Decision Elements Research Articles

The role of value-based healthcare in decision-making by executives in hospitals in the Netherlands: A nationwide evaluation

ABSTRACT Background This observational study investigates the role of value-based healthcare (VBHC) principles in executive decision-making in Dutch hospitals. Methods A total of 379 questionnaires were sent to executives in 69 Dutch hospitals. The survey included questions prioritizing VBHC and other elements in decision-making and the weight and frequency at which each VBHC element was considered. Results Responses were received from 82.6% of hospitals (57/69) and 26.9% of executives (102/379). ‘Clinical outcomes’ and ‘costs’ were most often considered in decision-making whereas ‘integration of care delivery across separate facilities’ and ‘bundled payments’ were considered the least. VBHC was reported as being considered in decision-making 8 out of 10 times and was given a median score of 8 out of 10. Members of the board of directors placed a higher priority on ‘clinical outcomes’, ‘internal politics’, ‘the ambition of healthcare professionals’ and ‘integrating care delivery across separate facilities’ and perceived that they include these elements more frequently than other direct colleagues. Conclusion This study reveals that, although VBHC is generally considered in managerial decision-making, ‘clinical outcomes’ and ‘costs’ predominantly have priority. Action must be taken to ensure executives implement all VBHC elements in decision-making to maximize the effects of VBHC.

Low-power Relaxation Oscillator with Temperature-compensated Thyristor Decision Elements

This paper presents a low-power 140 kHz relaxation oscillator (ROSC) for low-frequency clock generators and timers. In voltage-mode ROSCs, unavoidable shunt current consumption results from voltage slewing at the integration capacitor. The proposed circuit employs CMOS thyristor-based decision elements which effectively reduce shunt currents by exploiting internal positive feedback. A complementary-to-absolute temperature (CTAT) current reference compensates for the frequency’s temperature sensitivity. In order to achieve high negative temperature coefficient with small area and power overhead, the circuit reuses parts of the positive-to-absolute temperature (PTAT) bias generation block. Moreover, a modified start-up circuit with 3 times faster oscillator power-on is presented. The 0.09 mm{}^2 oscillator consumes 6.5 nW/kHz at 1.5 V to 2.5 V supply if only the CTAT source is considered, resulting in a power consumption of 907.4 nW at 140 kHz. The measured temperature coefficient of -514.7 ppm/K in the range of −40 °C to 85 °C shows an improvement of 5.5 times compared to the uncompensated case. A supply sensitivity of 2.62 %/V, a frequency resolution of 2.67 kHz/step, and an average clock jitter of 6.02 ns are achieved. The oscillator is embedded in an ultra-low power system-on-chip for autonomous environmental sensing.

Legal Regulation of Deep Synthesis Technology in the Context of Artificial Intelligent Systems: The Case of China and Russia

Artificial Intelligent systems are the one of the leading technologies that is closely related to the potential of the Internet of Things within the framework of the Industry 4.0 concept. A new round of development of technologies requires the timely and full legal regulation of relevant social relations. The study is devoted to the investigation of Artificial Intelligence within the field of law and in particular, to a comparative analysis of the Chinese and Russian legislation. China has already taken the first steps in reforming national legislation, while Russia is at the stage of active forming a legislative framework in this direction. The research purpose is to study the latest trends in the development of Chinese legislation regarding Artificial Intelligent systems, namely Deep Synthesis technology, as well as to analyze the possibility of implementing some regulatory solutions into Russian legislation. The research methodology is based on the theoretical analysis of the main legislative provisions concerning the regulation of Artificial Intelligence and Deep Synthesis technology. The legislation served as the informational base of the study. The scientific novelty lies in the formation of the authors' position regarding the possibility of borrowing certain elements of normative decisions: the definition of the legal status of Deep Synthesis and the subjects of relations related to the functioning of this technology, as well as the proposal of legislative consolidation of the classification of Artificial Intelligent systems, etc. The conducted research made it possible to identify the most ambiguous areas from the point of view of the legal consequences of the zones of implementation of the technology in question, as well as to set guidelines for the preventive measures’ development to minimise possible negative consequences.

