Few studies have examined best practices for advance care planning with adolescents and young adults. Aim: To identify core components of current guidelines, frameworks and tools for advance care planning discussions with adolescents and young adults with life-limiting or life-threatening conditions and their families. Design: A scoping review of the literature was conducted followed by a thematic analysis of the included papers. The scoping review was reported according to the Joanna Briggs Institute approach to the conduct of scoping reviews. Data sources: Five databases [Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews, PsycInfo, PubMed and Scopus] were searched for English-language papers published between inception until January 2023. Results: The search yielded 2976 papers, of which 9 met the inclusion criteria. Five main themes were identified: (i) utilisation of standardised documents and protocols; (ii) shared decision-making between the adolescents and young adults, their families and the healthcare team; (iii) the importance of open and honest communication with adolescents and young adults during advance care planning discussions; (iv) individualisation and flexibility in the advance care planning process and (v) timing of advance care planning initiation. Conclusions: Results highlight the importance of engaging adolescents and young adults in advance care planning and considering their unique needs when initiating and framing these discussions. Our findings can be used by healthcare professionals to inform advance care planning in this group. [ABSTRACT FROM AUTHOR]

Awards and competitions are representative policy instruments of the central government to promote urban governance. Compared with command-and-control tools, awards and competitions can encourage regulators and regulated parties to actively participate in governance. Using the panel data of 286 Chinese cities during 2005 to 2017 and regarding the National Civilized City (NCC) campaign as a quasi-natural experiment, we employ the difference-in-difference (DID) method to analyze the impact of the NCC campaign on enterprise production safety and its spillover effect. Our findings indicate that the NCC campaign significantly reduces enterprise production safety accidents and deaths in cities with the title of the NCC. However, this campaign appears to engender an unintended consequence: an increase in such incidents in the neighboring cities surrounding the NCCs. Heterogeneity analysis further shows that in non-old industrial base, low corruption and low economic growth target cities, the promotion effect of the NCC campaign on enterprise production safety is more significant. The increase in production safety input and the reinforcement of corporate social responsibility are the main influencing mechanisms. This paper can contribute to decision-makers thinking about how to improve enterprise production safety through awards and competitions under the governance structure with Chinese characteristics. [ABSTRACT FROM AUTHOR]

Military experience, as a special early experience exerts a very profound impact on individual decision making. This paper investigates the impact of military experience on male labor force entrepreneurial choices and its underlying mechanisms, using the 2014 to 2016 China Labor-force Dynamics Survey data. It is found that military experience significantly reduces the probability of individual entrepreneurship. The analysis of the influence mechanism shows that military experience inhibits survival entrepreneurship mainly by increasing employment opportunities in state-owned units, increasing the probability of becoming a member of the Communist Party of China(CPC), and accumulating human capital. This paper also finds that the inhibitory effect of military experience on individual entrepreneurship varies across household registration groups and is more significant for laborers with non-agricultural household. This paper not only reveals the impact of the military experience on individual entrepreneurship choices, but also provides empirical evidence for the development of innovation and entrepreneurship policies in emerging economies. [ABSTRACT FROM AUTHOR]

Scholars and practitioners have trumpeted business intelligence (BI) capability as a game-changer due to its significant impact on firm performance. Despite these claims, the amplifying and underlying mechanisms governing the relationship between BI capability and organizational performance are still in their infancy. This research examines the nexus between BI capability, decision-making speed, comprehensiveness, and organizational performance. This study, drawing on knowledge-based theory, proposes a conceptual model to explain how BI capability influences organizational performance through decision-making speed and comprehensiveness and the moderating role of firm size. The proposed moderated-mediated model was tested using survey data from 236 respondents occupying leadership positions in various Jordanian industries. Partial least squares structural equation modeling (PLS-SEM) was used to diagnose the proposed model. BI capability indirectly affects firm performance through decision-making speed and comprehensiveness. These mediating effects do not vary by company size. This paper contributed theoretically and practically to the BI framework considering decision-making, firm performance, and firm size. Implications for theory-building and practice are described. [ABSTRACT FROM AUTHOR]

GRADE-CERQual (Confidence in the Evidence from Reviews of Qualitative research) was developed to support the use of evidence from qualitative reviews within policy- and decision-making. To date, the approach has been applied predominantly to aggregative synthesis methodologies and descriptive review findings. GRADE-CERQual guidance recommends the approach be tested on more diverse review methodologies and outputs to support its evolution. This paper contributes to this evolution by reflecting on our experiences of applying GRADE-CERQual to findings that emerged from a recent Cochrane meta-ethnography on childhood vaccination. Specifically, we describe the similarities and differences, challenges and dilemmas we experienced applying the approach to more interpretive versus more descriptive review findings. We found that we were able to apply the core criteria and principles of GRADE-CERQual in ways that were congruent with the methodologies and epistemologies of a meta-ethnography and its findings. We also found that the practical application processes were similar across review finding types. The main differences related to the level of demand placed on the evidence and the level of complexity involved with the decisions. Compared to more descriptive findings, more interpretive findings required evidence that was richer, thicker, more contextually situated and methodologically stronger for us to have the same level of confidence in them. Making the assessments for these findings also involved more complicated forms of judgement. We provide practical examples to illustrate these complexities and how we approached them, which others applying GRADE-CERQual to more interpretive review findings could draw upon. We also highlight areas requiring further discussion, in the hope that this will offer a platform for engagement and the potential future refinement of the approach. Ultimately, this could enhance the usability of GRADE-CERQual for a larger range of qualitative review findings and in turn expand the kinds of knowledges that count within decision-making. [ABSTRACT FROM AUTHOR]

Through analysis and discussion of basic systemic properties of a rural municipality, this paper explores how aggregating data in planning and land use modeling can potentially obscure intricate real-world behavior. Complexity theory is applied as a theoretical framework for explaining this hypothesis. Thus, the aim of this study is to address the author's desire to understand systemic complexity when designing a data-driven decision-making model for rural planning. The novelty of this approach is two-fold: one, most studies on scalability issues in planning addresses spatial complexity, more so than systemic complexity within the complex system that the very act of planning strives to dictate. Two, although delimited to the scope of the study, the accessibility to and use of complete and valid socio-demographic data enables a rarely demonstrated accurate representation of an entire population. It is ultimately observed that on the disaggregated municipal level, systemic dispersion increases parallelly with population size, a correlation that is significantly influenced by gender ratio in any given parish – a characteristic that was not visible at the aggregated municipal level. In addition to advancing the understanding and placement of complexity science within spatial data science, these insights will make it easier to assess the generalizability of any given administrative unit by quantifying basic complexity attributes; in this case based on the correlation dispersion caused by the fragmentation of a municipality into its comprising parishes. [ABSTRACT FROM AUTHOR]

