Outcome Of Deliberations Research Articles

Anchoring as a Structural Bias of Deliberation

AbstractWe study the anchoring effect in a computational model of group deliberation on preference rankings. Anchoring is a form of path-dependence through which the opinions of those who speak early have a stronger influence on the outcome of deliberation than the opinions of those who speak later. We show that anchoring can occur even among fully rational agents. We then compare the respective effects of anchoring and three other determinants of the deliberative outcome: the relative weight or social influence of the speakers, the popularity of a given speaker’s opinion, and the homogeneity of the group. We find that, on average, anchoring has the strongest effect among these. We finally show that anchoring is often correlated with increases in proximity to single-plateauedness. We conclude that anchoring can constitute a structural bias that might hinder some of the otherwise positive effects of group deliberation.

Understanding the Impact of Collaborative Governance on Sustainability: Evidence from Buying Green in Local Governments in Florida, USA

ABSTRACT This paper analyzes collaboration patterns in procurement and outcomes as well as the impact of collaboration on green public procurement (GPP) implementation. It draws data from case studies in local governments in Florida and examines the literature on collaborative governance and resource exchange theory. The findings highlight collaboration patterns and note that collaboration may lead to economies of scale, more agile procurement, and enhanced capacity. The study also notes that GPP generally emerges as an unintended by-product of collaboration, rather than a deliberate outcome. It further offers evidence of the conditions under which collaboration can be leveraged to improve GPP.

The physician oncology referral process and its effect on tumor board outcomes.

e13752 Background: Oncology settings are known for their hierarchical structure, with distinct status demarcations among professional occupational specialties. The physician oncology referral process, a critical aspect of cancer management, reflects this hierarchical nature. This process, initiated upon suspicion of cancer, entails sequential clinical evaluation and treatment by physicians in the following order: surgeons, medical oncologists, specialty physicians, and referral physicians like interventional radiologists and radiation oncologists. Those at the top of the hierarchy wield considerable influence over the oncology referral process, directing subsequent patient care. While several studies have criticized the effectiveness of cancer management teams, little attention has been given to the potential role of the referral process in reinforcing hierarchical structures within tumor boards, possibly undermining their intended goals. Methods: This qualitative, ethnographic study investigated the interplay between the physician oncology referral process and tumor board outcomes in oncology settings. Data spanning three years were collected from seven research hospitals in the United States and the United Kingdom, encompassing observations from 44 tumor boards and eighteen semi- and unstructured interviews. The principal investigator conducted an analysis and synthesis of the gathered data. Results: The ethnographic study revealed that the hierarchies observed in tumor boards align with and are influenced by the traditional oncology referral process. Group interactions and treatment deliberation outcomes were significantly affected by the social dynamics of hierarchy mirrored in the referral process, ultimately compromising the intended objectives of tumor boards. Surgeons and medical oncologists, who traditionally lead the referral process, tended to dominate tumor board meetings. In contrast, sub-specialties like interventional radiologists and radiation oncologists, positioned at the end of the referral process, were less engaged in deliberations and often overlooked for treatment referrals. The higher the position in the hierarchy and referral process, the more pronounced the tacit authority and ability to direct patient treatment. Conclusions: This study highlights the alignment of traditional oncology referral processes with tumor board dynamics, showcasing similar social and clinical impacts. Despite potential resentment cultivated by reinforced hierarchy in the referral process, tumor board members tend to acquiesce, accepting decisions even when they may not align with optimal patient care.

The IPTA Nashville consensus conference on post-transplant lymphoproliferative disorders after solid organ transplantation in children: IV-consensus guidelines for the management of post-transplant lymphoproliferative disorders in children and adolescents.

