Central Decision Research Articles

How Polycentric Governance Affects Nature Conservation in Practice: The Case of Two Coastal Protected Areas in Suriname

This article focuses on the interactions between multi-level decision-making centers – local, national, international – in migratory species conservation in Suriname. Such multi-level interactions are crucial for transboundary conservation practices, but they have been researched very little by the scientific community so far, and not on Suriname at all. Moreover, although multi-level decision-making may differ per situation, it always poses governance and management challenges. To understand these, two Suriname case studies are analyzed in-depth: migratory shorebirds in the Bigi Pan Multiple Use Management Area and marine turtles in the Galibi Nature Reserve. A polycentric governance framework is used as an analytical lens, while a qualitative case study methodology is applied. The results of the analysis show that polycentric structures for the conservation of migratory species are currently only moderately in place and heavily dependent on donor finance. Yet, such vertical interactions are crucial for building connections – particularly among international NGOs, national governments and local communities – to achieve effective and legitimate conservation outcomes, irrespective of the presence or absence of donors. This paper, therefore, draws the following three key lessons for polycentric conservation efforts in the global South: (1) structural funding and alternative sources of income to donor money are crucial for transboundary conservation, (2) effective cooperation will require robust institution-building for enduring collective action, particularly at the local level, and (3) decision-making centers at all levels should be truly committed to a social-ecological approach of conservation, since a sole focus on biodiversity will not lead to legitimate results.

Private Enterprises and Innovative Interventions in Long-Term Care for Older People: Insights into Residual Stereotypes of Greek Rural Areas

In many areas of rural Greece there exist remnants of traditional stereotypes that were socially constructed in closed societies where the institution of the patriarchal family previously reigned and are regenerated by the dominant culture. These stereotypes have shaped over time the perception that long-term care for older adults should be provided within the family structure and exclusively by family members. Notably, it was previously considered a disgrace in Greek rural society if children moved their parents to a residential or nursing home. Public or other care facilities for older people emerged just two decades ago, except a few led by the church. However, these attitudes have been softened in recent years. European and National funded programmes have shaped different notions towards long-term care in these areas. This was facilitated by the structural changes that occurred in the Greek countryside in combination with the existing low birth rate in these areas and the presence of concrete migratory flows. The present study explores the business environment that is being formed and its potential to unleash the productive forces that have pinned down the relevant residual stereotypes. It also examines the socio-economic impact of the above enterprises on rural areas. Qualitative interviews were conducted with eight entrepreneurs who have invested in rural long-term care settings for older persons and eight elected chairpersons of local councils. Our findings indicate that regardless of financial support towards private care entities for older people, in order for the services offered to take a more prominent social role, the development of local consensus and innovative interventions is required in tandem. If achieved, such care providers can contribute to the socio-economic development of rural areas. This study provides international literature with further evidence on the crucial role of such enterprises on supportiveness towards inhabitants’ quality of life improvement while results can be useful for Greek and European decision-making centers as well as potential rural entrepreneurs.

Dynamic game research of food agricultural products supply chain based on blockchain traceability technology

PurposeFood quality and safety issues have always been imperative topics discussed by people. The anti-tampering of blockchain technology and the transparency of information make it possible to improve food traceability and safety quality. How to effectively apply blockchain traceability technology to food safety has great research significance for improving food safety and consumer quality trust.Design/methodology/approachThe paper aims to analyze the differences in product quality levels and market participants’ profits before and after the use of blockchain-driven traceability technology in the food agricultural product supply chain (SC) in the dynamic game frameworks of supplier-led and retailer-led modes, respectively, and explores the willingness, social welfare and consumer surplus of each member of the agricultural product SC to participate in the blockchain. Besides, We investigate the SC performance improvement with the mechanism of central centralized decision-making and revenue-sharing contract, compared to the SC performance in dynamic games.FindingsThe results are obtained as follow: The adoption of blockchain traceability technology can help improve the quality of food agricultural products, consumer surplus and social welfare, but the application and popularization of technology is hindered by traceability technology installment costs. Compared with the supplier leadership model, retailer-led food quality level, customer surplus and social welfare are higher.Research limitations/implicationsHow to effectively apply blockchain traceability technology to food safety has great research significance for improving food safety and consumer quality trust.Practical implicationsFood quality and safety issues have always been hot topics discussed by people. The anti-tampering of blockchain technology and the transparency of information make it possible to improve food traceability and safety quality.Social implicationsThe research results enrich the theories related to food safety and quality, and provide a valuable reference for food enterprises involved in the decision-making exploration of blockchain technology.Originality/valueBased on the characteristics of blockchain technology, the demand function is adjusted and the product loss risk of channel members is transferred through a Stackelberg game SC composed of agricultural products suppliers and retailers.Highlights:•We introduce two features of blockchain: quality trust and product information tracking.•The willingness of each member of the supply chain to use blockchain for product traceability was explored.•The overall traceability effect of the retailer-led blockchain is better than that of the manufacturer-led blockchain.•The cost of blockchain technology is a barrier to its adoption.•Blockchain brings higher consumer surplus and social welfare.

