Analysis Of Judgments Research Articles

Understanding the Concept of Phonetic and Visual Similarity Vis-A-Vis To Letter Trademarks Through Judicial Precedents

The assessment of the distinctiveness of trademarks, despite the criteria outlined in the Trademark’s Act of 1999, specifically under sections 9 and 11, presents a formidable challenge, often necessitating the discerning perspective of the judiciary. As a fundamental guiding principle, both examiner and courts are obliged to evaluate a trademark as a unified entity. In recent years, there has been a discernible rise in the scrutiny of phonetic similarities between marks. The legal framework for dealing with the infringement of a registered mark due to phonetic resemblance is encapsulated within section 29(9) of trademarks act 1999. This section expressly stipulates that a mark may be infringed by the oral as well as the visual representation of words. The Supreme Court has consistently affirmed the imperative need to consider both auditory and visual aspects when comparing trademark. This paper delves into an analysis of numerous judgements handed down by the Supreme Court and various High Courts, primarily focusing on the assessment of both phonetic and visual aspects of trademarks. Special emphasis has been placed upon letter trademarks and their susceptibility to both visual and phonetic infringement. While trademarks typically encompass various elements such as devices, color combinations, letters and images, letter trademarks, often consisting of a single letter with descriptive trade connotations, are generally considered weaker trade makers. To establish trademark rights in such instances compelling evidence of usage is requisite. Conversely, trademarks comprised of more than one letter, devoid of descriptive elements pertaining to goods and trade, are regarded as stronger trademarks. In cases where a letter trademark incorporates a unique device, it offers robust protection for the trademark. This paper references multiple case laws where esteemed courts have recognised unequivocally rights with respect to letter trademarks.

Husserl and the normativity of logic

AbstractIn this article, I analyze the evolution of Husserl's view on the normativity of logic and the corresponding changes in his phenomenological analysis of judgment. Initially, in the Prolegomena, Husserl claimed that the laws of pure logic are ideal and acquire normative status only as a result of application. Later, however, he revised this position and claimed that the same laws are at once ideal and normative. Sections 1 and 2 present textual evidence for attributing such a change of position to Husserl, which is not generally acknowledged in the literature. Section 3 critically examines Husserl's early position, with specific attention to the model of instantiation. Sections 4–6 identify three key stages in the development of Husserl's theory of judgment that lead to the normative conception of pure logic: (1) the critique of the dissociation of ideal content and assertive force; (2) the rejection of the instantiation model of proposition and the development of a new account in terms of identification; (3) the genetic‐phenomenological interpretation of proposition and the elaboration of the three‐layer structure of pure logic.

Ranking Competencies of Managers with the Combined Method of Dimtel and Network Analysis (Case study: Public Hospitals of Yazd Province)

Background: The success of any organization depends on the expertise and competence of human resources, especially its managers. Competence is defined as the knowledge and skills necessary to perform a job. The current study aimed to rank the competencies of managers based on the competence model of Dolewis and Higgs (2005), which was carried out using multi-criteria decision-making techniques (combined method of Dimtel and network analysis) in public hospitals of Yazd province.
 Methods: This inductive approach research was carried out quantitatively during 2021 to 2022 in public hospitals of Yazd province. In this study, multi-criteria decision-making techniques were used including the combined method of Dimtel and network analysis. The statistical population was a group of human resources experts and senior managers of public hospitals in Yazd province. Sampling was done first by judgment and then by snowball method and through the introduction of experts and based on the possibility of access to them, and 15 experts were selected as a sample. After extracting the data from the experts' questionnaires, Dimtel method was used to evaluate the relationships between the indicators.
 Results: In the current study, according to the experts’ opinions, the competence model of Doleviz and Higgs (2005) was considered, which included three managerial, personal, and intellectual dimensions. The dimension of managerial competence included components of success, empowerment, development, engaging and effective communication, resource management. The dimension of intellectual competence included components of judgment and critical analysis, perspective and foresight of strategic views. The dimension of personal competence included components of self-awareness and emotional resilience, intuitive understanding, interpersonal sensitivity, influence, motivation, and conscience. Based on the results of the super matrix of network analysis, the weights of competence in order of priority included managerial, intellectual, and personal competence. In managerial competence, the component of resource management, in personal competence, the influence component, and in intellectual competence, the components of foresight and perspective were more important.
 Conclusion: In order to be more successful in achieving future goals and perspective, hospital managers should strive to strengthen their competencies, since improving the competence of managers helps them in effective use of resources, better response to clients, and achieving goals, in accordance with the accreditation standards of public hospitals in Yazd province