The International Pediatric Transplant Association convened an expert consensus conference to assess current evidence and develop recommendations for various aspects of care relating to post-transplant lymphoproliferative disorders (PTLD) after pediatric solid organ transplantation. This report addresses the outcomes of deliberations by the PTLD Management Working Group. A strong recommendation was made for reduction in immunosuppression as the first step in management. Similarly, strong recommendations were made for the use of the anti-CD20 monoclonal antibody (rituximab) as was the case for chemotherapy in selected scenarios. In some scenarios, there is uncoupling of the strength of the recommendations from the available evidence in situations where such evidence is lacking but collective clinical experiences drive decision-making. Of note, there are no large, randomized phase III trials of any treatment for PTLD in the pediatric age group. Current gaps and future research priorities are highlighted.

The Social Construction of Organizational Communication Through Extension in The Mitigation Model of The Consultation on Village Development in Indonesia

Purpose: Understanding the social construction of organisational communication and deliberation is crucial to mitigating village development deliberation in Indonesia. Discrepancies in the outcomes of development deliberation from village to sub-district to district have implications for changes in the quality and quantity of development projects, which may not conform to the rules and policies set by the head village. Methods: This study employs a constructive approach and a normative qualitative method to examine village development. Primary and secondary materials, as well as legal norms, are used to collect data. The data is collected through literature review, observation, interviews, and narrative analysis based on inductive syllogism. Results and Conclusion: Organizational communication is crucial for the sustainability of development. Counseling on the concept of village development can help achieve this. The village head's policy implementation needs improvement in terms of quality and motivation. It is important to adhere to legal norms for village development. Research implications: This research examines the norms of sustainable rural development in Indonesia, providing knowledge, understanding, and skills to all parties involved. It identifies areas for improvement in the planning and implementation of development budgets to ensure quality and transparent development. Originality/value: Analyze the importance of integrating the village development budget plan with existing regulations with the social demands of the community to ensure the immediate realization of certainty and stability of development quality to lead to a special development sector in the rural economic sector that encourages economic growth of the village community.

What is a High-Quality Moral Case Deliberation?-Facilitators' Perspectives in the Euro-MCD Project.

The evaluation of the European Moral Case Deliberation Outcomes project (Euro-MCD) has resulted in a revised evaluation instrument, knowledge about the content of MCD (moral case deliberation), and the perspectives of those involved. In this paper, we report on a perspective that has been overlooked, the facilitators'. We aim to describe facilitators' perceptions of high-quality moral case deliberation and their Euro-MCD sessions. The research took place in Norway, Sweden, and the Netherlands using a survey combined with interviews with 41 facilitators. Facilitators' perceived that attaining a high-quality MCD implies fostering a safe and respectful atmosphere, creating a wondering mode, being an attentive authority, developing moral reflective skills, reaching a common understanding, and ensuring organisational prerequisites for the MCD sessions. Our central conclusion is that efforts at three levels are required to attain a high-quality MCD: trained and virtuous facilitator; committed, respectful participants; and organizational space. Furthermore, managers have a responsibility to prepare MCD participants for what it means to take part in MCD.

Thermal storage performance analysis of building envelope based on big data sensor network

In order to understand the thermal storage performance analysis of building envelope, the author proposes a research on thermal storage performance analysis of building envelope based on Big data sensor network. The author first compares and analyzes the thermal storage performance parameter systems of different theoretical methods, and determines the key characterization parameters of thermal storage performance under different working conditions based on the analysis of the thermal storage process. Second, in order to compare and verify the measured and simulated indoor temperature of the building, two groups of buildings with identical exterior wall insulation performance and distinct thermal storage performance were chosen. Three distinct thermal storage levels of the building?s exterior walls were used to simulate and analyze the internal surface temperature, heat flux density, and building cooling and heating load. Summer night ventilation was used to investigate the effect of ventilation volume on building cooling loads. In the end, a provincial office building was chosen as the research subject. The structure comprises of two stories, one underground and two over the ground, with a north hub point of 180?. The investigation object is a two-story room. The trial results demonstrate that the deliberate outcomes are in great concurrence with the mimicked results. For the district of the region, under a similar protection execution of the nook structure, the inner surface temperature of the weighty construction outside wall is higher in winter, lower in summer, with a higher intensity load in winter and a lower cooling load in summer. The proper air changes each hour of building night ventilation is 16 ach, and the effect on the cooling heap of weighty structures is huge. Demonstrated the precision of the reproduction technique and model.

