Opportunities For Decision Research Articles

Field-Configuring Events: An Important Mechanism Shaping the Institutionalization of Chinese Volunteering

Major events can and do play an important role in the development of volunteering in China. This article employs organizational neo-institutionalism as a lens to examine and interpret the meanings of major events for the development of Chinese volunteerism. We consider the Wenchuan earthquake and the Beijing Olympics as “Field-Configuring Events” that influenced the process of institutionalizing volunteering. The article’s findings highlight that these major events shaped the public’s culture and cognition of volunteering and the network-governance structure of volunteering, thereby opening a window of opportunity for volunteerism policy decision-making.

Ependymoma and pilocytic astrocytoma: Differentiation using radiomics approach based on machine learning

Mandatory accurate and specific diagnosis demands have brought about increased challenges for radiologists in pediatric posterior fossa tumor prediction and prognosis. With the development of high-performance computing and machine learning technologies, radiomics provides increasing opportunities for clinical decision-making. Several studies have applied radiomics as a decision support tool in intracranial tumors differentiation. Here we seek to achieve preoperative differentiation between ependymoma (EP) and pilocytic astrocytoma (PA) using radiomics analysis method based on machine learning. A total of 135 Magnetic Resonance Imaging (MRI) slices are divided into training sets and validation sets. Three kinds of radiomics features, including Gabor transform, texture and wavelet transform based ones are used to obtain 300 multimodal features. Kruskal–Wallis test score (KWT) and support vector machines (SVM) are applied for feature selection and tumor differentiation. The performance is investigated via accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) analysis. Results show that the accuracy, sensitivity, specificity, and AUC of the selected feature set are 0.8775, 0.9292, 0.8000, and 0.8646 respectively, having no significantdifferencescomparedwiththe overall feature set. For different types of features, texture features yield the best differentiation performance and the significance analysis results are consistent with this. Our study demonstrates texture features perform better than the other features. The radiomics approach based on machine learning is efficient for pediatric posterior fossa tumors differentiation and could enhance the application of radiomics methods for assisted clinical diagnosis.

ФОРМИ ЗАЛУЧЕННЯ МОЛОДІ НІМЕЧЧИНИ ДО ПОЛІТИЧНОГО ЖИТТЯ КРАЇНИ

The article deals with the features of political participation of German youth, in particular, information obtained from the results of studies of youth issues. Youth policy-making in Germany takes place at different levels. The cooperation between public and non-public institutions and organizations is determined by the principle of subsidiarity. The principle of subsidiarity is that a central authority performs only those tasks that cannot be executed by a person or organization at a local level. The guiding principle of this policy approach is the active participation of young people. The latest achievement in Germany as part of this strategy is the development of a so-called «youth check» (Jugendcheck), that serves to assess the impact of national legislation on the life of young people. «Youth check» also serves to examine if and how young people were involved in the democratic procedures and the development of public projects. Another issue in the Germany’s policies is the integration and support of young refugees. Young people lacking higher educational and professional qualifications run the danger of being isolated not only professionally and financially, but also politically, because they lack the political skills necessary to assert their political demands and because they use their political rights to a lesser extent. The Internet enables the acceleration and expansion of political activities of young people. The attraction of all media and forms of communication quickly and directly not only leads to a larger amount of information, communication and participation but also to a new level of quality in social interaction. The development of skills and certain personality characteristics also guarantees a positive social integration into the adult world under difficult and changed present social conditions. Young people with higher levels of education and political involvement tend to use opportunities for democratic political decision-making more frequently than others. It is safe to say that all forms of political participation, from the simple act of voting to time-consuming activities such as working for political parties, increase with the level of a person’s education. The study of the experience of policy participation of young people in other countries can be a good source for innovative ideas for educating civic identities in youth.

Optimizing future planning in Parkinson disease: suggestions for a comprehensive roadmap from patients and care partners.

