Hypothetical Scenarios Research Articles

A Bayesian inverse approach to proton therapy dose delivery verification

This study presents a proof-of-concept for a novel Bayesian inverse method in a one-dimensional setting, aimed at proton beam therapy treatment verification. Our methodology is predicated on a hypothetical scenario wherein strategically positioned sensors detect prompt- γ s emitted from a proton beam when it interacts with defined layers of tissue. Using these data, we employ a Bayesian framework to estimate the proton beam’s energy deposition profile. We validate our Bayesian inverse estimations against a closed-form approximation of the Bragg Peak in a uniform medium and a layered lung tumour.

Are social contracts possible without actual negotiation?

AbstractThis article addresses one of the several moral arguments for the state, the social contract argument, showing that this argument has been inadequately justified. The terms of any contract are determined by negotiation among the parties to the contract. The terms of any contract cannot be known absent actual negotiation to produce them. Social contract theorists widely believe that actual negotiation and actual agreement with a social contract did not occur, so their theories rest on hypothetical scenarios in which people would agree to the contract’s terms. Because actual negotiations did not produce a social contract, one cannot know its terms. This calls into question whether people could be obligated to abide by a social contract whose terms were not negotiated and hence are unknowable.

Hampered Monetary Policy Transmission ‐ A Supply‐Side Story?

AbstractThis paper shows that the supply side of credit is a major factor for hampered monetary policy transmission in monopolistic banking markets. Our stress test data containing projected interest rates of all 1,555 small and medium‐sized banks in Germany under two hypothetical scenarios provide a clear way to partial out demand shocks that are unrelated to monetary policy; we are thus able to show that while market power banks charge higher loan rates, they spare their borrowers a part of exogenous monetary policy contractions and withhold a substantial part of rising rates from their depositors. Because high market power banks are relatively more profitable, these banks could be able to insure their relationship customers against adverse shocks.

Impact of COVID-19 measures on psychosocial outcomes in Austria – a qualitative vignette study

Abstract During the COVID-19 pandemic, Austria implemented frequent and restrictive containment measures. We aimed to explore the perspectives of individuals affected by political and epidemiological decisions in Austria, particularly in Vienna and Lower Austria. A qualitative vignette-based study conducted from July to Oct 2023 utilized two hypothetical future pandemic scenarios to prompt in-depth discussions in semi-structured interviews with Austrian residents about their perspectives, either private or from the fields of healthcare, education, citizen representation, business, research, public health and politics. Interview data was analysed using a thematic analysis approach. To ensure results’ rigor and accuracy, we followed the COREQ guideline and included two citizen research partners. This project is funded by WWTF (Grant ID: LS22071). Preliminary thematic analysis from 28 interviewees (53.6% female) aged 19-77 (mean 53.0 years) shows that the negative effects of school closures was a major concern among participants. Despite diverging points of view on other topics, there was a broad consensus that school closures would have negative consequences, such as unstable educational modalities impairing young people’s individual development, decreasing psychosocial support in their peer groups, leading to long-term educational losses, not only for individuals but also for society as a whole, and having a negative impact on economic growth, social justice and innovation. The participants also described a lack of evidence for the necessity of the frequent school closures during the pandemic as had happened in Austria and suggested a different approach in a future pandemic. Further topics were the deterioration of mental health, incentives instead of mandatory measures, more transparent communication by authorities, agreement between experts and researchers, reducing uncertainties regarding pandemic management, compliance by the general public and democratic social cohesion. Key messages • Addressing the multi-faceted impact of a pandemic requires a comprehensive approach that considers mental health, social justice, communication and social cohesion alongside containment measures. • This work represents a learning from the COVID-19 pandemic. From the conclusions of this study, recommendations can be derived to be better equipped in future pandemics.

Evaluating health system resilience testing; what makes this practice successful?