Strategies for Enhancing Early Childhood Science Literacy Through STEAM Education

The primary objective of this study is to enhance young children's comprehension of scientific concepts by implementing the STEAM approach within the context of Early Childhood Education (PAUD). The STEAM (Science, Technology, Engineering, Art, and Mathematics) pedagogy for preschoolers emphasizes dynamic learning, stimulates cognitive engagement, facilitates problem-solving, nurtures structured and methodical reasoning, and enhances critical thinking skills. Conducted using the Classroom Action Research method guided by the Kemmis cycle model, this study involves a cohort of 15 participants from group B, aged 5-6 years, and spans across preliminary cycles, Cycle I, and Cycle II, comprising phases of planning, execution, observation, and reflection. The comprehensive deliberation's outcome establishes the potential for enhancing scientific literacy among young children through the implementation of STEAM education. This advancement in scientific understanding is facilitated through captivating balloon experiments, utilizing colors that resonate with children's preferences. The attainment of scientific knowledge, as evident through the STEAM approach, manifests at a rate of 10% during the Pre-Cycle, 26% during Cycle I, and an impressive 72% during Cycle II. The cumulative findings unequivocally underscore the profoundly positive role of STEAM pedagogy in augmenting scientific cognizance during the formative years of early childhood.

Introduction to the Special Issue From Mini-publics to Mass Publics

ABSTRACT Recent years have seen a proliferation of experiments in deliberative democracy, with much focus on the internal workings and throughput legitimacy of such innovations as mini-publics. The research on the links between such mini-publics and the public is still in its infancy and there is a strong debate around the legitimacy of extending the outcomes of small-scale deliberation to the public. This Special Issue addresses the questions of legitimacy mainly from two broad perspectives; the input and the output legitimacy while some papers provide insights on throughput legitimacy as well. Input refers to the representativeness of participants from demographic, attitudinal and intersectional points of view. Output refers to whether the mini-public outputs reflect what the broader electorate would think and how representatives and policymakers deal with their outputs. The papers provide both theoretical and empirical discussion on participants' representativeness in mini-publics and politicians' potential involvement as well as issues of the whole process and how citizens perceive the legitimacy of mini-publics. Analysis also focuses on issues of attitudinal congruence of participants and its importance while other papers examine the impact of mini-publics to the wider electorate by also considering the role the preferences of policymakers have in the whole deliberative process. Theoretical contributions in this special issue analyze the theoretical implications of these democratic innovations for our understanding of democracy and the way forward.

Experimental evaluation of bio medical titanium alloy stabilized with niobium

Niobium stabilized titanium alloy has very less cytotoxicity effect compared to commercially pure titanium alloy (Ti-6Al-4 V). Flow behavior of the metals during hot deformation depends mainly on the strain rate and temperature. Such parameter plays a major role in understanding, and enhancing the workability of metals alloys in real life applications. When bio medical metal alloys are considered where, complex shapes of bio implants are major concern for which mechanical properties are analyzed experimentally. Further allows to optimizing those parameters for hot forging process based on required geometrical modelling. Experimental analysis can make reliable and precise prediction of flow behavior in real time industrial forming process. In this experiment, tensile test on bio medical titanium alloy specimen carried out at two different elevated temperatures ranging from 300℃ and 400℃ at strain rate of 10-3. Experiment carried out shows us flow stress, relation between engineering stress vs strain and true stress vs true strain. Along with this tensile fracture behavior of titanium alloy is examined with electron microscope (SEM) over a range of magnification. Micro hardness and microstructure are observed on the specimen appear to show how dislocation density changes increases with increasing strain rate, but decreases with increasing temperature. Deliberate outcomes manifest the yield and ultimate tensile strength continuously decreased with increase in temperature, and ductility (% elongation) increased with rise in temperature.

