Knowledge Decision Research Articles

МЕТОД ФОРМАЛІЗАЦІЇ ЗНАНЬ ПРО ПРОЦЕС ВИЗНАЧЕННЯ ДОЦІЛЬНОЇ СТРАТЕГІЇ ПОЛЬОТУ БЕЗПІЛОТНИХ ЛІТАЛЬНИХ АПАРАТІВ В ХОДІ ПІДГОТОВКИ ДО ВЕДЕННЯ ПОВІТРЯНОЇ РОЗВІДКИ НА ОСНОВІ НЕЧІТКИХ ЛОГІЧНИХ СИСТЕМ

The article proposes an approach to the formalization of knowledge about the process of determining an appropriate flight strategy for an unmanned aerial vehicle at the stage of planning aerial reconnaissance using Hebrew-contiguous methods, which are the best in terms of taking into account practice, experience, intuition, knowledge of decision-makers , when conducting aerial reconnaissance, and are looking for solutions within some pidpros-tor of possible acceptable solutions. The developed method allows one to formalize factors, takes into account the tactical conditions of aerial reconnaissance, the influence of the external environment on the flight range of an unmanned aerial vehicle in the form of linguistic and interval-estimated parameters for each option, which allow for uncertainty. The initial data of the method is a recommendation regarding an expedient flight strategy for an unmanned aerial vehicle, containing information on the list of the most important reconnaissance objects, the start point, the end of the flight route, the initial flight path, the recommended flight altitudes in dangerous areas, the method search and inspection of miscevoste. Based on the structure of fuzzy production rules by the MISO-structure, in the conclusion of which real numbers (the number of the expedient strategy for the flight of an unmanned aerial vehicle) are used, which is proposed as a fuzzy inference algorithm in a fuzzy logical system of interval type 2 for derivation of inference for fuzzy sets of the second order. It is substantiated that the components of the architecture of a fuzzy logical system of interval type 2 provide the implementation of the corresponding inference mechanism, which is a set of inference rules and methods of their application.

Person-centred care in practice: perspectives from a short course regimen for multi-drug resistant tuberculosis in Karakalpakstan, Uzbekistan

IntroductionPerson-centred care, an internationally recognised priority, describes the involvement of people in their care and treatment decisions, and the consideration of their needs and priorities within service delivery. Clarity is required regarding how it may be implemented in practice within different contexts. The standard multi-drug resistant tuberculosis (MDR-TB) treatment regimen is lengthy, toxic and insufficiently effective. 2019 World Health Organisation guidelines include a shorter (9–11-month) regimen and recommend that people with MDR-TB be involved in the choice of treatment option. We examine the perspectives and experiences of people with MDR-TB and health-care workers (HCW) regarding person-centred care in an MDR-TB programme in Karakalpakstan, Uzbekistan, run by Médecins Sans Frontières and the Ministry of Health.MethodsA qualitative study comprising 48 interviews with 24 people with MDR-TB and 20 HCW was conducted in June–July 2019. Participants were recruited purposively to include a range of treatment-taking experiences and professional positions. Interview data were analysed thematically using coding to identify emerging patterns, concepts, and categories relating to person-centred care, with Nvivo12.ResultsPeople with MDR-TB were unfamiliar with shared decision-making and felt uncomfortable taking responsibility for their treatment choice. HCW were viewed as having greater knowledge and expertise, and patients trusted HCW to act in their best interests, deferring the choice of appropriate treatment course to them. HCW had concerns about involving people in treatment choices, preferring that doctors made decisions. People with MDR-TB wanted to be involved in discussions about their treatment, and have their preference sought, and were comfortable choosing whether treatment was ambulatory or hospital-based. Participants felt it important that people with MDR-TB had knowledge and understanding about their treatment and disease, to foster their sense of preparedness and ownership for treatment. Involving people in their care was said to motivate sustained treatment-taking, and it appeared important to have evidence of treatment need and effect.ConclusionsThere is a preference for doctors choosing the treatment regimen, linked to shared decision-making unfamiliarity and practitioner-patient knowledge imbalance. Involving people in their care, through discussions, information, and preference-seeking could foster ownership and self-responsibility, supporting sustained engagement with treatment.

