Effects of Outcome and Probabilistic Ambiguity on Managerial Choices

Information ambiguity is prevalent in organizations and likely influences management decisions. This study examines, given imprecise probabilities and outcomes, how managers make choices when they are provided with single-figure benchmarks. Seventy-nine MBA students completed two experiments. We found that, in a decision framed as a decision under certainty involving an ambiguous outcome, the majority of the subjects were ambiguity prone in the loss condition and switched to ambiguity aversion in the gain condition. However, in the presence of probabilistic ambiguity in a decision under risk, this expected switching pattern was shown only when the difference in riskiness between the two choice options (in the loss condition) was perceived to be relatively small. In a companion study, we used a written protocol approach to identify factors that affect decision makers' investment choices when faced with ambiguous outcomes. Protocols frequently mentioned that the ambiguous outcome option was risky, even in the case which was framed as a decision under certainty in the problem statement. In a decision under risk with ambiguous outcomes, the combination of probabilistic risk and outcome ambiguity was seen as even more risky.     

Explaining inconsistencies between patients and collaterals: validity in outcome studies of coercive alcoholism treatment

This study aims to assess the consistency of replies to questionnaires mailed to patients and two kinds of collaterals, i.e., social workers and significant others, at a public treatment center with socially unstable and compulsory committed patients. It compares the quantity and kind of discrepancies between replies by patients and collaterals on outcome data concerning social situation and drinking habits. It aims to measure the amount of systematic bias among factors that may explain inconsistencies between reports, especially the factors compulsory commitment, worse outcome, frequency of contact and type of collateral. The responders generally agreed. Variables in which there was less agreement were explored in logistic regressions using ten explanatory variables. Significant relations did not exceed those expected by chance. Discrepancies were not systematic in size and kind. On a six-rank ordinal scale of alcohol use or abuse, however, patients tended to underestimate the extent of their abuse. Inconsistencies here concerned the degree but not the presence of abuse. No difference in consistency due to type of collateral was found. In conclusion, the consistency of the questionnaires was high and independent of the social situation of the patient, of compulsory commitment and of other background or treatment factors, as well as of treatment outcome and type of collateral.     

Group work in the mental health field: researching outcome

This paper reviews outcome studies from groups facilitated for persons living with serious mental illness. Although the research base is limited (groups posing considerable methodological challenges), available studies show that, in general, group work is as effective as individual work, if not more so. This paper describes findings from studies of short-term, long-term and self-help groups dealing with mood disorders, schizophrenia, eating disorders and borderline personality disorders over the last 10 years. The concept of ‘time-effective’ group work is discussed as are the potentially harmful effects of group participation. The paper concludes by arguing that group work is an effective and less expensive treatment option that would benefit from further research to establish an evidence base, both for current practice and for the expansion of group work practice in the future.     

民事诉讼举证责任的分配

举证责任的分配是举证责任的核心问题。举证责任包括行为责任和结果责任两方面的含义。“谁主张,谁举证”的一般分配原则,不能合理、有效地解决结果责任的分配。结果责任的分配所要解决的问题是,当诉讼即将终结时若案件事实仍然真伪不明,由谁承担不利的诉讼后果。我国现行的司法解释,完善了举证责任分配的有关规则,但结果责任的分配,尚需确立明确的标准和分配的规则。民事诉讼证据立法需要从实体法和程序法进一步完善,公平、科学地解决举证责任的分配。     

Alcohol Use and Prior Substance Abuse Treatment in Relation to Gambling Problem Severity and Gambling Treatment Outcome

Recent research has made it clear that problematic gambling is often accompanied by problematic alcohol use. Unfortunately, little is known about the nature of this association, especially as it relates to gambling treatment outcome. The purpose of this study is to explore the effect of current alcohol use level and previous substance abuse treatment on the symptoms of a large cohort of pathological gamblers as well as on their response to treatment for pathological gambling. The sample included 464 men and 301 women recruited at six gambling treatment programs in Minnesota. Gambling treatment patients were assessed on a number of gambling problem severity and related clinical variables using the Gambling Treatment Outcome Monitoring System (GAMTOMS). Patients with frequent alcohol use had greater gambling involvement at baseline than infrequent alcohol users. Patients with a previous history of substance abuse treatment had more severe psychosocial problems, ostensibly resulting from their gambling behavior, than patients without past substance abuse treatment. A MANOVA with repeated measures showed that neither pretreatment alcohol use, nor past substance abuse treatment exerted significant effects on gambling treatment outcome. While the level of pretreatment alcohol use and a history of substance abuse treatment are markers for greater gambling problem severity, treatment outcome for pathological gambling was not adversely impacted by these variables.     