The Legal Infrastructure for Hybrid Organizations: The Case of Portugal, 1990-2019

In this study we present, measure, and test a theoretical model of how the legal infrastructure for hybrid organizations emerged from the parliamentary system of Portugal over three decades. To develop this model, we begin with an organized anarchy representation, describing the policy process as the confluence of four distinct streams: choice situations, participants, problems, and solutions. We suggest a theoretical distinction between anarchic policy processes, along the lines of the garbage can, where the streams remain relatively independent, and more structured policy processes, where institutional and political orders create more interdependence among the streams. We develop hypotheses that link the observed outcomes of legal deliberations, categorized as oversight, flight, or resolution, with a characterization of the policy process as more anarchic or more structured. Our findings suggest that the process is more structured than anarchic and show that mechanisms related to a dynamic mix of temporal, institutional, and political orders significantly affect legal outcomes. We close with a review of the findings and some implications for institutional theories of regulation and managers and advocates of hybrid organizations.

Intellectual property framework responses to health emergencies – options for Africa

We debate whether intellectual property (IP) protection of medical products and devices required to prevent, treat and contain COVID-19 should be waived, as proposed by South Africa and India, under the World Trade Organization (WTO)’s Agreement on Trade-related aspects of Intellectual Property Rights (TRIPS Agreement). We discuss existing public policy mechanisms under the TRIPS Agreement and how these have been implemented at national level in Africa, and find that these have proven inadequate and that they have been sub-optimally implemented. We then consider the TRIPS Waiver proposal which has been tabled due to the inadequacy of existing mechanisms and outline the EU’s counter proposal which is founded on existing mechanisms. Both proposals have served at multiple WTO council meetings and would have been the subject of the 2021 WTO Ministerial Conference, which was postponed and is now set to be held in June 2022. Meanwhile, the proposal has been the subject of negotiations between India, South Africa, the EU and the USA (‘the quad’) and, as of May 2022, has been opened for consideration by all Members. Whatever the outcome of WTO deliberations, African states must take necessary national IP regulatory reforms and cooperate at sub-regional and continental level to improve access to medical products and devices to meet their citizenry’s healthcare needs. Significance: There is need for a sustainable and comprehensive intellectual property framework that is responsive to health emergencies. Existing public policy mechanisms have not proven effective. Adaptation and innovation are required at the international norm-setting level as evidenced by the two in-progress proposals for a TRIPS Agreement waiver and for an International Treaty on Pandemics. Both are contested and may only actualise in the medium to long term. In the context of such uncertainty and delay, timely action should be taken at national level, through legislative reform coupled with necessary manufacturing capacity, which will be boosted by cooperation between African states.

Profile of patients presenting with deliberate drug overdose and outcome

Profile of patients presenting with deliberate drug overdose and outcome

When citizens met politicians – the process and outcomes of mixed deliberation according to participant status and gender

With deliberative democracy becoming increasingly incorporated into political processes, the instances of citizens and politicians meeting in deliberation, so-called mixed deliberations, is increasing too. While these are important steps towards more deliberative systems, the mixed deliberation setting nonetheless introduces certain risks regarding equality. Citizens and politicians have different deliberative capacities, which could affect the process of deliberation. Moreover, political inequalities such as gender gaps may be more evident in deliberations where politicians are present. This study focuses on a series of mixed deliberations in 2018 about a proposed municipal merger in Finland. Using content analysis of speech acts (N = 3404) as well as pre- and post-deliberation surveys (N = 225), we analyze patterns according to participant status (politician/citizen) and gender regarding dominance, deliberative discussion quality, and impact on internal and external efficacy. The findings show that politicians dominated the discussions and achieved a higher deliberative quality than citizens. The findings also revealed that women achieved higher deliberative quality in their speech acts.

The Effects and Antecedents of Perceived Fairness in the Deliberative Process for Sustainable Citizens’ Participation

Based on the data from Korean citizen’s deliberation experiments, we examined the effects and antecedents of perceived fairness of the deliberative process. Our empirical study tested whether the perceived fairness of the deliberative process was associated with the outcomes of deliberation (changes in civic participants’ opinions) and explored antecedents that facilitated the perceived fairness of the deliberative process. We found that perceived fairness of the deliberative process positively increased civic participants’ opinion change, information reliability, and culture of acceptance in the deliberative process cultivated the perceived fairness of deliberative process when we controlled personal orientation and characteristics (e.g., political orientation, gender, age and etc.). These results identified conditions for effectively facilitating deliberative civic engagement in the policy decision-making process.