Decision making in emergency laparotomy: updated results of an international multi disciplinary judgement analysis study

Abstract Aims The aim of our study is to assess how professionals take decisions when evaluating suitability of patients for emergency laparotomy or palliation. Methods We created and validated a dataset of 90 case vignettes based on real patients admitted with surgical pathology correctable only via an emergency laparotomy. We removed information concerning real life outcomes. We submitted the vignettes to consultants and trainees in surgery, anaesthesia and intensive care, asking them if they would offer an emergency laparotomy. Concordance between assessors and real life decisions, accuracy scores (the lower the value the higher the likelihood of operating on patients that survived) and inconsistency scores were calculated. Judgement Analysis methodology (binomial logistic regression) was used to identify variables relevant to the decision making process for each participant. Results This report includes results for the first 110 participants. Thirteen centres provided data (4 from Italy, 8 from the UK, 1 from Greece). 54 consultants, 39 registrars, 13 core trainees participated. 68 were surgeons, 26 anaesthetists and 9 intensivists. Median concordance between decision makers and real life was 78.9%. Median accuracy was 17 (IQR 11-34.3). Median inconsistency was 13% (IQR 7%-20%). Concordance, accuracy and consistency strongly correlated with each other and were better for consultants and worse for trainees. Judgment Analysis demonstrated differences between grades, specialities and institutions. Conclusions Different clinicians, when faced with the same information, make different decisions. Our updated data supports the adoption of multidisciplinary decision making protocols as well as senior involvement.

The Right to Silence Under Scrutiny: Unveiling the Significance of Section 313 of the Code of Criminal Procedure of India

Abstract The often-overlooked provision of criminal law, which holds significant importance is section 313 of the Code of Criminal Procedure 1973. Section 313 grants the accused an opportunity to provide their statement, ensuring their right to be heard and preventing self-incrimination. This article explores the background, evolution, and objectives of section 313 CrPC, as well as its alignment with the principles of natural justice. The main aim of the article is to demonstrate how India still falls short in upholding the right to silence as per section 313, through a detailed analysis of various judgments passed by the Supreme Court of India, and laws enacted in other jurisdictions around the world. The article addresses the issue of Indian courts using adverse inferences from an accused person’s silence, which conflicts with Article 20(3) of the Indian Constitution. It argues that drawing such inferences should be reconsidered by the courts, as it contradicts important legal principles and undermines the right to a fair trial.

Probability and confidence: How to improve communication of uncertainty about uncertainty in intelligence analysis

AbstractIntelligence agencies communicate uncertainty to decision‐makers through verbal probability phrases that correspond to numerical ranges (i.e., probability lexicons) and ordinal levels of confidence. However, decision‐makers may misinterpret the relationship between these concepts and form inappropriate interpretations of intelligence analysts' uncertainty. In two experiments, four ways of conveying second‐order probability to decision‐makers were compared: (a) probability and confidence phrases written in the text of a report, (b) the addition of a probability lexicon, (c) the addition of a probability lexicon that varied numerical ranges according to the level of confidence (i.e., revised lexicon), and (d) a probability phrase written in text followed by a numerical range that varied according to the level of confidence. The revised lexicon was expected to improve interpretations of second‐order probability. The 275 participants in Experiment 1 and 796 participants in Experiment 2 provided numerical estimates corresponding to analytic judgments provided in descriptions about three overseas military operations and also indicated their support for approving or delaying the operations. The results demonstrated that providing the numerical range in the text of the report or providing a probability lexicon, improved interpretations of probability phrases above the verbal phrase‐only condition, but not interpretations of confidence. Participants were unable to correctly interpret confidence with respect to the precision of their estimate intervals and their decisions about the operations. However, in Experiments 2 and 3 the effects on these variables of providing decision‐makers with information about the source of the analyst's uncertainty were examined. In Experiment 3 (n = 510), providing this information improved correspondence between confidence level and approval of the operation. Recommendations are provided regarding additional methods of improving decision‐makers' interpretation of second‐order probability conveyed in intelligence reporting.