Determinants of consumers’ purchase intention on digital business model platform: evidence from Ethiopia using partial least square structural equation model (PLS-SEM) technique

Online digital market platform business model designers, marketers, and retailers can further expand their marketing strategies to draw in and keep customers to gain a competitive edge globally if they are aware of the elements influencing consumers' purchasing intentions. The purpose of this research is to identify the crucial variables impacting Addis Ababa University, Graduating Engineering Students’ desire to purchase on online digital market platforms, and narrow the research gap on determinants of online purchase intention of Ethiopian consumers. This study adopted a descriptive and inferential survey design, epistemology assumption, and employed the positivism research philosophy approach to test the research hypotheses. The primary study technique used to collect relevant data was a closed-ended 5-point Likert scale questionnaire. The information was gathered from 100 Ethiopian, Addis Ababa University, graduating engineering students. With the use of SPSS version 23 and SmartPLS version 3.0 software, the data were examined using descriptive statistics and the inferential partial least square structural equation modeling (PLS-SEM) technique. The results of this study highlighted five useful decision-making elements that have an impact on the selected consumers' intention to buy on online digital market platforms including Website Design, Perceived Usefulness, Perceived Ease of Use, Trust, and Subjective Norms. The Practical Implication of this research is that with a clear understanding of the key determinants of consumers’ purchase intention on online digital market platforms; manufacturers, online marketers, and retailers can create effective market strategies, enhance technology, and make smart marketing choices that will help them gain global competitive advantage. This study is unique in that it uses a new conceptual research framework and the partial least square structural equation modeling (PLS-SEM) technique to analyze relationships between determinant variables and consumers’ intention to purchase on online digital market platforms. The major finding of this research provides empirical evidence towards the key determinant variables of consumers’ purchase intention on online digital market platforms. The small sample size is one of the limitations to generalize the finding of this research. Future studies should focus on enlarging the sample size and assessing more determinant variables to get a generalizable result.

Design, Simulation and Performance Evaluation of a Risk-Based Border Management System

Border control systems at Europe’s Schengen (and worldwide) borders are necessary to mitigate cross-border threats, but are perceived as free-traveling bottlenecks. Today’s applicable European regulations demand rule-based control schemes and do not allow risk-based elements. A policy shift towards risk-based border control has been considered in several studies and research (including HEU projects). However, there is a lack of scientific evidence on how they compare with existing rule-based schemes. This paper aims to fill that gap. The simulation allows design of a realistic border control system. The passenger flow is modeled via travelers with good and bad intents. The border control system includes decision-making elements to classify travelers into risk groups. System elements including operators and their interaction were modeled in terms of statistical distributions based on the subject matter experts’ input. The performance is estimated across security effectiveness, resource usage, passenger flow, and traveler experience. Assessment of a set of simulations reveals better scalability of risk-based systems in terms of resource usage and passenger flow. The potential factors to improve the detection rate of the border control process are also studied. Despite having several benefits, the model demonstrates that social acceptance of the risk-based system is the limiting factor for increased scalability.

A Delphi study to obtain consensus on medical emergency team (MET) stand-down decision making.