Living with Parkinson disease (PD) is complicated by an unpredictable disease course which can delay planning for future needs. This study explores patient and care partner needs related to future planning using a palliative care framework with physical, psychological, social, cultural, end-of-life, and ethical aspects of care in PD to guide analysis. Secondary analysis of patient and care partner interviews from a randomized clinical trial comparing interdisciplinary outpatient palliative care versus standard care for individuals with PD and care partners in an academic setting. Sixty participants were interviewed (30 patients and 30 care partners) about needs related to future planning. Team-based thematic analysis was used to identify key themes. Many care partners and patients living with PD described a desire for information about what to expect and how to plan for the future. Participants posed multiple questions about PD progression and devised the metaphor of a "roadmap" as a guide for decision making and planning. When exploring the concept of a PD roadmap, five themes emerged: (I) desire for a comprehensive tool for future planning, such as a roadmap, (II) care partner preferences for specific future planning, (III) PD-related life changes as opportunity for future planning and decision-making, (IV) cues from family, peers, and medical professionals about "location" on the roadmap, and (V) opportunities and challenges to integrating a PD roadmap into patient-centered care. Patients and care partners described key needs related to future planning that can inform a comprehensive roadmap to assist with education, communication, and decision making. A roadmap tool can promote individualized anticipatory guidance and multidimensional shared decision-making discussions between patients, care partners, and the healthcare team related to PD progression.

Fitness to drive in seizure and epilepsy: A protocol for Iranian clinicians

Driving restriction is a well-known undesirable consequence of epilepsy and causes significant problems regarding independence and employment for epileptic patients. Many countries all over the world have provided comprehensive protocols in this regard with the aim of providing the possibility of less restricted, but safe driving for epileptic patients and also providing the opportunity for uniform decision-making for clinicians. However, the available fitness to drive protocol in Iran still lacks sufficient details and clinicians might encounter serious problems in terms of the driving issue in epileptic patients. In order to provide a uniform protocol containing adequate practical data, a systematic review of literature addressing guidelines about driving and epilepsy and driving laws of different countries for epileptic patients was performed and, after consideration of cultural issues, a practical protocol for Iranian neurologists was suggested.

Three-dimensional computed tomography mapping of posterior malleolar fractures.

Posterior malleolar fractures have been reported to occur in < 40% of ankle fractures. To reveal the recurrent patterns and characteristics of posterior malleolar fractures by creating fracture maps of the posterior malleolar fractures through the use of computed tomography mapping. A consecutive series of posterior malleolar fractures was used to create three-dimensional reconstruction images, which were oriented and superimposed to fit an ankle model template by both aligning specific biolandmarks and reducing reconstructed fracture fragments. Fracture lines were found and traced in order to generate an ankle fracture map. This study involved 112 patients with a mean age of 49, comprising 32 pronation-external rotation grade IV fractures and 80 supination-external rotation grade IV fractures according to the Lauge-Hansen classification system. Three-dimensional maps showed that the posterior ankle fracture fragments in the supination-external rotation grade IV group were relatively smaller than those in the pronation-external rotation grade IV group after posterior malleolus fracture. In addition, the distribution analyses on posterior malleolus fracture lines indicated that the supination-external rotation grade IV group tended to have higher linear density but more concentrated and orderly distribution fractures compared to the pronation-external rotation grade IV group. Fracture maps revealed the fracture characteristics and recurrent patterns of posterior malleolar fractures, which might help to improve the understanding of ankle fracture as well as increase opportunities for follow-up research and aid clinical decision-making.

An Ethics of Unknowing: Discerning Ethical Patient-Provider Interactions in Clinical Decision-Making.

There is an irreducible amount of uncertainty in clinical decision-making. Both health care providers and patients experience anxiety elicited by clinical uncertainty, and this can lead to missed opportunities for healthy shared decision-making. In order to improve the patient-provider relationship and the ethical qualities of decision-making, the provider first needs to recognize where his/her "unknowing" exists. This article presents a model for a unique ethics of unknowing by identifying three levels at which the provider's knowledge or lack thereof impacts clinical decision-making. The model illuminates ethical choices that providers can make to promote healthy patient-provider relationships. The means by which an ethics of unknowing informs shared decision-making in patient care will be exemplified through a case study of one patient's encounters with several physicians while making difficult decisions throughout her breast cancer journey.