Dual-Channel Supply Chain of Agricultural Products under Centralised and Decentralised Decision-Making

The rise of rural e-commerce, accelerated by the COVID-19 pandemic, has driven agricultural development, resulting in a dual-channel model that combines offline supermarket docking with online e-commerce direct sales. Furthermore, given the perishable nature of most agricultural products, consumers exhibit a preference for high-quality logistics services. This paper analyses the dynamics of the agricultural supply chain, beginning with the “leading enterprises + farmers” production mode, and establishes two optimal decision-making models for online and offline dual-channel agricultural supply chains, incorporating logistics service levels. The first model considers centralised decision-making, where leading agricultural producers and community superstores make decisions simultaneously, aiming to maximise the overall profit of the supply chain. The second model addresses decentralised decision-making in which the producer, as the dominant player in a Stackelberg game, anticipates the reactions of retailers and sets the wholesale price, online sales price, and online logistics service level accordingly. Retailers, as followers, then determine the offline sales price and offline logistics service level based on the producer’s decisions. Finally, we conduct a sensitivity analysis of the proposed models. Our findings reveal that as consumer focus on logistics service levels increases, the overall profit of the supply chain improves, and as the unit logistics cost corresponding to the level of logistics service increases, the marginal benefits of decreasing profit brought about by the increase in unit logistics cost also decrease.

Robust ordering, production, and replenishment in a supply chain for innovative products: A two-echelon newsvendor problem with partial information in yield and demand

With partial yield and demand information, we investigate a two-echelon newsvendor problem in a supply chain for innovative product, in which the retailer and the supplier make sequential decisions in ordering, production, and replenishment, respectively. We adopt the minimax-regret criterion to assume the risk-averse nature and deduce the minimax-regret inventory decisions. We explore replenishment (emergency) production strategies for the supplier. Then we propose shortage penalty strategies as well as subsidized replenishment strategies for the retailer so that the supplier can maintain the required supply even under higher replenishment production costs. We further reveal the role of information uncertainty in the minimax-regret decisions and the bullwhip effect. Interestingly, the results show that the penalty strategies do not always lead to less regret for the retailer, and the information uncertainty does not necessarily lead to greater regret for the supplier. Moreover, some schemes to reduce the bullwhip effect are proposed, such as improving the accuracy of uncertain yield, increasing shortage penalty or replenishment subsidy, and decreasing replenishment cost. It is verified that the replenishment strategies can increase profits for both the retailer and the supplier under some conditions. In extensions, we reveal the supplier’s preference for emergency production and external procurement, as well as preferences for information sharing and confidentiality. Meanwhile, we find that decentralized decision-making may even outperform centralized decision-making in some situations when the minimax-regret criterion is adopted to deal with the information deficiency. Finally, the robustness of the replenishment strategies in reducing both enterprises’ regrets is checked.

