Sharing personal information in the child protection context: Impediments in the Australian legal framework

Professionals, including social workers, in the child protection context are frequently required to make decisions on whether to share sensitive personal information about children, their families, and others with colleagues and across institutional and jurisdictional boundaries. Sharing information across agencies and organisations is essential to allow joined‐up service provision and to effectively protect and support children and their families. A legal framework that supports this decision making is a necessary, although not sufficient, condition for effective information sharing. This article examines the complex legal framework that governs information sharing across the Australian states and territories. It identifies a number of structural and regulatory elements that unnecessarily limit information sharing or have a tendency to create a culture that is risk averse, rather than proactive, in sharing information. The article suggests structural and regulatory reforms that would improve the legal framework for sharing information, while at the same time giving due recognition to the human rights that come into tension in this policy context: the right to privacy and the rights of the child.     

Examination of the Child Protective Services Decision-Making Context with Implications for Decision Support System Design

Abstract

The general perception of Child Protective Services (CPS) decision making is that it is inconsistent and prone to error. As a result, risk assessment instruments were developed to enable investigators to make better decisions. The present study uses a qualitative approach with an explicit theoretical framework pertinent to management information systems and decision support system design to examine the context in which investigators operate and make decisions. The resulting information can be used to determine design requirements that would improve the experience of using a risk assessment instrument that serves as a decision support system (DSS) for CPS investigators.     

Consumer‐directed care for older Australians: Are resources identified on the Web adequate to support decisions about home‐based care packages?

Consumer‐directed care (CDC) was introduced as part of aged care policy reforms in Australia in 2012. CDC aims to promote choice and control for people with complex needs who need home care and supports. While more choices may bring benefits, information and resources are needed by people to navigate new and complex care‐related decisions. In 2017, we identified the resources available to support consumers of the new CDC Home Care Packages (HCP) program via an Internet search. Forty‐six resources were analysed to assess the adequacy of information to inform care choices. General information was most frequently found, but information to guide specific choices, such as choosing or changing service providers, was limited. Accessibility of information was limited for non‐English speakers and for people with low literacy or reduced capacity for decision making. No training opportunities were identified, and only one non‐partisan organisation offered support for decision making. Overall, the information and supports analysed were not adequate to assist older people to make choices to ensure consumer direction of care. There is an urgent need to improve the quality and accessibility of information and provide training and support for choice, particularly for those with limited decision‐making capacity, such as those living with dementia.     

Individual and couple decision behavior under risk: evidence on the dynamics of power balance

This article reports results of an experiment designed to analyze the link between risky decisions made by couples and risky decisions made separately by each spouse. We estimate both the spouses and the couples’ degrees of risk aversion, we assess how the risk preferences of the two spouses aggregate when they make risky decisions, and we shed light on the dynamics of the decision process that takes place when couples make risky decisions. We find that, far from being fixed, the balance of power within the household is malleable. In most couples, men have, initially, more decision-making power than women but women who ultimately implement the joint decisions gain more and more power over the course of decision making.     

Adjusting risky situations: A theoretical framework and empirical test

Experienced executives frequently try to modify the risky situations they face in order to make them more favorable rather than simply choosing from among available decision options. This article investigates several types of risk adjustments such as trying to influence the situation through bargaining and spending resources, gathering information, developing new options, and consulting one's superiors. A theoretical framework is presented that characterizes different types of adjustments and relates them to variables such as perceived risk, perceived control, perceived responsibility, decisiveness, and risky choice. The framework is tested using experienced decision makers who respond to four simulated risky business decisions.University of British Columbia     

The implications of irreversibility in emergency response decisions

The irreversibility effect implies that a decision maker who neglects the prospect of receiving more complete information at later stages of a sequential decision problem will in certain cases too easily take an irreversible decision, as he ignores the existence of a positive option value in favour of reversible decisions. This option value represents the decision maker's flexibility to adapt subsequent decisions to the obtained information. In this paper we show that the economic models dealing with irreversibility as used in environmental and capital investment decision making can be extended to emergency response decisions that produce important irreversible effects. In particular, we concentrate on the decision whether or not to evacuate an industrial area threatened by a possible nuclear accident. We show in a simple two-period evacuation decision model that non-optimal conclusions may be drawn when evacuation is regarded as a `now or never decision'. The robustness of these results is verified by means of a sensitivity analysis of the various model parameters. The importance of `options thinking' in this decision context is illustrated in an example.     