An Ethics of Unknowing: Discerning Ethical Patient-Provider Interactions in Clinical Decision-Making

There is an irreducible amount of uncertainty in clinical decision-making. Both health care providers and patients experience anxiety elicited by clinical uncertainty, and this can lead to missed opportunities for healthy shared decision-making. In order to improve the patient-provider relationship and the ethical qualities of decision-making, the provider first needs to recognize where his/her “unknowing” exists. This article presents a model for a unique ethics of unknowing by identifying three levels at which the provider’s knowledge or lack thereof impacts upon decision-making. The model illuminates ethical choices that providers can make to promote healthy patient-provider relationships. The means by which an ethics of unknowing informs shared decision-making in patient care will be exemplified through a case study of one patient’s encounters with several physicians while making difficult decisions throughout her breast cancer journey.

Impact of COVID-19 pandemic on people living with visual disability.

People living with visual disabilities/impairment are more likely vulnerable to get contracted from the severe acute respiratory syndrome coronavirus-2 (SARS-CoV 2) than people without visual impairment. This means more than 253 million people globally will be at higher risk of affecting by the COVID-19. The current pandemic, followed by a nationwide emergency lockdown to slow the unprecedented spread of the virus, will have a serious impact on people living with visual disabilities and even endangers their lives in the long run. Many restrictive and control measures, including the adoption of new behavioural changes (for example, social distance during outdoor movement, limiting touch or tactile contact) recommended by the government will pose immense challenges to individuals with a visual loss. This serious impact, including challenges in healthcare access, can be minimized through inclusive service approaches, involving persons with visual disabilities, caregivers, family members, and healthcare providers, along with the community to a large extent, and finally, support to improve the overall outcomes. The government, along with profit or non-profit private sectors, should consider initiating such inclusive approaches while planning responses to the pandemic. Indeed, the present COVID-19 pandemic provides an opportunity for health care planners and decision-makers of various organizations across India for a reformation of disabilities care. Impacts due to the pandemic and lockdown can be reduced substantially if planning and policy are in place before any emergency happened in the future.

Online teaching-learning in higher education during lockdown period of COVID-19 pandemic

The whole educational system from elementary to tertiary level has been collapsed during the lockdown period of the novel coronavirus disease 2019 (COVID-19) not only in India but across the globe. This study is a portrayal of online teaching-learning modes adopted by the Mizoram University for the teaching-learning process and subsequent semester examinations. It looks forward to an intellectually enriched opportunity for further future academic decision-making during any adversity. The intended purpose of this paper seeks to address the required essentialities of online teaching-learning in education amid the COVID-19 pandemic and how can existing resources of educational institutions effectively transform formal education into online education with the help of virtual classes and other pivotal online tools in this continually shifting educational landscape. The paper employs both quantitative and qualitative approach to study the perceptions of teachers and students on online teaching-learning modes and also highlighted the implementation process of online teaching-learning modes. The value of this paper is to draw a holistic picture of ongoing online teaching-learning activities during the lockdown period including establishing the linkage between change management process and online teaching-learning process in education system amid the COVID-19 outbreak so as to overcome the persisting academic disturbance and consequently ensure the resumption of educational activities and discourses as a normal course of procedure in the education system.

Economic evaluation methodologies for renewable energy projects

Typically, the economic analysis of Renewable Energy Projects (REP) has been assessed considering Classical Methodologies of Investment Analysis (CMIA) in which only a few set of indicators are included, highlighting the Payback, Net Present Value and Internal Rate of Return. This excessive reliance on CMIA has been criticized because it neglects managerial flexibility, and it may end up leading to the project's undervaluation. This paper attempts firstly, to identify and describe the complementarity among economic evaluation methodologies for REP. Secondly, a novel framework is proposed for conducting the economic analysis to help decision-makers in identifying the most suitable methodology before proceeding with the investment. The findings of the study suggest that CMIA may be suitable for the cases of projects presenting low volatility. However, the analysis should be supplemented by a new set of indicators for projects with medium or high volatility. The Multi-Index Methodology (MIM), the Extended Multi-Index Methodology (EMIM) and the Real Options Analysis (ROA) are proposed to increase the investors’ perception towards both the project’s profitability and risk and to account for flexibility. The application of the proposed framework is demonstrated for the case of a Small Hydropower Plant (SHP) investment project. The outcomes of this paper also include the opportunities for decision-makers to flexibly respond to changes in the business and economic market using the proposed conceptual framework.

What Twitter teaches us about patient-provider communication on pain.