Democratically Sustainable Local Development? The Outcomes of Mixed Deliberation on a Municipal Merger on Participants’ Social Trust, Political Trust, and Political Efficacy

Municipal mergers are typically contentious and polarizing issues among both citizens and politicians. In deciding on these, municipal-level referendums are often commissioned by municipal councils. Referendums, though, are also per se polarizing processes that only exacerbate an already polarizing issue. Adding deliberation to referendum processes has been shown in previous studies to be a more democratically sustainable process than mere referendums. In this study, we explore the use of mixed deliberation between citizens and politicians within a municipal merger process in the municipality of Korsholm in Finland, one year before a referendum on the issue occurred. The deliberations were two-hour sessions in February 2018, with local politicians present in each discussion group. Using pre- and post-deliberation surveys, we trace how citizens (n = 117) engaging in deliberation developed their social trust, political trust, and political efficacy during deliberation. Generally, we expected that all of these would be strengthened in deliberation. The results, however, reveal only a few statistically significant effects, some of which ran contrary to expectations.

Contesting Forms of Knowledge in Policy Deliberation Lessons from Disaster Coping Policies in Thailand

This article presents the case of policy deliberation on disaster coping strategies in Bangkok, Thailand. It demonstrates the challenges scientists faced when they sought to influence policymaking on flood mitigation. The article demonstrates different forms of knowledge that shaped Bangkok’s flood policy, and explains how lay knowledge promoted by farmers, local communities, and Buddhist monks were successful in persuading policymakers and the wider public in their preferred policy option. Meanwhile, scientific knowledge failed to make their case in public forums, and on some occasions, even alienated Thai citizens. The article concludes by drawing lessons on how scientific and lay knowledge can better contest as well as connect their claims to enrich the process and outcomes of public deliberation on disaster coping policy.

Safeguarding Public Values in Cooperation with Big Tech Companies: The Case of the Austrian Contact Tracing App Stopp Corona

In April 2020, at the beginning of the COVID-19 pandemic, the Austrian Red Cross announced it was encouraging a cooperation with Google and Apple’s Exposure Notification Framework to develop the so-called Stop Corona app – a contact tracing app which would support health personnel in monitoring the spread of the virus to prevent new infections (European Commission, 2020a). The involvement of Google and Apple to support combating a public health emergency fueled controversy over addressing profit-driven private interests at the expense of public values. Concerns have been raised about the dominant position of US based big tech companies in political decision concerning public values. This research investigates how public values are safeguarded in cooperation with big tech companies in the Austrian contact tracing app Stop Corona. Contact tracing apps manifest a bigger trend in literature, signifying power dynamics of big tech companies, governments, and civil society in relation to public values. The theoretical foundation of this research form prevailing concepts from Media and Communication Studies (MCS) and Science and Technology Studies (STS) about power dynamics such as the expansion of digital platforms and infrastructures, the political economy of big tech companies, dependencies, and digital platforms and infrastructure governance. The cooperative responsibility framework guides the empirical investigation in four main steps. First steps identify key public values at stake and main stakeholders. After, public deliberations on advancing public values and the translation of public values based on the outcome of public deliberation are analyzed. This research applies a qualitative case study, including document analysis and expert interviews. In total, 52 documents were analyzed and six expert interviews conducted. Findings show that key public values at stake concerning Stop Corona involve data protection and privacy, (cyber-)security and safety, accuracy, voluntariness and consent, accessibility, inclusiveness, transparency, trust, etc. Public deliberations of multiple stakeholders about public values can help to safeguard public values. While an involvement of EU, state, civil society, and science and research can be witnessed in defining and advancing public values, Google and Apple, ultimately, translate the outcome of public deliberations through technological design choices. Therefore, public deliberations require a public-value oriented process which is transparent and involves a strong civil society and science and research community, and a unified EU voice. There is a clear need for technical alternatives and policy frameworks to organize the cooperation with big tech companies at EU level.