The central role of Inuit Qaujimaningit in Nunavut’s impact assessment process

ABSTRACT In impact assessment (IA) the value of different forms of knowledge is increasingly acknowledged, but implementation and practice challenges continue. In Nunavut, a territory in the Canadian Arctic, Indigenous knowledge plays a key role in understanding and defining environmental baselines and guiding the assessment process; however, even here there are needs and opportunities for improved treatment and use of Indigenous knowledge in assessment and decision-making. This paper outlines the central role of Inuit Qaujimaningit/Qaujimajatuqangit (IQ) (Inuit knowledge) in shaping and defining Nunavut’s impact assessment process. The work highlights the potential of the Nunavut process to provide a model for the use of Indigenous knowledge in IA, and of co-management or Indigenous-led impact assessment. Focus groups were held with board members and staff of the Nunavut Impact Review Board – the co-management board responsible for impact assessment in the territory. The results highlight the unique qualities of the impact assessment process in Nunavut and demonstrate how IQ is a crucial component of project review, notably its role in decision-making and for ensuring that the process is meaningful to communities. The results and recommendations have value to a range of other jurisdictions that are also working towards using Indigenous knowledge in environmental decision-making or even seeking to advance Indigenous-led impact assessment.

Multilevel knowledge management for municipal climate action: Lessons from evaluating the operational situation of climate action managers in the German Federal State of Lower Saxony

Effective actions to mitigate climate change are urgently needed, especially in the context of cities, which are major sources of global CO2 emissions. Establishing and managing knowledge systems that integrate local knowledge can contribute to establishing more effective responses to climate change as well as transformative change towards sustainability. However, it is still unclear how new forms of urban governance should acquire, store, create, or disseminate knowledge for fostering sustainability transitions effectively. In this study, we present a multilevel knowledge system approach based on design principles informed especially by the knowledge management literature. These address (i) working environments across multiple levels, (ii) knowledge forms and types, and (iii) knowledge processes. We apply this approach to municipal climate action in the German energy transition. In particular, we focus on the operational work of municipal climate action managers of regional centers of Lower Saxony, one of the largest of the 16 federal states, and investigate their involvement in knowledge processes. Based on semi-structured interviews in 14 of the 17 regional centers, we show that structural pre-conditions for successful knowledge management and organizational learning are present. However, we also show that there is a need for improvement regarding (i) the multilevel coordination for accelerating routine operation, (ii) the persistence of local operational knowledge, and (iii) the exploitation of local innovations. Relying on these results, we offer general recommendations for municipal climate action and suggest that policies should (i) rely on local knowledge for effective decision-making, (ii) foster multilevel exchanges of explicit and tacit knowledge for implementation, and (iii) enable open-ended learning processes that leverage local innovations for creating usable transformational knowledge.

Combining GPS tracking and survey data to better understand travel behavior of out-of-bounds skiers

Our research seeks to expand existing knowledge of travel behavior and decision-making in avalanche terrain. We have done this by using GPS tracking to observe the travel behavior of out-of-bounds (OB) skiers and collecting survey data to investigate their terrain choices. We sampled participants in the field by distributing hand-held GPS units and surveys along the southern boundary of Bridger Bowl Ski Area, Southwest Montana, USA. In total, we used data from 136 participants that volunteered over the course of 19 field days, from February 2017 to February 2018. We analyzed the resulting GPS data using a GIS, and we derived terrain metrics from elevation and land cover data. We fit a multiple linear regression model using GPS track downhill starting distance from the ski area boundary as the response variable and survey responses, interaction with complex avalanche terrain (as defined using the Avalanche Terrain Exposure Scale), weather conditions, and avalanche hazard level as explanatory variables. This approach evaluates travel behavior as a function of human factors, terrain, weather, and snowpack, providing a holistic perspective on decision-making drivers. Our results show that gender (female), formal avalanche education, and perception of avalanche mitigation are statistically significant (p < 0.05) survey responses which indicate that participants travel further from the ski area boundary before descending Saddle Peak, which effects individuals avalanche terrain exposure. Downhill starting distance is also significantly correlated with time and distance in complex avalanche terrain (p < 0.05). Our results provide a case study of the terrain preferences and avalanche awareness of OB skiers and highlight specific “human factors” that are correlated with terrain selection. Two practical applications of this research are: 1) tailoring of targeted avalanche education outreach based on our results specific to the OB setting, and 2) designing new signage to illustrate the avalanche terrain near the ski area boundary for skiers who are inexperienced in the backcountry or unfamiliar with the specific area.