Probability or confidence, a distinction without a difference?

ABSTRACT How analytic uncertainty is presented can affect critical policymaker decisions. Analysts are told to offer separate: (1) assessments of the likelihood an analytic statement is true and (2) confidence statements that express how strongly analysts believe their assessments. The distinction between likelihood and confidence sounds clear but is not. The IC defines confidence poorly. Most intelligence products fail to distinguish likelihood from confidence and use the terms interchangeably to mean probability. The IC should abandon its confusing shorthand confidence descriptions. Instead, analysts should provide explanations of the nature and strength of evidence, and the reasoning behind analytic judgments.

Comparative-Legal Analysis of Judgment in Pilot Cases and Judicial Precedent

In the article, the legal nature and main features of the institution of model cases are analyzed from a theoretical point of view, in particular the decision in a model case, the main characteristics of the judicial precedent are studied in the doctrinal definition and their comparison is made. A comparative legal analysis of decisions in exemplary cases and court precedent was carried out, which boils down to the following: both are the result of the activity of the court of the highest instance; is the result of solving a specific case; the principle of effect of the decision in the exemplary case is vertical (decisions of courts of higher jurisdiction are universally binding for courts of lower jurisdiction when deciding similar cases), and the principle of effect of court precedent is vertical (must be applied in the ratio decidendi part by lower instances) and horizontal (must be applied by the same court or another court of the same level when deciding "similar" cases; both have a generally binding character when considering the next case, which concerns similar or sufficiently close issues (circumstances of the case); legal conclusions of decisions in exemplary cases and rules of court precedents are directed to judges, who are obliged to implement them, and also for law enforcement by other subjects; however, the decision in an exemplary case is made on the basis of a submission for consideration of one of the typical cases, and a court precedent arises during the consideration of a specific case; the decision in the exemplary case is binding in its entirety and must contain the circumstances clearly defined in the current legislation, and precedent decisions are binding not in their entirety, but only in part of the ratio decidendi, and the rest of the precedent decision, in particular, legal ones positions formulated by the court "inter alia” ("obiter dictum”) are not binding. The fact that the effect of decisions in exemplary cases, although it has the features of a precedent, is different from it, and this proves that effective changes are taking place in the judicial process.

Association between the risk perception of contracting COVID-19 and sociodemographic characteristics in a Peruvian population.

Background: The perception of risk regarding coronavirus disease 2019 (COVID-19) has been widely researched due to its association with the adoption of preventive measures. In addition, since the onset of vaccination, it has been reported that the population perceives a lower risk of getting infected. However, few studies have analyzed the factors associated with risk perception in low- and middle-income countries. The aim of this study was to determine the association between the risk perception of contracting COVID-19 and sociodemographic characteristics in Peruvian population. Methods: An analytical and cross-sectional study was conducted in four cities in Peru from October to December, 2021. The sample consisted of 821 individuals aged 18 years and older. A virtual questionnaire was used to collect sociodemographic data and assess the risk perception of contracting coronavirus based on the Health Belief Model. The process of back-translation, expert judgment, and reliability analysis using split-half correlation was conducted. Student's t-tests, analysis of variance with post hoc Tukey's test, and Spearman's correlation were employed. Results: Of the participants, 53.71% were women and 73.3% had a higher education level, 45.55% are self-employed, and 40.44% did not have a family member infected with COVID-19. The risk perception of COVID-19 infection was associated with participants' family antecedent of COVID-19 (p < 0.05). Regarding the factors analyzed, perceived susceptibility to COVID-19 was associated with age (p=0.002), occupation (p<0.05), and a history of COVID-19 (p<0.05), while the perceived benefits of adopting preventive measures against this disease were associated with educational level (p < 0.001). Conclusions: The risk perception of contracting COVID-19 was higher among whose had multiple infected relatives.. Furthermore, the perception of susceptibility and the perceived benefits of using preventive measures were associated with sociodemographic characteristics.

