Deliberative Process Research Articles

Setting the agenda for climate assemblies. Trade-offs and guiding principles

ABSTRACT Citizens’ assemblies on climate change are increasingly popular to support democratic decision-making. Such Climate Assemblies (CAs) convene representative groups of citizens formulating policy proposals after hearing experts and deliberating intensely. CAs may help addressing climate policy issues more effectively partly because their members need not worry about re-election. CAs’ effectiveness depends on their design such as the issues chosen (or not chosen) for deliberation. Agenda-setters exert substantial power by selecting certain issues and by choosing framings that benefit some solutions over others. In this paper I ask: What characterizes agendas that are suitable and legitimate for deliberation in CAs? The aim is to support practitioners in making informed agenda choices for CAs by providing a list of ten widely accepted guiding principles based on expert interviews, policy documents, and information gathered from the Knowledge Network on Climate Assemblies (KNOCA). The paper systematically discusses trade-offs of various agenda choices in the light of different CA rationales. Results show that those with system-supporting rationales tend to favour narrower agendas tailored to political demands aiming to increase immediate policy impact; those with system-disrupting rationales prefer more open agendas allowing citizens to challenge existing political practices and worldviews. Results support earlier arguments that distinctions of entire deliberative processes in either top-down or bottom-up are too simplistic and that a tool-box approach is more useful. Insights appear relevant for debates of deliberative minipublics more generally. Future research should investigate whom to involve in setting CA agendas and with how much power.

Deliberative process of health technology reassessment by health technology assessment agency in Korea.

In 2019, the National Evidence-based Healthcare Collaborating Agency (NECA) in Korea established a health technology reassessment (HTR) system to manage the life cycle of health technologies and develop operational measures promoting the efficient use of healthcare resources. The purpose of this study is to introduce the detailed implementation process and practical functional methods of the HTR implemented by NECA.The HTR is a structured multidisciplinary method for analyzing health technologies currently used in the healthcare system based on the latest information on parameters, such as clinical safety, effectiveness, and cost-effectiveness of optimizing the use of healthcare resources as well as social and ethical issues. All decision-making stages of the HTR are carefully reviewed and transparently managed. The HTR committee makes significant decisions, and the subcommittee decides the details related to the assessment process.Since the pilot began in 2018, 262 cases have been reassessed, of which, 126 cases (48.1 percent) were health services not covered by the National Health Insurance (NHI). Over the past 5 years, approximately 130 recommendations for the in-use technologies were determined by the HTR committee. In the near future, it will be necessary to officially develop and establish a Korean HTR system and a legal foundation to optimize the NHI system.

Decentralized Governance and the Performance of Garissa County, Kenya

Devolution is the strongest form of governance decentralization. Devolution involves rescaling of responsibilities or powers from the national to the regional political organization. The actual form and politics of such rescaling will vary substantially between states, however, amounting to a radical transfer of powers and resources in some cases and a more modest and rhetorical shift of responsibility and service delivery in others. The conceptual scope of this study will be limited to four governance structures variables namely financial decentralization, administrative decentralization, political decentralization and citizen participation. This study targeted staff of Garissa County and were composed of senior managers, middle level managers and operational staff. The study employed descriptive survey design. The researcher used questionnaires as research instruments to collect data to the study. The study adopted both primary and secondary data analysis research design. Primary data was collected using semi structured questionnaires containing both closed and open-ended questions to allow variety. The quantitative data was analyzed using descriptive statistics. In addition, the study used multiple regression analysis to analyze the data. From the study findings, this study concluded that administration decentralization has a significant and a positive effect on the performance of Garissa County. The study also concluded that political decentralization has a significant and a positive effect on the performance of Garissa County. From the findings, the study further concluded that financial decentralization had significant and a positive effect on the performance of Garissa County. The study finally concluded that citizen participation had a significant and positive effect on the performance of Garissa County. The study recommended that the government should increase county government autonomy to promote administrative decentralization. The study also recommended that national and county governments should put in place measures to safeguard the independence of political decentralization. The study further recommended that national and county governments should put in place a set of deliberate and proactive processes, policies and structures that support financial decentralization. Finally, the study recommended that county governments should improve citizen participation practices to ensure citizen involvement in governance.