Optimal decisions and coordination of a supply chain in the hybrid recycling mode with traceability and fairness concern

Considering the case of recycling competition between a manufacturer and a retailer, we construct game models under centralised and decentralised decision-making with or without fairness concern, respectively. By comparatively analysing the optimal decisions and profits under the three models, we design an improved two-part tariff contract to realise supply chain coordination. We have the following findings: First, in the supply chain with traceability, consumers’ preference for traceability and the impact of traceability on recycling are not only beneficial to the environment but also to each enterprise. Second, the retailer’s concern for fairness can harm the profits of the manufacturer and system. Moreover, the retailer’s disproportionate focus on fairness of the distribution of revenues hinders the introduction and development of the traceability system, leading to lower recycling volume and demand. Third, the traceability system is most efficient under centralised decision-making, attaining the highest traceability level, recycling volume, and system profit. The retail price and manufacturer’s recycling price are lower than those under decentralised decision-making. Our findings also suggest that improved two-part tariff contract can enhance the chain members’ performance. While fairness concern and fierce recycling competition hinder implementation of the coordination mechanism, and improved traceability facilitates the attainment of coordination.

A Study of Electronic Product Supply Chain Decisions Considering Extended Warranty Services and Manufacturer Misreporting Behavior

In the supply chain management of electronic products, asymmetric cost information is a prevalent issue that can lead manufacturer to misreport costs, thereby exacerbating supply chain imbalances. This study focuses on the electronic product supply chain with an extended warranty service, where the manufacturer bears the after-sales responsibility during the extended warranty period. It explores the decision-making (DM) issues within the supply chain under different information environments and power structures. The Stackelberg game theory is employed to solve and analyze these models, and the main findings are as follows: (1) When supply chain information is symmetrical, centralized DM is the best choice. However, in cases where the supply chain adopts decentralized DM, it is more beneficial for the retailer and the supply chain if the retailer assumes the role of DM leader. Additionally, when the retail price sensitivity coefficient is low, the manufacturer will compete with the retailer for DM priority. Conversely, when the retail price sensitivity coefficient is higher, the manufacturer is better off as a follower in DM; (2) When the supply chain information is asymmetric, the manufacturer may engage in misreporting, which benefits the manufacturer but is detrimental to both the supply chain and the retailer. Moreover, if the price sensitivity coefficient is low, the manufacturer should lead the supply chain DM. Otherwise, the retailer should take the lead in supply chain DM. Adopting such a flexible strategy will prove advantageous for all parties involved in the supply chain. (3) The strategy of “reducing the retail price and increasing the extended warranty price” is a favorable strategy for the supply chain.

SD-GPSR: A Software-Defined Greedy Perimeter Stateless Routing Method Based on Geographic Location Information

To mitigate the control overhead of Software-Defined Mobile Ad Hoc Networks (SD-MANETs), this paper proposes a novel approach, termed Software-Defined Greedy Perimeter Stateless Routing (SD-GPSR), which integrates geographical location information. SD-GPSR optimizes routing functions by decentralizing them within the data plane of SD-MANET, utilizing the geographic location information of nodes to enhance routing efficiency. The controller is primarily responsible for providing location services and facilitating partial centralized decision-making. Within the data plane, nodes employ an enhanced distance and angle-based greedy forwarding algorithm, denoted as GPSR_DA, to efficiently forward data. Additionally, to address the issue of routing voids in the data plane, we employ the A* algorithm to compute an optimal routing path that circumvents such voids. Finally, we conducted a comparative analysis with several state-of-the-art approaches. The evaluation experiments demonstrate that SD-GPSR significantly reduces the control overhead of the network. Simultaneously, there is a notable improvement in both end-to-end latency and packet loss rate across the network.

Governance fix? Power and politics in controversies about governing generative AI

Abstract The launch of ChatGPT in late 2022 led to major controversies about the governance of generative artificial intelligence (AI). This article examines the first international governance and policy initiatives dedicated specifically to generative AI: the G7 Hiroshima process, the Organisation for Economic Cooperation and Development reports, and the UK AI Safety Summit. This analysis is informed by policy framing and governance literature, in particular by the work on technology governance and Responsible Innovation. Emerging governance of generative AI exhibits characteristics of polycentric governance, where multiple and overlapping centers of decision-making are in collaborative relationships. However, it is dominated by a limited number of developed countries. The governance of generative AI is mostly framed in terms of the risk management, largely neglecting issues of purpose and direction of innovation, and assigning rather limited roles to the public. We can see a “paradox of generative AI governance” emerging, namely, that while this technology is being widely used by the public, its governance is rather narrow. This article coins the term “governance fix” to capture this rather narrow and technocratic approach to governing generative AI. As an alternative, it suggests embracing the politics of polycentric governance and Responsible Innovation that highlight democratic and participatory co-shaping of technology for social benefit. In the context of the highly unequal distribution of power in generative AI characterized by a high concentration of power in a small number of large tech companies, the government has a special role in reshaping the power imbalances by enabling wide-ranging public participation in the governance of generative AI.