Abstract Issue Health system resilience is an important and desirable attribute of health systems. We have evaluated the operationalization of our step-by-step guide for conducting a resilience test. Description of the problem Preparedness planning is often siloed and does not take the entire health system into account. The objective was to develop a new methodology for policy making that is adaptable to any health system context and shock scenario. Resilience testing uses a mixed-method approach to assess resilience by understanding health system strengths and weaknesses in relation to a hypothetical shock scenario. A programme logic model, semi-structured interviews and an online questionnaire were used to evaluate the methodology and to answer the following questions: Can resilience tests be used to identify strengths and weaknesses in different health system contexts? What are the determinants for successful resilience testing? Results Three resilience tests were conducted in Finland, Greece and the Asturias region of Spain. All resilience tests identified health system strengths and weaknesses. 97% of participants agreed that the test identified broader vulnerabilities. However, 76% thought that a different scenario would identify different strengths and vulnerabilities. 94% of participants agreed or strongly agreed that the test was a valuable exercise. The semi-structured interviews consistently found that successful resilience testing requires neutral facilitation and carefully selected test participants. Lessons Resilience test results have been used in 2 out of 3 cases to develop health policy. Resilience testing needs to be initiated and supported by the ministry of health to ensure results are considered in the policy making process. Key messages • Health system resilience tests can identify health system strengths, weaknesses, and steps towards remedial policy action to improve resilience in different European health system contexts. • Successful health system resilience testing requires carefully selected facilitators and test participants as well as support from the Ministry of Health.

Assessing the practicality of a novel heart failure therapeutic score (QUAD Score) for drug optimisation in heart failure with a reduced ejection fraction

Abstract Introduction The 4 pillars of drug treatment for heart failure with a reduced ejection fraction (HFrEF) [Angiotensin-converting enzyme inhibitors (ACEi)/Angiotensin receptor–neprilysin inhibitors (ARNi), β-blockers (BB), Mineralocorticoid receptor antagonists (MRA), and Sodium-glucose cotransporter 2 inhibitors (SGLT2i)], are recommended by international HF guidelines to improve patient outcomes. Treatment inertia remains a challenge with non-prescription or sub-optimal dosing of these therapies. We developed a pragmatic HFrEF treatment score (QUAD score) (Figure 1) to prompt initiation and/or titration of sub-optimally dosed foundational therapies. Patients are categorized as poor (<8), good (8-14), and excellent (15-24) based on the dose and number of foundational drugs prescribed. This study aims to assess the practical utility of the QUAD score and its influence on treatment optimization. Methods Unwarned prescribing HCPs were approached consecutively in person, within clinical settings. Participants were told the questions were part of a research project and they provided verbal consent. Responses were anonymous and no patients were involved; therefore, verbal consent was considered proportionate and reasonable. HCPs were given an information sheet describing the QUAD score (Figure 1). They were then presented with 3 hypothetical clinical scenarios of haemodynamically stable and uncomplicated HFrEF patients with uncalculated poor, good and excellent QUAD scores. They were asked to calculate the QUAD score and if they proposed any changes to treatment. Time was recorded using a stopwatch and proposed changes were recorded. They were then invited to answer a series of follow-on questions. Results Between September 2023 and February 2024, there were 70 respondents. 71% (50) were doctors and 29% (20) allied HCPs. 83% (58) placed patients in the correct treatment grade in at least one scenario. 62.9% (44) did so for all three scenarios (Figure 2) with numerically more HCPs compared to doctors (80% vs 56% p=0.06).The median (IQR) time in seconds required to calculate the QUAD score for clinical scenarios 1,2 and 3 was 158 (100-234), 86 (54-122) and 83 (53-119) respectively. In response to the calculated QUAD score, 94.3% (66), recommended drug treatment optimisations. On a 5-point Likert scale (1 -poor, 5- excellent), 77.1% of participants rated the QUAD score ≥3 for ease of use, and 88.6% rated ≥3 as an incentive for treatment optimization. Conclusion We demonstrated the rapid clinical usability of the QUAD Score in a cohort of unselected prescribing HCPs, with a decremental calculation time with each presented clinical scenario. HCPs were also motivated to achieve further HF drug therapy optimization based on the calculated score. We conclude that the QUAD Score as a HFrEF drug therapy score may have a role in addressing treatment inertia however, it needs validation against clinically relevant outcomes in a larger cohort of HFrEF patients.

When Time Is the Enemy: An Initial Test of the Process Model of Patience.

The process model of patience attempts to reconcile disparate approaches to understanding patience. This investigation provides an initial test of the tenets of this new theoretical model, which positions impatience as a discrete emotion and patience as a targeted form of emotion regulation. In three studies with diverse samples (N = 1,401; data collected 2022-2023), participants responded to hypothetical scenarios designed to tap into familiar experiences of impatience. Regarding impatience, findings support our claim that impatience arises in response to the perception that a delay is unreasonable or unfair, and situational and intrapersonal characteristics emerged as predictors of impatience. Regarding patience, findings were consistent with the conceptualization of patience as driven more by intrapersonal than situational factors and revealed a set of individual differences that predicted patience. This investigation lends support to the process model of patience as a viable approach, generative of testable research questions, with implications for well-being.

