Decisional Contexts Research Articles

Understanding Farmers’ Adoption of Sustainable Agriculture Innovations: A Systematic Literature Review

Adoption of sustainable agriculture innovations is acknowledged to be an effective response to agro-ecological challenges, such as climate change, pests, drought, natural catastrophes, and food insecurity. However, its level of dissemination is still low across the world, particularly in the Global South. There is a need for a better understanding of the adoption determinants of these innovations in order to enhance them. This paper presents a systematic literature review focused on the use of sociopsychological determinants to understand the adoption of sustainable agriculture innovations, combining conventional bibliometric analysis with the method of vote-count. This method enabled an evaluation of the ability of the determinants considered by the models, as well as respective sociopsychological constructs, to explain the innovation adoption. Our results show a significant growth in the research employing theory and models built on sociopsychological factors to understand the decision-making processes undertaken by farmers in the context of the adoption of sustainable agriculture innovations. The development of statistical models and techniques, such as the structural equation model (SEM), has facilitated the inclusion of a growing set of sociopsychological variables. However, our review highlights that the selection of the sociopsychological constructs used by research to explain farmers’ adoption of sustainability innovations relies mainly on constructs defined for other decisional contexts, such as the adoption of innovations by firms in other sectors. Hence, the low ability evidenced by the models to explain farmers’ adoption behavior is due to a poor selection of constructs. The review highlights that this poor selection is a result of repetition of constructs, such as attitude, subjective norms, and little inclusion of other relevant constructs such as knowledge. The paper suggests the need for a better selection of the innovation determinants and measurement of respective constructs adjusted to the case of agriculture and the specificities of the diverse geographical farming contexts.

Consent, capacity, and client sexuality policies in healthcare.

Healthcare organizations face significant ethical complexity when developing policies related to the sexual activities of clients within their facilities. On one hand, admission to healthcare facilities should not require clients to abstain from all sexual activity. On the other hand, clients' sexual activities within facilities have implications for other people, and many clients may be at risk of sexual mistreatment. In response, organizations may be tempted to approach their clients' decisions about sexual activity on the model of decisions about medical treatment. In this article, we argue that this approach is more ethically problematic than it may first appear. We review asymmetries between the decisional contexts of medical treatment and sexual activity and argue that those asymmetries generate ethical issues for any policy that treats clients' decisions about sex as analogous to decisions about treatment. We also offer suggestions for the development of ethically justifiable policies related to client sexuality.

Dynamic scheduling of manufacturing systems: a product-driven approach using hyper-heuristics

ABSTRACT Dynamic scheduling of manufacturing systems is encountered in many real-world industries such as the food and pharmaceutical industries. The scheduling of these systems must not only be efficient but also reactive to cope with dynamic job arrivals and machine breakdowns. Over the last decade, products within Product-Driven Control Systems (PDCS) have become smart entities capable of actively handling the manufacturing process. In this paper, a PDCS based on the design of Smart Products is proposed. A generic model of the decisional strategy allows Smart Products to characterize different decisional contexts and thus switch efficiently from one scheduling rule to another using a novel Hyper-Heuristics (HH) based approach. The implementation and testing of the proposed PDCS on hybrid flexible flow-shops with multiple constraints inspired by the pharmaceutical industry are presented. The comparative study with 168 combinations of scheduling rules from the literature highlighted the superiority of the HH to minimize the Mean Completion Time. Furthermore, the proposed approach enhanced both the global performance and the reactivity of the manufacturing control system.

Skills-based intervention to enhance collaborative decision-making: systematic adaptation and open trial protocol for veterans with psychosis