A Move towards Improving Good Governance in Kenya- Roles of Citizens in Promoting Good Governance

Aim: Governance is at the very apex of human society, wherein, the success of every facet of human life is anchored highly on improved government that is answerable to the needs and interests of the citizens. Good governance, therefore, impacts immensely on human life, as it creates conducive political, social, and economic environments for human survival and development. Every citizen is thereafter able to feel part and parcel of decision-making and all the activities and programs of the government. This paper, sought to articulate the role and obligations of citizens towards improving good governance in Kenya. Methods: The research is grounded upon a theoretical perspective using the literature drawn from various scholars from the year 2014 to 2024. The paper relied on secondary sources such as books, journals, reports and government records through government anti-corruption agencies. Results: Views from stakeholders such as government anti-corruption agencies, private sector, civil service organization, among others are considered. However, the people of Kenya in their diversity have been left aside in almost all the reviewed literatures, something which the paper believe is the reason for the word “mitigate corruption” instead of end corruption. The paper thereby, after perusing these literacy records from 2014 to 2024, is convinced that the people have cardinal role to play to end corruption. Conclusion: The study conclude that people’s involvement is required for any genuine move toward realizing the envisaged good governance in Kenya. Recommendations: A framework that allows the people to be at the center of decision-making in government’s activities should be sought. People must refuse manipulation and ethnic party politics, enforce the implementation of Kenyan 2010 constitution, and report any corrupt practices regardless of who is the victim. More studies should be conducted especially on the roles of citizens in ending not mitigating corruption.

PROPERTY RIGHTS GUARANTEES AS PREREQUISITES FOR ECONOMIC COMPETITION: AN EMPIRICAL STUDY

Economic competition by definition implies a choice between competing alternatives. But can economic agents always protect their rights to make this choice? In order to protect property rights, they should have a guarantor who imposes sanctions on the violator. However, the guarantor must be able to use violence, since the imposition of sanctions is often not voluntary. This paper shows that the uneven distribution of violence in society, which is not monopolized by one decision-making center and/or applied outside the rule of law, hinders economic competition. In such a situation, i.e. in a limited access social order, part of property rights remains unprotected, which prevents the entrepreneur from performing his/her function. The reason for this effect is the desire of the elite to maintain the status quo in distribution of rents: they try to avoid changes caused by the market process that may lead to a violation of existing political balance. In this study, the stated theses are confirmed on microdata of the BEEPS industrial enterprises survey by the European Bank for Reconstruction and Development - we test the hypotheses using stochastic frontier analysis (SFA) and discrete choice models. Empirical analysis allows us to argue that in the limited access order, the obstacle to participation in economic competition is a weak property rights protection - it forces firms to compete for limited resources not by satisfying the needs of consumers, but by following the interests of the property rights guarantor. The results of the study can be useful in developing competition policy measures and explaining the phenomenon of «regulatory bias» in antitrust policy of developing countries.