This paper aims to comprehensively define village social capital, assess its multifaceted dimensions in relation to farmers' entrepreneurial decision-making, and investigate the mediating role of rural development. The research sample consists of 14,133 farmers selected through a multi-stage proportional-to-size unequal probability sampling method. Data collection was carried out using questionnaires as part of the "Chinese Thousand Village Survey" project. Empirical analysis was conducted using binary logit and basic linear regression models, supplemented by probit models and other robustness testing methods. The findings indicate that village social capital exerts a significant and favorable influence on farmers' entrepreneurial decision-making. Controlling for other variables, a unit increment in farmers' village social network, village social participation, and village social trust is associated with a respective increase in farmers' odds of entrepreneurial decision-making by 3.96, 5.42, and 16.28%. Village social trust emerges as the most influential factor. Additionally, rural harmony and rural economy partially mediate the relationship between village social capital and farmers' entrepreneurial decision-making. This study contributes to a deeper understanding of the complex interplay between village social capital and farmers' entrepreneurial decision-making, offering valuable guidance for farmers looking to leverage village social capital in their entrepreneurial endeavors. It lays a theoretical foundation for relevant entities to strengthen village social capital and cultivate a supportive environment for rural entrepreneurship. To our knowledge, this paper is among the earlier studies that investigate farmers' entrepreneurial decision-making. Besides, the relationship between village social capital and rural development is rarely studied in the literature as two determinants of farmers' entrepreneurial decision-making. [ABSTRACT FROM AUTHOR]

Background: Shared decision-making is a key element of person-centred care and promoted as the favoured model in preference-sensitive decision-making. Limitations to implementation have been observed, and barriers and limitations, both generally and in the palliative setting, have been highlighted. More knowledge about the process of shared decision-making in palliative cancer care would assist in addressing these limitations. Aim: To identify and synthesise qualitative data on how people with cancer, informal carers and healthcare professionals experience and perceive shared decision-making in palliative cancer care. Design: A systematic review and metasynthesis of qualitative studies. We analysed data using inductive thematic analysis. Data sources: We searched five electronic databases (MEDLINE, EMBASE, PsycINFO, CINAHL and Scopus) from inception until June 2023, supplemented by backward searches. Results: We identified and included 23 studies, reported in 26 papers. Our analysis produced four analytical themes; (1) Overwhelming situation of 'no choice', (2) Processes vary depending on the timings and nature of the decisions involved, (3) Patient-physician dyad is central to decision-making, with surrounding support and (4) Level of involvement depends on interactions between individuals and systems. Conclusion: Shared decision-making in palliative cancer care is a complex process of many decisions in a challenging, multifaceted and evolving situation where equipoise and choice are limited. Implications for practice: Implementing shared decision-making in clinical practice requires (1) clarifying conceptual confusion, (2) including members of the interprofessional team in the shared decision-making process and (3) adapting the approach to the ambiguous, existential situations which arise in palliative cancer care. [ABSTRACT FROM AUTHOR]

The Nursing Theory-Guided Practice Expert Panel (NTGP-EP), one of the 14 Expert Panels, is officially designated to advance the mission and strategic goals of the American Academy of Nursing. The NTGP-EP has created a forum for dialogue among nurse scholars interested in advancing nursing theory to promote health and wellbecoming. The purpose of this paper is to share the important work of the NTGP-EP and its history, contributions, and accomplishments, and to propose a member-driven agenda to re-envision our preferred future and the impact of the use of nursing theory to guide nursing education, research, practice, and policy. [ABSTRACT FROM AUTHOR]

Introduction: In the COVID-19 era, burnout is a major occupational hazard among healthcare workers. This scoping review intended to investigate the pertinent literature concerning COVID-19 burnout among healthcare workers (HCWs) and the measures to prevent and reduce HCW burnout during the COVID-19 pandemic. Methods: The databases CINAHL, PubMed, ScienceDirect, and Scopus were systematically searched and screened for relevant papers. Additionally, manual searching was employed to supplement the electronic database results. The researchers examined 21 publications to answer the research question, "What have been the measures to prevent and reduce healthcare worker burnout during the COVID-19 pandemic?" The PRISMA 2020 checklist was used to guide the reporting of this scoping review. Results: It was found that to diminish healthcare workers' burnout, it is vital to use multilevel, evidence-based approaches. These interventions may include increasing awareness of the risks and preparing for potential occupational stress and burnout; promoting mindfulness and self-care practices to enhance mental well-being; enhancing organizational policies and procedures to address burnout among healthcare workers; and ensuring the availability of optimal mental health services, including the use of digital technologies to address workplace stress and facilitate mental health interventions. Conclusion: The interventions to prevent and reduce HCW burnout during the COVID-19 pandemic include supporting HCWs individually, improving work environments, and addressing health system factors contributing to burnout complemented by interventions aimed at enhancing work culture. [ABSTRACT FROM AUTHOR]

In relational event networks, the tendency for actors to interact with each other depends greatly on the past interactions between the actors in a social network. Both the volume of past interactions and the time that has elapsed since the past interactions affect the actors' decision-making to interact with other actors in the network. Recently occurred events may have a stronger influence on current interaction behavior than past events that occurred a long time ago–a phenomenon known as "memory decay". Previous studies either predefined a short-run and long-run memory or fixed a parametric exponential memory decay using a predefined half-life period. In real-life relational event networks, however, it is generally unknown how the influence of past events fades as time goes by. For this reason, it is not recommendable to fix memory decay in an ad-hoc manner, but instead we should learn the shape of memory decay from the observed data. In this paper, a novel semi-parametric approach based on Bayesian Model Averaging is proposed for learning the shape of the memory decay without requiring any parametric assumptions. The method is applied to relational event history data among socio-political actors in India and a comparison with other relational event models based on predefined memory decays is provided. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to discuss heuristics, guided by Parse's (2021a) community model, to understand how health policies emerge from the unique values and beliefs of community constituents. Within this paper, there is a discussion about heuristics, health policy, Parse's humanbecoming paradigm, and policy implications reflected upon with the change concepts of the humanbecoming community model. [ABSTRACT FROM AUTHOR]