[Indication and Contraindication of Video-Based Psychotherapy: A Qualitative Delphi Survey to Capture Psychotherapists' Reflection and Deliberation Processes].

The Corona pandemic forced many psychotherapists to make a rapid transition to video setting. Even after the acute phase of the pandemic, video-based treatments can be determined to a certain extent in practice. Thus, indication and contraindication recommendations are essential to ensure treatment quality. However, empirical studies are almost completely lacking in this regard. In the context of this work, the decision-making and consideration processes of psychotherapists regarding video-based treatments are to be recorded and those factors that can have an effect on the indication are to be identified. Two-stage, qualitative Delphi survey with psychodynamically oriented psychotherapists (n=9) and behavioural therapists (n=7) who can be assigned to the fields of research and practice. The quality of the therapeutic alliance guides the participants' choice of setting. An indication for video setting results from the feasibility of therapeutic interventions and the respective treatment goal. The therapists weighed the costs and benefits of video setting for various disorders. The changed feeling of control on both sides and the possibility of improving health care are decisive factors. Based on the results, a decision tree for psychotherapists was created, which includes the identified indication criteria.

The medium is the message: toxicity declines in structured vs unstructured online deliberations

Humanity needs to deliberate effectively at scale about highly complex and contentious problems. Current online deliberation tools—such as email, chatrooms, and forums—are however plagued by levels of discussion toxicity that deeply undercut the willingness and ability of the participants to engage in thoughtful, meaningful, deliberations. This has led many organizations to either shut down their forums or invest in expensive, frequently unreliable, and ethically fraught moderation of people's contributions in their forums. This paper includes a comprehensive review on online toxicity, and describes how a structured deliberation process can substantially reduce toxicity compared to current approaches. The key underlying insight is that unstructured conversations create, especially at scale, an “attention wars” dynamic wherein people are often incented to resort to extremified language in order to get visibility for their postings. A structured deliberation process wherein people collaboratively create a compact organized collection of answers and arguments removes this underlying incentive, and results, in our evaluation, in a 50% reduction of high-toxicity posts.

The Impact of Forgiveness in Emotional Regulation and Resilience in The Face of Adversity Among Young Adults

The Impact of Forgiveness in Emotional Regulation and Resilience in The Face of Adversity Among Young Adults

Construction and Optimization of Sports Athlete Selection and Talent Cultivation System Based on Data Analysis

Talent cultivation is the deliberate and systematic process of identifying, nurturing, and developing individuals' innate abilities and potential across various domains. It involves providing structured opportunities, resources, and guidance to help individuals flourish and excel in their chosen fields. This process encompasses education, mentorship, training programs, and practical experiences tailored to the specific needs and interests of each individual. This paper presents a novel approach to the construction and optimization of a Sports Athlete Selection and Talent Cultivation System through the integration of data analysis techniques, with a particular emphasis on the Anthropometric Invariance Gait Recognition for Pattern (AIGRP) system. Leveraging advanced algorithms, the AIGRP system enables precise characterization of athletes' biomechanical profiles based on anthropometric measurements and gait characteristics. By analyzing data collected from athletes, including age, gender, height, weight, and specific performance metrics, such as speed, strength, and endurance, the system facilitates personalized athlete selection and talent cultivation strategies. Furthermore, the objective and data-driven nature of the AIGRP system reduces biases inherent in traditional selection methods, leading to more efficient and effective talent identification. By analyzing data collected from athletes, including age, gender, height (mean: 175 cm), weight (mean: 70 kg), and specific performance metrics, such as speed (mean: 6.5 m/s), strength (mean: 140 kg), and endurance (mean: 47 min), the system facilitates personalized athlete selection and talent cultivation strategies.

