Decision-making Authority Research Articles

Examining contraceptive utilization behavior in Pakistani women

BackgroundThere is a dearth of research examining the couple characteristics in determining contractive utilization behavior in developing countries. This study fills the gap by analyzing the roles of women’s intra-household bargaining power and spousal age differentials in predicting contraceptive utilization behavior in Pakistani women.MethodsA sample of 13,331, excluding pregnant and sexually inactive married women aged 15–49, was extracted from the Pakistan Demographic and Health Survey 2017–18. The dataset is cross-sectional. Exploratory analysis was used to examine the pattern of contraceptive knowledge, types of contraceptive utilization, and intention to use contraceptives among women. Furthermore, binary regressions were employed to examine the association of women's intrahousehold bargaining power and spousal age difference with contraceptive utilization without and after accounting for all potential covariates.ResultsOnly 33% of women use contraceptives, while 30% express an intention to use contraceptives in the future. Almost all women (98%) knew about modern contraceptives. Compared to same-age couples, higher odds of current contraceptive use are observed among women whose husbands are at least 20 years older than them or whose husbands are young to them. The odds of the intention to use contraceptives tend to increase with the increase in spousal age difference. Women’s intra-household bargaining is a significant predictor of current contraceptive utilization and intention to use contraceptives.ConclusionFindings underscore the importance of considering the couple’s characteristics in reproductive healthcare programming and policies.RecommendationGreater women's intra-household bargaining power and smaller spousal age differences are associated with higher contraceptive usage. Empowering women and promoting their decision-making authority within households can enhance reproductive health outcomes.

Ethics of AI in medicine

Artificial intelligence (AI) is increasingly finding its way into medicine, and it is not yet clear how it will change the practice of medicine and the way doctors see themselves. This article explores the ethical limits of AI by (1) discussing the reductionistic elements inherent in AI, (2) working out the problematic implications of algorithmisation and (3) highlighting the lack of human control as an ethical problem of AI. The conclusion is that although AI is a useful tool to support medical judgement, it is absolutely dependent on human decision-making authority in order to actually prove beneficial for medicine.

Influence of Internal Control and Implementation of Accounting Information Systems on The Quality of Regional Government Financial Reports

The research aims to assess the impact of internal control and the installation of accounting information systems on the quality of financial statements in local government. The independent variables examined in this study are internal control and accounting information systems. The dependent variable being investigated is the quality of local government financial statements. The population in this study consists of the work units (SKPD) in Bandung. The sample was selected using purposive sampling, and it includes employees from various institutions such as Inspektorat, BPK, BPPD, Office of Communications and Information, Library and Archives, Office of Investment and PTSP, Office of Spatial Planning and Administration, Administrative Assistant, and Finance Department. The sample includes employees with decision-making authority, such as heads of field and heads of sub-sections. Data collection is conducted by disseminating questionnaires to 50 participants within the organization. This study employed multiple linear regression analysis utilizing the SPSS 23.0 tool for Windows. The research findings indicate that internal control has a significant positive impact of 47.2% on the quality of financial statements in local government. Similarly, the deployment of accounting information systems has a positive effect of 23.6% on the quality of financial statements in local government. The internal control and accounting information systems have a combined impact of 55.3% on the quality of local government financial statements, while the provisions contribute 44.7%.

The Evolution of the British Executive: Cabinet, Prime Minister and Core Executive Model

With the resignation of three prime ministers in the United Kingdom since 2019, the executive organ in the UK has become a topic of controversial discussion in the literature. The longstanding debate regarding who wields significant influence within the Executive branch and how executive power is exercised has reignited. It has been underscored that historically, the executive functioned either through the cabinet system, characterized by a collective decision-making structure, or the prime ministerial system, where the prime minister held primary decision-making authority. This article argues that neither the cabinet nor the prime ministerial system adequately explains the contemporary British executive. By analyzing the institutions of the cabinet and the prime minister's office from both historical and contemporary perspectives, this article seeks to explain this point. Ultimately, it examines the core executive model, positing that multiple actors and various factors such as resources, structure, strategy, and tactics collectively determine the functioning of the British executive today.