A medical emergency team (MET) stand-down decision is the decision to end a MET response and hand responsibility for the patient back to ward staff for ongoing management. Little research has explored this decision. This study aimed to obtain expert consensus on the essential elements required to make optimal MET call stand-down decisions and the communication required before MET departure. A Delphi design was utilised. An expert panel of 10 members were recruited based on their expert knowledge and recent clinical MET responder experience in acute hospital settings. Participants were emailed a consent form and an electronic interactive PDF for each survey. Two rounds were conducted with no attrition between rounds. The CREDES guidance on conducting and reporting Delphi studies was used to report this study. Consensus by an expert panel of 10 MET responders generated essential elements of MET stand-down decisions. Essential elements comprised of two steps: (1) the stand-down decision that was influenced by both the patient situation and the ward/organisational context; and (2) the communication required before actioning stand-down. Communication after the decision required both verbal discussions and written documentation to hand over patient responsibility. Specific patient information, a management plan and an escalation plan were considered essential. The Delphi surveys reached consensus on the actions and communication required to stand down a MET call. Passing responsibility back to ward staff after a MET call requires both patient and ward safety assessments, and a clearly articulated patient plan for ward staff. Observation of MET call stand-down decision-making is required to validate the essential elements. In specifying the essential elements, this study offers clinical and MET staff a process to support the handing over of clinical responsibility from the MET to the ward staff, and clarification of management plans in order to reduce repeat MET calls and improve patient outcomes. Minimal research has been focussed on the decision to hand responsibility back to ward staff so the MET may leave the ward with safety plan in place. This study provided expert consensus to optimise MET stand-down decision-making and the ultimate decision to end a MET call. Communication of agreed patient treatment and escalation plans is recommended before leaving the ward. This study can be used as a checklist for MET responder staff making these decisions and ward staff responsible for post-MET call care. The aim being to reduce the likelihood of potentially preventable repeat deterioration in the MET patient population. The CREDES guidance on conducting and reporting Delphi studies. None.

Supplier Selection Using the Analytical Hierarchy Process (AHP) Approach in Ma' Ipeh MSME

In the Analytical Hierarchy Process (AHP) method, a hierarchical structure chart is formed to be able to solve a complex and unstructured problem. Which aims to define a problem from the general to the specific. The problem hierarchy is structured to assist in a decision-making process by taking into account all decision elements involved in the system. Ma'Ipeh Micro, Small and Medium Enterprises (MSME) are one of the community industries that are engaged in onion processing, in order to be able to produce a product that is in accordance with the wishes of consumers. Until now, Ma'Ipeh MSME continue to maintain performance both in terms of products and suppliers. To keep things in good condition and continue to grow, it is necessary to select suppliers that are in accordance with the needs and criteria of MSME. The purpose of this study was to find criteria for selecting suppliers, determining the priority of onion suppliers, and determining follow-up on all other onion suppliers according to their performance. The method used in this research is the AHP. The AHP method is used for effective decision making on complex issues. The criteria used in selecting suppliers include price, quality, service and quantity determination. The results of calculations using AHP, obtained the onion supplier with the best value, namely supplier Saniyah with a weight of 0.951. The next priority supplier is Karim with a weight of 0.337, then Amelia with a weight of 0.279.

Retracted: Deep Learning for Decision Element Extraction in Fact Description of Legal Documents

Retracted: Deep Learning for Decision Element Extraction in Fact Description of Legal Documents

A Localized High-Fidelity-Dominance-Based Many-Objective Evolutionary Algorithm

The practicality of Pareto-dominance in solving many-objective optimization problems becomes questionable due to its inability to factor the critical Human Decision-making (HDM) elements, including, the number of better objectives, the degree of betterment in objectives, and objectives’ relative preference. Relevant dominance principles are recently proposed to incorporate the first two HDM elements, often with the need for new tunable parameters. This paper proposes a high-fidelity-dominance principle, that factors all the three HDM elements, explicitly and simultaneously, and without requiring tuning of any parameter. This principle has been implemented in a reference vector based framework, leading to a computationally efficient many-objective Evolutionary Algorithm (MaOEA), namely localized high-fidelity-dominance based EA (LHFiD). Critically, LHFiD also has an inbuilt mechanism for on-the-fly determination of the timing for: (a) intermittent nadir point estimation that enables faster convergence, and (b) its self-termination that bears practically utility. This paper is based on an extensive study involving 41,912 experiments, in which the proposed LHFiD approach is compared with existing competitive MaOEAs. The paper reports statistically better performance in about 60% instances, making it practical and worthy of further investigation and application.