BackgroundCollaborative decision-making is an innovative decision-making approach that assigns equal power and responsibility to patients and providers. Most veterans with serious mental illnesses like schizophrenia want a greater role in treatment decisions, but there are no interventions targeted for this population. A skills-based intervention is promising because it is well-aligned with the recovery model, uses similar mechanisms as other evidence-based interventions in this population, and generalizes across decisional contexts while empowering veterans to decide when to initiate collaborative decision-making. Collaborative Decision Skills Training (CDST) was developed in a civilian serious mental illness sample and may fill this gap but needs to undergo a systematic adaptation process to ensure fit for veterans.MethodsIn aim 1, the IM Adapt systematic process will be used to adapt CDST for veterans with serious mental illness. Veterans and Veteran’s Affairs (VA) staff will join an Adaptation Resource Team and complete qualitative interviews to identify how elements of CDST or service delivery may need to be adapted to optimize its effectiveness or viability for veterans and the VA context. During aim 2, an open trial will be conducted with veterans in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) to assess additional adaptations, feasibility, and initial evidence of effectiveness.DiscussionThis study will be the first to evaluate a collaborative decision-making intervention among veterans with serious mental illness. It will also contribute to the field’s understanding of perceptions of collaborative decision-making among veterans with serious mental illness and VA clinicians, and result in a service delivery manual that may be used to understand adaptation needs generally in VA PRRCs.Trial registrationClinicalTrials.gov Identifier: NCT04324944

Navigating decisional conflict as a family when facing the decision of stem cell transplant for a child or adolescent with sickle cell disease

ObjectivePatients with sickle cell disease (SCD) face unpredictable disease, with stem cell transplant being a curative treatment option with risks. The aim of this study was to describe the level and source of decisional conflict in families of children/adolescents with SCD facing a transplant decision. MethodsA multiple-case study approach described decisional conflict in various SCD severity/donor risk decisional contexts. Cases included parents, child/adolescent with SCD, and sibling donor. The level and source of conflict was measured via O’Connor’s Decisional Conflict Scale and analyzed using pattern-matching and cross-case synthesis. In-depth descriptions of conflict sources were obtained through thematic analysis of observation and interview data. ResultsAmong 11 participants in four cases (i.e. family units) decisional conflict was not unique not to the decisional context. Conflict levels represented a level that can be linked with feeling unsure and decisional delay. The theme, ‘navigating decisional conflict together’, described how family units discussed uncertainties. ConclusionVarying levels and sources of decisional conflict exist in pediatric patients with SCD and their families considering transplant. Practice ImplicationsIn our cases, decisional conflict and the transplant decision occurred at the family-level. Clinicians should encourage all family members to participate in discussions concerning transplant.

Ambivalent about travel mode choice? A qualitative investigation of car user and non-car user attitudes

• Semi-structured in-depth interviews explored attitudinal complexity of above-average mileage car users and non-car users. • Thematic analysis revealed attitudinal ambivalence and context-dependent variability of transport-relevant evaluations. • Identified specific situations in which ambivalence is salient. • Highlighted the complexity of aspects of transport convenience and inconvenience. • Findings suggest that specific survey questions may be prone to ambiguity. Attitudes towards travel mode choice have been regarded as bi-polar evaluations of travel options that remain stable across time and context. Intra-personal attitudes can be variable, becoming more or less salient and changing in strength or valence across decisional contexts. This study draws on theoretical underpinnings of attitudinal ambivalence, which proposes that a person can hold two-dimensional (negative and positive) evaluations about one attitude object simultaneously. The present research aimed to explore attitudinal ambivalence in relation to travel modes and examine the variability of attitudes in different contexts. Thirty semi-structured interviews explored above-average mileage car users’ (n = 15) and non-car users’ (n = 15) experiences of attitudinal ambivalence in relation to various transport modes and under which circumstances. Thematic analysis found support for attitudinal ambivalence and context-dependent attitude variability in relation to travel mode evaluations. Discussions of an a priori questionnaire confirmed the malleability of transport-relevant attitudes. Transport-relevant attitudes are complex and ambivalent. Attitudinal ambivalence and context-dependent attitude variability has implications for transport research design, interventions targeting travel-related attitudes and policies aimed to reduce single-occupancy driving.