EXEMPTION FROM CRIMINAL LIABILITY IN CONNECTION WITH MILITARY SERVICE

The article reflects the result of a scientific study of the provisions of legislation and doctrine that determine the content of the conditions under which criminal law measures are not applied to persons called up for military service during the period of mobilization or in wartime, as well as those imprisoned during the period of mobilization, wartime and (or) a martial law contract for military service in the Armed Forces of the Russian Federation, subject to their award or dismissal, on grounds specified by law. The relevance of such a study is predetermined primarily by the fact that the criminal law provisions in question were introduced into the Criminal Law quite recently. Provisions of Art. 78.1, 80.2 and part 3.1 of Art. 86 of the Criminal Code of the Russian Federation are of a blanket nature, the conditions and procedure for exemption from criminal liability and the punishments provided for in them differ in many respects from the conditions that are typical for other circumstances of exemption from liability. The authors note that the decision of the federal executive authorities on the non-application of criminal liability measures in connection with military service to persons who have committed a crime, does not depend on what category, in accordance with Art. 15 of the Criminal Code of the Russian Federation, this crime should be included. Exemption from criminal liability in connection with military service does not occur simultaneously, but involves at least two stages. The first is expressed in the suspension of the application of criminal legal measures to a person while he is serving, subject to control over him by the commander of a military unit or institution. The second is the final refusal to bring the person to criminal responsibility. The basis for the termination for a person of all criminal legal consequences of committing a crime in this case is one of the alternatives specified in the law. This is either the awarding of a state award to a serviceman or dismissal from military service due to reaching a certain age, or recognition of a person by a military medical commission as unfit for military service due to health reasons or due to the end of the mobilization period, the abolition (termination) of martial law and (or) the expiration of martial law time.

THE ROLE OF BANKING SYSTEM IN PROVINCIAL ECONOMIC DEVELOPMENT: A STUDY OF TURKIYE, FROM THE 70S TO THE 2000S

This research examines the relationship between banking activities and provincial economic development. In particular, the study offers insight on the nature of the regional economic development discrepancies in Turkiye. The study finds that, despite the trend towards decentralisation that takes place in regional economic policies, the banking system adopts centralisation policies. Using dynamic generalised method of moment (GMM) estimates, we evaluated a unique data set including 39 years of provincial demographic, socioeconomic, and financial factors in Turkey. The study demonstrates that the banking intermediation is detrimental to provincial development. The Turkish banking system’s hierarchical structure prevents financial intermediaries from fulfilling their role in fostering development. Consolidation and concentration strategies must be reassessed, since they tend to favour centralisation, which has been shown to be inefficient for regional convergence. The results also suggest that branch managers should be granted greater decision-making authority to make better use of locally produced information when approving or rejecting projects, which would eventually lead to a reduction in provincial disparities.

Prevalence and Risk Factors of Child Marriage Among Madhesi Women in Nepal's Terai Region.

Child marriage is a detrimental practice with negative consequences for girls' health and well-being. This study aims to identify the prevalence of child marriage and associated risk factors within the Madhesi community. A cross-sectional study was conducted in a sub-metropolitan city of Lumbini Province, Nepal, in 2023. A total of 352 married women were randomly selected using simple random sampling and interviewed using a structured questionnaire between March 28th and April 17th. Descriptive categorical variables were expressed as proportions. Risk factors associated with child marriage were measured using the Chi-square test and multivariate logistic regression analysis. All statistical analyses were performed using SPSS version 26. The majority of respondents (36.1%) were in the age group 21-25, with a mean age of 25.90 years ± 4.6 years. Most respondents (48.9%) received only basic-level education, with the majority (72.4%) reporting their parents as having no formal education. The primary family occupation was farming (40.1%). The prevalence of child marriage was high (77.0%), with a median marriage age of 18 years. Logistic regression analysis revealed significant risk factors including lower education levels of respondents and their parents, husband's occupation, lack of awareness about the legal marriage age, limited decision-making power regarding marriage, belief in the dowry system, discussions with friends about child marriage, and occurrence of child marriage among friends. Despite legal prohibition, child marriage remains prevalent in the Madhesi community. Educational interventions targeting women and parents, empowering women with decision-making authority, and addressing the dowry system are crucial for reducing this harmful practice.