An Impact of Motivational Factors to Enhance Human Productivity: A Case study of Private Healthcare Institution of Karachi

Worker motivation is a crucial factor for an organization's success, as it affects productivity and helps achieve its vision and objectives. Supervisors at specialized medical care institutions in Karachi face a challenge in achieving ideal motivation for their staff, which would significantly improve hierarchical execution. This study aims to understand the components that impact representative motivation and how it influences worker performance in these institutions. &#x0D; The research used an expressive exploration approach, with workers from Karachi's specialized medical care institutions as the focus. A Non-likelihood judgment analysis was used, and data was collected through Google structures and analyzed using SPSS software. Inferential measurements were used to assess the information. Results showed that worker motivation and the viability of data trade, as well as the nature of the workplace, had the most strong connection for external components, while representative motivation and occupation impact by partners had the least. The relationship between decency of treatment at work and worker motivation was the most strong, while the relationship between input on presentation and strengthening and representative independence and worker motivation was the most precarious. In conclusion, the study reveals significant strengths in the relationship between dependent and autonomous components, the significant impact of external and internal variables on worker motivation, and a basic impact of worker motivation on worker performance.

Estimation of the Term of Pre-Trial Investigation when Studying Its Materials: Theory and Practice

The analysis of court judgements established that the courts of first instance and the courts of appeal interpret and apply the provisions of Clause 10, Part 1 of Article 284, Part 5 of Article 219 of the Criminal Procedure Code of Ukraine differently. There are court rulings concerning the inclusion of the time when the defendant party did not yet have actual possession of the pre-trial investigation materials, based on the procedure described in Article 290 of the Criminal Code of Practice of Ukraine, into the timeframe of the pretrial investigation. This means including the time when the actual access to the materials was limited, impossible, or obstructed in some way, even though formal access could be granted and the formal requirements of the procedural law were satisfied by the investigator or prosecutor. In other words there are some situations where the prosecution failed to provide the defense with proper opportunities and conditions for unobstructed study of the pre-trial investigation materials. This appears to be the reason why the prevailing opinion is that this period is not a part of the term allocated for studying the materials of the pre-trial investigation and cannot be deducted from the total term of the pre-trial investigation. There is also an opinion that this approach contradicts the provisions of Part 5, Article 219 of the Criminal Code of Practice of Ukraine, because from the moment of sending out the notification of completion of the pre-trial investigation to the defense, the time limit for the pre-trial investigation is put on hold to provide the defense with an opportunity to study the materials.For this reason, the author attempted to demonstrate that when calculating the term of the pre-trial investigation, it is important to consider not only the day of notification indicating the completion of the pretrial investigation (which is included in the duration of the term of the pre-trial investigation), but also the actual provision of access to the pre-trial investigation materials for studying. Sending a notification that includes the date, time, and location for such study is not a sufficient proof of providing an actual access. It would be more appropriate to consider sending such a notification as one of the items in the list of the procedural and organizational measures aimed at facilitating further scheduled access to the materials. In its turn, access and subsequent study encompass the opportunity to copy and/or examine documents or their copies, physical evidence or relevant portions, etc. And it is the real opportunity provided for taking such actions, mentioning the names of the materials concerning which the party is granted such an opportunity (because the parties, having a real opportunity for such actions, have a right to refuse to take the mentioned actions at the pre-trial investigation) that one party of the criminal proceeding is obliged to confirm to the other, and the injured party, a representative of a legal entity, in relation to whom or which the proceeding is conducted, is to confirm it for the prosecutor (Part 9, Article 290 of the Criminal Procedure Code of Ukraine).