Purpose: This paper compares two iterations (in-person and online) of a multi-stage continuing education program for improving high-risk decision-making among mental health workers. Methods: The mixed-methods study analyzed the following: (1) physiological and psychological arousal during simulated patient interviews; (2) physiological and psychological arousal recorded during real-time decision-making over four months; and (3) thoughts on the process and outcomes of the intervention raised in reflective interviews. Findings: Quantitatively, there were no statistical differences in stress measures between in-person and online simulated interviews or decision-making logs, suggesting they were effective in eliciting reactions commonly found in challenging clinical situations. Qualitatively, participants in both iterations indicated that the intervention caused them to reflect on practice, consider a wider range of factors related to the decisions, and enact approaches to improve decision-making. Conclusions: A carefully constructed online continuing education experience can result in outcomes for experienced social workers that are equivalent to an in-person iteration. [ABSTRACT FROM AUTHOR]

Purpose: Values are critical to how individuals make decisions and cope, yet the values of heart failure (HF) patients and their family caregivers (FCGs) remain understudied. We sought to report the state of the science on how values are discussed, reflected upon, and acted on by patients with HF, their FCGs, or both related to health-related decision making and coping. Method: A scoping review was conducted of empirical studies using the following keywords: "heart failure," "values," "decision-making," and "coping." PubMed, PsycINFO, and Scopus were searched from inception to June 2022 in English. Included articles reported values as a key finding (outcome/theme) in their abstract. Results: Of 448 articles screened for eligibility, 16 met the inclusion criteria. Twelve articles reported findings addressing patient values, 3 addressed patient and FCG values, and 1 addressed FCG values. Values were reported to influence patient self-care behaviors and left ventricular assist device (LVAD) implantation decisions, although their prioritization varied across time and contexts. When prioritized values conflicted with recommended self-care activities, some patients modified their approach to achieving the value. Others modified or abandoned tasks in favor of the value and accompanying goals. Low motivation and alignment between unhealthy behaviors and values often led to nonadherent decisions. Five of 8 articles focusing on cardiac devices reported patient survival as the most prioritized value during implantation decisions. FCG values were rarely reported or evaluated separately from patient values. Patients leveraged several coping strategies, although the processes through which values affected coping was not described. Conclusions: Prioritized values influenced HF-related decisions, including self-care and LVAD implantation. While several articles reported on coping and values, none described processes through which values affect coping, which highlights a research gap. Highlights: Family caregiver values were rarely reported or evaluated separately from patient values, highlighting a gap in the literature. [ABSTRACT FROM AUTHOR]

An increasing body of work investigates the participation of a diverse set of actors in strategy making. We argue that extant research tends to gloss over a fundamental condition underpinning such participation: while participation may reflect a hierarchical mandate, insofar as it relates to the actual involvement of employees, it is the result of a process of self-selection. From this perspective, forms of participative strategizing are neither fully the outcome of deliberate top-down choice, nor do they form a random pattern that is subject to the whims of individual employees. Such forms of strategizing are rather, as we argue in this paper, based on an endogenous logic of whether and how an individual self-selects, and in turn involves her/himself in the process, or not. To conceptualize the broader phenomenon of strategy participation, we draw on practice theory to conceptualize how individuals knowingly choose to involve themselves in strategizing events and we develop in turn a process model of self-selection as an ongoing social accomplishment. This model elaborates different patterns of participation in strategy making (stabilizing and shifting trajectories) with variable emergent outcomes. We end the paper by discussing the implications of our theorizing for ongoing research on open and participatory strategizing, and for the body of work on strategy as practice. [ABSTRACT FROM AUTHOR]

The empirical results on the influence of inexperience and experience in decision making are inconclusive. This paper offers a resolution to the puzzle of how empirical studies that advance contradictory risk-related claims can all command empirical support. The paper employs a paradigmatic model of decision making that examines two variables: (1) the decision maker's personality, of which inexperience and experience is one component; and (2) the particulars of the decision problem. These two variables permit us to resolve the puzzle of inconclusive empirical results by identifying the separating conditions under which each risk-related claim holds. [ABSTRACT FROM AUTHOR]

Board informal hierarchy plays a crucial role in board governance and corporate strategic decision-making. The article empirically examines the impact of board informal hierarchy on corporate digital transformation based on relational contract theory, using a fixed-effects model with Shanghai and Shenzhen A-share listed manufacturing companies from 2012 to 2019 as research subjects. The findings of this study demonstrate a positive correlation between board informal hierarchy and digital transformation. Specifically, the presence of a chairman with the highest rank in the informal hierarchy strengthens this relationship, while the presence of a CEO with the highest rank weakens it. Mechanistic analysis shows that informal hierarchy accelerates digital transformation through three channels: improving board decision-making efficiency, mitigating management myopia, and facilitating information communication. This study extends existing research. On the one hand, this paper explores the drivers of digital transformation in manufacturing firms at the level of corporate governance and board characteristics. The findings provide empirical evidence to support the understanding of transformational change behaviors of manufacturing enterprises in the digital economy. On the other hand, it also opens up the "black box" of the internal operation of the board and provides valuable lessons for strengthening board governance. JEL Classification: D21; M12; Z13. Plain Language Summary: Board Informal Hierarchy and Digital Transformation The article empirically examines the impact of board informal hierarchy on corporate digital transformation based on relational contract theory, using a fixed-effects model with Shanghai and Shenzhen A-share listed manufacturing companies from 2012 to 2019 as research subjects. The findings of this study demonstrate a positive correlation between board informal hierarchy and digital transformation. Specifically, the presence of a chairman with the highest rank in the informal hierarchy strengthens this relationship, while the presence of a CEO with the highest rank weakens it. Mechanistic analysis shows that informal hierarchy accelerates digital transformation through three channels: improving board decision-making efficiency, mitigating management myopia, and facilitating information communication. This study extends existing research. On the one hand, this paper explores the drivers of digital transformation in manufacturing firms at the level of corporate governance and board characteristics. The findings provide empirical evidence to support the understanding of transformational change behaviors of manufacturing enterprises in the digital economy. On the other hand, it also opens up the "black box" of the internal operation of the board and provides valuable lessons for strengthening board governance. [ABSTRACT FROM AUTHOR]