Cognitive processing biases of social anxiety in adults who do and do not stutter

PurposeAdults who stutter are at risk of developing high levels of social anxiety, leading to negative outcomes and contributing towards stuttering relapse post treatment. To ensure that psychological treatments for social anxiety in stuttering adults are relevant and effective, a broader empirical understanding of the mechanisms of social anxiety in stuttering populations is required. Four key cognitive processing biases identified as maintenance factors in cognitive behavioral models of social anxiety were examined: self-focused attention, safety behavior use, negative self-imagery, and interpretation bias. MethodsAdults who stutter and non-stuttering adults (N = 186) were assessed via an online survey. Participants were categorised into two groups based on stuttering: formally diagnosed stuttering and non-stuttering. Within those groups, participants were further categorised as having low or high levels of social anxiety. Cognitive processing bias was assessed in response to two hypothetical social scenarios (i.e., social interaction and social performance). ResultsAs predicted, in both adults who stutter and who are non-stuttering, high social anxiety was related to greater self-focused attention, safety behavior use and negative self-imagery compared to low social anxiety. No significant effect of social anxiety or stuttering was found in relation to interpretation bias. A significant effect of social anxiety upon negative self-imagery was observed in formally-diagnosed adults who stutter compared to non-stuttering adults. ConclusionThe results support the use of cognitive behavioral models of social anxiety as a framework for research and treatment development within stuttering populations.

Vaccine Beliefs Among Uninsured People Receiving Care at Free Clinics.

Misinformation and vaccination hesitancy contribute to disparities in vaccination rates, particularly in under-resourced communities. This study aims to investigate perceptions and factors influencing vaccination decisions at free clinics serving diverse, under-resourced communities. Surveys were conducted across eight free clinics in the Greater Sacramento area, targeting uninsured or underinsured individuals. Information on demographics, sources of vaccine information, access to vaccines, vaccine perceptions, and vaccination decisions as pertaining to influenza and COVID-19 were collected on Qualtrics software. Chi-square and t-tests were used to analyze associations between demographics and vaccination rates. Among 109 participants (24-82 years old), vaccination rates were found to be higher than the county average, with notable demographic variations. Contrary to initial hypotheses, men had higher vaccination rates than women, and recent immigrants exhibited higher vaccination rates than more long-term U.S. residents. A higher number of participants regarded the COVID-19 vaccine as effective than as safe, while the reverse was true for the influenza vaccine. Healthcare providers were the most trusted and influential sources for vaccine information, followed by government agencies, and then family and friends. Answers to hypothetical vaccine scenarios elicited assessments on risks and benefits. The study provides insight into the dynamics of vaccine hesitancy and factors that play into the decision-making process in under-resourced communities, underscoring the role of trust in healthcare providers. These findings are vital for tailoring community outreach strategies to create trust, address barriers, and enhance vaccine uptake within free community clinics.

Evaluating the Effectiveness of a Large Language Model in the Psychological Assessment of Potential Liver Transplant Candidates: A Feasibility Study

Introduction: The use of artificial intelligence (AI) in medical settings has shown promise in various domains including diagnostics, treatment recommendation, and patient management. Recent advances have explored the potential of AI in pre-surgical assessments, but its application in transplant psychology remains unexplored. The objective of this study is to assess the effectiveness of AI in the context of screening potential liver transplant donors and recipients. To assess the feasibility of using ChatGPT-4 to screen potential liver transplant donors and recipients. Methods: This study utilizes a cross-sectional research design to evaluate the feasibility of using ChatGPT-4 in the preliminary screening of living liver donors and liver transplant candidates. The study aims to determine the accuracy and reliability of ChatGPT-4 in assessing hypothetical scenarios involving potential donors and recipients. Results: The analysis showed no found no significant differences between ChatGPT-4 and the expert panel in assessing liver transplant candidates, demonstrating an overall accuracy of 83.58%, sensitivity of 56.10%, and specificity of 80.49%. Additionally, the Cohen’s Kappa statistic of 0.68 (95% CI: 0.52-0.83) indicated substantial agreement between ChatGPT-4 and the psychologists’ evaluations. The absence of false positives (0%) and a low false negative rate (8%) emphasize ChatGPT-4's cautious and accurate decision-making capabilities. Conclusion: The findings of this study demonstrate that ChatGPT-4 has the potential to serve as an effective screening tool for liver transplant candidates, complementing the work of human experts and enhancing the overall efficiency of the transplant process. While challenges remain, the integration of AI into the liver transplantation workflow could lead to significant improvements in candidate evaluation and patient outcomes, paving the way for the broader application of AI in clinical practice.