PSC as an organisational level determinant of working time lost and expenditure following workplace injuries and illnesses

ObjectivesFinding an association between organisational factors and working time loss following workplace injury and illness (hereafter injury) could rightfully shift the focus in injury management strategies from the individual to the organisation. We investigate whether working time loss and expenditure following compensable injury can be predicted by knowing about organisational characteristics, particularly the Psychosocial Safety Climate (PSC) − the organisation’s climate for worker psychological health. MethodsOur prospective multisource study linked ‘objective’ reports of working conditions assessed in an independent Australian Workplace Barometer (AWB) sample (random population interviews of 1067 workers) to future workers compensation claims data held by a government safety regulator, by aggregating both data sets to the organisational (employer) level. We selected compensation data prior to big policy changes to a short tail scheme. We selected claims with working time loss due to injury or illness ≥1 day yielding 100 organisations and 12,624 claims. ResultsResults support organisational PSC as a leading indicator of future time loss and expenditure, and its effect was mediated through skill discretion, job satisfaction, and rewards. Decision authority, supervisory support, and bullying were also related to time loss but not as strongly as PSC. In very low PSC organisations, days lost were 160 % higher than for those in high PSC organisations (177 vs 68 days). Likewise, expenditure for the injury or illness (e.g., health expenses, wages) was 104 % higher in very low PSC vs high PSC organisations (AUD $67 260 vs $32 939). ConclusionPSC is a modifiable social determinant of injured workers working time loss and expenditure. Practically, it is essential to target PSC for safety improvement — beyond injury prevention PSC is important for return to work and to prevent the shift of the burden of organisational problems to the individual and public health.

Leadership culture and implementation of county integrated development plan in Western Counties, Kenya

In Kenya, the County Governments are required by planning and budgeting guidelines (URT, 2011) to have five years strategic plans (CIDP) which all the counties comply. However, its implementation is always not effective. The rationale of this cram was to study the role of organizational culture on implementation of county integrated development plans in devolved governments in western region Kenya. The selection of this subject was discriminatory by the reality that implementation of County Integrated Development Plan in the Counties in Western Region has been an issue for the last ten years. The aim of the study was to establish the effect of leadership culture on implementation of County Integrated Development Plans in devolved units of Western Region. The research used descriptive study design to gather information on the role of leadership culture on implementation of CIDP and was guided by balanced scorecard theory. A sample size of 364 and questionnaires was used in data collection. The research instrument was constructed based on the constructs identified in the conceptual framework. Both descriptive and inferential statistics were used to analyze the data. Data analysis was done using multi hierarchical regression model. Mean and standard deviation was also calculated and the results presented in form of tables. The findings of the study showed that leadership culture had a significant impact on CIDP implementation where the correlation coefficient (R) of 0.492 established a fair linear correlation linking leadership culture and CIDP Implementation among the devolved units of Western Region Counties. Leadership culture explained 24.2% of the variance in CIDP implementation in devolved units of Western Region as signified by R- square of 0.242. The significance value was 0.000<0.05. This showed that the model was statistically significant in predicting the influence of leadership culture on implementation of CIDP among the devolved units of Western Region. County Governments ought to look into their leadership culture as it positively influences the implementation of CIDP. Leadership culture comprises of vision and values, communication, empowerment and trust, decision-making, accountability and performance and development and learning. Additionally, granting a decision-making authority, access to information, collaboration and participation, skill development and training, recognition and rewards and supportive leadership contributes to enhanced CIDP implementation in County Governments across the Country.

Beyond tree planting: Mobilizing a global production network for savanna restoration in Brazil

Emerging global production networks innovate the supply of restoration products and services to reverse degraded ecosystems globally. Yet, savanna restoration interventions often neglect diverse plant life forms and planting techniques in implementing large-scale pledges. Drawing on global production network analysis, we examine how the configuration of savanna restoration practices in Brazil influences decision-making processes and outcomes. Our assessment of a case study in Central Brazil reveals a myriad of forces affecting the interconnections between institutional drivers, markets, and supply systems for restoration actions across multiple scales. Prevailing policies and regulations often disregard diverse expertise, economic strategies, and socio-cultural perspectives when setting savanna restoration priorities and incentives. While we identify different buyers influencing market demands to meet mandatory or voluntary environmental compliance, a wide range of suppliers remakes savanna restoration actions according to regional contexts. The experiences of community-led plant material supply systems in Central Brazil showcase collective organization that enables situated socio-technical innovations to link a high diversity of non-tree species with livelihood outcomes. This study contributes to revealing how institutional drivers and restoration markets assert political authority and commercial objectives in multifaceted decisions, while community partnerships catalyze place-based savanna restoration innovations.