This paper explores the root causes of student unrest in South African universities and evaluates the institutional responses to these protests, otherwise regarded as social unrest. The study is lensed through social movement theory and institutional theory. The study adopted transformative paradigm under qualitative approach and participatory research design to analyze the experiences of universities in South Africa that have experienced significant social unrest in recent years. Focus group discussion was conducted with university management staff, student activists, and security officers of the selected universities. The findings showed that lack of access, socio-economic inequalities, ineffective communication, and open engagement are the primary causes of social unrest. In contrast, providing equitable access, economic liberation, effective communication, and open engagement is the possible institutional response that alleviates social unrest on university campuses. Hence, promoting equitable access and economic liberation coupled with effective communication and open engagement among stakeholders was recommended. Plain Language Summary: Causes and Institutional Responses of Social Unrest. This paper investigates why South African university students protest and how the institutions respond. Using social movement and institutional theories, the study talks to university managers, student activists, and security officers in universities with recent protests. The key issues identified are limited access, economic inequalities, poor communication, and exclusion from decision-making. The suggested solution is to focus on fair access, reducing economic disparities, improving communication, and involving everyone in decisions. The researcher recommends promoting equitable access and economic fairness, alongside better communication and inclusive decision-making, as a way to address and prevent social unrest on university campuses. [ABSTRACT FROM AUTHOR]

Face ubiquitous demand uncertainty and channel cross-influence, how to make price decision to improve profits has become an issue faced by decision makers. This paper concerns multichannel price optimization for a closed-loop supply chain and constructs the deterministic and uncertain models. Taking a real closed-loop clothing supply chain as an example, we carry out parameter assumptions and numerical experiments and analyze the simulation results. Our analysis reveals: (1) The supply chain is more profitable under centralized policy. The company can maximize profits by expanding upstream and downstream. (2) When experienced experts give more accurate error terms, the companies can accurately predict the demand and make price decisions. (3) Raising wholesale price will not maintain manufacturer's profits growing. Beyond the threshold, the manufacturer's profit will decrease. (4) The channel cross-influence is beneficial to the supply chain. When other factors remain unchanged, the greater the cross price-demand sensitivity coefficient in a channel, the higher the retailing price and the total profit of the supply chain will be. Decision makers can adjust pricing in time to adapt to changes of cross-influence and uncertain demand. The findings provide theoretical guidance for each player in the closed-loop supply chain. Plain Language Summary: How to make price decision with demand uncertainty and channel cross-influence? Face ubiquitous demand uncertainty and channel cross-influence, how to make price decision to improve profits has become an issue faced by decision makers. This paper concerns multichannel price optimization for a closed-loop supply chain and constructs the deterministic and uncertain models. Taking a real closed-loop clothing supply chain as an example, we carry out parameter assumptions and numerical experiments and analyze the simulation results. Decision makers can adjust pricing in time to adapt to changes of cross-influence and uncertain demand. The findings provide theoretical guidance for each player in the closed-loop supply chain. [ABSTRACT FROM AUTHOR]

This paper examines the ordeals actors of SMEs face in the adoption process of Emerging Digital Marketing Technology (EDMT). A conceptual framework was proposed to capture actors that participate in EMDT and the difficulties they (themselves) pose that hinder successful adoption. However, a purposive sample of 26 participants drawn from Crunch online database, Luton were interviewed on unstructured and semi-structured bases and analyzed using a thematic approach. The interviews on the problems were coded and classified based on the actors involved in the adoption process to extend the T-O-E framework. The findings revealed that while extant problems relate to the contexts of technology, organization, and environment, the extended T-O-E framework unraveled more critical problems that are linked to the in-grained human context. Implicit is that vendors should work on decision-makers, given that some of the adoption decisions are critically and continuously influenced by the actors. Plain Language Summary: Critical issues facing SMEs Actors in Emerging Digital Marketing Technology adoption. This paper examines the ordeals actors of SMEs face in the adoption process of Emerging Digital Marketing Technology (EDMT). A conceptual framework was proposed to capture actors that participate in EMDT and the difficulties they (themselves) pose that hinder successful adoption. However, a purposive sample of 26 participants drawn from Crunch online database, Luton were interviewed on unstructured and semi-structured bases and analyzed using a thematic approach. The interviews on the problems were coded and classified based on the actors involved in the adoption process to extend the T-O-E framework. The findings revealed that while extant problems relate to the contexts of technology, organization, and environment, the extended T-O-E framework unraveled more critical problems that are linked to the in-grained human context. Implicit is that vendors should work on decision-makers, given that some of the adoption decisions are critically and continuously influenced by the actors. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to show what are the applicants' institution selection criteria in higher education in Hungary and what changes this will imply in higher education management and communication. These questions were investigated based on a review of the most relevant literature and the analysis of 1396 Hungarian higher education University of Pécs applicants in two consecutive years. Exploratory and confirmative factor analyses were used to identify the relative order of the application influencing factors: as a result, the first most important is the vivacity, followed by career and costs, fourth is image and the last one is the low commitment. In this context, the paper has shown that the identification of the application strategies requires renewed management and communication techniques. The results help the institutions to determine the possible actions to be implemented to attract more students and improve the level of offered services. The permanent system change of the Hungarian higher education as a phenomenon versus the applicants' institution selection criteria gives the uniqueness of the Hungarian situation, and this study provides information for researchers in higher education in this field additionally. [ABSTRACT FROM AUTHOR]