Valores normativos para el Cuestionario de Quejas Cognitivas para adultos entre 30 y 90 años

IntroductionThe Cognitive Complaints Questionnaire (CCQ) has proven to be a valid and reliable instrument according to expert judgment and concurrent validity analysis with objective measures, to assess people's cognitive complaints. This is important when considering them as a possible indicator of cognitive deterioration. In order to facilitate the interpretation and comparison of the results of the instrument, it is necessary not only that it present good psychometric properties, but also that it be standardized and regulated. ObjectiveGenerate normative values for the CCQ in a sample of adults between 30 and 90 years of age from Argentine. Subjects and methodQuantitative approach of instrumental type. The sample included 230 healthy people, residents in Argentina, with no psychiatric or neurological history. ResultsCorrelations were observed between the CCQ and age and years of formal education, for this reason the normative values of the CCQ were organized by groups according to age and years of formal education. For age groups were divided into 2, one from 30 to 70 years and the other from 71 to 90 years. And for the years of formal education, 3 groups were formed: less than 7 years, between 7 and 15 years, and more than 15 years. The analysis of the psychometric properties once again yielded very good internal consistency and validity indices. Normative values are presented. ConclusionThe CCQ is a useful instrument for exploring cognitive complaints.

Professional responsibility in obstetric-gynecological nursing: Update of the case law of the High Court of Justice of Andalusia (Spain).

Obstetric-Gynecological Nursing is articulated as one of the specialities with the greatest responsibility in the field of health care, due to the involvement of being in care not only for the life of the pregnant woman, but also for the future neonate. Settling down as a profession with a high number of legal claims, there are not many studies in Spain on legal claims in the field of Nursing in general, and Obstetric-Gynecological Nursing in particular. Retrospective analysis of judgments against midwives in the period from 2010 to the present through the CENDOJ database, with the aim of searching for criminal, civil and contentious-administrative judgments. Quality was assessed using the STROBE critical appraisal tool for observational studies. 19 judgments were selected from the 197 found that were related to the objective of the study. Fifty-three percent of the judgment analyzed resulted in acquittals, while the remaining 47% were upheld to varying degrees. Most of them were motivated damage to the newborn (79%), processed entirely through the contentious-administrative route. Most of the legal claims in the field of Obstetric-Gynecological Nursing are related to adverse events with fetal damage, most of them receiving higher monetary compensation as the contentious-administrative route is the jurisdiction with the highest number of claims filed, due to breaches of the lex artis ad hoc.

Judicial self-perceptions and the separation of powers in varied political regime contexts: the constitutional courts in Hungary and Slovakia

ABSTRACT The study of constitutional courts (CCs) of post-communist Europe typically entailed the belief in CCs’ transformative potential for the consolidation of democracy. Recently, this belief has been questioned, albeit the knowledge of why at least some CCs in the region failed to prevent the rise of non-democratic regimes remains limited. This article addresses this gap via the cases of Hungary and Slovakia, which have taken a different trajectory post-2010: the Slovak CC (SCC) remains an independent institution, while the Hungarian CC (HCC) has been packed by the executive. By combining contextual case law analysis of judgments referring to democracy and semi-structured interviews, the article shows that, during critical moments, the HCC did not perceive itself as responsible for Hungarian democracy, which resulted in its self-marginalisation. The SCC was largely spared from similarly critical moments, which, however, facilitated particular self-perceptions of its responsibility (or lack thereof). These findings offer empirical support for institutionalist scholarship that emphasizes the impact of ideas in calibrating the self-perceptions of political institutions and their positioning in the political system. Constitutional courts remain inseparable from the political regimes they are located in.