Decentralization and its impact on improving public services

Decentralization is the process of transferring decision-making power, authority and responsibility from the central government to regional governments or local entities. The process aims to bring government closer to the people, with the hope of improving the efficiency, accountability and responsiveness of public services to the specific needs of local communities. Decentralization is often regarded as a strategy to optimize resources, strengthen local democracy, and encourage active community participation in the policy-making process and its implementation. This study uses the literature research method. The results show that decentralization tends to improve the effectiveness and relevance of public services by empowering local governments to manage the specific needs of local communities. It creates a platform for wider public participation and increased government accountability and transparency. However, the findings also confirm that the negative elements of decentralization cannot be ignored. In particular, decentralization can result in inequalities in services between regions due to differences in resources, as well as pose policy coordination challenges. Lack of local capacity and the potential for increased corruption are significant obstacles to optimizing the benefits of decentralization.

The Duty of Explanation of using Medical AI

在医疗人工智能引起的法律议题中，运用医疗人工智能的说明义务亟须规范解释。医疗人工智能无法被当前的说明义务体系所涵摄，原因在于医疗器械不是知情同意制度所调整的对象，但这无法回应人工智能所带来的新型科技风险。说明义务的开放框架为披露医疗人工智的使用创造了弹性空间，技术水平、法律规范与医疗实践等多元基础进一步证立此项披露告知的必要性和重要性。医疗人工智能的说明义务在现阶段应采取理性患者与具体患者之混合标准、排除理性医生标准，在程度上应以简洁为要，照顾社会公众对医疗人工智能的认知水平。医疗人工智能说明义务的内容由“标准的风险与利益披露”所衍生，结合医疗决策主导权归属问题的探讨，应包括医疗人工智能的参与程度、固有风险、期待利益及替代措施四项基本信息。 In the legal issues caused by medical artificial intelligence, the duty of explanation of using medical artificial intelligence urgently needs to be normatively interpreted. Medical artificial intelligence cannot be covered by the current system of explanation duties, as medical devices are not the subject of the informed consent system. However, this cannot respond to the new technological risks brought by artificial intelligence. The open framework of the explanation duties creates flexible space for disclosing the use of medical artificial intelligence, and the diverse foundations of technological level, legal norms, and medical practice further establish the necessity and importance of this disclosure. The duty to explain medical artificial intelligence at the current stage should adopt a mixed standard of the reasonable patient standard and the subjective patient standard, excluding the reasonable doctor standard, and should be concise in terms of degree, taking into account the public’s awareness level of medical artificial intelligence. The content of the duty to explain medical artificial intelligence is derived from the “standard risk-benefit-disclosure” and should include four basic pieces of information: the level of involvement of artificial intelligence in medical decision-making, inherent risks, expected benefits, and alternative measures, combined with the exploration of the issue of medical decision-making authority.

Juridical Analysis of the Authority of Constitutional Court Decisions Regarding Elections

Juridical Analysis of the Authority of Constitutional Court Decisions Regarding Elections

Orthodox Monasteries as Centers of Christian Civilization on the Eastern Borders of the Russian State

The study is devoted to the history and activities of monastic monasteries in Siberia, their importance in the context of the integration of Siberian territories into the Russian statehood, due to the duration of the processes of Christianization: from the creation of a church administrative unit in Siberia (1620) and completion at the beginning of the twentieth century. The research involved complex and communicative approaches, axiological aspects and methodology of local history, involving the reconstruction of a regional historical narrative. It is noted that the establishment of monastic monasteries has become an important factor in the spread of Russian statehood. The ways of creating monasteries related to both monastic and public initiatives, as well as by decision of the diocesan authorities, are considered. We pay attention to the scientific discourse of modern historical science on the issues of dating the establishment of monastic monasteries and an individual research approach. The contribution of monasteries to the economic development of territories is determined, the main directions of social and educational activities of monastics are indicated. We consider the role of the women’s Orthodox communities of Siberia in the second half of the XIX century, contributing to the strengthening of the ideological basis of the empire, influencing the formation of moral and value attitudes and improving the educational level of local ethnic groups. The special role of monasteries in the history of the region is justified, due to the territorial and climatic conditions, the multi-confessional and multilingual nature of Siberia, when a few monks performed various functions, engaged in missionary, socio-educational and educational activities. We draw a conclusion that Orthodox monasteries in Siberia were outposts of the spread and establishment of Christian civilization, monasteries provided communication with the non-ethnic population, involving them in the Orthodox mentality, forming a vector of the socio-cultural topos of the peoples of Siberia.