We motivate and present the methodology of vignette studies. The primary contribution of this paper is our proposal of a novel vignette study design: "SMART vignettes." Our design has two notable features: the first is its use of sequential randomization, which conceptually originates from the sequential multiple assignment randomization trial (SMART) design developed by Murphy (2004). The second feature is adaptive allocation. These new features in vignette studies offer unique advantages not offered by traditional vignettes: (1) valid causal inferences on the conditional distributions of the primary outcome of interest, given other factors, (2) balanced allocations across groups, and (3) a greater degree of interactivity for the survey respondent. We illustrate the utility of our method using a case example of a vignette study used to probe physicians' attitudes toward an AI-embedded clinical system. In this example, a SMART vignette was used to randomize hypothetical scenarios to gain a better understanding of the causal impact of physician attitudes, given emerging evidence that a range of factors including previous decisions, play a role in influencing clinical decisions. We simulated hypothetical vignette studies under both SMART and conventional (i.e. single randomization at baseline) designs. We varied the number of factors for each study and fixed each factor to have two levels. Relative loss was used to compare the degree of imbalance between groups. Both designs had smaller relative losses with larger sample sizes. The SMART study design had lower loss than its conventional counterpart for all values of N for all studies, indicating better balance. As demonstrated by the relative loss in our simulations, our proposed SMART vignette design has an advantage over the conventional design. This method holds promise in generating new knowledge in decision making scenarios occurring over multiple and discrete time points. [ABSTRACT FROM AUTHOR]

This paper explores the implementation process of digital audience metrics as a key strategy in Swedish legacy news production during the last three decades. The historical adoption of metrics in the newsroom is not new but has grown fast (from analogue audience measurements in the 1950s and monthly statistics of unique visitors in the 1990s to a wide range of real-time data). This trend is important because Swedish news organisations have invested heavily in data analytics, which involves integrating metrics-driven journalism into a particularly strong and homogenous tradition of professional autonomy. Based on interviews with key senior managers and supported by the analysis of trade publications, as well as published interviews, the findings reveal three chronologically overlapping periods: the naïve stage of 'getting online', the destructive period of 'social media prominence', and the end of the 'paywall hesitation'. This trend has led to a new equilibrium in which audience metrics are perceived as better aligned with the professional values of news selection. More importantly, the industry-wide embrace of metrics as guidance for more relevant and rational news production revolves around two main factors: First, although metrics are tied to organisational targets, they remain under editorial control. Second, the degree of granularity and diversification of metrics allow for wider support of their use for strategic purposes. [ABSTRACT FROM AUTHOR]

India has witnessed a dramatic expansion of higher education, and women have emerged as noteworthy winners in the process. This paper focuses on the role of female college education on four dimensions of marriage: age at marriage, autonomy in the choice of spouse, work and financial empowerment, and quality of marital relationship. The study uses a sample of 35,561 currently married women from the 2011-2012 wave of the nationally representative India Human Development Survey (IHDS). It demonstrates that higher education, particularly college education, enables women to lead lives substantively different from their less-educated peers. College-educated women marry at later ages, enjoy greater autonomy in choosing their husbands, and have a more egalitarian relationship with their spouses. Furthermore, the study finds that educational homogamy and hypogamy afford greater autonomy to women. Even without a concomitant increase in labor force participation, college education among women appears to have a transformative effect on marriage in India. [ABSTRACT FROM AUTHOR]

Background and Objectives: Children with autism spectrum disorder (ASD) continue to experience significant delays in diagnosis and interventions. One of the main factors contributing to this delay is a shortage of developmental-behavioral specialists. Diagnostic evaluation of ASD by primary care pediatricians (PCPs) has been shown to be reliable and to decrease the interval from first concern to diagnosis. In this paper, we present the results of a primary care ASD diagnosis program in which the PCP serves as the primary diagnostician and leverages the infrastructure of the primary care medical home to support the child and family during the pre- and post-diagnostic periods, along with data on parental satisfaction with this model. Methods: Retrospective data from a cohort of patients evaluated through this program were analyzed to determine the mean age at diagnosis and interval from referral for evaluation to diagnosis. We used survey methodology to obtain data from parents regarding their satisfaction with the process. Results: Data from 8 of 20 children evaluated from April 2021 through May 2022 showed a median age of diagnosis of 34.5 months compared to the national average of 49 months. Mean interval from referral for evaluation to diagnosis was 3.5 months. Parental survey responses indicated high satisfaction. Conclusions: This model was successful in shortening the interval from referral to diagnosis resulting in significant decrease of age at diagnosis compared with the national average. Widespread implementation could improve access to timely diagnostic services and improve outcomes for children with ASD. [ABSTRACT FROM AUTHOR]

This paper sought to identify distinct classes of women who endorse wife-beating and the determinants of such justification to broaden current knowledge of the correlates of intimate partner violence in Zimbabwe. We drew on survey data from the 2015 Zimbabwe Demographic and Health Survey (ZDHS) and restricted our analytical sample to 2,966 currently partnered women. To classify women's responses into patterns of tolerant attitudes, we used latent class analysis, an unsupervised classification method that helps identify heterogeneity in a population using observable variables. The data supported a three-class solution characterized by the following probabilities: class 1, high tolerance (6%); class 2, moderate tolerance (26%); and class 3, low tolerance (66%). The results from the regression analysis suggest that older age, reading a newspaper frequently, and having more than primary education were negatively associated with membership in the moderate and high tolerance classes. Women who made joint decisions or had no say in their healthcare issues were more likely to belong to the moderate and high tolerance classes. In other words, tolerant attitudes toward wife-beating were negatively associated with personal empowerment. Therefore, interventions that increase personal empowerment in the form of education and access to media might be needed to redress the endemic acceptance of wife-beating in Zimbabwe. At the same time, gender role transformative interventions are required to challenge patriarchal thinking, which denies women decision-making autonomy and perpetuates attitudes that encourage marital violence. [ABSTRACT FROM AUTHOR]

Training to improve high school sport coaches' and athletic directors' knowledge, skills, and competencies to address and respond to rising mental health concerns is more important than ever. High school student-athletes are at increased risk for mental health concerns, given the pressures of balancing sport, school, and other responsibilities. This paper describes a community-based participatory research (CBPR) study that guided two years of public impact and social change efforts to improve coach education and training in one large Midwestern state in the United States. Our collective goal was to empower coaches and athletic directors to coach "beyond the Xs and Os." Using a CBPR framework, we describe the decision-making process that led to the co-development and implementation of a mental health training program piloted with 147 high school coaches and athletic directors. We also describe intermediate outcomes associated with our collective change efforts demonstrating the value of using a CBPR approach. Our "Coach Beyond" processes and outputs showcase how CBPR can lead to transformative action and social change to reorient sport as a context focused on the holistic health, wellness, and development of student-athletes. [ABSTRACT FROM AUTHOR]