Divergent Thinking: The Role of Decision-Making Styles

ABSTRACT Divergent thinking involves the ability to find many different and new responses or solutions to open-ended problems. The ability to think divergently has been associated with different cognitive processes, including intuitive and rational thinking styles. However, research has not specifically addressed the extent to which divergent thinking is associated to decision-making styles, which involve habits to react in a certain way in specific decisional contexts. The present study was devoted to explore the relationships between verbal and visual divergent thinking, assessed using the Torrance Test of Creative Thinking, and decision-making styles (e.g., rational, intuitive, dependent, avoidant, and spontaneous), assessed using the General Decision-Making Style inventory. The scores of both verbal and visual divergent thinking (e.g., fluency, flexibility, originality; elaboration only for visual divergent thinking) were converted in z-scores and summed separately in order to get verbal and visual composite creative indices. Results revealed that only and rational decision-making style predicted both creative indices. This finding confirms the key role of rationality during the creative process. Possible explanations for the lack of significance of intuitive decision-making style are presented. Future research directions are also discussed.

The power of anticipated regret: Predictors of HPV vaccination and seasonal influenza vaccination acceptability among young Romanians

BackgroundUnderstanding lay perceptions concerning vaccination and identifying the most important psychological determinants of vaccine acceptability are relevant for health promotion campaigns. MethodsThis cross-sectional study aimed to identify the psychological determinants of HPV vaccine and seasonal flu vaccine acceptability in a national sample of young adults. An extended version of the health belief model (HBM) provided the main theoretical framework. Four hundred and one adults aged 18–26 (79% women), completed the theory-based survey and were included in analyses. The main outcomes were intentions to vaccinate against HPV and the seasonal flu. Descriptive statistics, bivariate correlations and hierarchical multiple regression were used for data analysis. ResultsThe models predicted 51% and 60% of the variability in intentions to vaccinate against HPV and the seasonal flu, respectively. For both decisional contexts, anticipated inaction regret (assuming one were unvaccinated and later contracted infection) was the strongest predictor of intentions, contributing above and beyond the role of traditional risk belief constructs (HBM constructs). Other shared predictors of intentions were perceived effectiveness of vaccine, perceived vaccine safety, perceived susceptibility to disease and previous vaccine refusal. The study also provides insights into young adults’ vaccine-related knowledge and their information-seeking practices. ConclusionFindings outline directions for future research and implications for health communication campaigns.

Challenges for local adaptation when governance scales overlap. Evidence from Languedoc, France

In coastal areas around the world, actors are responding to multiple global changes by implementing adaptation plans, often confined within a single-focal perspective with few explanations of targeted changes and cross-scale interactions. To better anticipate the raising coordination issues and the potential feedbacks generated by adaptation in these complex social-ecological systems where governance scales overlap, we used the robustness framework (Anderies et al. 2004; Anderies 2015). We analyzed a case study along the Languedoc coastline in southern France, where governance is organized in multiple jurisdictions which we considered as interlinked adaptation situations. We identified three interacting changes impacting adaptation: demographic growth, climate change, and large-scale political changes, such as decentralization. We used the examples of land-use planning and coastal management to illustrate the major coordination challenges facing the implementation of adaptation plans in coastal areas by various intertwined communities. In the example of land-use planning, adaptation is impacted by miscoordination between multiple sectors that all rely on a shared resource, land, thus putting more pressure on the decision-makers to make explicit trade-offs between multiple issues. Coastal management illustrated how emerging adaptation strategies created new interdependencies in the system and how these were hardly considered due to confusion in the devolution of responsibility between multiple jurisdictions. In both examples, using coupled and evolving robustness diagrams was helpful in revealing renewed fragilities, foreseeing consequences of adaptation in inter-related decisional contexts, and promoting collective action to redefine the boundaries of adaptation situations and their coordination to cope with converging changes along coastlines.

