Participation In Decision-making Process Research Articles

Physician gender is associated with the quality of type 2 diabetes care

Patient gender influences the quality of medical care whilst the role of physician gender is not well established. To investigate the influence of physician gender on quality of care in patients with type 2 diabetes. Cross-sectional study in 51 053 outpatients (48.6% male), treated by 3096 office-based physicians (66.3% male; 74.0% general practitioners, 21.8% internists and 4.2% diabetologists). Outcome measures included processes of care, intermediate outcomes and medical management. Quality of care measures were based on current ADA guidelines. Hierarchical regression models were used to avoid case-mix bias and to correct for physician-level clustering. Adjusted odds ratios were calculated controlling for age, gender, disease duration and presence of atherosclerotic disease. The patients of female physicians were more often women, more obese, older and had more often atherosclerotic disease (34% in the total cohort). The patients of female physicians more often reached target values in glycaemic control (HbA1c < 6.5%; OR 1.14; 1.05-1.24, P = 0.002), blood lipoproteins (LDL-C < 100 mg dL(-1); OR 1.16; 1.06-1.27, P = 0.002), and blood pressure (systolic values < 130 mmHg; OR 1.11; 1.02-1.22, P = 0.018). They were more likely to receive antihypertensive drug therapy in general (OR 1.35; 1.24-1.46, P < 0.0001) and angiotensin converting enzyme (ACE) inhibitors in particular (OR 1.17; 1.09-1.25, P < 0.0001). The patients of female physicians less often performed glucose self-monitoring (OR 0.83; 0.76-0.91, P < 0.0001) and less often received oral hypoglycaemic agents (OR 0.88; 0.82-0.95, P = 0.001). Physician gender influences quality of care in patients with type 2 diabetes. Female physicians provide an overall better quality of care, especially in prognostically important risk management.

Visualisation Techniques For Facilitating Stakeholder Decision Making In Urban Planning

Public participatory geographical information systems (PPGIS) are becoming widely recognised as powerful tools for informed participatory decision-making processes within urban planning projects. This paper discusses a technique recently used within a case study for providing visualisations of traffic flows and how to incorporate local community perceptions of their neighbourhoods into a PPGIS software tool. In particular, the paper demonstrates a new methodology for visualisation of qualitative social data, facilitating dialogue and discussion amongst stakeholders and planning professionals in an urban context. The paper concludes with a discussion on techniques for developing software and presenting visualisations in an understandable and usable manner catering for a diversity of participants.

Investigating the Potential Role of Visualization Techniques in Participatory Coastal Management

The current shift toward “soft” forms of coastal defense as means of adapting to future sea level rise requires careful communication and consultation if they are to gain widespread public acceptance. For this to be achieved then coastal managers must improve the manner in which they communicate with stakeholders and members of the public. One possible solution may be through the application of landscape visualization techniques to illustrate how new policies or management interventions may shape the coast. This article investigates the potential role of such methods in participatory coastal management. Using interviews with coastal managers, the potential application of visualization techniques in coastal management processes are explored in detail. The findings suggest that while a number of possible roles for visualization techniques exist, there is an urgent need for practical testing and evaluation of the technology in participatory decision-making processes.

Why mothers choose to enrol their children in malaria clinical studies and the involvement of relatives in decision making: evidence from Malawi.

This study was aimed at researching the reasons why mothers enrol their children in malaria clinical research and how family members or relatives are involved in the decision-making process. Issues related to informed consent were also a particular focus of this study. A total of 81 participants took part in 8 focus group discussions. Thirty-nine participants were recruited from Blantyre, an urban setting, and forty-two participants were from Chikwawa, a rural setting. All the participants were mothers whose children had participated or were participating in the Intermittent Prevention Therapy post-discharge (IPTpd) Malaria Research. A majority of the participants reported that they chose to participate in the IPTpd research as a way of accessing better quality medical care. They also decided to enrol their children in order to benefit from the material and monetary incentives that were being given to participants for their participation. Most participants reported that they made the enrollment decisions on their own. They informed their family members/marital partners about their enrollment decisions after they had given their consent. A few made their enrollment decisions after consulting their family members. There was also a sense of trust in health workers who asked the potential participants to join the IPTpd research. Most participants decide to take part in malaria research because of better medical treatment. Partners and relatives play a very small role in the decision-making process of participants in malaria clinical research. Research participants'have a sense of trust in health workers who enrol them in clinical research.

