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Decision-making Process (decision-making + process)

Distribution by Scientific Domains
Medical Sciences32%
Humanities and Social Sciences22%
Business, Economics, Finance and Accounting16%
Psychology7%
Life Sciences5%
Engineering5%
Earth and Environmental Science4%
Law and Criminology2%
3 Other Domains7%
Distribution within Medical Sciences
Nursing General31%
Consumer Health General9%
26 Other Subdomains60%

Kinds of Decision-making Process

  • clinical decision-making process
    		•

    Selected Abstracts

    Confronting Uncertainty and Missing Values in Environmental Value Transfer as Applied to Species Conservation

    CONSERVATION BIOLOGY, Issue 5 2010
    SONIA AKTER
    conservación de especies; error de transferencia; incertidumbre; transferencia de valor ambiental; valores de no uso Abstract:,The nonuse (or passive) value of nature is important but time-consuming and costly to quantify with direct surveys. In the absence of estimates of these values, there will likely be less investment in conservation actions that generate substantial nonuse benefits, such as conservation of native species. To help overcome decisions about the allocation of conservation dollars that reflect the lack of estimates of nonuse values, these values can be estimated indirectly by environmental value transfer (EVT). EVT uses existing data or information from a study site such that the estimated monetary value of an environmental good is transferred to another location or policy site. A major challenge in the use of EVT is the uncertainty about the sign and size of the error (i.e., the percentage by which transferred value exceeds the actual value) that results from transferring direct estimates of nonuse values from a study to a policy site, the site where the value is transferred. An EVT is most useful if the decision-making framework does not require highly accurate information and when the conservation decision is constrained by time and financial resources. To account for uncertainty in the decision-making process, a decision heuristic that guides the decision process and illustrates the possible decision branches, can be followed. To account for the uncertainty associated with the transfer of values from one site to another, we developed a risk and simulation approach that uses Monte Carlo simulations to evaluate the net benefits of conservation investments and takes into account different possible distributions of transfer error. This method does not reduce transfer error, but it provides a way to account for the effect of transfer error in conservation decision making. Our risk and simulation approach and decision-based framework on when to use EVT offer better-informed decision making in conservation. Resumen:,El valor de no uso (o pasivo) de la naturaleza es importante pero su cuantificación con muestreos pasivos consume tiempo y es costosa. En ausencia de estimaciones de estos valores, es probable que haya menos inversión en acciones de conservación que generen beneficios de no uso sustanciales, tal como la conservación de especies nativas. Para ayudar a superar decisiones respecto a la asignación de dólares para conservación que reflejan la carencia de estimaciones de los valores de no uso, estos valores pueden ser estimados indirectamente por la transferencia de valor ambiental (TVA). La transferencia de valor ambiental utiliza datos existentes o información de un sitio de estudio de tal manera que el valor monetario estimado de un bien ambiental es transferido a otro sitio. Un reto mayor en el uso de TVA es la incertidumbre sobre la señal y el tamaño del error (i.e., el porcentaje en que el valor transferido excede al valor actual) que resulta de la transferencia de estimaciones directas de los valores de no uso de un sitio de estudio a uno político, el sitio adonde el valor es transferido. Una TVA es más útil si el marco de toma de decisiones no requiere información muy precisa y cuando la decisión de conservación está restringida por tiempo y recursos financieros. Para tomar en cuenta la incertidumbre en el proceso de toma de decisiones, se puede seguir una decisión heurística que guie el proceso de decisión e ilustre sobre las posibles ramificaciones de la decisión. Para tomar en cuenta la incertidumbre asociada con la transferencia de valores de un sitio a otro, desarrollamos un método de riesgo y simulación que utiliza simulaciones Monte Carlo para evaluar los beneficios netos de las inversiones de conservación y que considera posibles distribuciones diferentes de la transferencia de error. Este método no reduce el error de transferencia, pero proporciona una manera para considerar el efecto del error de transferencia en la toma de decisiones de conservación. Nuestro método de riesgo y simulación y el marco de referencia basado en decisones sobre cuando utilizar TVA permiten la toma de decisiones en conservación más informadas. [source]

    Conservation Biology Framework for the Release of Wild-Born Orphaned Chimpanzees into the Conkouati Reserve, Congo