Decision-Making in the Moments Before Death: Challenges in Prehospital Care

Background: The primary charge of Emergency Medical Services (EMS) is to save lives. However, EMS personnel are frequently called to scenes where prolonging life may not be the primary goal. When someone is nearing death, family members may feel compelled to call 9-1-1 because they are feeling uncertain about how to manage symptoms at the end of life. Objective: We sought to explore prehospital providers’ perspectives on how the awareness of dying and documentation of end-of-life wishes influence decision-making on emergency calls near the end of life. Methods: The study design was exploratory, descriptive, and cross-sectional. Qualitative methods were chosen to explore participants’ perspectives in their own words. In-depth in-person interviews were conducted with 43 EMS providers. Interviews were audio recorded and professionally transcribed. Interview transcripts were entered in Atlas.ti for data management and coding. The analysis was deductive and guided by a conceptual model of 4 contexts of end-of-life decision-making that is not setting-specific, but has been applied to prehospital care in this study. Results: The findings illustrate the relationship between awareness of dying and documentation of wishes in EMS calls. The 4 decisional contexts are: (1) Awareness of Dying-Wishes Documented: Families were prepared but validation and/or support was needed in the moment; (2) Awareness of Dying-Wishes Undocumented: EMS must initiate treatment, medical control guidance was needed; (3) Unaware of Dying-Wishes Documented: Shock, expectation that EMS can stop the dying; and (4) Unaware of Dying-Wishes Undocumented: Families were unprepared, uncertain, frantic. Each context is illustrated by representative quotes from participants. Discordance and conflict was found in each decisional context. Conclusions: This study illustrates that EMS providers are acutely aware of the impact of their decisions and actions on families at the end of life. How emergency calls near the end of life are handled influences how people die, whether their preferences are honored, and the appropriate use of ambulance transport and ED care. The findings highlight how the intersection of awareness of dying and documentation of wishes influence prehospital decision-making in end-of-life emergencies and demonstrate the key role EMS providers have in this critical period.

Validation of the Decisional Conflict Scale for Evaluating Advance Care Decision Conflict in Community-dwelling Older Adults

PurposeDecisional conflict is a significant and important barrier in end-of-life care planning, and it is often encountered in health professionals' discussions with patients and their families. Little is known about the measurement of decisional conflict, and existing measures are not suitable for all contexts. In this study, psychometric properties of the Decisional Conflict Scale, which was translated for the first time into Korean [Korean version of DCS (K-DCS)], were examined. MethodsA sample of 273 community-dwelling elders was surveyed (mean age: 77.26 years; 80.2% women). Internal consistency reliability and stability reliability were tested by calculating Cronbach α and Pearson's correlation coefficients. Exploratory factor analysis and logistic regression analyses were performed to test validity. ResultsReliability of the K-DCS was acceptable with Cronbach α =.87; test-retest correlation r = .76. Factor analysis showed a two-factor structure with nine items: informed/values clarity and uncertainty. Concordance between K-DCS and the four treatment directives was significant (kappa values ≥.78). Controlling for age and gender, those with decision implementation were more likely to implement their decisions on tube feeding (odds ratio = 5.15, p = .033) and hospice care (odds ratio = 2.83, p = .017). ConclusionThe K-DCS appears to be a valid measure to evaluate decisional conflict about advance directives in community-dwelling Korean older adults. Further validation of the K-DCS is warranted, though caution should be exercised in using subscales because of differences in decisional contexts.

The Nexus Between the Documentation of End-of-Life Wishes and Awareness of Dying: A Model for Research, Education and Care

The convergence of medical treatment that can extend life with written medical orders that make it possible to refuse such treatment brings the differential dynamics of contemporary end-of-life decision making into sharp focus. Communication between families and clinicians can be confusing, uncertain, and pressured when death is imminent. These situations create distress that ultimately influences the end-of-life experience for people who are dying and those who care for them. This article presents the analysis of the decisional dynamics that emerge from the intersection of the patient-family-provider awareness that death is near with the presence or absence of documentation of expressed wishes for end-of-life care. A heuristic analysis was conducted with data from three studies about urgent decision making at the end of life. Original study data included 395 surveys, in-depth interviews with 91 prehospital (paramedics and emergency medical technicians), and content analysis of 100 Medical Orders for Life Sustaining Treatment forms that led to the development of an overarching conceptual model of decision making. Four decisional contexts emerged from the intersection of awareness of dying and documentation of wishes: 1) Aware Documented, 2) Aware Undocumented, 3) Unaware Documented, and 4) Unaware Undocumented. This generalizable model, which is agnostic of setting, can help clinicians more astutely recognize the clinical situation when death is imminent, assess patients and caregivers, and intervene to help focus conversation and direct decision making. The model can also inform research, education, and care for people in some of the most vulnerable moments of life.

