Temporary Decision Research Articles

Rapid health technology assessment to inform policy: a case study with respiratory syncytial virus

Abstract Background Respiratory syncytial virus (RSV) can cause severe acute respiratory tract infection in infants and older adults. However, until recently, no immunisation interventions were available to reduce the burden of RSV disease in the general population. New health technologies have now been authorised in Europe for infants (a long-acting monoclonal antibody (nirsevimab) and a maternal vaccine (RSVpreF)), and two vaccines for adults aged ≥60 years (RSVPreF3 and RSVpreF). A rapid health technology assessment (HTA) was requested by the Irish Department of Health to support an interim decision on RSV immunisation. Methods The rapid HTA commenced in January 2024, and comprised description of technology, a summary of international practice, national and international epidemiology and burden of disease, and a costing analysis. The summary of international practice (including underpinning evidence) was undertaken rather than a systematic review of effectiveness and safety due to the rapidly changing evidence base and short timeline within which information was required. Results While new recommendations regarding immunisation against RSV are emerging internationally in response to recently authorised technologies, implementation and funding strategies are not currently widespread. Compared with a full HTA, a rapid HTA enabled an efficient and flexible approach to producing a high quality evidence synthesis to inform a temporary policy decision, taking approximately 6 months to complete rather than 12 months or longer. A full HTA is planned to inform long-term decision-making on this topic, but would not have been feasible to inform an interim decision. Conclusions This rapid HTA will inform a temporary decision on immunisation policy for a single RSV season in Ireland. Conducting a rapid HTA prior to a full HTA has enabled timely decision-making, with implications for Ireland’s national healthcare system and people at risk of severe RSV-related disease. Key messages • Innovations in immunisation against RSV are leading to changes in policy across Europe. • Rapid HTA can support timely, evidence-based public health decision-making in a fast-evolving field.

The PEMENUHAN HAK PEREMPUAN DAN ANAK DALAM PENYELESAIAN SENGKETA HARTA BERSAMA PASCA PERCERAIAN (Pada Putusan Perkara No 5034/Pdt.G/2022/Pa.Grt Di Pengadilan Agama Kelas I A Garut Bulan Januari Tahun 2023)

The problem is how to resolve disputes over post-divorce women's rights through the courts, of course there are pros and cons. The point of view studied is KHI (Islamic Law Collection) Articles 105 and 156 as well as Law No. 1 of 1974 which was changed to Law No. 16 of 2019 and Law No. 23 of 2002 concerning the rights of women and children by analyzing the report on the divorce suit decision as of January in 2023 by the Garut Religious Court. The analytical method used is empirical with a qualitative approach. Primary and secondary sources as well as observations are used at all times. In conclusion, the implementation of court decisions is not all carried out effectively and as expected, this is because the level of husband's economic ability is uncertain and even dominated by absenteeism in solving problems. the consequences will be the same, namely it will not be realized. From the research, it is known that 78% have carried out the decisions set by the Court with the results of the Verstek Decision, but there are some who have not carried out in accordance with the Court's provisions, due to economic factors and the current situation after the pandemic. And one of the decisions in the case with Number. 5034/Pdt.G/2022/PA.Grt with the result of the judge's consideration decision, which is granted in part and Custody of one of the children is with the Plaintiff but for joint assets it is still in a temporary decision or under review.

Reconstruction of Bankruptcy Regulations and Suspension of Debt Payment Obligations Based on Islamic Legal Values

The background of this research is that as it happens in the business world, the need for funds is a basic need that must be met by business actors, to overcome the problem of funding needs, capital loans are the solution. The problem that arises is if within the specified time the debtor is unable to pay it. The purpose of this study is to malign and find that bankruptcy regulations and PKPU have not been based on Islamic justice values, analyze and find weaknesses in current bankruptcy regulations and PKPU, and analyze and find reconstructions of bankruptcy regulations and PKPU based on Islamic justice values. In this study, the constructivism paradigm was used. namely the paradigm that is the antithesis of the understanding that lays observation and objectivity in finding a reality or science, This type of research is descriptive analysis, the approach that the author uses is a Sociological Juridical approach, This research is categorized into doctrinal hukun research (both normative and philosophical juridical), The data analysis method used in this study is qualitative data analysis to obtain descriptive data. This research uses Islamic legal theory as an applied theory, namely the Mashlahah Theory According to Imam Al-Ghazali which is a concept that is used as the main consideration in solving Islamic legal problems because the principle contained in maslahah is the maintenance of the objective purpose of law (maqasid al-shari'ah) that is, the maintenance of religion, soul, reason, heredity, and property. Based on the results of this study, it was found that the first Bankruptcy Regulation and Suspension of Debt Payment Obligations have not been based on Islamic justice values, especially in article 2 paragraph (1), article 17 paragraph 2 and article 225 paragraph 4, Second, weaknesses were found in the current bankruptcy and PKPU regulations, including bankruptcy requirements of at least 2 creditors, the temporary decision of PKPU was only given 45 days, and the fee for curator is too great. For this reason, it is necessary to reconstruct the Bankruptcy Regulation and PKPU, including increasing the bankruptcy requirements for more than 2 creditors, extending the temporary bankruptcy of PKPU for more than 45 days or 1 year, changing the Curator fee calculation system based on agreements with debtors and creditors.