Choice Modeler: A Web‐based Spatial Multiple Criteria Evaluation Tool

AbstractThis article presents a concept of a Web‐based spatial multiple criteria evaluation tool for individual and group use called Choice Modeler (CM). CM was originally conceived as part of a larger Participatory Geographic Information System for Transportation project (PGIST; http://www.pgist.org) aimed at developing and evaluating Internet‐hosted capabilities to support participatory decision processes. CM is designed to be either a part of a larger information system such as PGIST or a standalone tool used for evaluation of decision variants. The decision support functions provided by CM aid in reducing the cognitive complexity of the decision space characterized by multiple decision options, evaluation criteria, and criterion weights. This is achieved by incorporating in CM the sensitivity analysis functions for the identification of criteria that do not influence the decision option ranking. Users can remove such criteria from further consideration and thus lessen the cognitive burden of evaluation, which may be essential in multi‐stakeholder participatory decision processes. The additional capabilities of CM include a vote aggregation function to collate individual option rankings into a group ranking, and measures of agreement/disagreement to inform the participants about a group‐derived desirability of specific decision options. The design of CM was implemented using Web‐service architecture. In the article we describe the design of CM and discuss its advantages and limitations.

Czy kapitalizm może być etyczny?

It is the individualistic approach which prevails in previous analysis of the problem of ethics in economy. The problem of the ethical attitude concerns individuals, business people, managers, politicians and economists. The publications about business ethics lack analysis of system circumstances in which individuals and companies act. If capitalism is just the power of capital owners over workers and if, according to Schumpeter, it is “the civilization of inequality and of the family fortune”, than it can be easily judged as a system of predominantly unethical tendencies. Nevertheless, it is worth raising questions about ethical character of various types of capitalism. Participation capitalism is one which ensures (nearly) full employment, a social minimum wage for everyone and the real power of society including workers’ participation in decision processes. The structural conditions of such capitalism force and even encourage ethical behaviour. The capitalism of the protective state was founded by J.M. Keynes, W. Beveridge and Will Hutton with his stakeholder capitalism. Many European countries approach this standard of capitalism. Predacious capitalism (turbo-capitalism) is a maximum-profit-oriented capitalism with no regard to social costs. The nearest example is the post-Reagan American capitalism. Polish capitalism fails to pass muster even in regard to the liberal capitalism.

Implementing a public transport line: multi-criteria decision-making methods that facilitate concertation

Since the 1980s, when the city of Nantes set up its tram system, tramways and segregated lanes for buses have been thriving in French metropolitan areas, while public transportation has been expanding. The layout of the lines within a city and the introduction of the transportation platform into the public space are the result of the tradeoffs made between the technical stakes of the project and the local stakeholders’ expectations. In this article, we propose a methodology that facilitates a process of concertation involving reasoned public discourse (the French word “Concertation” does not have any real equivalent in English. It designates a participative decision-making process in which the various stakeholders are able to express their point of view and have it taken into account in the decision-making process). This methodology, based on historical research about past transportation projects, uses multi-criteria decision-making methods to reach a compromise between the technical stakes and local expectations.

Optimization methods applied for sustainable management of water-scarce basins

This paper aims to present the information-based technologies used for water management in a test basin within the scope of the EU-sponsored SMART and OPTIMA projects. The study uses a dynamic simulation model with its associated databases and a water resources planning and optimization system, established through a web-based client–server implementation to support distributed use and easy access for multi-criteria optimization and decision support. The results clearly illustrate how a consistent and well-integrated set of advanced but practical Decision Support System (DSS) tools can be used for efficient “optimal” water management strategies and policies of use, designed for a participatory public decision-making process.

Discourse strategies In corporate communication for enhancing democracy

Analyzing Public Relations’ contribution to Democracy and specifically how Corporate Communication can involve publics in participatory decision-making processes, not only PR tools should be investigated but also the discourse strategies applied for attaining this aim.In democratic settings, addressees have to contribute to developing the social reference system, making choices based on correct information efficiently processed, as well as expressing them patronizing suitable linguistic means.In this perspective, I want to explore, within a functional linguistic framework, the discursive strategies for:- activating the targets as citizens and not primarily as customers- transferring knowledge- building consensus as well as competencies.

Social Decision-Making Processes in Local Contexts: An STS Case Study on Nuclear Power Plant Siting in Japan

This is an STS case study of the social decision-making process on the siting of a nuclear power plant in Japan, from the point of view of a sociological case analysis. Energy technologies are critically important for industrial society but often trigger serious disputes through the R&D phase and the phase involving introduction into society. Nuclear power technology especially has provoked a lot of conflicts all over the world. By focusing on serious trust issues among decision-making processes and stakeholders, we found very interesting consequences and/or results of participatory social decision-making process in nuclear issues. As an example, we take up the case of a local referendum in the siting area (Maki-machi town, Niigata prefecture of Japan) and describe and analyze it to highlight the critical sociological factors involved in the application of participatory methods in social decision-making processes regarding technological issues. Through this description and analysis, we would like to emphasize the effects of the complicated and subtle structure of local context on the consequence of local decision-making processes. We then propose a concept, “relevant marginal actor,” to clarify which actors play critical roles in the whole local decision-making process in which controversial technological issues are framed, and reframed.