MEASURES OF STATE SUPPORT DURING THE FAMINE OF THE 1930S IN CENTRAL KAZAKHSTAN

In the article, the authors consider measures to provide state aid during the famine of the 1930s in the territory of Central Kazakhstan. The purpose of the article is to consider in the regional aspect the main measures taken in Central Kazakhstan as the main measures to eliminate the consequences of hunger and to provide food assistance to the starving population. Based on archival documents and collections of materials, the authors managed to identify that the state has worked out several ways to help the hungry in order to eliminate the consequences of hunger. First, it is the provision of food, industrial goods and loans to starving areas. Secondly, the issuance of permits for the maintenance of livestock in settled areas to restore livestock production, and thirdly, a reduction in the grain delivery plan, or exemption from it, as well as a reduction or exemption from the unified agricultural tax. Using the example of the Nurinsky district, the authors analyze the implementation of the main decisions of state authorities to eliminate the consequences of famine. The authors of the article conclude that despite the fact that the state handed over wheat, millet and other food support to the hungry, the assistance provided was not insufficient and was delayed. The authors, having studied materials of the archival fund of the Nurinsky district, identified a list of collective farms that received food aid in the form of grain, wheat and other crops, and came to the following conclusion. Firstly, the food aid provided by the state turned out to be late, since at the time of its arrival, famine reached its peak, farms fell into decline, the population died out, and the survivors were forced to migrate; secondly, the amount of aid provided by the state was insufficient to solve the food problem; thirdly, food aid was distributed not only without taking into account the size of farms, but also not for their intended purpose; fourthly, the state authorities failed to correct the current situation in the Kazakh villages.

Justitia ex machina: The impact of an AI system on legal decision-making and discretionary authority

Governments increasingly use algorithms to inform or supplant decision-making. Artificial Intelligence systems in particular are considered objective, consistent and efficient decision-makers, but have also been shown to be fallible. Furthermore, the adoption of artificial intelligence (AI) in government is fraught with challenges which are only partly understood and rarely studied in practice. In this paper, we draw on science and technology studies and human computer interaction and report on a critical case study of the development and use of an AI system for processing traffic violation appeal at a Dutch court. Although much empirical work on algorithms in practice is primarily observational in nature, we employ a canonical action research approach and actively participate in the development of the AI system. We draw on data collected in the form of interviews, observations, documents and a user-experiment. Based on this material we provide: 1. An in-depth empirical account of the tensions between street-level bureaucrats, screen-level bureaucrats and street-level algorithms; 2. An analysis of the differences between decisions made by, with and without the AI system and find that use of the AI systems impacts decisions made by legal experts; 3. A confirmation of earlier work that finds AI systems can best be applied in support of legal-decision making and demonstrate how the decision-making process of the traffic violation cases may mitigate some of the risks of algorithmic decision-making.

How Being Outvoted by AI Teammates Impacts Human-AI Collaboration

Recent advances in artificial intelligence (AI) enable AI agents to go beyond simply supporting human activities and, instead, take more control in team decision-making. While significant literature has studied human-AI collaboration through the lens of AI as a “second opinion system,” this type of interaction is not fully representative of many human-human team collaboration scenarios, such as scenarios where each decision maker is granted equal voting rights for the team decision. In this research, we explore how imparting AI agents with equal voting rights to the human impacts human-AI decision-making and team performance. Using a human subjects experiment in which participants collaborate with two AI teammates for truss structure (aka, bridge) design, we manipulate a series of voting scenarios (e.g., AI agents outvoting the human vs. AI agents agreeing with the human) and AI performance levels (high vs. low performing). The results indicate that changes in human self-confidence are not consistent with whether the quality of the final team-voted design action is advantageous or disadvantageous relative to their own actions. The results also show that when humans are outvoted by their AI teammates, they do not show strong negative emotional reactions if the team-voted decision has an advantageous outcome. Additionally, AI performance significantly influences the human-AI team decision-making process and even one low-performing AI (i.e., an AI that is frequently incorrect) on the team can significantly deteriorate team performance. Taken together, this research provides empirical evidence on the effects of AI voting with equal decision authority on human-AI collaboration, as well as valuable insights supporting real-world applications of human-AI collaboration via voting.