    CONSERVATION BIOLOGY, Issue 5 2001
    Caroline E. G. Tutin
    Release of captive individuals is complex and controversial, however, particularly when risks are potentially high, as in the case of orphaned apes. We describe the decision-making process that led to the successive release of 20 wild-born orphan chimpanzees ( Pan troglodytes troglodytes) into the Conkouati Reserve in the Republic of Congo. Recommendations of the Reintroduction Specialist Group of the World Conservation Union's Species Survival Commission were followed closely. The conservation status, ecology, and behavior of wild chimpanzees; the biological, social, economic and political context of the release site; and the health and genetic status of the candidates for release were all taken into account in the planning and execution of the project. Rigorous post-release monitoring of behavior and health allowed documentation of the outcome. The project was of benefit to the chimpanzees that were released but also brought broad benefits to the site through effective protection from poaching and deforestation, and direct and indirect benefits to local people. The genetic and behavioral diversity of chimpanzees require a variety of conservation strategies to reduce threats and maintain as many viable wild populations as possible. Resumen: El retorno de animales confiscados a sus hábitats nativos es deseable cuando ocasiona una contribución positiva para la conservación de la especie. Sin embargo, la liberación de individuos cautivos es compleja y controversial, particularmente cuando los riesgos son potencialmente altos, como es el caso de los monos huérfanos. Describimos el proceso de toma de decisiones que condujo a la liberación de exitosa de 20 chimpancés silvestres huérfanos ( Pan troglodytes troglodytes) dentro de la Reserva Conkouati de la República de Congo. Las recomendaciones del Grupo de especialistas en reintroducción de la UICN-SSC fueron seguidas de cerca. El estatus de conservación, ecología y conducta de los chimpancés silvestres; el contexto biológico, social, económico y político del sitio de liberación y la salud y estatus genético de los candidatos a ser liberados fueron también tomados en consideración en la planeación y ejecución del proyecto. El monitoreo riguroso post-liberación de la conducta y salud permitió la documentación de los resultados. El proyecto fue benéfico para los chimpancés liberados pero también trajo beneficios amplios al sitio mediante la protección efectiva de la caza fortuita y la deforestación y beneficios directos e indirectos para la población humana local. La diversidad genética y conductual de los chimpancés requiere de una variedad de estrategias de conservación para reducir las amenazas y mantener cuantas poblaciones silvestres viables sean posibles. [source]

    Rationality in Strategic Information Technology Decisions: The Impact of Shared Domain Knowledge and IT Unit Structure,

    DECISION SCIENCES, Issue 1 2002
    C. Ranganathan
    ABSTRACT Rationality is a fundamental concept to several models of IT planning and implementation. Though the importance of following rational processes in making strategic IT decisions is well acknowledged, there is not much understanding on why discrepancies occur in the IT decision-making process and what factors affect rationality. Drawing upon structural and resource-based perspectives of strategy, this study examines the influence of shared domain knowledge and IT unit structure on rationality in strategic IT decisions. Data were gathered from 223 senior IT executives using a survey to examine the relationships among the research constructs. The results suggest a positive impact of shared domain knowledge and formalization of IT unit structure on rationality in strategic IT decisions. Further, a highly centralized IT unit structure was found to negatively influence shared domain knowledge. On the other hand, formalization of IT structure positively influenced shared domain knowledge. The implications of the findings for research and practice are presented. [source]

    Interferon Alfa-2b or Not 2b?

    DERMATOLOGIC SURGERY, Issue 1 2007
    Significant Differences Exist in the Decision-Making Process between Melanoma Patients Who Accept or Decline High-Dose Adjuvant Interferon Alfa-2b Treatment
    BACKGROUND Patients with thick (Breslow >4 mm) primary melanoma and/or regional nodal metastasis have a high risk of tumor recurrence. High-dose adjuvant interferon (IFN) alfa-2b offers ,10% improvement in relapse-free survival and overall survival with significant toxicity. OBJECTIVE The objective was to determine which prognostic factors and patient characteristics are significant in the decision to undergo IFN therapy. METHODS Of 781 patients who underwent sentinel lymph node (SLN) biopsy, 135 of 781 (17.3%) had positive SLN or thick melanomas and were informed of a ,50% risk of recurrence/disease-related mortality and offered IFN. Telephone surveys delineated reasons behind patients' decisions to accept IFN. RESULTS Acceptors, 60 of 135 (45%), decided to take IFN alfa-2b whereas 75 of 135 (55%) declined. Being female (OR, 2.4; 95% CI, 1.17,5.03; p=.017) and positive SLN status (OR, 2.2; 95% CI, 1.01,4.97; p=.048) were strongly associated with patients who chose IFN. Acceptors of IFN were younger, more influenced by physicians, and less affected by depression and side effect profile (p<.05 for all). Decliners were more concerned by strained relationships with family and social life (p<.05). CONCLUSIONS Gender and positive SLN were predictive of high-risk melanoma patients' acceptance of IFN treatment. Physician insight into melanoma patients' therapeutic decision-making process can guide patients through this difficult disease. [source]