Topical Finasteride: A Comprehensive Review of Androgenetic Alopecia Management for Men and Women.

The most prevalent kind of alopecia, androgenetic alopecia, commonly known as male or female pattern hair loss, affects both men and women, with the frequency rising with advancing years. Even though practicing dermatologists and hair experts frequently encounter it, it might be one of the most challenging disorders to treat since choosing a course of action frequently requires a comprehensive analysis of several variables and moral judgment. Effectiveness, side effect profiles, practicability, promoting compliance, and treatment cost are the most important factors to take into account, especially given the chronic nature of androgenetic alopecia. A clinician's ability to select the optimum course of treatment for each patient may be constrained and clouded by their knowledge base, experience, and financial compensation. A search was done to find research on the effectiveness of topical finasteride therapy, including clinically pertinent case reports and papers. Only topical minoxidil and oral finasteride are now approved by the Food and Drug Administration and the European Medicines Agency for the treatment of androgenetic alopecia. Despite being effective for hair regeneration, systemic use of finasteride is accompanied by adverse effects that prevent long-term use. Investigating topical finasteride as another possible treatment plan may be fruitful. Early research on the use of topical finasteride is safe and encouraging, despite its limitations. More research on drug distribution, ideal topical strength and usage regularity, adverse effects, and application for other alopecias would aid in elucidating the range of topical finasteride use.

Disputes Related to Dismissal of Ｗorkers Suffering from Occupational Accidents-An Analysis of the Civil Judgment for No. 12 in 2020 by Taiwan High Cour

Disputes Related to Dismissal of Ｗorkers Suffering from Occupational Accidents-An Analysis of the Civil Judgment for No. 12 in 2020 by Taiwan High Cour

Transformation of the procedural powers of the court regarding the application of a proper and effective way of protecting civil rights

The article focuses on the problem of rejection of the claim due to the plaintiff’s choice, although provided by law or contract (that is, proper), of an ineffective way of protecting the violated right in a specific legal relationship. The mentioned problem is considered in the context of the new draft law, which proposes to establish a ban on the refusal to satisfy the claim on the grounds of the plaintiff’s choice of an ineffective method of defense, if such a method is provided for by law or contract. The need to transform the procedural powers of the court regarding the application of a proper and effective way of protecting civil rights is substantiated. A scientific and practical analysis of specific judgments of the Supreme Court is carried out, in which a position is expressed regarding the proper and effective way to protect civil rights. The concept of ways to protect civil rights through the disclosure of their purpose is characterized. An understanding of the concept of an appropriate way of protecting rights is given. The ratio of features of propriety and efficiency, as well as the conditions of application of such methods of protection, is determined. The conclusion is argued, if the plaintiff has chosen a specific method of protecting his right and such a method is appropriate (that is, provided by law or a contract for disputed legal relations and corresponds to the nature of the delinquency), then due to the principle of dispositivity, the court has no grounds to refuse in granting the plaintiff of protection in the method chosen by him, since such a method must be recognized as effective under any conditions, because, given its consolidation in the norms of material law for specific disputed legal relations, it will necessarily lead to the material and legal consequences required by the plaintiff. At the same time, it is concluded that it is worth talking about effectiveness only in the aspect of the court’s application of a method of protection not provided for by law or contract. It is substantiated that since the task of civil proceedings is addressed specifically to the court, therefore, consideration and resolution of civil cases by the court should be carried out specifically for the purpose of effective protection of violated rights. Therefore, it is emphasized that it is the court that should be entrusted with full responsibility for the effective restoration of rights, and therefore the duty to choose the correct method of protecting the violated right, effective and adequate in the specific disputed legal relations of the parties, with consideration of the factual circumstances of the case established by the court. In this regard, it is justified that the method of defense specified by the plaintiff in the statement of claim should not be decisive for the court, if the court comes to the conclusion that, under the specific circumstances of the case, the method of defense chosen by the plaintiff is not appropriate, but to eliminate the legal dispute and protect the violated rights of the plaintiff will be possible only in another way, not provided for by law or contract (but which will be effective). At the end, it is stated that relevant legislative changes, which would provide grounds for the protection of civil rights (in particular, features of possible violations of civil rights), determine the purpose of protecting civil rights (because efficiency will be determined precisely by comparing the declared goal with the obtained result), as well as establishing the conditions for providing legal protection (taking into account the grounds for applying an appropriate and/or effective method of protecting civil rights). Key words: civil rights, violation, legal protection, method of civil law protection, proper method, effective method, plaintiff, court, civil process, provision of protection, effective protection of rights