ACS: MANAGEMENT IN A FIRST LEVEL ED

Abstract The DIDO is the time between the patient‘s arrival in a center without haemodynamics and the departure by ambulance towards the center with haemodynamics. It affects the D2B and the patient‘s prognosis and is an indicator of the effectiveness of the performance on STEMI care when it is less than 30 minutes. From 2009, a protocol was developed on the management of PCI in our hospital, whose primary objective was the containment of DIDO within 30 minutes. After the application of this protocol we went to evaluate our performance on patients who arrived consecutively from 1 January 2022 to 31 December 2022 at the San Benedetto del Tronto ED, Spoke centre not equipped with haemodynamics. Inclusion criteria: age over 18 years, chest pain <12 hours, discharge diagnosis of STEMI ACS. Excluded 2 patients with cardiac arrest admitted to the ICU, 2 patients with diagnostic uncertainty centralized subsequently, 2 patients with no indication for PCI in emergency admitted to the Cardiac Intensive Care Unit, there are 35 patients, 10 females (29%) and 25 males (71%), with an average age of 64.57 years. Comorbidities were present in 71% of patients (cardiovascular pathologies, diabetes and obesity), while in 29% of patients no comorbidity was present. No comorbidity was observed in 60% of patients between 18 and 55 years and in 30% of patients between 65 and 75 years. We evaluate our performance by comparing the trend, over the years, of this indicator. A reduction in the average DIDO was achieved from 56 minutes in 2014 to 33 minutes in 2022 reaching the value of 17 minutes in 75% of cases. The percentage of cases outside the cut off is 25.71%. We tried to hypothesize the causes responsible for a DIDO>30 minutes: an inappropriate attribution of the priority color code to Triage, the presence of comorbidities. In reality, as well as data from international literature, cases of DIDO >30 minutes were associated with delay accumulated for necessary specialist consultations for difficult to interpret ECGs and the delay of the transport the patient to the Hub hospital. To conclude is necessary direct centralization of STEMI ACS patients from 118 to haemodynamics and reduce centralization decision–making times by identifying criteria facilitating the transfer decision in cases of difficult–to–interpret ECGs.

The development and structural validity testing of the Person-centred Practice Inventory-Care (PCPI-C).

Person-centred healthcare focuses on placing the beliefs and values of service users at the centre of decision-making and creating the context for practitioners to do this effectively. Measuring the outcomes arising from person-centred practices is complex and challenging and often adopts multiple perspectives and approaches. Few measurement frameworks are grounded in an explicit person-centred theoretical framework. In the study reported in this paper, the aim was to develop a valid and reliable instrument to measure the experience of person-centred care by service users (patients)-The Person-centred Practice Inventory-Care (PCPI-C). Based on the 'person-centred processes' construct of an established Person-centred Practice Framework (PCPF), a service user instrument was developed to complement existing instruments informed by the same theoretical framework-the PCPF. An exploratory sequential mixed methods design was used to construct and test the instrument, working with international partners and service users in Scotland, Northern Ireland, Australia and Austria. A three-phase approach was adopted to the development and testing of the PCPI-C: Phase 1 -Item Selection: following an iterative process a list of 20 items were agreed upon by the research team for use in phase 2 of the project; Phase 2 -Instrument Development and Refinement: Development of the PCPI-C was undertaken through two stages. Stage 1 involved three sequential rounds of data collection using focus groups in Scotland, Australia and Northern Ireland; Stage 2 involved distributing the instrument to members of a global community of practice for person-centred practice for review and feedback, as well as refinement and translation through one: one interviews in Austria. Phase 3: Testing Structural Validity of the PCPI-C: A sample of 452 participants participated in this phase of the study. Service users participating in existing cancer research in the UK, Malta, Poland and Portugal, as well as care homes research in Austria completed the draft PCPI-C. Data were collected over a 14month period (January 2021-March 2022). Descriptive and measures of dispersion statistics were generated for all items to help inform subsequent analysis. Confirmatory factor analysis was conducted using maximum likelihood robust extraction testing of the 5-factor model of the PCPI-C. The testing of the PCPI-C resulted in a final 18 item instrument. The results demonstrate that the PCPI-C is a psychometrically sound instrument, supporting a five-factor model that examines the service user's perspective of what constitutes person-centred care. This new instrument is generic in nature and so can be used to evaluate how person-centredness is perceived by service users in different healthcare contexts and at different levels of an organisation. Thus, it brings a service user perspective to an organisation-wide evaluation framework.