Decision settings analysis – a tool for analysis and design of human activity systems

The paper describes a methodology to be used for analysis and design of human activity systems. The methodology is based on an analysis of the decision settings whereas most other decision analysis methodologies are analysing the process. The decision concept is analysed and discussed. A distinction between programmed and programmable as well as non-programmed and non-programmable decisions is proposed. A classification of different information types for decision making is presented. A methodology based on a systemic and systematic analysis of the information requirements of an organization is proposed. This methodology also indicates organizational discrepancies and information imbalances. The methodology focuses the settings of the decisions on all levels of organizations. The methodology can be regarded as a dynamic, learning system. The author proposes further research on the individuals decision making abilities.     

One-shot decisions under Linear Partial Information

This paper purports to make a contribution to the analysis of a class of decisions that has received little attention in the literature, although it appears to be of considerable importance. Certain decisions cannot be repeated but must be made under fuzziness in the sense that state probabilities are not exactly known (LPI-fuzziness). The analysis of Linear Partial Information is applied to the principle of neglecting small probabilities found by Allais (1953), enabling the decision maker to break away from the maxmin criterion. By systematic exploitation of the fuzzy information available, strategies are shown to exist that provide payoffs whose lower bound exceeds the maxmin benchmark with sufficiently high probability. The same methodology is shown to be useful for dealing with the case of only ordinal preference orderings that are so typical of those crucial decisions that may be made only once in a lifetime.     

Preferences for information on probabilities versus prizes: The role of risk-taking attitudes

Many real-world decisions entail choices between information on either probabilities or payoffs (i.e., prizes). Simplified versions of such decisions are examined to gain insight into preferences for different types of information as a function of risk-attitudes. General and simple decision rules are derived for cases where the utility function is concave (or convex) over the relevant payoff interval.The article further describes several experiments to test business students' intuitions concerning these optimal decision rules. In general, risk-taking attitudes did not correlate significantly with subjects' preferences for information, in violation of theorems regarding mean-preserving spreads of risk. Other tests, e.g., narrowing certain probability ranges, also resulted in preferences contrary to expected utility (EU) theory.     

Positive confirmation bias in the acquisition of information

An experiment is reported which tests for positive confirmation bias in a setting in which individuals choose what information to buy, prior to making a decision. The design – an adaptation of Wason's selection task – reveals the use that subjects make of information after buying it. Strong evidence of positive confirmation bias, in both information acquisition and information use, is found; and this bias is found to be robust to experience. It is suggested that the bias results from a pattern of reasoning which, although producing sub-optimal decisions, is internally coherent and which is self-reinforcing.     

Decisions concerning the allocation of scarce medical resources

This paper aimed to determine the criteria participants use to make decisions about scarce medical resources (allocation to use a kidney machine). It varied information about patients on 4 factors (sex, smoking, employment status, community service). It also set out to see if decisions made in groups differed from aggregated decisions of those made alone. In the first study, participants completed a simple questionnaire requiring them to rank-order sixteen hypothetical patients. In the second study, a group discussion (in groups of three participants) preceded the group putting an agreed rating on the identical questionnaire. Participants favoured patients who were employed, non-smokers and participated in community service. This suggests that participants adopted a utilitarian moral ideology. Participants' smoking habits interacted with the hypothetical patients' smoking habits, indicating in-group favouritism. In the second study it was found that when the decision was made in a group of three it amplifies the decision made by an individual. In this sense there was clear evidence of group polarization.     