Monte-Carlo Sensitivity Analysis for Controlled Direct Effects Using Marginal Structural Models in the Presence of Confounded Mediators

In randomized trials, investigators are frequently interested in estimating the direct effect of a treatment on an outcome that is not relayed by intermediate variables, in addition to the usual intention-to-treat (ITT) effect. Even if the ITT effect is not confounded due to randomization, the direct effect is not identified when unmeasured variables affect the intermediate and outcome variables. Although the unmeasured variables cannot be adjusted for in the models, it is still important to evaluate the potential bias of these variables quantitatively. This article proposes a sensitivity analysis method for controlled direct effects using a marginal structural model that is an extension of the sensitivity analysis method of unmeasured confounding introduced in the context of observational studies. The proposed method is illustrated using a randomized trial of depression.     

Psychosocial risk factors for excessive gestational weight gain: A systematic review

BackgroundExcessive weight gain during pregnancy can have adverse health outcomes for mother and infant throughout pregnancy. However, few studies have identified the psychosocial factors that contribute to women gaining excessive weight during pregnancy.AimTo review the existing literature that explores the impact of psychosocial risk factors (psychological distress, body image dissatisfaction, social support, self-efficacy and self-esteem) on excessive gestational weight gain.MethodsA systematic review of peer-reviewed English articles using Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature, MEDLINE Complete, PsycINFO, Informit, Web of Science, and Scopus was conducted. Quantitative studies that investigated psychosocial factors of excessive GWG, published between 2000 and 2014 were included. Studies investigating mothers with a low risk of mental health issues and normally-developing foetuses were eligible for inclusion. From the total of 474 articles located, 12 articles were identified as relevant and were subsequently reviewed in full.FindingsSignificant associations were found between depression, body image dissatisfaction, and social support with excessive gestational weight gain. No significant relationships were reported between anxiety, stress, self-efficacy, or self-esteem and excessive gestational weight gain.ConclusionThe relationship between psychosocial factors and weight gain in pregnancy is complex; however depression, body dissatisfaction and social support appear to have a direct relationship with excessive gestational weight gain. Further research is needed to identify how screening for, and responding to, psychosocial risk factors for excessive gestational weight gain can be successfully incorporated into current antenatal care.     

Co-designing preconception and pregnancy care for healthy maternal lifestyles and obesity prevention

ProblemA recognised gap exists between current and recommended practices in the provision of lifestyle advice and weight management support for women across preconception and pregnancy care.BackgroundPreconception and pregnancy are critical stages for promoting healthy maternal lifestyles and obesity prevention. Co-design is a novel approach with the potential to strengthen existing models of care to facilitate the implementation of clinical practice guidelines promoting preconception and pregnancy health, especially in relation to preconception weight management and preventing excessive gestational weight gain.Aim and methodsThe aims of this discussion paper are to (i) define co-design in the context of preconception and pregnancy care, (ii) outline key considerations when planning co-design initiatives and (iii) describe co-design opportunities in preconception and pregnancy care for promoting women’s health and obesity prevention.DiscussionWhile several definitions of co-design exist, one critical element is the meaningful involvement of all key stakeholders. In this discussion, we specifically identified the involvement of women and expanding the role of practice nurses in primary care may assist to overcome barriers to the provision of healthy lifestyle advice and support for women during preconception. Co-designing pregnancy care will involve input from women, nurses, midwives, obstetricians, allied health and administration and management staff. Additional attention is required to co-design care for women considered most at-risk.ConclusionThere is potential to enhance current provision of preconception and pregnancy care using co-design. Nursing and midwifery professions are active across both preconception and pregnancy and therefore, they have an important role to play.     

Bayesian sample‐size determination methods considering both worthwhileness and unpromisingness for exploratory two‐arm randomized clinical trials with binary endpoints

A randomized exploratory clinical trial comparing an experimental treatment with a control treatment on a binary endpoint is often conducted to make a go or no‐go decision. Such an exploratory trial needs to have an adequate sample size such that it will provide convincing evidence that the experimental treatment is either worthwhile or unpromising relative to the control treatment. In this paper, we propose three new sample‐size determination methods for an exploratory trial, which utilize the posterior probabilities calculated from predefined efficacy and inefficacy criteria leading to a declaration of the worthwhileness or unpromisingness of the experimental treatment. Simulation studies, including numerical investigation, showed that all three methods could declare the experimental treatment as worthwhile or unpromising with a high probability when the true response probability of the experimental treatment group is higher or lower, respectively, than that of the control treatment group.     

Re-examining pregnancy-related anxiety: A replication study

Background

Recognition of pregnancy-related anxiety as a distinct anxiety is supported by evidence differentiating it from general anxiety and depression. Adverse associations with pregnancy-related anxiety further support this distinction. An influential study by Huizink et al. (2004), demonstrated that anxiety and depression contribute little to the variance of pregnancy-related anxiety, yet this study has not been replicated. Further, addressing limitations of the original study will provide further clarity to the findings.