Are we heroes or couriers? A phenomenological study on reappropriation of professional subjectivity and agency among health professionals during COVID-19 contact tracing in Türkiye

During the COVID-19 pandemic, Türkiye implemented a distinctive contact tracing approach involving in-person home visits by medical professionals to individuals who tested positive for the virus. This study examines the experiences of health professionals involved in contact tracing, exploring how they reappropriated their professional subjectivity and agency during their deployment in this role. It is an interpretive phenomenological qualitative study. We conducted 21 semi-structured in-depth interviews, subsequently carried out two separate focus group interviews with an additional 31 participants from various districts in Istanbul. Participants were selected from different medical professions (i.e. doctors, nurses, midwives), career stages, gender and age groups, and hierarchical levels (i.e. officers and directors). Data analysis was conducted collaboratively by the research team from sociology and public health disciplines.Our main finding is that for the majority of health professionals, contact tracing was a novel experience with challenges and ambivalances. Yet, regardless of their perceptions (positive, negative, or mixed), the experience promoted a reaffirmation of professional identity and reappropriation of professional subjectivity and agency, which discloses that professional subjectivity is not firm but dynamic, carrying stability as well as flexibility and adjustment. Four main themes are identified in their reappropriation of professional subjectivity and agency: uncovering professional fulfillment, feeling restrained in professional dissatisfaction, assessing the job, and engaging in professional and bureaucratic negotiations.The profound exploration into the dynamics of contact tracing amidst the pandemic illuminates a multidimensional narrative that transcends the conventional discourse on physical and psychological stress experienced by medical professionals. Contact tracing experience had a transformative impact on meaning and purpose of professional identity. Our findings highlight a need for a balanced approach between centralized decision-making, mobilization of professionals, quantitative evaluation, and professional autonomy and discretion, qualitative assessments, and meaningful engagement.

The straight and narrow: A game theory model of broad- and narrow-spectrum empiric antibiotic therapy

Physicians prescribe empiric antibiotic treatment when definitive knowledge of the pathogen causing an infection is lacking. The options of empiric treatment can be largely divided into broad- and narrow-spectrum antibiotics. Prescribing a broad-spectrum antibiotic increases the chances of covering the causative pathogen, and hence benefits the current patient’s recovery. However, prescription of broad-spectrum antibiotics also accelerates the expansion of antibiotic resistance, potentially harming future patients. We analyse the social dilemma using game theory. In our game model, physicians choose between prescribing broad and narrow-spectrum antibiotics to their patients. Their decisions rely on the probability of an infection by a resistant pathogen before definitive laboratory results are available. We prove that whenever the equilibrium strategies differ from the socially optimal policy, the deviation is always towards a more excessive use of the broad-spectrum antibiotic. We further show that if prescribing broad-spectrum antibiotics only to patients with a high probability of resistant infection is the socially optimal policy, then decentralization of the decision making may make this policy individually irrational, and thus sabotage its implementation. We discuss the importance of improving the probabilistic information available to the physician and promoting centralized decision making.

Children affected by armed conflict – reintegration of child-soldiers from the International Humanitarian Law perspective

The recruitment and use of minors in armed conflicts, which is contrary to humanitarian law, applies to any race, religion, or political system. Still, there is a harmful tendency to associate this problem only with undemocratic, poor, and underdeveloped countries, far from the large geopolitical decision-making centers. Most children are abducted, intimidated, coerced, and manipulated by actors of armed conflicts, both formally functioning in the state apparatus as soldiers, but also guerrillas, members of terrorist groups or other non-state entities. Minors are not only witnesses of brutality and suffering but are also forced to participate in torture and murder. This, in turn, causes traumatic mental reactions, such as depression, suicide attempts or lack of sensitivity to harm as adults. Hence, the reintegration of child soldiers is a long-term and troublesome process also for their families and communities, which, nevertheless, do not receive sufficient help at the mental, financial, and logistical level to be able to take care of the returning children. Global solutions still fail to deliver the expected solutions, to the detriment of children’s development and rights.

Optimal pricing strategy in the closed-loop supply chain using game theory under government subsidy scenario: A case study

Automotive battery production always receives government supports which directly affect the recycling of used products collected from secondary markets. Accordingly, an optimal product pricing strategy and efficient policy suggestions must be provided for this industry. This study used Stackelberg models to analyze three categories of pricing strategies related to the recycling process of car batteries when government subsidy is paid. These models are applied to make optimal decisions in two centralized and decentralized modes to investigate the links between and influences of different parameters of the problem on one another. Finally, a numerical example based on a real case study in Iran is applied to the models. The results indicate that making centralized decisions leads to a higher level of profitability than decentralized decision-making in the under-study industry. Accordingly, maintaining coordination and integration among the supply chain components in the decision-making process increases the profitability of the entire network.