    WOMEN IN DEVELOPING COUNTRIES AND BENEFIT SHARING

    DEVELOPING WORLD BIOETHICS, Issue 3 2006
    FATIMA ALVAREZ-CASTILLO
    ABSTRACT The aim of this paper is to show that any process of benefit sharing that does not guarantee the representation and participation of women in the decision-making process, as well as in the distribution of benefits, contravenes a central demand of social justice. It is argued that women, particularly in developing countries, can be excluded from benefits derived from genetic research because of existing social structures that promote and maintain discrimination. The paper describes how the structural problem of gender-based inequity can impact on benefit sharing processes. At the same time, examples are given of poor women's ability to organise themselves and to achieve social benefits for entire communities. Relevant international guidelines (e.g. the Convention on Biodiversity) recognise the importance of women's contributions to the protection of biodiversity and thereby, implicitly, their right to a share of the benefits, but no mechanism is outlined on how to bring this about. The authors make a clear recommendation to ensure women's participation in benefit sharing negotiations by demanding seats at the negotiation table. [source]

    From Disaster to Sustainable Civil Society: The Kobe Experience

    DISASTERS, Issue 1 2004
    Rajib Shaw
    Nine years after the Kobe earthquake in Japan, social issues are still prominent, and the rehabilitation process is still ongoing. The earthquake caused two major changes in Japanese society: an increase in voluntary and non-government activities, and the enhancement of cooperation between local government and the residents' association. People's participation in the decision-making process was a significant achievement. To sustain the efforts generated after the earthquake, the Kobe Action Plan was formulated and tested in different disaster scenarios. The current study suggests that civil societies in urban areas are sustainable if, first, the activities related to daily services are provided by the resident's associations; and second, these are linked to economic incentives. Leadership plays a crucial role in collective decision-making. Creation of the support system is essential for long-term sustainability of civil-society activities. These observations are exemplified in the case study in Nishi Suma, one of the worst-affected areas in the Kobe city. [source]

    The Use of 3D Contrast-Enhanced CT Reconstructions to Project Images of Vascular Rings and Coarctation of the Aorta

    ECHOCARDIOGRAPHY, Issue 1 2009
    Thomas G. Di Sessa M.D.
    Background: Aortic arch and pulmonary artery anomalies make up a group of vascular structures that have complex three-dimensional (3D) shapes. Tortuosity as well as hypoplasia or atresia of segments of the aortic arch or pulmonary artery makes the conventional two-dimensional (2D) imaging difficult. Methods: Nine patients with native coarctation or recoarctation and 4 patients with a vascular ring had a CT scan as a part of their clinical evaluation. There were 7 males. The mean age was 11.7 years. (range 19 days to 29 years) The mean weight was 22.7 kg (range 3.3,139.0 kg). The dicom data from contrast CT scans were converted by the Amira software package into a 3D image. The areas of interest were selected. The images were then projected in 3D on a standard video monitor and could be rotated 360° in any dimension. Results: Adequate CT scans and 3D reconstructions were obtained in 12 of 13 patients. There were 85,1,044 slices obtained in the adequate studies. We could not reconstruct a 3D image from a patient's CT scan that had only 22 slices. The anatomy defined by 3D was compared to 2D CT imaging and confirmed by cardiac catheterization or direct visualization in the operating room in the 12 patients with adequate 3D reconstructions. In 5 of 12 patients, 3D reconstructions provided valuable spatial information not observed in the conventional 2D scans. Conclusion: We believe that 3D reconstruction of contrast-enhanced CT scans of these complex structures provides additional valuable information that is helpful in the decision-making process. [source]

    BioPrEP , a regional, process-based approach for assessment of land with high conservation value for Bush Heritage Australia

    ECOLOGICAL MANAGEMENT & RESTORATION, Issue 1 2010
    Brendan Mackey
    Summary, A framework is presented for terrestrial conservation assessment that has been developed for Bush Heritage, an Australian non-profit organisation that manages land of outstanding conservation value through acquisition or working in partnership with other landowners. The framework is called Biodiversity Prediction using Ecological Processes and comprises seven conservation goals, with a set of candidate criteria and indicators for each goal. Particular emphasis is given to criteria that relate to habitat quality in addition to the more conventional focus on land quantity. The MCAS-S graphic user interface is used to help analyse the indicators and visualise the results in a transparent way that assists the decision-making process. The interface also allows indicators to be weighted differently, which among other things, allows analyses to reflect inter-regional differences in what represents high quality land. The framework was tested in a case study region (the Woodland region of south-eastern Australia), and the results reveal land that is potentially a priority for conservation investments. While the framework and case study results are indicative, and further analyses are required before they can be considered operational, the approach has potential application to other organisations in the private conservation sector. [source]

    RATIONAL PARTISAN THEORY, UNCERTAINTY, AND SPATIAL VOTING: EVIDENCE FOR THE BANK OF ENGLAND'S MPC

    ECONOMICS & POLITICS, Issue 2 2010
    ARNAB BHATTACHARJEE
    The transparency and openness of the monetary policy-making process at the Bank of England has provided very detailed information on both the decisions of individual members of the Monetary Policy Committee (MPC) and the information on which they are based. In this paper, we consider this decision-making process in the context of a model in which inflation forecast targeting is used, but there is heterogeneity among the members of the committee. We find that rational partisan theory can explain spatial voting behavior under forecast uncertainty about the output gap. Internally generated forecasts of output and market-generated expectations of medium-term inflation provide the best description of discrete changes in interest rates, in combination with uncertainty in the macroeconomic environment. There is also a role for developments in asset, housing and labor markets. Further, spatial voting patterns clearly differentiate between internally and externally apzpointed members of the MPC. The results have important implications for committee design and the conduct of monetary policy. [source]