Assessing optimal water quality monitoring network in road construction using integrated information-theoretic techniques

The environmental impacts of road construction on the aquatic environment necessitate the monitoring of receiving water quality. The main contribution of the paper is developing a feasible methodology for spatial optimization of the water quality monitoring network (WQMN) in surface water during road construction using the field data. First, using the Canadian Council of Ministers of the Environment (CCME) method, the water quality index (WQI) was computed in each potential monitoring station during construction. Then, the integrated form of the information-theoretic techniques consists of the transinformation entropy (TE), and the value of information (VOI) were calculated for the potential stations. To achieve the optimal WQMNs, the Non-dominated Sorting Genetic Algorithm II and III (NSGA-II, and III) based multi-objective optimization models were developed considering three objective functions, including i) minimizing the number of stations, ii) maximizing the VOI in the selected network, and iii) minimizing redundant information for the selected nodes. Finally, three multi-criteria decision-making models, including Technique for Order Preference by Similarity to Ideal Solution (TOPSIS), Preference Ranking Organisation Method for Enrichment Evaluations (PROMETHEE), and Analytical Hierarchy Process (AHP) were utilized for choosing the best alternative among Pareto optimal solutions considering various weighing scenarios assigned to criteria. The applicability of the presented methodology was assessed in a 22 km long road construction site in southern Norway. The results deliver significant knowledge for decision-makers on establishing a robust WQMN in surface water during road construction projects.

Reliability block diagram (RBD) and fault tree analysis (FTA) approaches for estimation of system reliability and availability – a case study

PurposeIn the present worldwide situation, the survival of a business is a major crucial aspect. The business cannot be succeeded unless it produces the anticipated production levels. Achievement of this can be possible only by maintaining the equipment into an adequate level. Load-Haul-Dumpers (LHDs), as the main workhorse and massive transporting machines, are highly utilized in underground mining operations. Despite the usage of LHDs, these are prone to the uneven and unexpected occurrence of potential failures. These are causes to minimize the production and productivity of capital intensive equipment. To get a good profitability index, it is very necessary to have the required levels of equipment reliability and availability. Estimation of reliabilities and availabilities play a critical role in the performance evaluation of equipment.Design/methodology/approachBy keeping the significance of the present research work in view in this research paper one of the well appropriate techniques such as fault tree analysis (FTA) was utilized to assess the reliability of the LHD system based on the function flow diagram. Best fit distribution of data sets were made by the utilization of Kolmogorov–Smirnov (K-S) test. Parametric estimation of theoretical probability distributions was done by utilizing the maximum likelihood estimation (MLE). Failure rate of each LHD system has computed based on the best fit results from “Isograph Reliability Workbench 13.0”. Reliability configuration of each LHD system has modeled using reliability block diagram (RBD), as well as the FTA.FindingsIndependent and identical distribution (IID) assumption of data sets was validated through statistic U-test (Chi Squared test). On the basis of test results, the data sets are in accordance with IID assumption. Therefore renewal process approach has been utilized for further investigation. Allocations of best fit distribution of data sets were made by the utilization ofK-S test. Parametric estimation of theoretical probability distributions was made by utilizing maximum likelihood estimation (MLE) method. Reliability of each individual subsystem has been computed according to the best fit distribution. The deductive method called RBD was utilized to investigate the given system reliability by analyzing with graphical representations of logic system and observed highest percentage of reliability as 69.44% (LH29). FTA has been utilized to investigate the availability percentage of a system and observed highest percentage value as 79.51% (LH29). This technique also helps to identify the most critical parts/cut sets by using Fussell-Vesely (F-V) importance measure.Research limitations/implicationsAs the reliability analysis is one of the complex techniques, it requires strategic decision-making knowledge for the selection of methodology to be used. As the present case study was from a public sector company, operating under financial constraints the conclusions/findings may not be universally applicable.Originality/valueThe present study throws light on this equipment that need a tailored maintenance schedules, partly due to the peculiar mining conditions, under which they operate. This analysis provides the information on several aspects such as present working condition of the machines, occurrence of various potential failure modes, influence of failure modes on its performance and reliable life aspects etc. Also, these investigations asses the forecasting of necessary managerial practices or control measures like possible design modifications and replacement actions of components to ensure the required levels of availability and utilization of the equipment. Both qualitative and quantitative analysis of FTA has been performed to determine the minimal/most influencing cut sets of the system and to estimate overall system availability within the work environment. Based on the computed results reasons for performance drop of each machine was identified and suitable recommendations were suggested to improve the performance of capital intensive systems.

