Decision‐Making in Paediatric Rehabilitation: Exploring Professionals' and Children's Views on Decision‐Making Involvement

The article explores the distinction that professionals make between difficult and less difficult decisions in paediatric rehabilitation interventions. This distinction is explored by looking at the involvement of two children in decisions regarding paediatric rehabilitation interventions. The article argues for a clinical practice where children's experiences are extensively used to improve practice and to accommodate the child's right to participate in medical decisions concerning their own body and life. The different ways the children and the professional describe their experiences provide an avenue for a discussion on how medical reasoning can curtail children's involvement in decisions.     

论行政决策中的公众参与权

突破公众参与有效性瓶颈依赖于对公众参与权的依法确认、不断充实及有效保护。鉴于我国对公众参与权的研究比较迟缓、参与权制度发展仍然非常缓慢的现实困境,应当在准确界定公众参与权的性质、明确公众参与权的内容构成基础上,尽快构建起一系列具体的、可操作的法律制度,真正实现公众参与权的民主价值。     

Conditional entropy,entropy density,and strong law of large numbers for generalized controlled tree-indexed Markov chains

In this paper, we first introduces a tree model without degree boundedness restriction namely generalized controlled tree T, which is an extension of some known tree models, such as homogeneous tree model, uniformly bounded degree tree model, controlled tree model, etc. Then some limit properties including strong law of large numbers for generalized controlled tree-indexed non homogeneous Markov chain are obtained. Finally, we establish some entropy density properties, monotonicity of conditional entropy, and entropy properties for generalized controlled tree-indexed Markov chains.     

An Integrated Risk Assessment Model of Township‐Scaled Land Subsidence Based on an Evidential Reasoning Algorithm and Fuzzy Set Theory

Land subsidence risk assessment (LSRA) is a multi‐attribute decision analysis (MADA) problem and is often characterized by both quantitative and qualitative attributes with various types of uncertainty. Therefore, the problem needs to be modeled and analyzed using methods that can handle uncertainty. In this article, we propose an integrated assessment model based on the evidential reasoning (ER) algorithm and fuzzy set theory. The assessment model is structured as a hierarchical framework that regards land subsidence risk as a composite of two key factors: hazard and vulnerability. These factors can be described by a set of basic indicators defined by assessment grades with attributes for transforming both numerical data and subjective judgments into a belief structure. The factor‐level attributes of hazard and vulnerability are combined using the ER algorithm, which is based on the information from a belief structure calculated by the Dempster‐Shafer (D‐S) theory, and a distributed fuzzy belief structure calculated by fuzzy set theory. The results from the combined algorithms yield distributed assessment grade matrices. The application of the model to the Xixi‐Chengnan area, China, illustrates its usefulness and validity for LSRA. The model utilizes a combination of all types of evidence, including all assessment information—quantitative or qualitative, complete or incomplete, and precise or imprecise—to provide assessment grades that define risk assessment on the basis of hazard and vulnerability. The results will enable risk managers to apply different risk prevention measures and mitigation planning based on the calculated risk states.     

Community Resilience and Decision Theory Challenges for Catastrophic Events

Extreme and catastrophic events pose challenges for normative models of risk management decision making. They invite development of new methods and principles to complement existing normative decision and risk analysis. Because such events are rare, it is difficult to learn about them from experience. They can prompt both too little concern before the fact, and too much after. Emotionally charged and vivid outcomes promote probability neglect and distort risk perceptions. Aversion to acting on uncertain probabilities saps precautionary action; moral hazard distorts incentives to take care; imperfect learning and social adaptation (e.g., herd‐following, group‐think) complicate forecasting and coordination of individual behaviors and undermine prediction, preparation, and insurance of catastrophic events. Such difficulties raise substantial challenges for normative decision theories prescribing how catastrophe risks should be managed. This article summarizes challenges for catastrophic hazards with uncertain or unpredictable frequencies and severities, hard‐to‐envision and incompletely described decision alternatives and consequences, and individual responses that influence each other. Conceptual models and examples clarify where and why new methods are needed to complement traditional normative decision theories for individuals and groups. For example, prospective and retrospective preferences for risk management alternatives may conflict; procedures for combining individual beliefs or preferences can produce collective decisions that no one favors; and individual choices or behaviors in preparing for possible disasters may have no equilibrium. Recent ideas for building “disaster‐resilient” communities can complement traditional normative decision theories, helping to meet the practical need for better ways to manage risks of extreme and catastrophic events.     

Using agency data for evidence-based programming: a university-agency collaboration

Agencies providing residential treatment are encouraged, or even mandated, to collect outcomes data and to implement evidence based practices, yet little guidance has been provided on how to do so using agency administrative data that are collected on an ongoing basis. We examined data on Child and Adolescent Functional Assessment Scale (CAFAS) scores for 1608 admissions to a residential treatment center from 2002 through 2008. CAFAS scores were measured every 90 days, providing multiple CAFAS scores for each individual. Results demonstrated that on average residents improved in functioning over time. Sensitive to the evolving needs of residents who had been entering the program, the treatment center made significant program changes in 2006 to attempt to better serve residents through a broad array of specialized programming. Compared to the overall results, the analysis suggested that residents who entered the program since October 2006 appeared to have made larger improvements in their CAFAS scores. Results were derived by employing multilevel models appropriate for estimating growth trajectories with repeated measures data. Conversations with agency staff suggested that using administrative data, and advanced statistical models, were extremely helpful for organizational decision making and evidence-based programming.     