The objective of this study was to understand how pain patients and health care providers (HCPs) are engaging on Twitter and what insights this engagement might provide. By identifying how information is spread by and between these audiences, organizations such as patient advocacy groups may be better poised to develop and share materials that facilitate online communication between HCPs and pain patients, with an end goal of improving a shared decision-making process around pain management. We analyzed the Twitter audiences most engaged on pain topics by conducting a Social Network Analysis (SNA) of a large network of connected users on Twitter. The analysis segmented users based on the sources they cited and measured their influence based on who follows them. As a point of comparison, we also conducted an SNA of Twitter audiences most engaged on oncology topics. Oncology was chosen as a comparison due to what was perceived to be a highly developed online network of both patients and physicians. The populations included in this research included 12,086 accounts that were highly engaged on pain-related topics, and 12,617 accounts that were highly engaged on oncology-related topics. Network statistics were generated for variables including: word use, sources cited, retweets, and mentions. We also statistically analyzed the Twitter follow relationships among select HCPs and patient groups within each SNA. The creation of separate pain and oncology SNAs allowed the team to compare relationships and engagement related to these topics. We found that on Twitter, pain patients and providers appear to interact less than oncology patients and providers. Pain patients do not appear to follow medical professionals or share medical or health-related information on Twitter to the same extent as oncology patients. In addition, we found that pain patients do not communicate on Twitter in the same language as HCPs. Our results are important because they underscore that challenges in communication are not just problematic in face-to-face interactions, but also in digital social network (Twitter) interactions, serving as an additional roadblock to what can be shared decision-making opportunities around pain management. Contributing to this roadblock is access to quality information and a potential need for an online, evidence-based resource hub that could benefit the pain patient community in the same way that cancer.gov serves as a source of aggregated materials for oncology patients and HCPs. This study is an illustration of how social media networks like Twitter can be used to better understand the relationships, language gaps, and shared resources between pain patients and providers and offers a template for using digital social network (Twitter) interactions to research other difficult-to-treat or rare disease states.

Biological Citizenship: from Patient Organizations to Consumer Genomics

В развитии концепции биологического гражданства значительную роль сыграло осмысление активизма пациентских организаций. Объединенные общей «биологической судьбой» и поиском новых форм влияния на политику в области научных исследований и здравоохранения, они поставили под вопрос прежний формат взаимоотношений науки, общества и институтов здравоохранения, бросив вызов традиционному разрыву между неспециалистами и экспертами. Пациентским организациям удалось заявить о правах граждан на решение их проблем, создать новые каналы коммуникации с органами власти и научными учреждениями, сформировать эффективную модель деятельности. Новое пространство взаимодействия врачей-клиницистов, ученых, политиков, пациентов и их родственников получило дополнительный импульс развития благодаря прогрессу информационно-коммуникативных технологий. Создание онлайн-платформ взаимопомощи пациентов, возможности быстрого обмена знаниями и опытом привели, кроме прочего, к расширению полномочий и автономии пациентов, включению неспециалистов в процессы принятия решений. В таком контексте оптика биологического гражданства представляет интерес для анализа потребительской геномики, которая не связана с какими-либо гражданскими проектами или инициативами, но в значительной степени влияет на тенденции самомедикализации, расширения автономии и полномочий пациентов. Потребительская геномика открывает возможности для принятия самостоятельных решений и информированной независимости от специалистов, оказывая влияние на выбор образа жизни и оптимальных стратегий в сфере «заботы о себе». Однако тенденциям индивидуализации противостоит расширение связей с родственниками на основе новых геномных данных и вовлечение незнакомых людей в обсуждение повествовательных описаний биологической идентичности.

Clinical Applications of Echo Strain Imaging: a Current Appraisal.

This article reviews recent advances in echocardiographic strain imaging, particularly in its ability to prognosticate in cardiovascular outcomes and impact clinical decision making. Strain has been proposed as a sensitive tool in detecting early ventricular dysfunction. Left ventricular global longitudinal strain (LV-GLS) detects subtle changes in myocardial function, often not quantifiable by ejection fraction alone. Thus, LV-GLS provides the opportunity for early decision-making, and the implementation of more effective treatments, improving outcomes in a variety of diseases such as valvular heart diseases, cardio-oncology, ischemic heart disease, cardiomyopathies, heart transplantation, and pericardial diseases and cardiomyopathies. Strain is a promising tool for the early detection of myocardial dysfunction in patients with preserved left ventricular ejection fraction and can prognosticate long-term outcomes.