    The use of technical knowledge in European water policy-making

    ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 5 2010
    Perry J. M. van Overveld
    Abstract Environmental policy-making often involves a mix of technical knowledge, normative choice and uncertainty. Numerous actors, each with their own distinct objectives, are involved in these policy-making processes. One question these actors face, is how they can effectively communicate their technical knowledge and represent their interests in policy-making. The objective of this paper is to identify the factors that influence the use of technical knowledge and its impact on decision-making in the European Union. This is done for case of water policy-making for organic micropollutants, such as pesticides and pharmaceuticals. These pollutants enter the surface water in many ways and although concentrations are low, adverse effects cannot be ruled out. Via the EU Water Framework Directive, legislation has been developed to reduce the emissions of pollutants that pose a risk to ecology or public health. Using the advocacy coalition framework, the formal EU decision-making processes are analyzed for the identification of priority pollutants (Priority Substances) and the derivation of maximum allowable concentrations (Environmental Quality Standards). To enable a detailed analysis, the focus is on three specific micropollutants that pose health risks via drinking water supply. The findings show the extent to which actors can influence the decision-making process with technical knowledge. Early involvement in the drafting process that is led by the European Commission is important to influence decision-making outcomes. For this, organizational capacity in coalitions to mobilize and coordinate the required targeted contribution of technical knowledge is crucial. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment. [source]

    Adaptation to climate change in the European union: efficiency versus equity considerations

    ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 3 2010
    Stine Aakre
    Abstract EU climate policy based on reduction (mitigation) of greenhouse gas emissions is coupled with measures aimed at responding efficiently to the unavoidable consequences of climate change (adaptation). However, as the European Commission stated recently in its Green and White Papers on adaptation in Europe, there is still need to develop an overall EU adaptation strategy. Moreover, such a strategy should take into consideration both efficiency and equity concerns. In this article we propose a framework for EU adaptation policy that addresses the two concerns and which enables a transparent decision-making process. In the proposed scheme universal weightings of the individual policy objectives have to be agreed upon prior to actual decision-making. Copyright © 2010 John Wiley & Sons, Ltd and ERP Environment. [source]

    The European Union in international environmental negotiations: an analysis of the Stockholm Convention negotiations

    ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 1 2009
    Tom Delreux
    Abstract This article focuses on the way the European Union acted as a negotiating party during the international negotiations leading to the Stockholm Convention on Persistent Organic Pollutants (1998,2000). Starting from a principal,agent model, the article discusses how the EU participated in these negotiations and how the internal decision-making process developed. It argues that the EU was able to negotiate in a unified and influential way by defending a common position, which was expressed by a flexible negotiation arrangement, at the international level. Three features of the EU decision-making process engendered such a strong EU negotiation arrangement: homogeneous preferences among the actors in the EU, symmetrically distributed information among them and a cooperative and institutionally dense decision-making context. Copyright © 2009 John Wiley & Sons, Ltd and ERP Environment. [source]

    The European Water Framework Directive and economic valuation of wetlands: the restoration of floodplains along the River Elbe

    ENVIRONMENTAL POLICY AND GOVERNANCE, Issue 1 2007
    Jürgen Meyerhoff
    Abstract This paper concerns the economic valuation of riparian wetlands ecological services within the European Water Framework Directive (WFD). The directive is an integrated approach to river basin management in Europe and aims at achieving a good water status for both surface and ground water. It introduces economic analysis as a core part of the development of integrated river basin management plans. However, to date the WFD has not clearly stated to what extent wetlands should be used for the achievement of environmental objectives, or what scope the economic analysis should have. Our study of the river Elbe shows that riparian wetlands provide significant benefits that should be considered in river basin management decisions. To neglect these benefits would lead to biased cost,benefit analysis results and might therefore misguide the decision-making process. Copyright © 2007 John Wiley & Sons, Ltd and ERP Environment. [source]