“载道”的乌鸟——辞赋中的乌意象论略

由于地区和时代风俗的不同,人们对乌鸦的喜恶或有差异。但乌鸟意象作为中国文学中较为复杂的意象之一,却一直为文人墨客所喜爱。此意象不仅涵义丰富,而且在辞赋中又和其在诗词中有显著的区别。唐前,辞赋中的乌鸟是作者借以表达"出"、"处"生存观念的寄托,乌意象亦随辞赋作者表情达意的需要"出""处"儒道两家,其中《神乌傅》正反映了作者在"出"、"处"间的徘徊和抉择。有唐一代,乌意象的灵异祥瑞成为辞赋书写的重要内容。宋以降,辞赋中的乌鸟渐渐摆脱了其作为祥瑞之兆的使命,而被赋予了更多的儒家道德品性。此时的乌意象集忠、孝、仁等儒家大加称扬的道德于一身,堪称"奉行"儒家伦理道德的典范。而明代《孝乌赋》,凸显乌鸟意象的"孝"德,是彰扬乌意象孝行的典型作品。     

Understanding Community Resilience from a PRA Perspective Using Binary Decision Diagrams

Probabilistic risk assessment (PRA) is a useful tool to assess complex interconnected systems. This article leverages the capabilities of PRA tools developed for industrial and nuclear risk analysis in community resilience evaluations by modeling the food security of a community in terms of its built environment as an integrated system. To this end, we model the performance of Gilroy, CA, a moderate‐size town, with regard to disruptions in its food supply caused by a severe earthquake. The food retailers of Gilroy, along with the electrical power network, water network elements, and bridges are considered as components of a system. Fault and event trees are constructed to model the requirements for continuous food supply to community residents and are analyzed efficiently using binary decision diagrams (BDDs). The study also identifies shortcomings in approximate classical system analysis methods in assessing community resilience. Importance factors are utilized to rank the importance of various factors to the overall risk of food insecurity. Finally, the study considers the impact of various sources of uncertainties in the hazard modeling and performance of infrastructure on food security measures. The methodology can be applicable for any existing critical infrastructure system and has potential extensions to other hazards.     

Production systems and supplier selection: a multi-phase process model

Abstract

Purpose: This paper presents a combined multi-phase supplier selection model. The process repeatedly revisits the criteria and sourcing decision as the development process continues. This enables a structured adoption of product and production system innovation from strategic suppliers, where previously the literature purely focuses on product innovation or cost reduction. Design/methodology/approach: The authors adopted an embedded researcher style, inductive, qualitative case study of an industrial supply cluster comprising a focal automotive company and its interaction with three different strategic stamping suppliers. Findings: Our contribution is the multi-phased production and product innovation process. This is an advance from traditional supplier selection and also an extension of ideas of supplier-located product development as it includes production system development, and complements the literature on working with strategic suppliers. Specifically, we explicitly articulate the previously unreported issue of whether a supplier chosen for its innovation capabilities at the start of the new product development process will also be the most appropriate supplier during the production system development phase, when an ability to work collaboratively may be the most important attribute, or in the large-scale production phase when an ability to manufacture at low unit cost may be most important. Originality/value: The paper identifies a multi-phase approach to tendering within a fixed body of strategic suppliers which seeks to identify the optimum technological and process decisions as well as the traditional supplier sourcing choice. These areas have not been combined before and generate a valuable approach for firms to adopt as well as for researchers to extend our understanding of a highly complex process.     

Deep Uncertainties in Sea-Level Rise and Storm Surge Projections: Implications for Coastal Flood Risk Management

Sea levels are rising in many areas around the world, posing risks to coastal communities and infrastructures. Strategies for managing these flood risks present decision challenges that require a combination of geophysical, economic, and infrastructure models. Previous studies have broken important new ground on the considerable tensions between the costs of upgrading infrastructure and the damages that could result from extreme flood events. However, many risk-based adaptation strategies remain silent on certain potentially important uncertainties, as well as the tradeoffs between competing objectives. Here, we implement and improve on a classic decision-analytical model (Van Dantzig 1956) to: (i) capture tradeoffs across conflicting stakeholder objectives, (ii) demonstrate the consequences of structural uncertainties in the sea-level rise and storm surge models, and (iii) identify the parametric uncertainties that most strongly influence each objective using global sensitivity analysis. We find that the flood adaptation model produces potentially myopic solutions when formulated using traditional mean-centric decision theory. Moving from a single-objective problem formulation to one with multiobjective tradeoffs dramatically expands the decision space, and highlights the need for compromise solutions to address stakeholder preferences. We find deep structural uncertainties that have large effects on the model outcome, with the storm surge parameters accounting for the greatest impacts. Global sensitivity analysis effectively identifies important parameter interactions that local methods overlook, and that could have critical implications for flood adaptation strategies.