The way social workers discursively construct 'service user' identities in everyday interactions (interviews, conversations and text) can affect quality of relationships and practice outcomes. Even though research has focused on the construction of 'service user' identities by professionals and service users, little has been done to explore such discursive formulations by pre-qualifying social work students. This is especially relevant, given the strengthening of the 'expert by experience' identity in social work education. This paper seeks to make visible mechanisms of student identity constructions as to 'who a service user is', and implications for practice through the examination of student written work pre- and post- a module focussing on lived experience. A critical discursive psychology approach was followed, recognising the interplay between localised professional encounters and wider contexts of power relations. The findings show a shift in the 'service user' identities employed by the students mainly based on individualistic discourses and deserving/undeserving themes (substance misuse the result of vulnerability, rather than selfishness, domestic abuse narratives denoting resilience rather than victimhood). The effect to practice showed shifts between the reflective, expert, person-centred and critical/radical practitioner, mainly stressing the need for professional growth at an individual level, with less emphasis on addressing social inequality. The paper argues that predominantly individualistic discourses can perpetuate de-politicised or oppressive categorisations of 'service users' and calls for further critical engagement with the discursive micro-practises enacted and developed in the social work classroom, if we are to unveil and challenge narrow, or stigmatising categorisations early on. [ABSTRACT FROM AUTHOR]

The future of the field of entrepreneurship is bright primarily because of the many research opportunities to make a difference. However, as scholars how can we find these opportunities and choose the ones most likely to contribute to the literature? This essay introduces me-search and a special issue of research-agenda papers from leading scholars as tools for blazing new trails in entrepreneurship research. Me-search and the agenda papers point to the importance of solving a practical problem; problematizing, contextualizing, and abstracting entrepreneurship research; and using empirical theorizing to explore entrepreneurial phenomena. [ABSTRACT FROM AUTHOR]

Early planning and knowing which factors to consider when planning the location of death (LOD) of a palliative child, may help minimize the burden of hasty decision-making in the future, and may provide families with a sense of control. The current paper reviewed which factors were associated with pediatric LOD and further considered some emerging factors that should are important to better facilitate integrative planning. Three overarching areas of consideration related to pediatric LOD planning were identified including health service factors, familial factors and patient factors. Multiple sub-factor considerations are presented. Further, the paper presents a conceptual model of the factors found to be related to pediatric LOD planning. The limitations that exist with rigorously and empirically studying pediatric LOD preferences are apparent from the dearth of knowledge seen in the field. However, future studies should continue to examine such factors more closely to better understand the nuanced implications. [ABSTRACT FROM AUTHOR]

Study Design: This paper presents a description of a conceptual framework and methodology that is applicable to the manuscripts that comprise this focus issue. Objectives: Our goal is to present a conceptual framework which is relied upon to better understand the processes through which surgeons make therapeutic decisions around how to treat thoracolumbar burst fractures (TL) fractures. Methods: We will describe the methodology used in the AO Spine TL A3/4 Study prospective observational study and how the radiographs collected for this study were utilized to study the relationships between various variables that factor into surgeon decision making. Results: With 22 expert spine trauma surgeons analyzing the acute CT scans of 183 patients with TL fractures we were able to perform pairwise analyses, look at reliability and correlations between responses and develop frequency tables, and regression models to assess the relationships and interactions between variables. We also used machine learning to develop decision trees. Conclusions: This paper outlines the overall methodological elements that are common to the subsequent papers in this focus issue. [ABSTRACT FROM AUTHOR]

Fracture Risk Assessment Tool is a free, online fracture risk calculator which can be used to predict 10-year fracture risk for women and men over age 50 years. It incorporates seven clinical risk factors and bone density to give a 10-year risk of major osteoporotic fracture and hip fracture. This dynamic tool can be used with patients at the bedside to help guide treatment decisions. There are some limitations to Fracture Risk Assessment Tool, with the most central limitation being the fact that inputs are binary. Much research has been done to try to refine Fracture Risk Assessment Tool to allow for more accurate risk prediction, and this article describes the data for adjusting Fracture Risk Assessment Tool depending on the clinical scenario such as the dose of glucocorticoid use, presence of diabetes and others. Recently, the new FRAXplus tool has been developed to address many of these concerns and will likely replace the old Fracture Risk Assessment Tool in the future. At the current time, it is available in beta form. Plain Language Summary: Methods for Refining the FRAX® Tool in Patients with Low Bone Density to Help Improve the Accuracy of Osteoporotic Fracture Risk Prediction Many patients who have low bone density develop fragility fractures, even those whose bone density is not yet within the osteoporosis range. Thus, in patients with low bone density, the health care team should estimate the risk of fracture to decide which patients should take medications to prevent fractures. Factors such as age, body mass index, steroid use, family history and other clinical factors can influence the fracture risk, in addition to bone density. There is an online calculator called the Fracture Risk Assessment Tool (FRAX®) which allows patients and doctors to integrate these risk factors with bone density in order to estimate the 10 year risk of osteoporotic fractures. FRAX® asks a series of yes/no questions about the patient's risks for fracture, and also takes into account the patient's country of residence, age, gender, race and bone density at the femur neck. However, there are some important limitations of this calculator. For example, we think that steroid medications increase the risk of fractures, and the higher the dose, the higher the risk of fractures. However, FRAX® only allows a "yes" or "no" input to the steroid use question. This paper aims to descibe methods for refining the FRAX® calculation to make the fracture risk prediction more accurate. For example, it describes a mathematical adjustment to FRAX® to account for the dose of steroids used. It also reviews methods for FRAX® adjustment for diabetes type 1 and 2, and severity of rheumatoid arthritis, among other considerations. Importantly, there is a new FRAX® tool that is currently in beta testing which will also further refine the accuracy of fracture risk prediction. [ABSTRACT FROM AUTHOR]

Background: Experiences of living with and seeking care for multimorbidity is a relatively under-researched field. By analysing experiences of people with multimorbidity, caregivers and care professionals, we can better understand the complex care needs of those with multimorbidity and identify improvements to care management. This paper reports findings from research that elicited the views of key stakeholders to inform future care practice and policy. Aim: To elicit care recipient and care provider views to understand the care needs of those living with and seeking care for multimorbidity. Method: A qualitative interview study using purposive sampling of those living with and providing care in multimorbidity. Results: Increased support to those with multimorbidity and caregivers to navigate care systems was advocated. Establishing trusting care relationships featured prominently in participants accounts. Fragmented care, inadequate coordination and poor communication between care providers, were identified as system-wide challenges. There was agreement that integrated care models were needed, which delivered personalised care, such as shared decision-making, choice in care options and accessing services, and individualised care plans. Conclusion: We found significant agreement among stakeholders on care need and management in multimorbidity. Understanding the experiences of those with multimorbidity, caregivers and care professionals, can inform future improvements in care management. [ABSTRACT FROM AUTHOR]