Images as Information: Context-Rich Images and the Communication of Place-Based Information Through Increased Representation in Environmental Governance

Practitioners widely acknowledge the importance of including local and Indigenous knowledge in environmental research and decision-making. Nevertheless, it remains a challenge to achieve this integration in a meaningful way. The pilot study reported here was a necessary step toward developing improved methods for communicating local and Indigenous knowledge to decision-makers, with a focus on public sector practitioners as audience and visual content as medium. The proposed methodology extends previous research on climate change adaptation in the Alaskan Arctic, and it examines the effect of a reporting approach that introduces two components outside of general conventions in public sector information dissemination; 1) the application of context-rich images to help convey the social and cultural nuances of place-based information, and 2) multiple evidence base (MEB) reporting which engages information from both Western science and local/Indigenous knowledge systems. Context-rich images  defined here as detailed visuals that address the particularities of specific environments and cultures – are explored given their potential merits in expressing place-based concepts, such as social life and lived experience quickly and concisely when presented in tandem with text. With a focus on practical application, public sector conventions for reporting place-based information to decision-makers are investigated, including the benefits and limitations associated with these conventions. Insights from both theory and practice informed the research methodology, and the design of a sample report and online questionnaire tested with upper-level public sector practitioners who have influence on environmental decision-making. Pilot study results indicated significant benefits of using context-rich images in addition to quotes about lived experience for reporting information about the local context and experience of Northern environmental changes. When presented alongside research from Western science, neither local observations in the form of quotes, nor context-rich images posed negative impacts on the perceived credibility of the report. The pilot study revealed the proposed methodology to be particularly beneficial for a target audience of practitioners who may lack expertise in the local context or field of research being reported. Additionally, several potential improvements to the content and design of research materials were identified for the benefit of future studies.

Knowledge and legitimacy in asylum decision-making: the politics of country of origin information

ABSTRACT State institutions engage in the production of knowledge and representations about the countries of origin of asylum seekers. Building on science and technology studies (STS), critical migration studies and critical citizenship studies, this article analyzes the alignment of government Country of Origin Information (COI) with the public. We examine the different processes through which public legitimacy of asylum knowledge is fostered in three bureaucratic settings. The case studies highlight the variable legitimacy-constructing technologies and practices of publication (Norway), evaluation (United Kingdom) and consultation (European Union) vis-à-vis asylum-relevant information. We demonstrate how this shifting style in the knowledge-based governance of asylum does not consistently enhance legitimacy and stabilization of asylum-relevant information, and can provoke new forms of contestation in this environment of high-stakes policymaking. Finally, we highlight the lack of political subjectivity of asylum seekers to intervene in the production and possibly contest the legitimacy of this information about themselves and their country of origin.

Building resilience to natural hazards through coastal governance: a case study of Hurricane Harvey recovery in Gulf of Mexico communities

This paper provides an evidence-based contribution to understanding coastal governance in response to hurricane hazards. It uses the five-part conceptual framework for coastal governance, which includes 1) complexity, 2) vulnerability, 3) adaptive management, 4) stakeholder participation, and 5) the integration of technical knowledge in decision-making. A case study of the Harvey-impacted Texas communities in the Gulf of Mexico is presented within this framework. This particular case is important because of current high level discussions that suggest subnational, state-centric policy response to hazards may be the new model for disaster response moving forward. This study presents insights on the current trends toward devolved, subnational policy response to disasters, as well as a revised framework for coastal governance, where resilience is linked to all concepts in the governance framework as an outcome. Several major findings are discussed. First, higher scales of government take much longer than is necessary to respond to hazards because of their complex administrative policies and procedures. This is worsened in places that have not experienced hazards in recent decades. Innovative adaptation by subnational policy-makers may be one pathway to quicken policy response, as are the commendable but fragmented efforts of charities and voluntary groups. However, devolved policy responses may face their own challenges in implementation, increasing adaptive capacity but decreasing resilience. This study found that participatory, multi-stakeholder processes enhance resilience through disaster simulation exercises and participatory planning processes. These participatory processes enhance learning and the capacity to implement recovery-focused public policy within the constraints of the disaster.