Treatment preferences in spinal muscular atrophy: A swing weighting study for caregivers of patients with SMA types 1 and 2.

Spinal muscular atrophy (SMA) is a genetic neuromuscular disorder characterized by skeletal muscle weakness and atrophy. Patients with SMA types 1 and 2 develop severe disabilities conferring substantial patient and caregiver burden. Caregiver treatment characteristic preferences are useful for informing treatment choices and improving adherence. We aimed to identify drivers of SMA treatment preference from the perspective of caregivers of patients with SMA types 1 or 2 in the United States. We quantified the relative importance of different treatment characteristics and compared preferences for hypothetical treatment scenarios. Treatment attributes and attribute levels elicited were based on a literature search and interviews with caregivers and health care professionals. The most important treatment characteristics from the perspective of health care professionals and caregivers were identified and used in a survey to quantify relative importance for caregivers. Caregivers completed surveys regarding their preferences using swing weighting methodology. These results were used to estimate the relative value of four hypothetical SMA treatment scenarios exploring different modes of treatment administration. The swing weighting survey, completed by 20 caregivers, demonstrated that the attributes driving treatment preference were reduction in permanent ventilation needs and risk of severe adverse events, followed by treatment access (including cost coverage and availability), increased ability to sit without support, and less treatment administration burden. The hypothetical SMA treatment scenarios with the highest relative value offered an easier mode of administration, lowest risk of severe adverse events, less need of permanent ventilation, and highest ability of patients to feed and sit without support. Our findings suggest that caregivers prefer a treatment with reduced clinical burden and risk in which the cost is covered and treatment is available in the short term. These results can provide important contextual information for decision-makers and help promote patient-centered care for patients with SMA.

The adequacy of residential parking requirements: a comparison of demand and required supply in European cities

Minimum residential parking requirements exist in most European cities to regulate the number of off-street parking spaces built for new or converted residential buildings. As minimum parking requirements can have various negative impacts, they are controversially discussed and increasingly complemented or replaced by maximum requirements in several cities around the world. This paper evaluates the adequacy of residential minimum and maximum parking requirements in 12 mid-sized cities in Germany, the Netherlands and Switzerland. By calculating the number of required parking spaces and by comparing this required supply to the estimated parking demand, we evaluate the impacts and possible steering effects of parking standards. We base our estimations on a hypothetical scenario, in which all existing residential buildings comply with the requirements and use the number of registered cars as a proxy for residential parking demand.Our results reveal great differences between the cities’ parking standards. Some cities have minimum requirements, which would lead to a parking supply exceeding the current parking demand in large, mainly densely-populated and centrally located areas. These requirements would result in an oversupply of off-street parking at the place of residence of more than 50% of all residents, which in some areas would even exceed the parking demand by a factor of 2. In contrast to that, other cities have quite stringent requirements, which fall well below the current parking demand at the place of residence of 64 to 81% of all residents. Some of these restrictive cities complement their minimum parking requirements with additional measures by enforcing maximum requirements, limiting access to parking permits or reducing the overall parking capacity. Based on these findings, we discuss the adequacy of the parking requirements, their likely underlying objectives and their possible impacts on future urban development.

The human cost of war: An experimental study of Taiwanese attitudes towards war casualties

This paper investigates public attitudes toward types of war casualties. Through a survey experiment, we examine Taiwanese responses to hypothetical scenarios involving casualties among Taiwan's own military, the US military as allies, the Chinese military as enemy combatants, and mainland Chinese civilians. Our paper reveals three findings: first, there is a stronger aversion among Taiwanese citizens to their own military casualties compared with those of their allies. Second, Taiwanese attitudes toward their own military casualties are more adverse than those incurred by enemy military. Lastly, Taiwanese support for military action diminishes more significantly with Chinese civilian casualties than with Taiwanese military losses.