The concept of rational suicide argues that suicide could be a rational choice, in certain circumstances. Such an argument faces criticism when there is an accompanying mental illness, as many view suicide as a symptom of mental illness rather than as a rational choice about one's life. More specifically, the rational suicide debate has mostly excluded individuals with schizophrenia, as it is widely seen as a disorder that impairs rational decision making. This paper aims to examine the concept of rational suicide in schizophrenia: Could it be possible that some acts of suicide are driven from a rational choice by patients suffering from schizophrenia ? This paper does not include discussions related to physician-assisted dying in schizophrenia. [ABSTRACT FROM AUTHOR]

This paper presents a new perspective on the problem of bias in artificial intelligence (AI)-driven decision-making by examining the fundamental difference between AI and human rationality in making sense of data. Current research has focused primarily on software engineers' bounded rationality and bias in the data fed to algorithms but has neglected the crucial role of algorithmic rationality in producing bias. Using a Weberian distinction between formal and substantive rationality, we inquire why AI-based algorithms lack the ability to display common sense in data interpretation, leading to flawed decisions. We first conduct a rigorous text analysis to uncover and exemplify contextual nuances within the sampled data. We then combine unsupervised and supervised learning, revealing that algorithmic decision-making characterizes and judges data categories mechanically as it operates through the formal rationality of mathematical optimization procedures. Next, using an AI tool, we demonstrate how formal rationality embedded in AI-based algorithms limits its capacity to perform adequately in complex contexts, thus leading to bias and poor decisions. Finally, we delineate the boundary conditions and limitations of leveraging formal rationality to automatize algorithmic decision-making. Our study provides a deeper understanding of the rationality-based causes of AI's role in bias and poor decisions, even when data is generated in a largely bias-free context. [ABSTRACT FROM AUTHOR]

This paper presents and justifies Gephisto, an experimental tool visualizing networks in one click. Gephisto's design exemplifies how we can interfere with a user's utilitarian goals, by giving them what they wish (an easy way to get a network map) but in disobedient ways (the produced map is different every time the tool is used) that encourage them to engage further with the tool's methodological tenets. As an apparatus, Gephisto aims to incentivize untrained users to become more critical of their network mapping practices. As an intervention into the field of digital methods, it aims to show that tools that support critical thinking do not have to be hard to use and hostile to beginners. We criticize the idea that tools range from easy-to-use black boxes for unreflexive lazy-thinkers, to complex and demanding instruments for hard-thinking experts. We argue that learners need ease of use and critical thinking at the same time, and that it is possible to design tools that support both needs at once. We offer an alternative model where we acknowledge the active role of the user in deciding the tradeoff between learning to master the tool, and progressing toward their utilitarian goals. We argue that the design of the tool should not oppose the beginner's need for assistance in decision making, but find other ways to incentivize critical thinking. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to explore the potential of dialectical pluralism (DP) for nursing knowledge development. Nursing scholars have discussed ways of developing nursing knowledge, exploring the fit and relevance of various worldviews for knowledge development and examining the dynamic and perpetual processes of knowledge development. Scholars have argued that knowledge development occurs under a certain worldview to which the researcher adheres. Many nurses employ various worldviews, which can give rise to ontological and epistemological conflicts. DP can help nurses appreciate the diversity of worldviews and recognize the importance of implicit worldviews to generate more practical nursing knowledge. DP as a philosophical approach can enable nurses to communicate between diverse worldviews, become tolerant of conflicting differences, and develop an array of nursing knowledge. [ABSTRACT FROM AUTHOR]

Background: Parental involvement in the decision-making processes about medical treatment for children with life-limiting conditions is recognised as good practice. Previous research highlighted factors affecting the decision-making process, but little is known about how parents experience their participation. Aim: To explore how parents experience their participation in the process of decision-making about treatment and future care for their children with life-limiting conditions. Design: A systematically constructed review using narrative synthesis. The PRISMA guidelines were followed to report the findings. Databases Medline, EMBASE, SCOPUS, CINAHL and PsycINFO were searched up to December 2023. The study protocol was registered at PROSPERO (RN CRD42021215863). Results: From the initial 2512 citations identified, 28 papers met the inclusion criteria and were included in the review. A wide range of medical decisions was identified; stopping general or life-sustaining treatment was most frequent. Narrative synthesis revealed six themes: (1) Temporal aspects affecting the experience with decision-making; (2) Losing control of the situation; (3) Transferring the power to decide to doctors; (4) To be a 'good' parent and protect the child; (5) The emotional state of parents and (6) Sources of support to alleviate the parental experience. Conclusions: Parental experiences with decision-making are complex and multifactorial. Parents' ability to effectively participate in the process is limited, as they are not empowered to do so and the circumstances in which the decisions are taking place are challenging. Healthcare professionals need to support parental involvement in an effective way instead of just formally asking them to participate. [ABSTRACT FROM AUTHOR]

Background: Research on genomics has increased while the biobank activities are becoming more common in different countries. In the mental health field, the questions concerning the potential participants' vulnerability as well as capacity to give the informed consent can cause reluctancy in recruiting persons with mental health problems, although the knowledge and understanding of mental health problems has remarkable changed, and practice is guided with inclusive approaches, such as recovery approach. Aim: The aim of this study was to describe the current knowledge of informed consent practices in the context of genomic research on mental health from the nurses' viewpoint. Methods: An integrative review was conducted with search from seven international databases. Data consist 14 publications which were analyzed with thematic analysis. Ethical considerations: Ethical requirements were respected in every phase of the research process. Findings: Most of the papers were published in USA and between 2000–2010. Eight reports were categorized as discussion papers, four qualitative studies and one quantitative study. The thematic analysis provided information on five themes: complexity with the capacity to consent, mixed emotions towards participation, factors influencing the decision to participate, nurses' informed consent process competence and variations between consent procedures. Discussion: In the informed consent practices, there are various aspects which may affect both the willingness to participate in the study and the informed consent process itself. Implications for practice, education, research, and policies are discussed. Conclusion: There is a need for more updated international research on the topic in the context of different international and national guidelines, legislation, and directives. This study provided a viewpoint to the more collaborative research activities with people with lived experiences also in this field of research following the ideas of recovery approach. [ABSTRACT FROM AUTHOR]