The documented layer of children's rights in care order decision‐making

The recognition of children as rights holders is a true challenge for any policy and practice that involves children, but it is even more so for making decisions about taking children into care. This article departs from the view that when children are perceived as bearers of rights, this should also be reflected in the institutional documents of decision‐making. That is why the documented layer of decisions about taking a child into care is examined here. The empirical data consist of documents of hearings (prehearing and hearing reports) in which children (33) are asked to give their view about a proposed care order and placement in Finland. The documented layers of involving children as rights holders are divided into two types: a minimalist type and a more individualised, thorough and detailed type. The former type represents children as rights holders in a routinised manner, whereas the latter one treats them in a particularised manner: how this particular child in this particular hearing received and gave information and on what grounds her/his view rested. As the documents may have some controversial implications, the recording of children as rights holders should not be treated as an isolated and technical issue.     

Today's Studies,Tomorrow's Meta-Analyses: Implications for Evidence Informed Decision–Making in Social Work

ABSTRACT

Meta-analyses play an important role in understanding aspects of human functioning and program effectiveness. Meta-analyses also inform practice and policy decision making in areas of interest to social work. This study examined the degree to which recent quantitative reports in top social work journals are eligible for inclusion in future meta-analytic studies based on method rigor. The results suggest a mixed picture. Articles in top social work journals typically present sufficient information on participant characteristics, p values, and Mean values, yet they often fail to present sufficient information on variance indicators or the precise numbers of participants, which limits the ability to calculate effect sizes. Furthermore, less than 10% of the reports utilized randomized experimental designs or tested for group equivalence. To enhance social work's ability to make evidence-based decisions by producing more meta-analyses, researchers should provide more detail in study reports and use stronger research designs.     

Dynamic reasoning and time pressure: Transition from analytical operations to experiential responses

Based upon the Decision Field Theory (Busemeyer and Townsend 1993), we tested a model of dynamic reasoning to predict the effect of time pressure on analytical and experiential processing during decision-making. Forty-six participants were required to make investment decisions under four levels of time pressure. In each decision, participants were presented with experiential cues which were either congruent or incongruent with the analytical information. The congruent/incongruent conditions allowed us to examine how many decisions were based upon the experiential versus the analytical information, and to see if this was affected by the varying degrees of time pressure. As expected, the overall accuracy was reduced with greater time pressure and accuracy was higher when the experiential and analytical cues were congruent than when they were incongruent. Of great interest was the data showing that under high time pressure participants used more experiential cues than at other time pressures. We suggest that the dynamic reasoning paradigm has some future potential for predicting the effects of experiential biases in general, and specifically under time pressure.     

Professional Perspectives on Decision Making about the Long-term Care of Older People

With the increasing pressure on social and health care resources,professionals have to be more explicit in their decision makingregarding the long-term care of older people. This groundedtheory study used 19 focus groups and nine semi-structured interviews(99 staff in total) to explore professional perspectives onthis decision making. Focus group participants and intervieweescomprised care managers, social workers, consultant geriatricians,general medical practitioners, community nurses, home care managers,occupational therapists and hospital discharge support staff.The emerging themes spanned context, clients, families and services.Decisions were often prompted by a crisis, hindering professionalsseeking to make a measured assessment. Fear of burglary andassault, and the willingness and availability of family to helpwere major factors in decisions about living at home. Serviceavailability in terms of public funding for community care,the availability of home care workers and workload pressureson primary care services influenced decision ‘thresholds’regarding admission to institutional care. Assessment toolsdesigned to assist decision making about the long-term careof older people need to take into account the critical aspectsof individual fears and motivation, family support and the availabilityof publicly funded services as well as functional and medicalneeds.     