First-year college students’ experiences of a brief sexual health seminar

ABSTRACTCollege provides young adults with ongoing opportunities for relationship and sexual decision-making, but to date only limited attention has been given to college-level sexual health education experiences among first-year students. This study examined the experiences of 46 (31 women, 15 men) first-semester college students who participated in a brief sexual health seminar. Data were collected using semi-structured interviews and subjected to qualitative content analysis. Participants identified five content areas related to their experience of the course: (a) reasons for course involvement, (b) retrospective expectations for course involvement, (c) course takeaway messages, (d) efficiency of course content and coverage, and (e) course impact. Findings are discussed in terms of the most to least prominent themes within each content area. Participants reported positive perceptions of course involvement and gaining the greatest knowledge in areas of sexual and relational health, prevention and healthy decision-making. Implications for research and the development of future sexual health curricula to meet the needs of diverse college student populations are discussed.

Data-Driven Decision Making in Precision Agriculture: The Rise of Big Data in Agricultural Systems

In this paper, we provide a review of the research dedicated to applications of data science techniques, and especially machine learning techniques, in relevant agricultural systems. Big data technologies create new opportunities for data intensive decision-making. We review works in agriculture that employ the practice of big data analysis to solve various problems, which reveal opportunities and promising areas of use. The high volume and complexity of the data produced pose challenges in successfully implementing precision agriculture. Machine learning seems promising to cope with agricultural big data, but needs to reinvent itself to meet existing challenges.

A Right to Reasonable Inferences: Re-Thinking Data Protection Law in the Age of Big Data and AI

Big Data analytics and artificial intelligence (AI) draw non-intuitive and unverifiable inferences and predictions about the behaviors, preferences, and private lives of individuals. These inferences draw on highly diverse and feature-rich data of unpredictable value, and create new opportunities for discriminatory, biased, and invasive decision-making. Data protection law is meant to protect people’s privacy, identity, reputation, and autonomy, but is currently failing to protect data subjects from the novel risks of inferential analytics. The legal status of inferences is heavily disputed in legal scholarship, and marked by inconsistencies and contradictions within and between the views of the Article 29 Working Party and the European Court of Justice (ECJ). This Article shows that individuals are granted little control or oversight over how their personal data is used to draw inferences about them. Compared to other types of personal data, inferences are effectively “economy class” personal data in the General Data Protection Regulation (GDPR). Data subjects’ rights to know about (Articles 13–15), rectify (Article 16), delete (Article 17), object to (Article 21), or port (Article 20) personal data are significantly curtailed for inferences. The GDPR also provides insufficient protection against sensitive inferences (Article 9) or remedies to challenge inferences or important decisions based on them (Article 22(3)). This situation is not accidental. In standing jurisprudence the ECJ has consistently restricted the remit of data protection law to assessing the legitimacy of input personal data undergoing processing, and to rectify, block, or erase it. Critically, the ECJ has likewise made clear that data protection law is not intended to ensure the accuracy of decisions and decision-making processes involving personal data, or to make these processes fully transparent. Current policy proposals addressing privacy protection (the ePrivacy Regulation and the EU Digital Content Directive) and Europe’s new Copyright Directive and Trade Secrets Directive also fail to close the GDPR’s accountability gaps concerning inferences. This Article argues that a new data protection right, the “right to reasonable inferences,” is needed to help close the accountability gap currently posed by “high risk inferences,” meaning inferences drawn from Big Data analytics that damage privacy or reputation, or have low verifiability in the sense of being predictive or opinion-based while being used in important decisions. This right would require ex-ante justification to be given by the data controller to establish whether an inference is reasonable. This disclosure would address (1) why certain data form a normatively acceptable basis from which to draw inferences; (2) why these inferences are relevant and normatively acceptable for the chosen processing purpose or type of automated decision; and (3) whether the data and methods used to draw the inferences are accurate and statistically reliable. The ex-ante justification is bolstered by an additional ex-post mechanism enabling unreasonable inferences to be challenged.