Effectiveness of Decision Aid in Men with Localized Prostate Cancer: a Multicenter Randomized Controlled Trial at Tertiary Referral Hospitals in an Asia Pacific Country.

There are several treatment options for localized prostate cancer with very similar outcome but vary in terms of technique and side effect profiles and risks. Considering the potential difficulty in choosing the best treatment, a patient decision aid (PDA) is used to help patients in their decision-making process. However, the use and applicability of PDA in a country in Asia Pacific region like Malaysia is still unknown. This study aims to evaluate the effectiveness of a PDA modified to the local context in improving patients' knowledge, decisional conflict, and preparation for decision making among men with localized prostate cancer. Sixty patients with localized prostate cancer were randomly assigned to control and intervention groups. A self-administered questionnaire, which evaluate the knowledge on prostate cancer (23 items), decisional conflict (10 items) and preparation for decision-making (10 items), was given to all participants at pre- and post-intervention. Data were analyzed using independent T test and paired T test. The intervention group showed significant improvement in knowledge (p = 0.02) and decisional conflict (p = 0.01) from baseline. However, when compared between the control and intervention groups, there were no significant differences at baseline and post-intervention on knowledge, decisional conflict and preparation for decision-making. A PDA on treatment options of localized prostate cancer modified to the local context in an Asia Pacific country improved patients' knowledge and decisional conflict but did not have significant impact on the preparation for decision-making. The study was also registered under the Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN12614000668606 registered on 25/06/2014.

Discovering Influential Positions in RFID-Based Indoor Tracking Data

The rapid development of indoor localization techniques such as Wi-Fi and RFID makes it possible to obtain users’ position-tracking data in indoor space. Indoor position-tracking data, also known as indoor moving trajectories, offer many new opportunities to mine decision-making knowledge. In this paper, we study the detection of highly influential positions from indoor position-tracking data, e.g., to detect highly influential positions in a business center, or to detect the hottest shops in a shopping mall according to users’ indoor position-tracking data. We first describe three baseline solutions to this problem, which are count-based, density-based, and duration-based algorithms. Then, motivated by the H-index for evaluating the influence of an author or a journal in academia, we propose a new algorithm called H-Count, which evaluates the influence of an indoor position similarly to the H-index. We further present an improvement of the H-Count by taking a filtering step to remove unqualified position-tracking records. This is based on the observation that many visits to a position such as a gate are meaningless for the detection of influential indoor positions. Finally, we simulate 100 moving objects in a real building deployed with 94 RFID readers over 30 days to generate 223,564 indoor moving trajectories, and conduct experiments to compare our proposed H-Count and H-Count* with three baseline algorithms. The results show that H-Count outperforms all baselines and H-Count* can further improve the F-measure of the H-Count by 113% on average.

670-P: Effectiveness of Using Simulation to Train Nursing Students in Providing Preconception Counseling to Women with Diabetes

Nurses can be pivotal to providing diabetes education, including, preconception counseling (PC) to prevent pregnancy-related complications in women with diabetes. However, many health professionals, including nurses, have reported self-deficits in these areas due to a lack training or knowledge. Simulation is an effective educational strategy utilized in schools of nursing to enhance critical thinking, decision-making, skills building and increase knowledge. However, little is known about the effectiveness of using simulation to train nursing students in providing diabetes education and preconception counseling to patients. Therefore, this study examined the effectiveness of a newly developed diabetes education/PC simulation training program developed for nursing students. The sample was 30 junior level baccalaureate nursing students who completed pretest and posttest measures on their awareness and knowledge of diabetes, pregnancy and PC. We used the 45 min video of READY-Girls (Reproductive-health Education and Awareness of Diabetes in Youth for Girls) PC program during the simulation training session because it is a validated evidenced-based, theory-driven program that targets female adolescents, and is endorsed by the American Diabetes Association. They also observed a live 10 minute simulation of actors portraying a diabetic educator and a diabetic female adolescent and their clinical interaction. Data were analyzed using a paired t-test. The mean pretest score was 9.33, while the mean posttest score was 15.00 with a statistically significant gain (t = 15.89; p = .000). Therefore, it appears that PC simulation may be an effective educational strategy to train nursing students on caring for women with diabetes. Disclosure J.L. Thurheimer-Cacciotti: None. D. Charron-Prochownik: None.