Does the Claim for the Price of Made-to-Order Products Apply to Short-Term Extinctive Prescription? A Brief Analysis of the Civil Judgment of Supreme Court (112) Tai-Shang Tsu No. 963

Does the Claim for the Price of Made-to-Order Products Apply to Short-Term Extinctive Prescription? A Brief Analysis of the Civil Judgment of Supreme Court (112) Tai-Shang Tsu No. 963

Assessment of port resilience using Bayesian network: A study of strategies to enhance readiness and response capacities

Ports, as critical infrastructure, are a crucial part of the maritime transportation system (MTS) and are increasingly vulnerable to disturbances and disasters in the post-pandemic era. Resilience plays a crucial role in building sustainable infrastructure, and developing a resilient port system is a priority in planning and developing MTS. This paper aims to develop measures to enhance port resilience that can cope with risks and uncertainties. A circular four-stage method is proposed to study port resilience. The major disturbances that are currently affecting ports are summarized and classified. Then, a port resilience assessment model using the Bayesian network is proposed, in which various resilience strategies are categorized into different metrics to assess resilience capabilities (i.e. readiness and response capacities). The model is constructed based on expert judgment and statistical analysis. The Shanghai Yangshan Deepwater Port in China is used as a case study. The results show that natural disasters are major disruptors plaguing ports. The overall resilience of automated terminals is higher than that of non-automated terminals. Strategies to enhance visibility, such as building real-time data management systems and data analysis programs, have the most significant impact on improving ports’ readiness. Strategies to enhance recovery such as facility restoration and technology restoration are the most important when improving ports’ response capability.

812 Decision Making in Emergency Laparotomy – Do Trainees and Consultants Take Decisions Differently? Preliminary Results of an International Quality Enhancement Initiative (DILEMMA Study)

Abstract Aim The aim of our study is to assess how professionals take decisions when evaluating suitability of patients for emergency laparotomy and compare judgement profiles between trainees and consultants. Method We created and validated a dataset of 90 short case vignettes based on real patients admitted with surgical pathology correctable only via an emergency laparotomy. We removed any information concerning real life outcomes. We submitted the vignettes to consultants and trainees in surgery, anaesthesia, and intensive care, asking them if they would or not offer an emergency laparotomy. The data was analysed using Judgement Analysis methodology (binomial logistic regression) to identify factors playing a role in the decision-making process. We then compared judgement profiles, accuracy scores (the lower the value the higher the likelihood of operating on patients that survived at 30 days), and inconsistency between trainees and consultants and between trainees of different grades. Results Twelve centres provided data (4 from Italy, 7 from the UK, 1 from Greece). 47 consultants, 9 SAS doctors, 28 higher trainees, 13 core trainees or equivalent took part in the study. Average concordance between decision makers and real life was 78.9%. Median accuracy was 16.5 (IQR 11-30.5). Median inconsistency score was 13% (IQR 7%-20%). Accuracy and inconsistency were better for consultants and worse for trainees. Judgment Analysis demonstrated differences between grades, specialities, and institutions. Conclusions Different clinicians, when faced with the same information, make different decisions. Accuracy and consistency differed between trainees and consultants.