Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.     

Living with dementia,interdependence and citizenship: narratives of everyday decision-making

This article argues that interdependent relationships are key in realising inclusion and citizenship for people living with dementia. We focus on decision-making as one aspect of everyday life which reflects opportunities and challenges associated with citizenship. Accounts of everyday decision-making from people living with dementia provide insight into strategies for negotiating responsibilities as they shifted with dementia. An inductive, secondary data analysis developed decision narratives from the data of 61 interviews conducted in the United Kingdom. The interviews were with 12 people with a diagnosis of dementia plus their nominated care-partner in a qualitative study which focused on information management and sense of self. The secondary data analysis identified strategies for inclusion, emphasising relational interdependency amidst challenges. The five-stage framework of an Ethic of Care positions this interdependency as a response to barriers to inclusion and citizenship. Interdependency, therefore, emerges as key to realising relational citizenship.     

Cross-validation of the screening scale in an adult protective services sample

Adult Protective Services (APS) professionals are often called on to assess decision-making capacity when investigating financial exploitation. Previous research found that in consecutive APS cases, a decision-making screening scale (LFDSS) also detected financial exploitation. The purpose of this study was to apply the clinical cutoff scores derived from the previous study to a new sample of APS cases. Using a sample of 105 participants, from APS workers across 5 counties this study investigated the clinical utility of the LFDSS to detect financial exploitation based on ratings by APS professionals using the scale. Results demonstrate that the LFDSS has excellent internal consistency and clinical utility properties. This paper provides support for use of the LFDSS as a reliable and valid instrument. Instructions for use of the LFDSS are included in the article, along with information about online support tools.     

Application of hybrid framework to facilitate lean six sigma implementation: a manufacturing company case experience

This study aims to propose a hybrid framework for lean six sigma (LSS) based on the prioritisation of barriers and solution approaches, to facilitate hassles free applications for handling the challenges of wastes reduction and quality improvement. The study identifies 27 LSS barriers and 22 solution approaches through literature review and utilises feedback from industry experts. For framework, study uses fuzzy AHP-PROMETHEE to prioritise LSS barriers and solution approaches. Incorporating fuzzy sets in analytical hierarchy process (AHP) ensures the optimality of barrier weights. Whereas, preference ranking organisation method for enrichment of evaluations (PROMETHEE) helps in pairwise comparisons of solution approaches with respect to each LSS barrier, facilitating fair judgements. This research guides regarding the development of framework and checks its suitability and robustness through case application of an Indian manufacturing organisation. Authors expect that researchers and practitioners will find study useful for LSS and multi criteria decision making(MCDM) domains.     

目标导向层次分析方法

对含有抽象属性的多属性层次结构而言,层次分析法即AHP（包括DIS-AHP、ABS-AHP、IDE-AHP和SUP-AHP四种具体方法）会因比率比较基准缺失、权重内涵模糊不清或方案评价不保序而缺乏科学理性。为发展AHP,基于摆幅置权（SW）判断模式和多属性决策属性价值公度方法,首先给出了能为层次结构抽象属性上的SW判断提供支持的规约性多属性决策属性价值公度方法,然后由此并结合多属性价值理论给出了能够克服现有层次分析法内在缺陷的目标导向层次分析方法即ToAHP。相对于AHP,ToAHP在判断模式与权重内涵、方法建构的理论基础和相关假设检验、方案评价保序与其内在数理依据上具有明显的相对科学合理性。应用分析表明：在输入信息可比的条件下,ToAHP明显优于AHP的四种分析方法之中最具可信性的SUP-AHP方法。     

基于犹豫模糊语言信息的前景决策方法

本文首先回顾了模糊信息下前景理论研究的现状,发现犹豫模糊语言这一决策中常见的信息表达形式在前景理论框架中的研究被忽略,同时犹豫模糊环境下的前景决策方法具有一定的应用背景;基于此,本文考虑到决策者在实际决策过程中惯用的信息表达以及面对收益和损失时不同的风险态度,试图在犹豫模糊语言环境下构造新的前景理论决策框架,建立基于犹豫模糊语言信息的前景决策方法,并给出具体的决策步骤;最后通过算例分析展示了该方法的实际应用过程,并与犹豫模糊语言环境下的期望效用决策结果进行对比,说明了该方法更符合实际决策情景。     

女大学生在情绪后悔下择偶决策的信息加工方式

以42名20-26岁之间的某高校未婚女大学生为被试,采用诱发情绪后使用信息板进行择偶决策的方式探讨了她们在后悔情绪下择偶决策的信息加工方式。结果表明：（1）用影片和自由想象的方式能够诱发被试的后悔情绪;（2）无论情绪类型,时间限制和候选人数量均影响被试择偶决策的信息加工方式;（3）情绪类型即后悔情绪与中性情绪,对女大学生择偶决策的信息加工方式无显著影响。     

‘I walk from trouble’: exploring safeguards with adults with intellectual disabilities – an Australian qualitative study

People living with intellectual disabilities have a right to be safe from abuse and neglect and have a right to be included in the decision-making process determining safeguards that will affect them. However, the research evidence that could underpin good professional practice in terms of co-producing safeguards against abuse and neglect directly involving people with intellectual disabilities is largely missing. This article, based on qualitative research involving semi-structured interviews conducted during the first half of 2014, seeks to strengthen this evidence base. It reports on the prevention strategies identified by 12 adults with intellectual disabilities about how to stay safe and compares these with the findings of similar research. The article suggests that a comprehensive safeguarding approach comprises both life course-focused safety training and access to assisted decision-making. The article argues that given the plethora of risk situations encountered by people living with intellectual disability, assisted decision-making should take the form of a co-creation process that is situation specific and grounded in everyday life.     

传统行政文化对决策科学化与民主化的负面影响

传统行政文化是影响到决策的深层因素,其思维模式、权威型人格、差序格局和知识阶层的依附性对决策产生了负面影响,是决策科学化与民主化的主要障碍。决策要实现科学化与民主化,除了要进行制度上的改革,更应该从基础因素入手,即促进我国行政文化的创新。     

Child protection decision-making

The effects of interagency collaboration on risk assessment in child protection practice were analysed in respect of the decision-making processes in child death inquiries. Universal features in the assessment of risk as identified in psychological literature were applied; in particular, the concepts of ‘groupthink’, the ‘certainty effect’ and ‘group polarization’. It is suggested that case conference decisions are inherently more risky than those taken by professionals with individual responsibility because of the way in which cases are framed in terms of losses.