Stripping path optimization decision-making of non-performing asset based on integration methods of SUMDII, fuzzy rough sets and PP

Aiming at the problem that manufacturing enterprises that rely more on asset projects currently lack effective means of divestiture of non performing assets, starting from incomplete information theory, this paper derives an optimal decision-making model for the divestiture path of non performing assets caused by the quality and safety crisis of manufacturing enterprises in an incomplete information environment, and uses the comprehensive method of SUMDII to establish a comprehensive integrated optimization model that reflects subjective evaluation and objective information. In addition, this study provides specific decision-making methods and implementation steps for optimizing the stripping path of non-performing assets. The empirical analysis results verify and demonstrate the feasibility, operability, accuracy, and applicability of the established model. The results show that the model designed in the study exhibits strong stability in sensitivity testing. When the parameter vectors are taken as (1,0,0,0), (1,1,0,0), (1,1,0,0), and (1,1,1,1), respectively, the ranking results corresponding to the first three parameter vectors are stable, all of which are A2 > A4 > A1 > A3. At the same time, the applied decision-making result of the model is A4 > A1 > A2 > A3, which is consistent with the best scheme evaluated by experts and superior to most comparative models. At the same time, in the analysis of decision-making characteristics, the research and design model has the most comprehensive review of decision-making elements, which is superior to other comparative models. It can be seen that the model designed by the research can lead to higher quality NPL divestiture schemes, which can help manufacturing enterprises improve asset quality and weaken the negative impact of the quality and safety crisis in manufacturing enterprises.

Exploring and Testing Wildfire Risk Decision-Making in the Face of Deep Uncertainty

We integrated a mechanistic wildfire simulation system with an agent-based landscape change model to investigate the feedbacks among climate change, population growth, development, landowner decision-making, vegetative succession, and wildfire. Our goal was to develop an adaptable simulation platform for anticipating risk-mitigation tradeoffs in a fire-prone wildland–urban interface (WUI) facing conditions outside the bounds of experience. We describe how five social and ecological system (SES) submodels interact over time and space to generate highly variable alternative futures even within the same scenario as stochastic elements in simulated wildfire, succession, and landowner decisions create large sets of unique, path-dependent futures for analysis. We applied the modeling system to an 815 km2 study area in western Oregon at a sub-taxlot parcel grain and annual timestep, generating hundreds of alternative futures for 2007–2056 (50 years) to explore how WUI communities facing compound risks from increasing wildfire and expanding periurban development can situate and assess alternative risk management approaches in their localized SES context. The ability to link trends and uncertainties across many futures to processes and events that unfold in individual futures is central to the modeling system. By contrasting selected alternative futures, we illustrate how assessing simulated feedbacks between wildfire and other SES processes can identify tradeoffs and leverage points in fire-prone WUI landscapes. Assessments include a detailed “post-mortem” of a rare, extreme wildfire event, and uncovered, unexpected stabilizing feedbacks from treatment costs that reduced the effectiveness of agent responses to signs of increasing risk.

Characterization of channelized turbiditic reservoirs using elastic properties modeling: An application in the Sergipe-Alagoas basin, Brazil

Sandy channelized reservoirs in deep water environments are significant for oil exploration and production. The 3D nature of the outcrops described in the literature and the local limitation of the information acquired through drilled wells are limiting factors for the reliable subsurface characterization of this type of sedimentary environment and its related heterogeneities. Aiming to overcome the information absence between the sampled well points in hydrocarbon reservoir studies, the 3D seismic data is a conventional approach adopted. However, due to the intrinsically low seismic resolution aspect, the usage of inverted seismic volumes enhances the confidence rock properties spatial distribution into the geological models, even though the uncertainties are not eliminated. This study presents a methodology of synthetic elastic properties modeling in association with measured physical properties, velocity, density and thickness to assess and optimize the geostatistical built model using real turbiditic reservoirs data of a Maastrichtian section of Calumbi Formation, in the Sergipe sub-basin, Brazil. It was successively tested geomorphological and geological features, as described in the previous work as well as similar Alagoas Sub-basin outcrops, associating their responses in terms of compressional and shear velocities, densities, and thicknesses, reducing uncertainties in the spatial distribution of them, which are present in high vertical-resolution well data. The obtained results show that compressional and shear waves variations are the main influences for the seismic signal and the related attributes rather than the intrinsically geometrical features. It was built a specific equation intending to model the effects of these attributes over the measured seismic data to identify paths to implement needed corrections in the geometric and faciological characteristics of the evaluated reservoir-rocks. They confirm the importance for better understanding of subsurface geological characterization using the seismic data as conditioning, even below the intrinsically data resolution, especially when dealing with seismic inversion. Additionally, the 1D synthetic model acts to do deal with tuning effect and to control the elastic property distribution avoiding misinterpretations that may suggest unfavorable portions for new well locations, enhancing the hydrocarbon production because it provides feasible elements for project decision-making.