    The impact of stomatological disease on oral health-related quality of life

    EUROPEAN JOURNAL OF ORAL SCIENCES, Issue 4 2003
    Carrie Diane Llewellyn
    The clinical diagnosis of stomatological disease may indicate its cause and prognosis; however, it says little about the resulting level of impairment from the patient's perspective. The primary objective of this study was to test whether patients attending an outpatient oral medicine clinic would have worse oral health related quality of life (OHR-QoL) compared with the general population. In addition, we aimed to assess whether anxiety or depression could be predicted by OHR-QoL and to explore the relationship between clinical diagnoses, OHR-QoL and anxiety/depression. Data were collected from patients (n = 97) through face-to-face interviews using the Oral Health Impact Profile Short form (OHIP-14) to measure OHR-QoL, the Hospital Anxiety and Depression Scale (HADS) for psychiatric morbidity, and a visual analogue scale for self-rated general health. Age- and sex-matched controls (n = 388) were provided from a normative data set collected in a UK national survey in 1998. Participants had significantly lower OHR-QoL scores than the general population on all domains and overall OHR-QoL scores. Of the variance in anxiety, 55% was predicted by general health ratings and OHR-QoL domains of ,psychological discomfort' and ,psychological disability'. Of the variance in depression, 54% was predicted by general health ratings and OHR-QoL domains of ,functional limitation' and ,social disability'. Patient centred, routine assessment of OHR-QoL provides an additional dimension that may help to improve awareness of the impact of disease on the individual's life and enhance the clinical decision-making process. [source]

    The limits to local participation and deliberation in the French ,politique de la ville'

    EUROPEAN JOURNAL OF POLITICAL RESEARCH, Issue 4 2007
    YVES SINTOMER
    This article looks at whether it has led to a genuine democratisation of policy making. The following four questions are discussed: Have participatory procedures improved the efficiency of public policy? Have they fostered the strengthening of the social bond? Has setting up new procedures improved deliberation between political and nonpolitical actors? And has this new policy generated a renewal of local elites and modified the decision-making process? The authors conclude that these different attempts have had only a very limited impact. [source]

    Differentiating and Linking Politics and Adjudication,The Example of European Electricity Policy

    EUROPEAN LAW JOURNAL, Issue 3 2002
    Adrienne Héritier
    The paper analyses how politics and adjudication answer similar questions in the context of policy-making. It contrasts how societal problems are selected, defined, solved and legitimised by both disciplines. We raise these questions in regard to the liberalization of the European Electricity markets. We reconstruct the decision-making process at the political and adjudicative arena taking place in this policy area. By so doing, we elaborate the differences and establish the links between politics and adjudication. We argue that what differentiates these two disciplines constitutes their very links; that is, the adjudicative and political arena are linked precisely because they are different at various level. [source]

    CHILDREN'S AND PARENTS' PERCEPTIONS ON CHILDREN'S PARTICIPATION IN DECISION MAKING AFTER PARENTAL SEPARATION AND DIVORCE*

    FAMILY COURT REVIEW, Issue 1 2008
    Judy Cashmore
    This article outlines the views of children and parents involved in family law disputes, about the need for and appropriateness of children's participation in decisions regarding residence and contact arrangements. Ninety parents and 47 children (ranging in age from 6 to 18 years) who had been through parental separation, were interviewed. Both parents and children had a range of views about the general appropriateness and fairness of children being involved, but the great majority, particularly of parents, thought that children should have a say in these matters. Core findings of the study include the considerable influence that older children had over the arrangements either in the aftermath of the separation or in making further changes over time, and the higher stated need of children who had experienced violence, abuse, or high levels of conflict to be heard than those in less problematic and noncontested matters. Parents involved in contested proceedings supported the participation of children at a younger age than those who were not. There was a reasonable degree of agreement between parents and children about the need for children to be acknowledged and the value of their views being heard in the decision-making process. Parents, however, expressed concern about the pressure and manipulation that children can face and exert in this process, whereas children were generally more concerned about the fairness of the outcomes, and maintaining their relationships with their parents and siblings. [source]

    Factors influencing the scope and quality of science and management decisions

    FISH AND FISHERIES, Issue 1 2002
    (The good, the bad, the ugly)
    Abstract The lecture traces the historical path to overfishing of the world's fish and shellfish stocks, and provides an assessment of marine fish resources in the later half of the 1990s. The basis of overfishing as noted by various fishery scientists is reviewed. Four factors, including institutional paralysis, the rapidity of technological developments, uncertainty of science, and the inability to monitor and enforce regulations are identified as the major problems leading to overfishing. The failure of the world community to deal with extensive overfishing, appears to have motivated managers and scientists to promote a new fishery management paradigm that focuses on a broader set of problems resulting from fishing, and establishes a more conservative decision-making process founded on precautionary principle and uncertainty. The author feels that the evolving paradigm will result in the rebuilding of a number of stocks in the United States, but is less certain of its adoption on a global scale, and whether or not science will play a more useful role in fisheries management. It is noted that the support for fisheries science and the status of fisheries have followed opposite courses. Over the past half century marine science has boomed, diversified and become intellectually and materially enriched, while the number of overfished stocks and ecological disasters has increased. Looking ahead it is expected that fisheries management will move into a more conservative era. The focus of fisheries has moved from full use of ocean resources to establishing yields that take into account the impacts of fisheries on target and non-target species and the ecosystem in general. Although there has been wide-spread abuse in the use of the world's fishery resources and condemnation of the fishing industries, the author feels that the government institutions must bear the primary responsibility for the historical course of fishery management and its failure. [source]