Fathers' rejection sensitivity: Links with fathers' and children's social information processing

AbstractObjectiveJoining efforts to reveal how fathers affect their children's social competence, we examined whether fathers' rejection sensitivity was associated with biases in their children's social information processing. We also explored whether this link was indirect via biases in fathers' social information processing of their children's peer interactions and, in particular, fathers' behavioral responses.BackgroundChildren's social information processing biases predict their social competence and well‐being. Studies have explored how mothers' rejection sensitivity may impact children's social information processing. Yet, little is known about the role of fathers in this context.MethodParticipants were 85 fathers living in Israel (68.24% Jewish; 31.76% Arab) and their kindergarten children (55.29% female; MChild age in months = 68.70, SD = 5.59). Fathers completed the Adult Rejection Sensitivity Questionnaire and reported their attributions, emotions, and likely behaviors in ambiguous hypothetical scenarios that might suggest a rejection of their child by peers using the Peer Rejection Scenarios measure. Children were interviewed using the Social Information Processing Interview–Preschool Version, tapping hypothetical peer interactions.ResultsFathers' rejection sensitivity was indirectly related to children's generation of maladaptive responses to ambiguous peer interactions through fathers' reports of their more negative emotions and overinvolved behavioral responses.ConclusionResults underscore the role of fathers' rejection sensitivity and emotional and behavioral responses in children's social information processing.ImplicationsThe study points to the need to consider paternal rejection sensitivity in research and interventions focused on promoting children's social competence.

To Bequeath or not to Bequeath? A South African Law Analysis of the "Problematic Areas" Found in the Islamic Law of Intestate Succession

The fairness of the Islamic Law of compulsory succession remains a heavily contested issue all over the world. Frequently debated topics, referred to in this article as the "problematic areas", include the 2:1 division of inheritance in favour of the male, the disqualification of a child born out of wedlock and the exclusion of an adopted child from the Islamic intestate inheritance equation. This equation is found in the primary texts of the religion of Islam i.e., the Holy Qur'ān and Prophetic teachings. These texts contain a formula dictating how the assets in a deceased person's estate should devolve, with individual freedom of testation limited to only a third of the net estate. The position followed in South African law is vastly different to the aforementioned. This article focusses on these so-called problematic areas found in the Islamic law of intestate succession. Part One of this article demonstrates these differences through the use of a hypothetical scenario involving person X. This hypothetical scenario includes an investigation of all three "problematic areas" mentioned. The article further progresses to uncover the rationale for each of these principles. The concluding section of this article provides recommendations on the lawful remedies available to Muslim testators wanting to create a more equitable distribution.

How could you think that? Supervisor misattribution leads to reduced subsequent employee organizational citizenship behavior

PurposeFrom a social cognitive perspective, the current study examines how the relationship between the employee and the organization changes following supervisor motive misattribution of organizational citizenship behavior (OCB).Design/methodology/approachThe current study utilizes an experimental vignette methodology (EVM), linear regression and Hayes' (2017) Process Version 4 macro in SPSS to examine the relationships between supervisor misattribution of employee OCB, personality and individual differences and future organizational citizenship behavior intentions.FindingsResults indicate that supervisor misattribution of employee OCB, specifically when the act is attributed to impression management, will reduce the intention to engage in future OCBs. Results also indicate that this negative relationship is enhanced when subordinates are high in openness.Research limitations/implicationsThis study extends social exchange theory by demonstrating how the misattribution of motivation to perform OCBs creates a negative social exchange and discourages future organizational citizenship behavior from the employee. The current research demonstrates the importance of supervisors understanding employees' motivations for engaging in (OCB). If an employee engages in OCB based on intrinsic motivation, such as a desire to help others, and their motivation is attributed to external motivation, such as impression management, the employee may feel misunderstood and believe their values and motivations are incorrectly perceived, leading to reduced OCB.Originality/valueThe current research is examined using EVM. By immersing participants in realistic hypothetical scenarios, experimental vignette methodology allows researchers to explore the intricacies of decision-making across unique scenarios, unraveling both the “why” and the “what next” behind decision-making.

Efficiency of dynamic traffic signal control in work zones with shuttle operation: theory and practice

Portable traffic signals with fixed-time signal plans are a common type of traffic control at work zones with shuttle traffic. The most-used alternatives are flagging and intelligent transport systems with traffic-actuated signals. These can provide more efficient traffic control, but existing policies often do little to encourage their practical application. This paper provides a clear and accessible overview of shuttle operations and a comparison of the main signal control types while addressing some knowledge gaps, such as whole-day operation efficiency. The relations between different variables of the signal plan and traffic flow are derived to build a theoretical framework and models for both deterministic and random arrivals to estimate delays and to find the optimal signal plan setting for a wide range of circumstances. The hypothetical scenarios are supported by a case study. Traffic and signal control data from several construction phases of a work zone with shuttle operation were gathered, processed, analysed, and used to compare different control scenarios. The results provide solid evidence for the efficiency of the dynamic systems. The magnitude of the difference is heavily affected by circumstances. The efficiency of the green signal almost doubled with the dynamic control. The case study also revealed a severe impact of road conditions (milling) on the work zone capacity. Several standards and policies are proposed based on the findings to encourage wider and more efficient adoption of traffic-actuated signals in work zones.