Improved Causal Bayesian Optimization Algorithm with Counter-noise Acquisition Function and Supervised Prior Estimation

Causality is an important element in decision-making and interventions are required to optimize results of target values. In this paper, based on the model of Causal Bayesian Optimization, a counter-noise version of acquisition function is proposed and new prior estimation algorithms including Support Vector Regression, Ridge Regression and Random Forest are evaluated. This paper provides an improved framework to facilitate causal inference and optimization processes.

Does Black Lives Matter support moderate the effect of procedural justice on legitimacy? Testing the procedural justice invariance thesis

PurposeProcedurally just policing positively affects legitimacy regardless of differences in some demographic and neighborhood characteristics. Yet, less is known about how critical citizen views of police influence the effect of procedural justice on legitimacy. Citizen Black Lives Matter (BLM) support is an indicator of views toward police and provides a useful measure to test the procedural justice invariance thesis. The purpose of this study is to examine if BLM support moderates the effect of procedural justice on legitimacy.Design/methodology/approachData from a survey experiment of Americans (n = 363) are used to explore whether BLM support moderates the effect of procedural justice on legitimacy.FindingsResults suggest BLM support is negatively associated with encounter-specific perceptions of police legitimacy and provides tentative evidence suggesting BLM support moderates the effect of the decision-making element of procedural justice on legitimacy. Specifically, the interaction suggests that at higher levels of BLM support, procedurally unjust decision-making reduces legitimacy. However, there was little erosion of legitimacy among BLM supporters during procedurally just encounters.Originality/valueThis study tests the procedural justice invariance thesis in a BLM context. Results support an association between BLM support and encounter-specific perceptions of police legitimacy and provide preliminary evidence that the effect of procedural justice on legitimacy may vary by levels of BLM support.

A Port Entry Risk Assessment Model Based on Bayesian Networks and Elements of the e-Navigation Concept

Most maritime accidents are caused by human error. To reduce these errors, increase safety, protect the marine environment, reduce the administrative burden, and optimize maritime trade, the International Maritime Organization (IMO) decided to implement a concept called e-Navigation. The term e-Navigation refers to the integration of the most modern information and communication systems, both on board and ashore. The research scope of this work is the safety of navigation of the ship during the port entrance. Particularly in this case, the elements that affect the safety of the ship during port entrance are analyzed in a case study of New York port. An adaptive model based on the Bayesian Belief Network (BBN) was created, which evaluates the decision-making elements and risk assessment for port entry. The model is adaptable in the context of the different port requirements. With the presented model, all entities (ships, shipping companies, and service providers) have insight into the estimated decision to enter the port based on the given elements. Further research needs to be continued on the issue of comparing the proposed model with similar models, and how much reliance on the model burdens or facilitates the Master’s decision.

Rethinking student placement to enhance efficiency and student agency

Placement tests are used to support a particular need in a local context—to determine the best starting place for a student entering a specific programme of language study. This brief report will focus on the development of an innovative placement test with self-directed elements for our local needs at a university in Canada for students studying English or French as a second language. Our goals are to produce a more efficient assessment instrument while allowing students more agency through the process. We hope that sharing these details will encourage others to consider the potential of incorporating self-directed elements in low-stakes placement decision-making.