    The development of the Finnish inland fisheries system

    FISHERIES MANAGEMENT & ECOLOGY, Issue 4-5 2001
    M. Sipponen
    The efficiency of Finnish inland fisheries administration has improved during the past 15 years because of changes in fisheries legislation. The establishment of regional management units particularly has improved the practice of co-management, which has allowed the participation of many relevant interest groups in the decision-making process. The long-term private market equilibrium supply for recreational fishing with active types of gear accounted for 50% of the Finnish lake surface area. Presently the public sector has become involved in the supply of recreational fishing licences. The improvement in the system owes much to political initiatives. As regards commercial fishing, state-ownership of fishing grounds is a channel for recruitment into the occupation. Private ownership has led to a suboptimal allocation of fisheries resources, particularly in the commercial branch of the industry. However, by giving priority to social instead of economic goals the statutory fishery associations will help to maintain social and community values, which are locally important. [source]

    Anatomy of Failure: Bush's Decision-Making Process and the Iraq War

    FOREIGN POLICY ANALYSIS, Issue 3 2009
    David Mitchell
    The Bush administration's decision-making process leading to the invasion of Iraq in 2003 has been singled out for its many shortcomings: failure of intelligence; lack of debate concerning options; an insufficient invading force; and poor postwar planning. Contrary to the administration's claim that no one foresaw the difficulties of waging a war in Iraq, many concerns about the challenges the United States would face were raised inside and outside of government. Yet, none of this information had a significant effect on the decision-making process. This paper develops a decision-making model that integrates elements from the individual to the organizational level and explains how important information was marginalized, leading to a poor policy outcome. The model illustrates how the combined effects of the president's formal management style, anticipatory compliance on the part of key players, bureaucratic politics, and the intervening variable of the 9/11 terrorist attacks contributed to a defective decision-making process. [source]

    Empathy and Strategic Interaction in Crises: A Poliheuristic Perspective

    FOREIGN POLICY ANALYSIS, Issue 2 2009
    Jonathan W. Keller
    Empirical evidence supports the poliheuristic (PH) theory of decision making, which states that leaders typically employ a two-stage non-compensatory decision-making process. In stage one leaders reject options that do not meet some minimum criteria of acceptability on one or more dimensions, and in stage two they choose among the remaining options using a more rational utility-maximizing rule. While PH theory has primarily been applied at the monadic level, to explain the process and content of states' decisions, we contend it has important implications for strategic interaction and can help to explain outcomes in world politics. Specifically, we argue that a crucial variable shaping crisis outcomes is the degree to which leaders' non compensatory decision criteria in stage one include options' acceptability to the opponent. When leaders empathize with their opponent and screen out those options the opponent considers unacceptable, crises will be resolved more quickly and with a lower likelihood of escalation. Empathy introduced during the second, utility-maximizing stage, may also dampen conflict but is less effective than stage one empathy. We illustrate this dyadic non compensatory model by examining two cases involving the U.S.,China and U.S.,Iraq bilateral relationships. [source]

    Political Institutions and Constrained Response to Economic Sanctions

    FOREIGN POLICY ANALYSIS, Issue 3 2008
    Susan Hannah Allen
    Institutional constraints within the target state not only influence a leader's ability to resist economic sanctions, but they also affect the decision-making process within the target state and the nature of information that a sender can ascertain about likely response. Autocratic leaders, who are less constrained, send noisier signals about their probable behavior. This lack of constraint also allows more freedom to resist sanctions, as they can shunt the costs of sanctions off onto the general public, who have little influence over policy outcomes or leadership retention. Democratic leaders are more constrained and more susceptible to sanctions pressure. As result, there is less uncertainty for senders about probable response. Using a heteroskedastic probit model to explore potential systematic components of the variation surrounding sanctions response, the impact of sanctions is shown to differ by regime type,both in the response to coercion as well as in the variance surrounding that response. The results presented here suggest that as expected, democracies are more susceptible to sanctions pressure, but the response of mixed and authoritarian systems are more difficult to predict. These findings have implications for the design of future sanctions policy as well as suggesting which states make the best targets for economic coercion. [source]

    Centralizing Advisory Systems: Presidential Influence and the U.S. Foreign Policy Decision-Making Process