Moral competence, moral teamwork and moral action - the European Moral Case Deliberation Outcomes (Euro-MCD) Instrument 2.0 and its revision process

BackgroundClinical Ethics Support (CES) services are offered to support healthcare professionals in dealing with ethically difficult situations. Evaluation of CES is important to understand if it is indeed a supportive service in order to inform and improve future implementation of CES. Yet, methods to measure outcomes of CES are scarce. In 2014, the European Moral Case Deliberation Outcomes Instrument (Euro-MCD) was developed to measure outcomes of Moral Case Deliberation (MCD). To further validate the instrument, we tested it in field studies and revised it. This paper presents the Euro-MCD 2.0 and describes the revision process.MethodsThe revision process comprised an iterative dialogue among the authors as Euro-MCD-project team, including empirical findings from six Euro-MCD field-studies and input from European experts in CES and theory. Empirical findings contained perceptions and experiences of MCD outcomes among healthcare professionals who participated in MCDs in various settings in Norway, Sweden and the Netherlands. Theoretical viewpoints on CES, literature on goals of CES and MCD and ethics theory guided the interpretation of the empirical findings and final selection of MCD outcomes.ResultsThe Euro-MCD 2.0 Instrument includes three domains: Moral Competence, Moral Teamwork and Moral Action. Moral Competence consists of items about moral sensitivity, analytical skills and virtuous attitude. Moral Teamwork includes open dialogue and supportive relationships and Moral Action refers to moral decision-making and responsible care. During the revision process, we made decisions about adding and reformulating items as well as decreasing the number from 26 to 15 items. We also altered the sentence structure of items to assess the current status of outcomes (e.g. ‘now’) instead of an assumed improvement over time (e.g. ‘better’) and we omitted the question about perceived importance.ConclusionsThe Euro-MCD 2.0 is shorter, less complex and more strongly substantiated by an integration of empirical findings, theoretical reflections and dialogues with participants and experts. Use of the Euro-MCD 2.0 will facilitate evaluation of MCD and can thereby monitor and foster implementation and quality of MCD. The Euro-MCD 2.0 will strengthen future research on evaluation of outcomes of MCD.

Climate change communication and public engagement in interpersonal deliberative settings: evidence from the Irish citizens’ assembly

ABSTRACT Citizens are being increasingly called upon to participate in climate change policymaking. Citizen assemblies have been proposed as a viable and effective way of boosting public support for ambitious climate policies. This study examines the varying effects of climate change communication on citizen support for the speaker’s policy proposals, in the framework of the most consequential citizen-centred experimentation in environmental policymaking to date – the Irish Citizens’ Assembly. Drawing on the six-principle framework for authors of the Intergovernmental Panel on Climate Change (IPCC), we test whether effective communication contributes to explaining outcomes of deliberation on climate change. Methodologically, we take a set-theoretic approach, using fuzzy-set qualitative comparative analysis (fsQCA) to operationalise conditions and analyse the data. Our findings show that effective communication does explain why certain policy proposals were adopted by the Irish Citizens’ Assembly over others, in conjunction with other conditions, such as having a high proportion of proposals being repeated by other speakers. Key policy insights Citizen assemblies and other deliberative fora can boost public support and provide legitimacy for ambitious climate policy. The information presented to participants in such fora has an effect upon engagement with, and support for, policy proposals. It is not climate change information per se, but how it is communicated that matters for participants’ uptake of ambitious climate measures. Speakers who communicate effectively see greater uptake of their policy proposals. Differences exist in the paths to success for expert and non-expert speakers. While the former were successful when they presented a high number of proposals, the latter were successful when they presented a simple, unique message. Organisers of citizens’ assemblies should encourage the participation of such non-expert speakers who can connect with audiences on ‘real-life’ climate action.