Holistic, adaptive management of the terrestrial carbon cycle at local and regional scales

Actions to manage carbon dioxide (and other greenhouse gas) emissions at regional and local scales take place amid multiple requirements, participants, and agents. To address and solve tensions that emerge from diverse objectives and stakeholder needs, participatory decision processes and information tools are required. This paper explores how regional carbon budget information can contribute to the broader goal of holistic, adaptive regional development. We sketch the characteristics of a novel integrative framework for adaptive carbon management in the context of multiple criteria. An ex-post case study on carbon mitigation from Chiapas, Mexico, demonstrates challenges and trade-offs in a real-world setting.

Social Decision-making Processes in Local Contexts: An STS Case Study on Nuclear Power Plant Siting in Japan

This is an STS case study of the social decision-making process on the siting of a nuclear power plant in Japan, from the point of view of a sociological case analysis. Energy technologies are critically important for industrial society but often trigger serious disputes through the R&D phase and the phase involving introduction into society. Nuclear power technology especially has provoked a lot of conflicts all over the world. By focusing on serious trust issues among decision-making processes and stakeholders, we found very interesting consequences and/or results of participatory social decision-making process in nuclear issues. As an example, we take up the case of a local referendum in the siting area (Maki-machi town, Niigata prefecture of Japan) and describe and analyze it to highlight the critical sociological factors involved in the application of participatory methods in social decision-making processes regarding technological issues. Through this description and analysis, we would like to emphasize the effects of the complicated and subtle structure of local context on the consequence of local decision-making processes. We then propose a concept, “relevant marginal actor,” to clarify which actors play critical roles in the whole local decision-making process in which controversial technological issues are framed, and reframed.

E-cognocracy and its voting process

e-Cognocracy [J.M. Moreno-Jiménez, J.M. Polasek, e-Democracy and knowledge: a multicriteria framework for the new democratic era, Journal of Multicriteria Decision Analysis 12 (2003) 163–176 [15]; J.M. Moreno-Jiménez, J.M. Polasek, e-Cognocracy and the participation of immigrants in e-governance, TED Conference on e-government 2005. Electronic democracy: The challenge ahead, Schriftenreihe Informatik, vol. 13, University Rudolf Trauner-Verlag, 2005, pp 18–26 [16]; G.E. Kersten, e-Democracy and participatory decision processes: lessons from e-negotiation experiments, Journal Multi-criteria Decision Analysis 12 (2003) 127–143 [13]] is a new democratic system that focuses on the creation and social diffusion of the knowledge gained from the scientific resolution of highly complex problems associated with public decision making. In this scenario, e-voting is not limited to the choice of a given political party, but to the extraction of the relevant knowledge. Even though e-voting systems have been widely studied, some situations are still not covered by the conventional literature, and this makes it necessary to consider certain variations to the main schema. In this paper, we will present one such lacuna (associated with e-cognocracy), and will examine the changes required in conventional e-voting processes and their implications.

Salud y democracia en Brasil. Valor público y capital institucional en el sistema único de salud

The health care system reform in Brazil was launched as part of the struggles for building a democratic regimen, in the last quarter of the XX century. Defending the universal right of health care as part of the citizenship status and the State duty to provide it, this social movement has been able to provoke a deep transformation in the health care policy. Three different and simultaneous processes were at the roots of the transformations although they not always were convergent. They are the processes of constitucionalization, institutionalization, and individualization. Constitucionalization means the norms and laws that assure a legal frame to the health care right; the institutionalization deals with the creation of a new pact for the federalism and a decentralized and participatory decision-making process, based in consensus building. Individualization requires the construction of political actors and a new political arena. This article analyzes the creation of the SUS (National Health Care System), considered as the most original policy in the Brazilian democracy and evaluates the progresses and contradictions among the mentioned processes regarding the public value of fighting poverty and social exclusion.

Critical reflections on participatory action research for rural development in Iran

Critical reflections are presented from two pilot participatory action research (PAR) projects in rural Iran that aimed to improve communication between state development workers and male and female rural extension workers, and to increase participants' knowledge of participatory communication and their gender awareness. The research team adopted the perspective that people cannot be developed, they can only develop themselves. One of the main findings was that critical gender analysis is valuable in relation to all participants, including the research team. This is important in a predominantly patriarchal system. Conducting this ongoing PAR has been very challenging in a society with a centralized hegemonic structure, where participatory research is very new. In this context, achieving authentic participation and communication requires patience, commitment and sacrifice on the part of action researchers. Despite this, the project has changed the attitudes of rural extension workers and bureaucrats towards a more participatory decision-making process.