    FOREIGN POLICY ANALYSIS, Issue 2 2005
    David Mitchell
    This study is motivated by a simple yet vitally important question for an understanding of U.S. foreign policy. Quite simply, how does a president's choice of management style influence the U.S. foreign policy decision-making process and decision outcomes? Presidents play a critical role in the formulation of U.S. foreign policy; however, the presidential studies literature and foreign policy analysis literature arrive at very different conclusions regarding how presidents influence the policy process and both are often inaccurate. This study develops an Advisory Systems Typology to address how presidents influence the decision-making process. In addressing this question, this study overcomes the deficiencies of both the presidential studies and foreign policy analysis literature. Four different types of decision-making processes are produced by a president's choice of advisory structure and level of centralization. In addition, the study identifies "unstructured solutions" that indicate how the presidential advisers and president choose to resolve policy disagreements, thereby providing an indication of the decision outcome. The identified decision-making processes and their associated decision outcomes are explored using four cases of decision making on security policy drawn from the Nixon (Vietnam War), Carter (Strategic Arms Limitation Talks II), Reagan (Strategic Arms Reduction Talks I), and Clinton (Bosnia conflict) administrations. The case studies are constructed using the method of structured,focused comparisons, whereby a set of theoretically based questions and anticipated observations to those questions are made in order to guide the research and allow for comparison of decision making within and between cases. [source]

    Post-return experiences and transnational belonging of return migrants: a Dutch,Moroccan case study

    GLOBAL NETWORKS, Issue 4 2010
    JUNE DE BREE
    Abstract In this article we explore the links between return migration, belonging and transnationalism among migrants who returned from the Netherlands to northeast Morocco. While transnationalism is commonly discussed from the perspective of a receiving country, this study shows that transnationalism also plays a vital role in reconstructing post-return belonging. Return migration is not simply a matter of ,going home', as feelings of belonging need to be renegotiated upon return. While returnees generally feel a strong need to maintain various transnational practices, the meanings they attach to these practices depend on motivations for return, gender and age. For former (male) labour migrants, transnational practices are essential for establishing post-return belonging, whereas such practices are less important for their spouses. Those who returned as children generally feel uprooted, notwithstanding the transnational practices they maintain. The amount of agency migrants are able to exert in the return decision-making process is a key factor in determining the extent to which returnees can create a post-return transnational sense of home. [source]

    Ground Water Recharge and Chemical Contaminants: Challenges in Communicating the Connections and Collisions of Two Disparate Worlds

    GROUND WATER MONITORING & REMEDIATION, Issue 2 2004
    Christian G. Daughton
    Our knowledge base regarding the presence and significance of chemicals foreign to the subsurface environment is large and growing , the papers in this volume serving as testament. However, complex questions with few answers surround the unknowns regarding the potential for environmental or human health effects from trace levels of xenobiotics in ground water, especially ground water augmented with treated waste water. Public acceptance for direct or indirect ground water recharge using treated municipal waste water (especially sewage) spans the spectrum from unquestioned embrace to outright rejection. In this paper, I detour around the issues most commonly discussed regarding ground water recharge and instead focus on some of the less-recognized issues,those that emanate from the mysteries created at the many literal and virtual interfaces involved with the subsurface world. My major objective is to catalyze discussion that advances our understanding of the barriers to public acceptance of waste water reuse with its ultimate culmination in direct reuse for drinking. I pose what could be a key question as to whether much of the public's frustration or ambivalence in its decision-making process for accepting, or rejecting, water reuse (for various purposes including personal use) emanates from fundamental inaccuracies, misrepresentation, or oversimplification of what water is and how it functions in the environment,just exactly what the water cycle is. These questions suggest it might behoove us to revisit some very elementary aspects of our science and how we are conveying them to the public. [source]

    Measuring horizontal inequity in Belgian health care using a Gaussian random effects two part count data model

    HEALTH ECONOMICS, Issue 7 2004
    Tom Van Ourti
    Abstract We estimate the determinants of utilisation of physician and hospital services in Belgium using a one- and two-part panel count data model, and a one- and two-part pooled count data model. We conclude that the two-part panel count data model is most appropriate as it controls for unobserved heterogeneity and allows for a two-part decision-making process. The estimates of the determinants of utilisation of health care are then used to calculate indices of horizontal inequity. We find that inequity for general practitioner and hospital services is stable across time and in favour of low-income individuals, in the sense that, overall, they consume more than one would expect on the basis of their need, albeit the indices for hospital care are not significant. Horizontal equity applies to specialist care in all years, but from 1999 onwards, some evidence (although not statistically significant) of pro-rich inequity is found. Copyright © 2004 John Wiley & Sons, Ltd. [source]