دور عنصر الشكل والاجراء في تحقيق شفافية القرار الاداري دراسة مقارنة

Transparency represents a value that must be in the administrative decision and preserved for its importance in preventing corruption and deviation in power, improving the relationship between the administration and the public, achieving satisfaction, obtaining rights, and enhancing public confidence. The element of form and procedure is one of the most effective elements of the administrative decision. The formalities and procedures imposed by the legislator have a key role in informing individuals of the content of the decision before it is issued, informing him of the reasons that prompted the administration to take it and determining the source of the decision, and providing other important guarantees for the individuals addressed by those decisions towards ensuring their right to defense, and adopting the best means of expressing the will to ensure the achievement of a great deal of transparency and openness.

Motivation as an Element of Managerial Decision Making in Manufacturing Companies: The Case of the Slovak Republic

On an international scale, it can be argued that the key currency of business entities is human resources. They are a dominant part of corporate assets. They are also decisive determinants of competitiveness if they work with adequate performance, which is influenced by motivation. Managers are aware of this and pay increased attention to the study of factors that increase the performance and motivation of employees. In Slovakia, the importance of human resources increased gradually after the transformation of the economy to market conditions; currently, the management of human resources corresponds to international standards. However, it is necessary to increase attention in the management of some areas that personnel managers have competence in. Motivation can be included among these. The submitted contribution deals with the motivation of employees, as the subject area is not sufficiently addressed in the conditions of the Slovak Republic. According to the analysis of motivational processes in selected manufacturing companies operating in Slovakia, changes are proposed in the motivational system to increase employee motivation. The aim is to reveal the important aspects of motivational policy. To achieve the research objective, a qualitative study of data collection was carried out using an unstructured questionnaire survey. A questionnaire was used to develop the hypotheses. After data collection, established hypotheses were tested using the chi-square test of independence. The data were analysed using descriptive and inferential statistics. According to the analysis, proposals for changes in the incentive system were developed. The recommendations are presented in the form of individual concrete proposals and measures in various areas within motivational processes, which, after implementation, have the potential to increase the level of employee motivation.

Climate-sensitive planning. Opportunities through the study of LCZs in Chile

Urban planning, through urban design and land use allocation, affects urban climate dynamics and patterns at different vertical layers of the urban boundary layer and spatial multiscale. Climate-sensitive urban planning and design draws attention to the consideration of climate parameters and their explanatory factors as a relevant element in decision-making. Local climate zones, defined from urban design variables such as building density and building height, allow for the recognition of homogeneous units useful for directing planning actions that allow cities and their population to adapt their climate behavior.This research compares the meso-scale climatic characteristics of the local climate zones proposed by Stewart and Oke for Chilean large cities located on an extensive latitudinal gradient (roughly 18°S to 45°S), on the coast of Chile and inland. In particular, the relationship between the behavior of surface temperature and vegetation is evaluated through the average Normalized Difference Vegetation Index (NDVI) for the decade (2008–2018). The results account for differences in the behavior of surface temperatures between climatic zones. In turn, vegetation is inversely related to the surface temperature, making it possible to distinguish the differences inside the LCZ, it being warmer in areas where the NDVI is lower.

Strategy, flexibility and performance: how cost leaders’ lack of structural flexibility negatively impacts nonfinancial performance

Purpose This study analyzes strategic flexibility with a two-dimensional approach (structural and decisional flexibility). It also investigates the relationships among competitive strategy, structural flexibility, decisional flexibility, and financial and nonfinancial performance.Design/methodology/approach The authors collected data from members of 16 chambers of commerce in the United States and used PLS-SEM (partial least squares structural equation modeling) to test the hypotheses.Findings The findings suggest that strategic flexibility impacts financial and nonfinancial performance in different ways. While financial performance is influenced by both the structural and decisional dimensions of strategic flexibility, nonfinancial performance is impacted only by structural flexibility. In addition, the research indicates a negative relationship between cost leadership and structural flexibility and positions structural flexibility as a mediator between cost-leadership and nonfinancial performance.Originality/value The authors contribute to strategic flexibility research in the following ways: (1) analyzed the impact on nonfinancial performance; (2) examined structural and decisional elements and (3) identified cost leadership as a potential barrier.