Empowering Data Mining Sciences by Habitual Domains Theory, Part I: The Concept of Wonderful Solution

Often big companies and governments fail to produce a successful plan of action in the post-data mining analysis and decision-making stage to face challenging situations, which results in billions of dollars loss. Indeed, this crucial stage is left to the decision makers (DMs) to make decisions based on their experience, available information, mindset and habits without any scientific and systematic approach. In this paper, we present a general formal model for decision-making and new knowledge generation that can be used in post-data mining analysis to derive better decisions. The proposed model is formulated in the framework of Habitual Domains theory. The concepts of optimization in changeable spaces and the related solution, the wonderful solution, are introduced in Part I of the paper. Further, ways on how to find wonderful solutions by expanding DMs Habitual Domains in post-data mining analysis and decision-making are presented with applications in Part II of the paper. The proposed model is a significant departure from the traditional decision models that are based on utility function. It can also be used to empower other sciences such as political sciences, medical sciences, management sciences and research activities in all areas.

The role of tacit knowledge in communication and decision-making during emerging public health incidents

Strong communication systems for knowledge exchange are required to prevent, respond to and mitigate the effects of emerging public health incidents (EPHIs). The objective of this paper is to examine how “tacit knowledge” – implicit knowledge used to guide everyday practice – is employed in professional relationships and communication processes between public health and acute care settings. A qualitative study design was used to explore the experiences of key informants from public health and acute care settings in Ontario, Canada, to examine how specific dimensions of tacit knowledge are employed in communications about EPHIs. Twenty-six in-depth interviews were conducted from 2014 to 2015. The results describe the way in which participants employ discretion and knowledge of local context, and rely on relationships built on trust and credibility, to facilitate decision-making and communication during EPHIs. Given the uncertainty characterizing most EPHIs, communicators rely a great deal on their informal knowledge and networks which allow them to remain flexible and respond quickly to changing situations. The results reveal that communication about public health guidance during emergencies is a complex and active process that draws from past experiences of the individuals involved, and is shaped by the requirements of local circumstances. The broader implications of these findings for building resilient and responsive health systems are considered. In particular, for rethinking the authority of standardized forms of evidence in public health decision-making, and the importance of knowledge which is grounded in the uniqueness of specific local contexts.

Sex offender registries: exploring the attitudes and knowledge of political decision-makers

Sex offender registries (SORs) were established due to policies and practices intended to protect the public from individuals who commit sexually violent acts, and yet the empirical literature does not show that public SORs reduce or prevent sexual crimes. Given that politicians prominently influence SOR policies, the current study explores the views of SORs by 26 political decision-makers from Canada and the United States. Participants completed a survey on their opinions regarding SORs and their knowledge of SOR eligibility. Attitudes and political perspectives were assessed to examine their association with SOR opinions. Almost two thirds of those surveyed believed SORs should be publicly available, and one third believed SORs helped to protect the public. These beliefs were associated with those with conservative-leaning political views. These findings help us to explore the perspectives of political decision-makers and gain insight into attitudinal factors that may play a role in influencing opinions regarding SORs.