Mathematical programming-based methodology for the evaluation of supply chain collaborative planning scenarios

Nowadays, supply chain (SC) decentralised decision making is the most usual situation in SC operations planning. In this context, different companies can collaboratively plan to achieve a certain level of individual and SC performance. However in many cases, there is reluctance to collaborate because it is not known a priori which benefits will be reported. This paper aims to develop a mathematical programming-based methodology for the evaluation of different supply chain collaborative planning scenarios (MPM-SC-CP). It is assumed that different SC decision centres (DCs) make decisions based on mixed and integer linear programming models. Two main inputs feed the proposed MPM-SC-CP, a framework and associated methodology that support the integrated conceptual and analytical modeling of the SC-CP process in which several DCs make decisions according to spatio-temporal integration. Finally, an application to a real ceramic SC was conducted.

Research on the improvement mechanism of value-based healthcare objectives in pharmaceutical group procurement

Focusing on the research scenario that integrates value-based healthcare objectives with the pharmaceutical group purchasing model, this study delineates value-based healthcare objectives in pharmaceutical group purchasing from three perspectives: drug sales price, drug quality, and service level. We construct a three-level pharmaceutical group purchasing supply chain consisting of drug manufacturers, medical institutions, and non-profit drug group purchasing organisations. Under centralised and decentralised decision-making, we introduce cost-sharing contracts and “cost-sharing-quantity-discount” contracts to analyse the impact of factors such as drug sales price, quality, and sensitivity of the service level. The study found that: (1) Compared with centralised decision-making, the optimal drug quality and service level in decentralised decision-making and the optimal profits of drug manufacturers and medical institutions will decrease. However, the optimal drug sales price in decentralised decision-making always deviates from that in centralised decision-making, leading to higher or lower drug sales prices. (2) The incorporation of value-based healthcare objectives in the pharmaceutical group purchasing through cost-sharing contracts depends on changes in the proportion of drug quality costs borne by medical institutions. If the proportion is too high, medical institutions will suffer greater losses because they bear too much of the cost. (3) Under certain conditions, cost-sharing contracts can improve supply chain efficiency but cannot achieve supply chain coordination, while the combination of “cost-sharing-quantity-discount” contracts can achieve supply chain coordination in pharmaceutical group purchasing.

The Epistemic Status of AI in Medical Practices: Ethical Challenges

In recent years, discussions have been increasingly emerging in modern scientific research that, in connection with the development of AI technologies, questions arise about the objectivity, plausibility and reliability of knowledge, as well as whether these technologies will not replace the expert figure as the authority that has so far acted as a guarantor of objectivity and the center of decision-making. Modern historians of science Duston L. and Galison P. in their book on the history of scientific objectivity, they talk about the alternation of "epistemic virtues", as one of which objectivity has been established since a certain moment. At the same time, the promotion of one or another virtue regulating the scientific self, i.e. acting as a normative principle for a scientist when choosing one or another way of seeing and one or another scientific practice, depends on making decisions in difficult cases requiring the will and limitation of the self. In this sense, epistemology is combined with ethics: a scientist, guided by certain moral principles, gives preference to one or another way of behavior, choosing, for example, not a more accurate hand-drawn image, but an uncluttered photograph, perhaps fuzzy, but obtained mechanically, which means more objective and free from any admixture of subjectivity. In this regard, the epistemic status of modern AI-based technologies, which increasingly assume the functions of the scientific self, including in terms of influencing final decision-making and obtaining objective knowledge, seems interesting. For example, in the field of medicine, robotic devices already provide significant support, taking over some of the functions, for example, of a first-level doctor to collect and analyze standardized patient data and diagnostics. There is an assumption that AI will take on more and more responsibilities in the near future: data processing, development of new drugs and treatment methods, establishing remote interaction with the patient, etc. But does this mean that the scientific self can be replaced by AI-based algorithms, and another epistemic virtue will replace objectivity, finally breaking the link between ethics and epistemology – this question needs to be investigated.