Enhancing clinical reasoning for management of non-communicable diseases: virtual patient cases as a learning strategy for nurses in primary healthcare centers: a pre-post study design

BackgroundIn Rwanda, nurses manage all primary care at health centres, and therefore are their clinical reasoning skills important. In this study, a web-based software that allows the creation of virtual patient cases (VP cases) has been used for studying the possibility of using VP cases for the continuous professional development of nurses in primary health care in Rwanda. Previous studies in pre-service education have linked VP cases with the enhancement of clinical reasoning, a critical competence for nurses. This study investigated the feasibility of continuous professional development through VP cases to further train in-service nurses in clinical reasoning.MethodThe study used a pre-post test design. Initially, seventy-six participants completed a questionnaire as part of the pre-test phase, subsequently invited to engage with all four VP cases, and finally responded to the post-test questionnaire evaluating clinical reasoning skills. Fifty-six participants successfully completed the entire study process and were considered in the analysis. The primary outcomes of this study were evaluated using a paired t-test for the statistical analysis.ResultsThe results show that the mean score of clinical reasoning increased significantly from the pre-test to the post-test for all four illness areas (p < 0.001). The study findings showed no statistically significant difference in participants’ scores based on demographic factors, including whether they worked in urban or rural areas. Conclusion and recommendationUtilizing VP cases appears to significantly enhance the continuous professional development of nurses, fostering a deliberate learning process that enables them to reflect on how they manage cases and, in turn, refine their clinical reasoning skills. This study strongly recommends incorporating VP cases in the continuous professional development of nurses at the primary health level (health centers). This is especially pertinent in a context where nurses are required to perform diagnostic processes similar to those employed by physicians.

How should artificial intelligence be used in Australian health care? Recommendations from a citizens’ jury

AbstractObjectiveTo support a diverse sample of Australians to make recommendations about the use of artificial intelligence (AI) technology in health care.Study designCitizens’ jury, deliberating the question: “Under which circumstances, if any, should artificial intelligence be used in Australian health systems to detect or diagnose disease?”Setting, participantsThirty Australian adults recruited by Sortition Foundation using random invitation and stratified selection to reflect population proportions by gender, age, ancestry, highest level of education, and residential location (state/territory; urban, regional, rural). The jury process took 18 days (16 March – 2 April 2023): fifteen days online and three days face‐to‐face in Sydney, where the jurors, both in small groups and together, were informed about and discussed the question, and developed recommendations with reasons. Jurors received extensive information: a printed handbook, online documents, and recorded presentations by four expert speakers. Jurors asked questions and received answers from the experts during the online period of the process, and during the first day of the face‐to‐face meeting.Main outcome measuresJury recommendations, with reasons.ResultsThe jurors recommended an overarching, independently governed charter and framework for health care AI. The other nine recommendation categories concerned balancing benefits and harms; fairness and bias; patients’ rights and choices; clinical governance and training; technical governance and standards; data governance and use; open source software; AI evaluation and assessment; and education and communication.ConclusionsThe deliberative process supported a nationally representative sample of citizens to construct recommendations about how AI in health care should be developed, used, and governed. Recommendations derived using such methods could guide clinicians, policy makers, AI researchers and developers, and health service users to develop approaches that ensure trustworthy and responsible use of this technology.

Political Discourse Analysis in Deliberative Processes: Application to the Public Debate on Mineral Waters in Brazil

Two Brazilian cities in the southern region of the state of Minas Gerais have engaged in public debate on the exploitation of their mineral waters by the private sector, with prompted contestation from organised civil society and other actors to the governmental decision. This study aimed to analyse that public debate using the theoretical-methodological approach of argument analysis within critical discourse analysis (CDA). A news report and a legal text formed the corpus of analysis as representative of ongoing argumentations because these discourses can influence public policy decision-making. The results showed how the controversy is rooted mainly in the conflict of values between two parties &amp;ndash; on the one hand, the concern over sustainability and environmental conservation, cultural identity, the concept of water as a common good, and the defence of public participation and, on the other hand, the predominance of values focused on economic development and the efficiency of financial management of resources.