Fostering Creativity in Order to Develop Mental Model Templates for Planning in National Emergencies

National Emergencies set the need for quick responses and actions from all institutions that are responsible for national security and/or citizens’ health. Course of action development as part of mitigation planning in such situations, is a complex and difficult procedure because of the uncertainty of the future events, the risk associated with decisions for human actions and the time pressure because of the emergency. This means that planning for addressing national emergencies is not a common and simple task. Moreover, because emergencies appear seldom, most of the stakeholders have lack of experience. Thus, they need more time to assimilate the incoming information into their mission planning process and finally to propose the appropriate courses of actions. An antidote to the above difficulties can be the appropriate training in combination with the enhancement of the creativity of the stakeholders. In order to address that, we propose a novel methodology of creating mind map templates, based on creativity techniques, for specific operations that can be applied to national emergencies. Our methodology, called “MEMOS”, was developed according to the relative theoretical frameworks and then tested with a case study, including hypothetical security scenarios in national emergency situations. The proposed templates can be used as inspiration tools or idea tanks in order to guide and speed up the process of course of action development in mitigation planning for similar future security operations.

Gender-Specific Impacts of the COVID-19 Pandemic on Orthopedic and Traumatology Care: An Analysis of Hospital Admissions and Length of Stay.

Understanding gender disparities in healthcare outcomes is crucial, especially during crises like the COVID-19 pandemic. The absence of gender-specific data on hospital admissions and lengths of stay for orthopedic and traumatology patients limits the precision of current analyses, making conclusions speculative. This study aims to highlight the potential insights that could be gained from gender-disaggregated data, illustrating how a more precise gender-based analysis could reveal healthcare disparities in orthopedic and trauma care during the pandemic. A robust analysis would require gender-disaggregated data, including variables such as admission rates, lengths of stay, injury types, and access to care, along with factors like age and socioeconomic status. In the absence of such data, a hypothetical framework was developed based on known healthcare disparities, using general trends to project possible gender-specific impacts. Without gender-disaggregated data, it remains challenging to identify specific gender differences in outcomes accurately. Hypothetical scenarios suggest that disparities in admission rates, hospital stay durations, and access to care could be influenced by factors such as increased caregiving responsibilities for women or differential access to healthcare based on socioeconomic status. To accurately assess gender disparities in orthopedic and trauma care during the pandemic, future studies must prioritize the collection and use of gender-disaggregated data. This approach is essential for drawing reliable conclusions and developing targeted interventions to address healthcare inequities effectively.

Evaluation of the impact of security perception on the structural changes of MSEs through system dynamics

Micro and Small businesses (MSEs) face several challenges to survive in the market, some of these challenges are related to security matters which are the subject of this article. In Mexico MSEs are victims of crimes such as extortion, theft, and assaults, among others; this situation leads them to spend their economic resources to make structural changes to be able to continue with their commercial activities. This article is based on a survey conducted on 370 MSEs in the central region of the state of Veracruz in Mexico; the present study aims to evaluate the impact of structural changes made by businesspeople in their perception of business security. In this way, the decision-making process of MSEs facing insecurity is statistically analyzed through a simulation model considering the system dynamics methodology. To evaluate this phenomenon, we have identified four main subsystems: 1) Crime, 2) Security Perception, 3) Structural Changes, and 4) Government Policy Changes; at the same time three hypothetical scenarios were simulated: 1) Reduction in crimes committed against MSEs, 2) Government changes in public infrastructure, and 3) the combination of the previous two. The approach allows us to identify that companies make structural changes based on the events around them, rather than on the crimes that they suffer, making abrupt or precipitated decisions. Therefore, we have identified that it is not only necessary to eliminate crimes, but also to work with government strategies that allow MSEs owners and staff to improve their perception of security. This simulation model can be replicated to evaluate the implementation of security policies in other regions with high insecurity rates.