Adam Smith’s Theory of Prudence Updated with Neuroscientific and Behavioral Evidence

Other-perspective taking (OPT), distancing, time discounting as well as risk and loss aversion highly affect decision-making. Even though they influence each other, so far these cognitive processes have been unrelated or only partly related to each other in neuroscience. This article proposes a philosophical interpretation of these cognitive processes that is elaborated in the updated theory of Adam Smith’s prudence (UTSP). The UTSP is inspired by Smith’s account of prudence and is in line with the neuroscientific and behavioral studies on OPT, distancing, time discounting as well as risk and loss aversion. The UTSP represents a framework aiming to interpret and connect these cognitive processes and providing a consistent and empirically sound account of a “Smithianly” prudent style of decision-making. The two pillars of the UTSP are the shift of perspective in space and time (from the individual to others and from the present self to the future self) and loss aversion. On the basis of this theory, a normative updated theory of Smithian prudence is outlined (NUTSP). The latter is useful for moral philosophy for two reasons: firstly, according to preliminary evidence, it is effective in guiding the agent in decisional contexts in which her well-being is at stake and she can affect other people with her actions. Secondly, since the NUTSP is based on neuroscientific findings on decision-making, it has a sound empirical basis that prevents a source of alienation for the agent.

How Can the Context Affect Policy Decision-Making: The Case of Climate Change Mitigation Policies in the Greek Building Sector

The influence of context dynamics in the course of the climate change mitigation policy instruments’ (PIs) deployment cycle, usually causes a need for policy adaptation mechanisms to ensure that policies can meet the sector needs efficiently and effectively. In this paper, we argue that important contextual factors are the ones that are perceived to have a great impact over policy effectiveness by key related actors. By examining more thoroughly those effects over PIs, as perceived by policy and market actors, useful feedback on observed policy adaptations can be highlighted. In this context, the aim of this paper is to present a conceptual framework which seeks to investigate the impact of key external factors on policy decision-making. This framework is then applied to policies intended to foster sustainability in the Greek building sector. Contextual parameters that are influential over the effectiveness of the national energy conservation measures are identified through a stakeholder survey. Cluster analysis is then employed for the elicitation of three distinct decision-making priorities’ scenarios. General macroeconomic trends, energy costs, characteristics of the building sector and socio-institutional factors are prioritized differently from various types of actors and induce certain types of PI changes. Distinguishing among the different types of PI change can help explain better under which contextual circumstances policy adaptations occur and provide guidance to other policy makers when found in similar decisional contexts.

La parità di genere "assistita"

Over the past few years, a conspicuous number of countries has begun coping with the issue of gender inequality trying to delineate possible solutions. Concerns have been raised by the scarce share – and in many case lack – of women active in the legislative assemblies at different levels of government and in the decisional contexts where the fundamental and the most influential decisions spilling over the different life areas of a country are normally taken. Italy has been characterized by an underlining situation of backwardness in the last years, keeping still while the rest of the world was issuing laws to sustain a gender balance in the political scene. The approval of the 2015/2012 law was the turning point. This law transferred on the municipal level some of the mechanisms protecting the gender balance already in place at the regional level, in particular the double gender preference and the minimum gender threshold needed to form the electoral rolls. Starting with the adoption of this law, the Italian legislator showed the will of introducing at all governing levels instruments aimed at guaranteeing fair and equal opportunities of accessing the local political institutions for both men and women. This paper aims at demonstrating the positive impact unfolded by the 215/2012 law and the first article, paragraph 137 of the so-called Delrio's law on the equilibrium of gender of candidates, elected and appointed people during the municipal elections of May 2014. The research upon which the article is based has been conducted on a sample of 25 cities analysing and comparing the electoral results of the 2014 with the results of the previous elections (when no instruments of gender quality were applied).