An Evaluation of U.S. Economic Decoupling from China

The economic relationship between the United States and China, marked by extensive trade agreements, substantial foreign investments, and significant technological collaborations, has developed over decades into a complex tapestry of interdependence, creating a multifaceted and intricate economic partnership. Within this context, economic decoupling refers to the strategic unwinding of these deep-seated ties. In this deliberate process, the U.S. aims to reduce its dependency on China, particularly in critical national security and technological advancement areas. This drive towards decoupling stems from a constellation of concerns, encompassing national security issues, the imperative to safeguard intellectual property rights, and a burgeoning desire to attain greater economic self-sufficiency and resilience.

How does leader emotional labor influence employee voice: the mediating roles of psychological safety and perceived voice efficacy

Purpose This study aims to explore the impact of leader emotional labor on employee voice. According to the emotion as information theory and the voice as a deliberate decision-making process framework, this study develops and tests a model that examines the mediating effects of psychological safety and perceived voice efficacy in this relationship. Design/methodology/approach This study conducted two studies to test hypotheses. Study 1 used a quantitative research methodology using a two-wave survey of 435 employees and 58 leaders in China. The research model was analyzed using multilevel path analyses. Study 2 collected 301 full-time employees from Prolific Platform. Hypotheses were tested using Mplus. Findings The results in Study 1 reveal that leader deep acting has a positive indirect relationship with employee voice via psychological safety. Conversely, leader surface acting has a negative indirect effect on employee voice through psychological safety. The results in Study 2 supported the hypotheses. Originality/value This study contributes to the voice as a deliberative process literature by introducing leader emotional labor as an antecedent of voice behavior. Additionally, this study indicates that perceived psychological safety and perceived voice efficacy are two important mediating mechanisms for implementing voice behavior.

Application of Multi-Criteria Decision Analysis (MCDA) to Prioritize Real-World Evidence Studies for Health Technology Management: Outcomes and Lessons Learned by the Canadian Real-World Evidence for Value of Cancer Drugs (CanREValue) Collaboration.

Multi-criteria decision analysis (MCDA) is a value assessment tool designed to help support complex decision-making by incorporating multiple factors and perspectives in a transparent, structured approach. We developed an MCDA rating tool, consisting of seven criteria evaluating the importance and feasibility of conducting potential real-world evidence (RWE) studies aimed at addressing uncertainties stemming from initial cancer drug funding recommendations. In collaboration with the Canadian Agency for Drugs and Technologies in Health's Provincial Advisory Group, a validation exercise was conducted to further evaluate the application of the rating tool using RWE proposals varying in complexity. Through this exercise, we aimed to gain insight into consensus building and deliberation processes and to identify efficiencies in the application of the rating tool. An experienced facilitator led a multidisciplinary committee, consisting of 11 Canadian experts, through consensus building, deliberation, and prioritization. A total of nine RWE proposals were evaluated and prioritized as low (n = 4), medium (n = 3), or high (n = 2) priority. Through an iterative process, efficiencies and recommendations to improve the rating tool and associated procedures were identified. The refined MCDA rating tool can help decision-makers prioritize important and feasible RWE studies for research and can enable the use of RWE for the life-cycle evaluation of cancer drugs.

Who is “anti-science”?

Objectives“Anti-science” accusations are common in medicine and public health, sometimes to discredit scientists who hold opposing views. However, there is no such thing as “one science”. Epistemology recognizes that any “science” is sociologically embedded, and therefore contextual and intersubjective. In this paper, we reflect on how “science” needs to adopt various perspectives to give a comprehensive and nuanced understanding of a phenomenon. Study designOpinion paper. MethodsBased on a targeted literature survey, we first clarify the known limits of traditional scientific methods and then reflect on how the scientific reporting about Covid-19 mRNA vaccines has evolved. ResultsThe first reports of the Covid-19 mRNA vaccines randomised controlled trial results showed impressive efficacy. Nevertheless, an abundant literature has since depicted a far more nuanced picture of the effectiveness and safety of those vaccines over the medium-term. We organise them around five themes: (i) differentiating between relative and absolute reduction; (ii) taking account of time in reporting effectiveness; (iii) taking account of all outcomes, including adverse effects; (iv) stratifying effectiveness and considering other decision criteria (efficiency, equity, and acceptance); (v) changing the outcome of concern and assessing vaccines’ effectiveness on mortality. ConclusionsScience offers a wide range of perspectives on a given study object. Only the process of deliberation amongst scientists and other stakeholders can result in accepted new knowledge useful to support decision-making. Unfortunately, by trying to reduce “science” to simple messages set in stone, scientists can become the worse enemies of science.