In recent years, policymakers have begun to problematize how legislation stands in the way of the digitalization of the public sector. We are witnessing the emergence of a new phenomenon, digital-ready legislation, which implies that, whenever possible, new legislation should build on simple rules and unambiguous terminology to reduce the need for professional (human) discretion and allow for the extended use of automated case processing in public-sector organizations. Digital-ready legislation has potentially wide-ranging consequences because it creates the conditions for how public organizations are digitalized. The processes, practices, choices, and responsibilities for drafting digital-ready legislation, however, are not well-described or debated. Digital-ready legislation is a dormant issue. This paper develops the notion of the "double darkness" of digitalization to account for this. Based on a qualitative study, the paper investigates how digital-ready legislation as a sociotechnical arrangement is shaped by policy tools and by a complex, collaborative process where responsibility for legislation is fragmented. It argues that although the policy tools are aimed at making actors responsible for digitalization and creating clarity about the process, actors seem to be reluctant to take on the responsibility for making political decisions related to digitalization. [ABSTRACT FROM AUTHOR]

This theoretical paper draws extensively on the extant literature to examine the role of expert intuition in the management of non-routine crises within a volatile, uncertain, complex, and ambiguous (VUCA) environment. It follows a theoretically driven inductive design to explore the construct of intuitive expertise, with a specific focus on high-risk domains. Methodically, the paper builds on the naturalistic decision-making (NDM) theory to explore how experienced crisis managers perform complex tasks with the aid of their tacit and intuitive knowledge. Evidence suggests that experienced decision-makers are more likely to solve time-pressured tasks using their intuitive mode as the default strategy, only switching to a deliberative mode when the proposed course(s) of action require some form of justification or where pattern recognition has proven insufficient. The paper also develops a four-dimensional framework that describes both individual and situational factors that generally influence decision-making dynamics in a VUCA crisis environment. A synthesis of the literature results in the emergence of four theoretical propositions, with implications discussed for crisis and emergency practice. A key recommendation is to integrate the NDM sub-discipline into the field of crisis management, with suggestions that such integration may lead to significant improvements in crisis response effectiveness. [ABSTRACT FROM AUTHOR]

In the UK, following the enactment of the Communications Act 2003, amending the Enterprise Act 2002, the assessment of mergers involving broadcaster and/or newspaper enterprises is subject to – alongside the regular competition standard under the 'substantial lessening of competition' (SLC) test – a public interest standard. Under this standard, certain media mergers need to be assessed pursuant to the following considerations: media plurality, broadcasting standard objectives and free expression of opinion grounds. While the statute defines these terms ambiguously, it does provide guidance to the Secretary of State, the competition authority and the courts to decide how the statute is intended to be applied consistently. The paper will analyse how the media plurality test has been applied, some of the considerations of the CMA and OFCOM, and in doing so it will touch on the discretion of the decision making stakeholders. [ABSTRACT FROM AUTHOR]

Little is known about the decision-making processes around seeking more supportive care for dementia. Persons with dementia are often left out of decision-making regarding seeking more supportive care as their dementia progresses. This paper provides a description of findings from the Decision-making in Alzheimer's Research project (DMAR) investigating the process of decision-making about transitions to more supportive care. We conducted 61 qualitative interviews with two stakeholder groups: 24 persons with dementia, and 37 informal caregivers to explore supportive care decisions and associated decision-making factors from the perspectives of persons with dementia and their caregivers. We identified four main decisions that persons with dementia and their informal caregivers played a role in: (1) sharing household responsibilities; (2) limiting routine daily activities; (3) bringing in formal support; and (4) moving to a care facility. Based on our findings we developed a schematized roadmap of decision-making that we used to guide the discussion of our findings. Four crosscutting themes emerged from our analysis: unknowns and uncertainties, maintaining life as you know it, there's no place like home and resource constraints. These results will be incorporated into the development of instruments whose goal is to identify preferences of persons with dementia and their caregivers, in order to include persons with dementia in care decisions even as their dementia progresses. [ABSTRACT FROM AUTHOR]

Scholars developing the concept of post-normal science have focused on high stakes and uncertainty to illustrate scientific inquiry and decision-making under post-normal conditions. While uncertainty and decision stakes are often challenges in any decision-making process, we argue that they are not the key factors that warrant the use of a post-normal approach, in which facts are ambiguous, values are in dispute, and stakes are high. In this paper, we center the role of time in the definition of post-normal science and offer a model of decision-making that incorporates uncertainty and high stakes within an overarching context of urgency. We then present three cases of decision-making with varying time horizons to illustrate the significance of time: The period leading up to the 2022 Russian invasion of Ukraine, the U.S. development of the atomic bomb during the Manhattan Project, and U.S. space exploration in the 1960s, culminating in the Apollo 11 Moon landing. Elaborating on the role of time in post-normal science is crucial to public administration because our field routinely involves decision making amidst ambiguous facts, disputed values, high stakes, and urgency. As the three illustrative cases further show, administrators on the ground during the lead-up to the Russian invasion of Ukraine, the Manhattan Project, and space exploration also included extended peer communities. [ABSTRACT FROM AUTHOR]

The use of smartphones has empowered tourists to make travel decisions while at a destination. The purpose of this paper is to explore how tourists use metaheuristics to achieve a near-optimal solution for onsite decisions mediated by smartphones. An event-based narrative inquiry technique with semi-structured interviews was used to collect the data. The findings identify two types of decision contexts based on temporal and geographic distance to direct experience/consumption. The findings also reveal that tourists use serial heuristics for a near-optimal solution under different decision contexts, and this solution is achieved through three steps of a tourist decision journey including the initialization solution, acceptance and selection, and final decision. These heuristics can be consciously deployed or unconsciously triggered. The findings offer marketing managers direction regarding what to emphasize when delivering marketing stimuli in onsite destination decision-making contexts. [ABSTRACT FROM AUTHOR]