3D Computed Tomography Mapping of Thoracolumbar Vertebrae Fractures.

BackgroundFractures of the thoracolumbar (TL) spine represent 90% of all spinal fractures, followed by cervical and lumbar spine fractures. This study aimed to create fracture maps of the traumatic thoracolumbar (TL) fracture vertebral body (T12-L2) through the use of CT mapping as a big data visualization method to reveal recurrent patterns and characteristics of traumatic TL fractures.Material/MethodsA consecutive series of 174 fractured vertebrae (T12–L2) was used to create three-dimensional (3D) reconstruction images, which were superimposed and oriented to fit a model vertebral template by aligning specific bio-landmarks and reducing reconstructed fracture fragments. Fracture lines were found and traced to create a fracture map of the vertebral body.ResultsOur study consisted of 165 patients with an average age of 47 years. A total of 174 fractured vertebrae were collected, consisting of 59 T12 vertebral fractures, 60 L1 vertebral fractures, and 55 L2 vertebral fractures. Two-dimensional (2D) maps, 3D maps, and heat maps showed that the fracture lines tended to be concentrated in the upper third and anterior third of the vertebral body, as well as being distributed in annular wedges along the anterior and lateral sides of the vertebral body. When compared with T12, the distribution of fracture lines in L1 and especially in L2 was more scattered and disorganized.ConclusionsFracture maps revealed recurrent patterns and characteristics of the traumatic TL fracture vertebral body, which improves understanding of TL fractures, as well as helping to increase opportunities for follow-up research and aid clinical decision-making.

Understanding the Role, Expectations, and Challenges That Policy-Makers Face in Using Educational Research

This study provides an insight into the challenges faced in establishing a closer collaboration between educational research and its use in the policy-making process. It aims to identify the factors influencing transfer from research to policy-making and the policy-makers’ needs, expectations, and perception on the use of educational research. Thirteen semi-structured interviews were conducted with representatives of Romanian national and local institutions. Specific software was used to facilitate data management and coding. The results indicate that there is a disconnect between policy-makers’ expectations and the input they receive from the research community, as well as a lack of an institutional framework to facilitate communication and interaction between them. There are systemic blockages on both sides: politics and the cost of opportunity for decision-making, a high level of bureaucracy, limited resources and accessibility of results, a lack of financing and of institutionalized communication, as well as a lack of consultation and cooperation between the two parties. The results indicate a willingness on the policy-makers’ side to acknowledge the importance of using research to inform decisions and their role in facilitating this process. This implies that researchers have limited control over the subsequent stages and could indicate the early point in the research process when other actors should be involved in order to ensure the potential or actual impact of research on policy.

Risk Recall of Complications Associated with Vestibular Schwannoma Treatment.

To assess the risk recall of complications among patients who underwent different vestibular schwannoma (VS) treatments. Patients with VS completed a voluntary and anonymous survey. Survey links were distributed via the Acoustic Neuroma Association (ANA) website, Facebook, and email list. Surveys were distributed to ANA members from January to March 2017. Of the 3200 ANA members with a VS diagnosis at the time of survey distribution, 789 (25%) completed the survey. Subjects reported the following incidence of posttreatment complications: imbalance (60%), hearing issues (51%), dry eyes (30%), headache (29%), and facial weakness (27%). Overall, 188 (25%) recalled remembering all the risks associated with their treatment. Among those in the surgical cohort (52%) who experienced balance issues, facial weakness, cerebrospinal fluid leak, meningitis, and stroke, 73%, 91%, 77%, 67%, and 33% claimed recall of these associated risks. Among those in the radiosurgery cohort (28%) who experienced balance issues, facial weakness, and hydrocephalus, 56%, 52%, and 60% recalled discussions of those risks. Patients with higher-level education (P = .026) and those who underwent surgery (P = .001) had a significantly higher risk recall ratio, while sex, age, and tumor size were not significant contributing factors. Not all patients with VS who experienced treatment complications recalled remembering those risks being discussed with them. Patients with higher education and those who underwent surgery had a better recall of risks associated with different treatment modalities. The risk recall ratio of patients experiencing complications ranged 33% to 91%, suggesting an opportunity for decision-making and discussion improvement.