Experiential knowledge representation and reasoning based on linguistic Petri nets with application to aluminum electrolysis cell condition identification

Fuzzy Petri nets (FPNs) play an important role in knowledge representation and reasoning (KRR), and they have been widely used in many fields. Linguistic terms are usually used to express the experiential knowledge of decision-makers in the above fields. However, cognitive nonconformity, fuzziness and uncertainty of experiential knowledge are widespread in industrial production processes, making it difficult for current FPNs to precisely model the experience or cognition of experts. In an effort to overcome the shortcomings of FPNs, linguistic Petri nets (LPNs) are proposed based on interval type-2 fuzzy sets theory and FPNs in this paper. The extended TOPSIS (ETOPSIS) is proposed to fuse together the cognition of multiple decision-makers. An interval type-2 fuzzy ordered weighted averaging operator is proposed to improve the knowledge reasoning capability of LPNs. Two comparisons are presented to demonstrate the validity of the proposed ETOPSIS and LPNs. In addition, the KRR model for aluminum electrolysis cell condition identification (AECCI) is proposed and AECCI results show the proposed methods are efficient to embrace cognitive nonconformity and manage fuzziness and uncertainty of experiential knowledge.

ЗАРАХУВАННЯ вступників ДО ЗАКЛАДІВ ВИЩОЇ ОСВІТИ ЯК ЗАДАЧА БАГАТОКРИТЕРІАЛЬНОГО ПРИЙНЯТТЯ РІШЕНЬ за УМОВ НЕВИЗНАЧЕНОСТІ

Проблема аналізу виконання передумов застосування алгоритму Гейла – Шеплі до розподілу вступників є актуальною, оскільки цей алгоритм використовується при прийомі до закладів вищої освіти в Україні та багатьох інших країнах. В роботі визначено основні фактори невизначеності, що стосуються переваг вступників і закладів вищої освіти та впливають на результати розподілу. Перехід до фінансування закладів вищої освіти за результатами діяльності може зменшити вплив цих невизначеностей.

The knowledge and attitude of Ghanaian decision-makers and researchers towards health technology assessment.

Although health technology assessment (HTA) is intended to provide policymakers with objective information, the likelihood that a health decision-maker (HDM) will use this information is associated with their knowledge, role and perception of the HTA process. In Ghana, policymakers are working towards formalising the use of HTA, but HDM knowledge of and attitude towards HTA are not known. Between March and May 2016, we conducted in-depth interviews and used inductive thematic analysis to explore Ghanaian HDMs (n=23) and researchers' (n=4) perceptions of and barriers to HTA and identify ways to promote HTA. We compare our findings with those reported in previous studies conducted in low-and-middle-income countries. Common themes were that resources, political and cultural factors act as barriers to HTA use. Recommendations made in previous studies which were also identified in this study included the need for the development of both human and data capacity, allocating funds to HTA and stakeholder involvement in HTA processes. Specific recommendations made by Ghanaian HDMs and researchers in this study focused on the establishment of an HTA body: its location, the constitution of the appraisal team, the type of evidence to appraise and who makes the final decision. The findings provide important information in the context of current planning to institutionalise HTA in Ghana. Addressing the identified barriers will enable policymakers to maximise the chances of realising the expected benefits of HTA, as participants who are potential producers and end-users are likely to use what they have contributed to.

After an end-of-life decision: Parents' reflections on living with an end-of-life decision for their child.

Parents' role as end-of-life decision-makers for their child has become largely accepted Western health-care practice. How parents subsequently view and live with the end-of-life decision (ELD) they made has not been extensively examined. To help extend understanding of this phenomenon and contribute to care, as a part of a study on end-of-life decision-making, bereaved parents were asked about the aftermath of their decision-making. A qualitative methodology was used. Semi-structured interviews were conducted with parents who had discussed ELDs for their child who had a life-limiting condition and had died. Data were thematically analysed. Twenty-five bereaved parents participated. Results indicate that parents hold multi-faceted views about their decision-making experiences. An ELD was viewed as weighty in nature, with decisions judged against the circumstances that the child and parents found themselves in. Despite the weightiness, parents reflected positively on their decisions, regarding themselves as making the right decision. Consequently, parents' comments demonstrated being able to live with their decision. When expressed, regret related to needing an ELD, rather than the actual decision. The few parents who did not perceive themselves as their child's decision-maker subsequently articulated negative reactions. Enduring concerns held by some parents mostly related to non-decisional matters, such as the child's suffering or not knowing the cause of death. Results suggest that parents can live well with the ELDs they made for their child. End-of-life decision-making knowledge is confirmed and extended, and clinical support for parents informed.