Go to the Hospital or Stay at Home? A Qualitative Study of Expected Hospital Decision Making Among Older African Americans With Advanced Heart Failure

To address the need for more information concerning hospital decision making, we conducted in-depth interviews among African Americans with heart failure and their family caregivers (n?=?11 dyads). Using a case scenario, we asked participants about their anticipated hospitalization decisions. Most patients indicated that they would seek care to avoid further deterioration or death from their worsening condition. Many family caregivers anticipated having an active influence on hospitalization decisions. Findings suggest that social workers should encourage the development of adequate home-based services, recognize diverse communication styles, and use this information to facilitate medical decision making by these patients and their caregivers.     

Factors Affecting the LGBT Population When Choosing a Surrogate Decision Maker

ABSTRACT

For individuals in the marginalized population of lesbian, gay, bisexual, and trans- gender persons (LGBT), choosing a health care surrogate to make medical decisions is an emotionally challenging task. These decisions become more difficult when compounded by issues of discrimination, lack of legal and social support, varying levels of relationship commitment, and complications of disclosure to family and medical professionals. Limited research exists regarding the social, legal, medical, and familial environments that impact the choice of a surrogate decision maker for an LGBT individual. This systematic review examines 14 articles to identify factors influencing individual surrogate choice and existing gaps in the literature. To remedy current research limitations, future research recommendations address the areas of design, sampling, data collection, and data analysis within diverse subgroups of the LGBT population. This review further identifies related areas of service required by members of the LGBT population relative to diversity, demographics, and social, legal, medical, and familial environments influencing their choice of a surrogate decision maker.     

Informational Asymmetries and Observational Learning in Search

As economics modeling moves from super rational decision makers to considering boundedly rational agents, some economic problems deserve a second look. This paper studies the effects of learning on the efficiency of search. Once learning is taken into account, the structure of information flow becomes important. In particular, I highlight the truncated information structure in the search problem. Agents stop searching once a sufficiently attractive price is found. Therefore, they observe the performance of shorter searches, but do not directly observe the performance of longer searches. I design and conduct an experiment to test the hypothesis that this asymmetric flow of information leads agents to search too little. I find strong evidence in its favor. This suggests that in the presence of learning, the provision of a more symmetric information structure will make search more efficient.JEL Classification: C91, D83     

Health Care Fraud and Industry Structure in the United States

The cost of health care fraud and abuse is enormous. Not only is it costing us a lot of money but one wonders how many more people could afford and receive medical insurance if fraud and abuse were significantly lower. This paper will show that the problem is embedded in the way America does health business. The problem needs to be better addressed by both the criminal justice community and the health care industry. Most importantly, those making the health care industry policy decisions need to make a paradigm shift. The system is out of balance because of past policies and decisions that have given excessive power and liberty to the medical services community and insurance providers. Using O’Toole's Compass Card of the four major ideas that have influenced political decision‐making as a guide, this paper recommends that current decision‐making needs to strengthen the equality and community poles and restrict the liberty and efficiency poles so that more balance might exist within the American health care system. Talcott Parsons saw the dangers of commercializing health care over half a century ago. The health care scene of today shows that he was correct in his appraisal.     

宗教与美国的外交政策

由美国核心文化WASP和"公民宗教"所塑造的美国国家特质中的宗教性,尤其是强烈的宗教认同感和宗教信仰在其社会生活中的重要地位,使得宗教的影响力相比别国而言更容易渗透到美国外交政策中。宗教价值观念是"美国例外论"和"天命观"的主要根源,在外交政策上表现为"威尔逊主义"外交理念,进而对美国外交决策者的外交思维和外交行为造成影响,并形成对外输出民主价值观念的政策偏好。国内宗教团体利用广泛的社会资本,通过民主的渠道,将自身的政策主张上升到外交决策中并影响美国对外关系的议事日程。传教士利用自身对对象国的了解,为外交决策者提供情报,并有可能受邀参与决策过程从而影响外交决策。