Weakness of Political Will

In this paper I provide a preliminary account of weakness of political will (political akrasia). My aim is to use theories from the weakness of will literature as a guide to develop a model of the same phenomenon as it occurs in collective agents. Though the account will parallel the traditional view of weakness of will in individuals, weakness of political will is a distinctly political concept that will apply to group agents such as governments, institutional actors, and other political collectives. I further argue that blaming inaction by collective political agents on a “lack of political will” should be understood as blaming a kind of akratic break within the deliberative process, leading to an inability of the collective agent to capitalize on existing group attitudes in order to translate them into policy or legislation. My primary example throughout will be U.S. political inaction with respect to the climate crisis.

Learning Strategies: A Resource for Clinical Neuropsychopedagogical Intervention

Learning strategies can be understood as deliberate processes aimed at achieving a certain level of learning effectively. The objective is to explore the application of learning strategies as a tool in neuropsychopedagogical intervention within a clinical setting, particularly in the context of teaching or stimulating brain functions where the patient can contemplate their own mental processes. Our aim is to present an intervention that enhances learning opportunities, thus broadening cognitive assumptions. This research contributes knowledge about cognitive and metacognitive processes related to learning strategies within the framework of learning how to learn, suggesting that the Neuropsychopedagogue, informed by neuroscience, selects appropriate stimuli to facilitate learning and evaluates the effectiveness of this process. The majority of studies focused on Neuropsychopedagogy and specific functions such as attention, memory, and executive functions. Another notable observation was the lack of studies utilizing or developing an instrument to assess learning strategies in a clinical-individual context, with the emphasis primarily on studies within an institutional-collective context. Hence, it can be concluded that learning strategies hold promise for enhancing learning and aiding in the organization and utilization of various information from our environment, thereby justifying their classification as a tool for clinical neuropsychopedagogical intervention. This comprehensive understanding underscores the significance of integrating diverse strategies into clinical practice, ensuring tailored interventions that address individual learning needs effectively.

Stakeholder engagement: the role of facilitators and gender in ‘opening up’ conversations and enabling participation

ABSTRACT A successful global transition to net-zero emissions requires complex transformational change involving stakeholders from across society. Traditionally, stakeholder engagement has been debated predominantly from a pragmatic, functionalist and instrumental perspective. Recent approaches in business communication, sustainability, energy and environmental management show that meaningful and ‘sustainable’ stakeholder engagement is helpful in maintaining an organisation’s social licence to operate. We problematise the notion of participation in deliberative processes and analyse whether the outcomes of an online Australian citizens’ panel are truly representative of all participants or whether specific cultural and demographic factors, particularly gender, influence participation, potentially shaping the outcome. The study shows how gender need to be considered and managed as part of a legitimate deliberation process. Applying Gastil’s input-process-outcome model as a framework, we examine the engagement achieved through deliberations conducted on Zoom. We focus on gender as a variable and the role of the facilitator in managing participation. The results suggest that participants’ contributions to discussions vary based on gender of both participants and facilitators. Based on findings, the challenges of achieving equality in participatory processes are identified. The facilitator’s role is re-defined as a curator of the stakeholder engagement processes, complementing existing theory on stakeholder participation and engagement.