Participação cidadã no planejamento das ações da Emater-RN

Os serviços públicos de assistência técnica e extensão rural no país são desenvolvidos em espaço onde coexistem grupos sociais muito distintos, desde empresários do agribusiness até grupos tradicionais de agricultores familiares. Tendo como tema a participação dos agricultores familiares na elaboração das ações de assistência técnica e extensão rural, este artigo analisou o processo decisório participativo do planejamento 2005 da EmaterRN, utilizando como referência teórica principal a escada de participação cidadã de Arnstein (1969). Foi realizada uma pesquisa de campo, documental e bibliográfica, de tipo exploratório, com abordagem qualitativa, e os dados, coletados de diferentes fontes - entrevistas, observações não-participantes e documentos - foram submetidos à análise de conteúdo do tipo categorial (Bardin, 1977). Os resultados evidenciaram que o nível de participação do agricultor no planejamento da instituição se encontra em uma situação intermediária entre uma participação simbólica e uma participação real. Essa busca contínua de aperfeiçoamento dos canais participativos é relevante, no sentido de que mais que a institucionalização, acredita-se que o aperfeiçoamento e a continuidade dos processos de gestão participativa dependem da relação, sempre tensionada e crescentemente qualificada, entre a sociedade organizada e o Estado.

Hydro-economic Modeling in River Basin Management: Implications and Applications for the European Water Framework Directive

Economic ideas and processes are becoming increasingly integrated with more traditional engineering and hydrologic models of water management problems. Combining economic management concepts and performance indicators with an engineering-level of understanding of a hydrologic system can provide results and insights more directly relevant for water management decisions and policies. When such models are developed and used with involvement of stakeholders, they can become a basis for shared understanding of water problems as a foundation for negotiated management and policy solutions. When implemented with optimization software, integrated hydro-economic models also can suggest promising innovative solutions for policy-makers to consider. Their applications to river basin management problems are reviewed. Economic and integrated economic-engineering-hydrologic modeling is then discussed in the context of the evolving European Water Framework Directive. Relevant items are cost recovery and water pricing, cost-effectiveness of water management measures, and public participation in decision processes.

Participation of adolescents in household decision-making process in Bangladesh

<b>Background:</b> The decision-making authority is one of the ways of measuring the female empowerment, although mere participation in any matter does not corroborate full empowerment of women. However, participation in decision-making process in household matters considers that a female is accounted in the family. <b> Objective:</b> The present study investigated to the extent at which the female adolescents participated in decision-making process in household matters and assessed the factors influencing them. <b> Study Setting:</b> Both rural and urban areas of Bangladesh. <b> Study Design:</b> A quantitative and a qualitative study designs were adopted for this study. <b> Sample Size and Sampling:</b> A cluster sampling technique was used to select the sample. A sample of 3362 female adolescents irrespective of their marital status was selected using a cluster sampling technique. To complement the results found in quantitative analysis, a series of focus group discussions were also conducted among the adolescents. <b> Results:</b> The analysis revealed that a large proportion of the study adolescents did not participate in any decision-making process in their household matters. Only about one-third (31.1%) of the adolescents participated in any household matter; however, the acceptance of their opinions was minimal. In spite of little participation of adolescents in family matters, multivariate logistic regression analysis revealed that older adolescents aged 15-19 years, years of schooling, work status, and the family members with a positive attitude toward female education appeared to be the influencing factors for adolescent participation in household affairs (<i> P < 0.05</i> ). <b> Conclusions</b> : The study concluded that gainful economic activities of adolescents and female education are the key elements for participation of female adolescents in different household matters.

A refined model of factors affecting convention participation decision-making

In this study, a two-step refinement of conceptual models was performed: firstly, an existing model developed by Oppermann and Chon [1997. Convention participation decision-making process. Annals of Tourism Research, 24(1), 178–191] was used as the foundation framework; secondly, while referring to the model and other literature, a modified model was proposed as the conceptual framework for future study. The new refined model of factors affecting convention participation decision-making comprises four main dimensions, association/conference factors, personal/business factors, location factors, and total cost factors. Attributes under each dimension were also carefully examined. This proposed model should provide research insights, make a contribution to the existing literature and guide future research on the factors affecting convention participation decision-making.

Determinants of Longevity and Success in Lebanese Family Businesses: An Exploratory Study

This article explores the characteristics of Lebanese family businesses using a sample of 114 firms and tests various propositions regarding the relationships between correlates of effective succession planning and longevity. Successful family businesses in Lebanon exhibit a variety of responses to the variables that are conducive to success. The findings indicate that older firms are more inclined to use a participatory decision-making process, as evidenced by more reliance on advisory boards. A significantly larger proportion of older firms relative to younger ones holds family meetings and has formal redemption and liquidity plans. Firms in our sample are characterized by liberal attitudes: more than 75% consider female ownership acceptable and more than two-thirds of the firms respond positively to potential female CEOs.