    Osteoporosis medication profile preference: results from the PREFER-US study

    HEALTH EXPECTATIONS, Issue 3 2007
    Thomas W. Weiss DrPH
    Abstract Objective, To assess patient preferences for two osteoporosis medications. Design, Women aged 50+ were surveyed via the Internet to assess preferences for two osteoporosis medication profiles. Drug A and Drug B, consistent with ibandronate and alendronate, respectively, differed by: time on market (recently vs. 10 years), dosing frequency (monthly vs. weekly), effectiveness (not proven vs. proven to reduce non-spine or hip fracture after 3 years) and dosing procedure (60 vs. 30 min wait before eating/drinking). Each profile had the same out-of-pocket costs, side-effects, potential for drug interaction and spine fracture efficacy. Patients force ranked and rated the importance of each attribute. Subgroup comparisons included diagnosed vs. at-risk respondents and treated vs. untreated respondents. Results, Among the 999 respondents, Drug B was preferred by 96%. Effectiveness was ranked as the most important determinant of preference (79% ranked it #1) compared with time on market (14%), dosing procedure (4%) and dosing frequency (3%). Effectiveness had the highest mean importance rating on a scale of 1 (extremely unimportant) to 7 (extremely important): mean (SD) = 6.1 (1.8), followed by time on market: 4.7 (1.7), dosing procedure: 4.6 (1.4) and dosing frequency: 4.5 (1.4). No significant differences in profile choice were found across study subgroups. Conclusions, The drug profile showing reductions in non-vertebral and hip fracture risk was chosen by almost all respondents. Drug effectiveness was the most important determinant of preference, while dosing frequency was the least important determinant. Incorporation of patient preferences in the medication decision-making process could enhance patient compliance and clinical outcomes. [source]

    Eliciting patients' preferences for adjuvant chemotherapy in breast cancer: development and validation of a bedside decision-making instrument in a French Regional Cancer Centre

    HEALTH EXPECTATIONS, Issue 2 2000
    Marie-Odile Carrère PhD
    Introduction In developed countries, the physician-patient relationship is moving from a paternalistic model to new decision-making models that take patient preferences into account. Objectives Our aim was to develop a Decision Board (DB) and to test its acceptability in a French Regional Cancer Centre regarding the decision on whether or not to use chemotherapy after surgery in postmenopausal women with breast cancer. This paper presents the development process for this instrument and reports the pretesting phase, as well as the corresponding results. Methods A working group was created with oncologists, psychologists and economists. Following the first phase, i.e. the development process, a first version of the instrument was presented to health professionals. Their feedback led to important modifications of the instrument. The DB was then presented to experienced patients, which resulted in slight changes. The second phase consisted of pretesting the comprehension, internal and across-time consistency of the DB on healthy volunteers. Results The DB was pretested in a group of 40 healthy volunteers. Eighteen respondents chose chemotherapy and 22 chose not to have chemotherapy. Comprehension rates were very high (,87.5%). Internal consistency was assessed considering option attitudes based on outcomes and option attitudes based on process. Women shifted their choices in a predictable way. Across-time consistency was appraised using the test-retest method with Visual Analog Scales. The Intraclass Correlation Coefficient was 0.97. Discussion-conclusion Due to cultural differences, the DB developed in our French Cancer Centre is quite different from the DBs previously developed elsewhere. Our instrument showed good comprehension and consistency properties, which are corroborated by the DB literature. Whether our DB is acceptable for patients with breast cancer must still be tested. Patients' reactions will tell us which type of decision-making model is at work. Further research is needed in order to explore the shared decision-making process and clarify the concept. [source]

    A spy on the payroll?

    HISTORICAL RESEARCH, Issue 220 2010
    William Herle, the mid Elizabethan polity
    A body of recent work focusing on the components of Tudor policy has drawn attention to those ,second-rank' figures crucial for the efficient running of the Elizabethan administration. After close archival excavation, men like Robert Beale, largely marginal to the historiography of the period for so long, have now been identified and credited with a role which was fundamental to the smooth operation of the Tudor political system. In this group of men, participating on the fringes of the polity and whose activities, whether clerical or more recondite, contributed to the formation of domestic and international policy, is found William Herle, an agent, diplomatic envoy and intelligencer for Elizabeth I's ministers. An elusive figure, and passed over by many scholars, Herle's epistolary contribution to the administrative and intelligence bureaux of William Cecil, Lord Burghley, Robert Dudley, earl of Leicester, and Sir Francis Walsingham reveals the information channels and structures behind the decision-making process of this triumvirate of political heavyweights and their conciliar fraternity. [source]

    Classification of liver and pancreatic trauma

    HPB, Issue 1 2006
    GABRIEL C. ONISCU
    Abstract The liver is the most frequently injured intra-abdominal organ and associated injury to other organs increases the risk of complications and death. This has highlighted the critical need for an accurate classification system as a basis for the clinical decision-making process. Several classification systems have been proposed in an attempt to incorporate the aetiology, anatomy and extent of injury and correlate it with subsequent clinical management and outcome. The widely accepted Organ Injury Scale is based on anatomical criteria that quantify the disruption of the liver parenchyma and defines six groups which may influence management strategies and relate to outcome. The less common pancreatic injury remains a major source of morbidity and mortality due to the likelihood of associated solid or hollow-organ injuries. The implication of a delay in diagnosis and management emphasizes the need for an accurate classification system. The Organ Injury Scale is widely used for pancreas trauma and recognizes the importance of progressive parenchymal injury and in particular ductal injury. Advances in imaging techniques have led to the development of newer radiological classification systems; however, validation of their accuracy remains to be proven. An accurate classification of liver and pancreatic trauma is fundamental for the development of treatment protocols in which clinical decisions are based on the severity of injury. [source]