Tiny clue reveals the general trend: a bibliometric and visualized analysis of renal microcirculation

Background Renal microcirculation plays a pivotal role in kidney function by maintaining structural and functional integrity, facilitating oxygen and nutrient delivery, and waste removal. However, a thorough bibliometric analysis in this area remains lacking. Therefore, we aim to provide valuable insights through a bibliometric analysis of renal microcirculation literature using the Web of Science database. Methods We collected renal microcirculation-related publications from the Web of Science database from January 01, 1990, to December 31, 2022. The co-authorship of authors, organizations, and countries/regions was analyzed with VOSviewer1.6.18. The co-occurrence of keywords and co-cited references were analyzed using CiteSpace6.1.R6 software to generate visualization maps. Additionally, burst detection was applied to keywords and cited references to forecast research hotspots and future trends. Results Our search yielded 7462 publications, with the American Journal of Physiology-Renal Physiology contributing the most articles. The United States, Mayo Clinic, and Lerman Lilach O emerged with the highest publication count, indicating their active collaborations. ‘Type 2 diabetes’ was the most significant keyword cluster, and ‘diabetic kidney disease’ was the largest cluster of cited references. ‘Cardiovascular outcome’ and ‘diabetic kidney diseases’ were identified as keywords in their burst period over the past three years. Conclusion Our bibliometric analysis illuminates the contours of nephrology and microcirculation research, revealing a landscape ripe for challenges and the seeds of future scientific innovation. While the trends discerned from the literature emerging opportunities in diagnostic innovation, renal microcirculation research, and precision medicine interventions, their translation to clinical practice is anticipated to be a deliberate process.

Charting futures: understanding anticipatory professional socialisation practices of prospective accountants within higher education

ABSTRACT Drawing on Bourdieu’s sociological framework, this study examines how prospective accountants engage with professional socialisation opportunities within the accounting higher education field. Prospective accountants globally experience anticipatory professional socialisation through which they develop employability skills and shape their professional trajectories. Through interviews with Malaysian prospective accountants and insights from local accounting professionals and academics, this study reveals that the prospective accountants’ professional socialisation practice is not solely a conscious and deliberate process. Instead, it involves ongoing negotiation between an individual’s habitus (way of being), capital (resources), and the opportunities that the accounting higher education field offers to them. The findings also highlight the ways in which an individual’s way of being is influenced by their class and ethnic background, and how this impacts their socialisation and career orientations. Individuals from privileged backgrounds tend to possess greater cultural and social capital, positioning them advantageously to benefit from professional development opportunities provided by their institutions compared to those from less privileged backgrounds. These findings raise questions about the role of higher education institutions in promoting equity and expanding access to the accountancy profession for underprivileged groups.

Please don't throw me in the briar patch! Empirical evidence on the role of instructional cues on eco-label usage in fish consumption decisions

While contributing to the conservation of natural fish stocks, the aquaculture sector imposes environmental repercussions. The growing popularity of colour-graded eco-labels in promoting pro-environmental practices in food production underscores the need for scientific insights into consumer responses to such labels, particularly with the imminent prospect of a harmonized European labelling framework. The existing literature, although limited and divergent, advocates for real-life testing with fresh, perishable food products, emphasizing the inadequacy of standalone labels and the necessity for complementary measures. Furthermore, the mechanisms underlying how consumers process multi-coloured Front-of-Pack (FOP) labels remain ambiguous, with uncertainties regarding induced consumption shifts stemming from both deliberate information processing and less deliberate associations. This article presents findings from a randomized control trial conducted in a simulated fishmonger store in Derio, Bizkaia, Spain, involving 200 consumers. Participants selected various sea bass products out of multiple options. This task was subject to a 2 (Enviroscore: with vs without) x 2 (Supporting info on Enviroscore: with vs without) between-subject design, resulting in four treatment groups. A 16% increase in the likelihood of selecting lower-impact products was observed. Notably, this effect was evident only in the absence of supporting information on Enviroscore, and the observed impact could not be attributed to any indirect attention effect. In conclusion, Enviroscore exhibits potential in steering consumer choices toward more environmentally friendly aquaculture fish options, even in physical retail settings. However, these effects may be rooted in unconscious responses rather than deliberate environmental considerations, raising questions about the suitability of envisaged policy orientations encompassing disaggregated environmental, nutritional, animal welfare, and social welfare scores. Generalization of these findings warrants validation through further research encompassing a more comprehensive range of products.