(Joint) Bank Savings, Female Empowerment, and Child Labor in Rural Ethiopia

Abstract This study examines whether the random allocation of single and joint savings accounts to cash crop farmers in rural Ethiopia is associated with increased savings and changes in decision-making authority and control over resources that could ultimately affect child labor and schooling resource allocations. Consistent with posited channels of intrahousehold bargaining models, women from households assigned to the joint saving treatment group show significant gains in autonomy and control of savings resources, broader financial empowerment, and increased labor participation. Positive effects on school participation and attendance are reported for girls, although point estimates are measured imprecisely. In a setting where schooling and child labor are not mutually exclusive, children work more when joint deposit accounts are available. In the absence of impacts on household income, this increase in child labor is explained by complementarities between adult farm labor and child labor in the household production function, which is reinforced by lumpy investments in labor-intensive agricultural inputs that likely increased the opportunity costs of children's time.

Prognostic clinical decision support for pneumonia in the emergency department: A randomized trial.

Hospitalization rates for childhood pneumonia vary widely. Risk-based clinical decision support (CDS) interventions may reduce unwarranted variation. We conducted a pragmatic randomized trial in two US pediatric emergency departments(EDs) comparing electronic health record (EHR)-integrated prognostic CDS versus usual care for promoting appropriate ED disposition in children (<18 years) with pneumonia. Encounters were randomized 1:1 to usual care versus custom CDS featuring a validated pneumonia severity score predicting risk for severe in-hospital outcomes. Clinicians retained full decision-making authority. The primary outcome was inappropriate ED disposition, defined as early transition to lower- or higher-level care. Safety and implementation outcomes were also evaluated. The study enrolled 536 encounters (269 usual care and 267 CDS). Baseline characteristics were similar across arms. Inappropriate disposition occurred in 3% of usual care encounters and 2% of CDS encounters (adjusted odds ratio: 0.99, 95% confidence interval: [0.32, 2.95]). Length of stay was also similar and adverse safety outcomes were uncommon in both arms. The tool's custom user interface and content were viewed as strengths by surveyed clinicians (>70% satisfied). Implementation barriers include intrinsic (e.g., reaching the right person at the right time) and extrinsic factors (i.e., global pandemic). EHR-based prognostic CDS did not improve ED disposition decisions for children with pneumonia. Although the intervention's content was favorably received, low subject accrual and workflow integration problems likely limited effectiveness.Clinical Trials Registration: NCT06033079.

Indigenous peoples and the power(lessness) of public participation: Assessing effects of Indigenous community input in the Alaskan Coastal Plain oil and gas leasing program environmental impact statement

Public participation in the U.S. environmental impact assessment process is legally required under the National Environmental Policy Act, yet the procedural norms of the process often leave members of the public feeling powerless. While public participation has the appearance of a democratic process, it is imbued with unequal power dynamics and federal agencies maintain decision-making authority. Despite sovereignty and treaty rights, Indigenous communities in the U.S. do not participate in environmental decision-making through a collaborative governance structure. Instead, Indigenous communities interested in project impacts primarily voice their concerns through the public comment process. This paper explores Indigenous participants’ impacts on environmental impact decision-making through an illustrative case study structure. The phenomenon is explored in an in-depth analysis of the recent leasing environmental impact statement (EIS) for oil exploration and development in the 1002 Coastal Plain area of the Arctic National Wildlife Refuge in Alaska. This work uses a qualitative content analysis of the Coastal Plain case study to assess how public comments, particularly comments from Indigenous peoples, impact change in the documents that follow public participation processes. From this analysis, this article aims to illustrate a few key issues with how Indigenous input is considered in public participation processes. Findings indicate that public comments may result in minor changes to assessment documents but, overall, public input has little influence on project outcomes.