Reservations about likelihood ratios (and some other aspects of forensic 'Bayesianism')

The focus of the article is the application of modern Bayesianism in the context of forensic science, as advocated by many in England and Europe. The article reviews the many aspects of modern Bayesianism that extend well beyond the analytic truth of Bayes’s Theorem, and focuses, among other things, on the limits of what can be accomplished by the invocation of ‘subjective’ probabilities. In a sense, all probabilities are subjective, since they are all mind dependent. However, the important issue in forensic contexts, as in others, is not the subjective nature of invoked probabilities, but the characteristics of the belief warrant to be required for them in different decisional contexts.

Some Reservations About Likelihood Ratios (and Some Other Aspects of Forensic Bayesianism)

This paper is an expansion of a talk given at the 8th International Conference on Forensic Inference and Statistics in Seattle, July 19, 2011. The focus of the paper is the application of modern Bayesianism in the context of forensic science, as advocated by many in England and Europe. The paper reviews the many aspects of modern Bayesianism that extend well beyond the analytic truth of Bayes’s Theorem, and focuses, among other things, on the limits of what can be accomplished by the invocation of “subjective” probabilities. In a sense, all probabilities are subjective, since they are all mind dependent. However, the important issue in forensic contexts, as in others, is not the subjective nature of invoked probabilities, but the characteristics of the belief warrant to be required for them in different decisional contexts. In the end, I find myself drawn to forensic Bayesianism, but not fully converted.

Uncertainty and its perception: experimental study of the numeric expression of uncertainty in two decisional contexts

According to a consolidated tradition of research about the psychology of decisions (Newell et al. 2007) and the psychometric psychology (Sartori 2008), the present study aims at analysing the preferences of individuals between the main numeric expressions of uncertainty: the probabilistic form (expressed by percentages) and the fractional form (expressed by fractions). The purpose is to verify a different management of credit on the basis of a different expression of the representation of risk. The scientific outline refers to the most relevant studies in the field of decision making, which show the demonstrations and the experiments carried out by different authors starting from the investigations by Kahneman and Tversky. These results joined in their most accredited two theories: the Framing Effect and the Cumulative Prospect Theory, an evolution of the Prospect Theory. The following survey is designed to experimentally demonstrate the change in preferences on the basis of a different numeric representation of uncertainty. The study considers a generic sample of 100 individuals who were submitted two questionnaires especially designed. The obtained data were drawn up with statistic means in order to find out common norms in decision-making processes. The results showed the tendency of individuals to assign a different preference on the basis of the numeric representation, probabilistic or fractional. Referring to this feedback, one hypothesis is proposed as well as a new theory linked to the informative context of the options is presented.

Commentary on Development of a Support Tool for Complex Decision-Making

Hearns, Klein and colleagues set out to develop a maternity care decision-making tool for the British Columbia Northern Health Authority to assist with assessing community needs and values. They are to be commended for thinking outside the traditional decision-making approach which focuses, as they say, on “administration, fiscal and safety issues. Solutions often follow previously made decisions … [because] this approach is less time-consuming, simpler and safer.” They go on to point out the problems with this approach, such as minimal engagement of community members or representation of their interests, potentially resulting in disempowerment and bitterness. They claim that their process rectifies this lack of engagement:

Health decision making: lynchpin of evidence-based practice.

Health decision making is both the lynchpin and the least developed aspect of evidence-based practice. The evidence-based practice process requires integrating the evidence with consideration of practical resources and patient preferences and doing so via a process that is genuinely collaborative. Yet, the literature is largely silent about how to accomplish integrative, shared decision making. for evidence-based practice are discussed for 2 theories of clinician decision making (expected utility and fuzzy trace) and 2 theories of patient health decision making (transtheoretical model and reasoned action). Three suggestions are offered. First, it would be advantageous to have theory-based algorithms that weight and integrate the 3 data strands (evidence, resources, preferences) in different decisional contexts. Second, patients, not providers, make the decisions of greatest impact on public health, and those decisions are behavioral. Consequently, theory explicating how provider-patient collaboration can influence patient lifestyle decisions made miles from the provider's office is greatly needed. Third, although the preponderance of data on complex decisions supports a computational approach, such an approach to evidence-based practice is too impractical to be widely applied at present. More troublesomely, until patients come to trust decisions made computationally more than they trust their providers' intuitions, patient adherence will remain problematic. A good theory of integrative, collaborative health decision making remains needed.