Influence of the European Commission on Innovation Development During the Execution of Merger Control

Problem setting. The research focuses on examining the nature of European Commission’s evaluation practices, concerning the merger agreements, that are conducted by this body on the basis of the EU Merger Regulation. The modern dimension of informational society has led to revolutionary changes in Commission’s policy regarding mergers. The European dimension criteria and quantitative evaluations of an undertaking are the main but not the only tools, provided by the Regulation 139/2004, that define the scope of measures, available to the Commission during the investigation. The problem is, that the modern startups progression pattern leads to the alteration of the nature of the market, where the nonessential undertakings can become extremely essential in a dramatically short period of time. This factors have become an incentive to the European Commission to conduct research not only by taking the past and the present factors into consideration, but also using various methods to evaluate the future outcome of the merger with a company, that falls under the Commission’s jurisdiction, which leads to appearance of serious concerns about the integrity of the subsidiarity principle. Analysis of recent researches and publications. The role of the Commission’s evaluation procedure in the merger agreements between the innovative subjects has been researched by the following scientists: Oskar Törngren, Joseph Bromfield, Matthew Olczak, Thomas Buettner, Giulio Federico, Szabolcs Lorincz, Kyriakos Fountoukakos, Dafni Katrana, Agathe Célarié, Massimo Motta, Martin Peitz. The issue in question has also been duly revised and studied by the lawyers and responsible staff of the European Commission. Target of the research is to study a multidimensional nature of merger evaluation, conducted by the EU Commission towards the deals between the undertakings, that contain innovation. Article’s main body. The main instrument, possessed by the Commission and designed to evaluate a substantial threat of a merger to trade via the EU remains the significant impediment of effective competition (SIEC) test, which outlines, that the merger agreement must maintain the balance between competition hindrance and possible benefits and positive commercial outcomes of the deal. In order to make a distinction between lawful and unlawful agreements, the Commission uses a set of criterions and techniques to make sure that the current and the future position of the parties on a relative market will not become object to abuse of the parties. The criterions are not excessive and may encompass both legal and non-legal approaches. The Commission investigates how the position of the parties, their market share, the innovative nature of their product or the difficulty of access to the relevant market can affect the trade within the Internal Market. One of the most recent techniques, which is being used by the Commission as a response to the emerging power of innovative international corporate structures is the loss of innovation criteria. The European Commission insists on the position, that so-called «acquisition killing» is illegal within the EU competition law framework and has conducted a number of landmark investigations, where the conclusion has been made, that the innovative nature of some companies does not allow them to be a subject of merger because of the objective misgiving about the loss of the innovative product as a result of the merger, which may lead to the stoppage of a valuable research. The fact that most of the «acquisition killings» do not fit neither into the national nor the supranational jurisdiction is continuing to be a huge challenge for the Commission to tackle. Nevertheless, the recent practice alterations, concerning the use of the referral procedure, set in art.22 of the EU Merger Regulation allows the Commission to create at least a temporary decision of the problem by giving the Member States an incentive of voluntary application submission in case when the national competition authorities can’t cope with the issue newly set. Conclusions and prospects for the development. It’s worth noting, that the referral procedure use is neither a complete, nor a permanent decision of the problem. However, these steps from the Commission allow us to think that the new wave of integration concerning competition is still awaiting the EU and its Members. The Commission’s practice is a step forward to entering the new era of information economics, where the cooperative activities and mutual strategies of the national governments and the EU institutions are crucial for maintaining the sustainable development principle without hindering subsidiarity.

Influence of the European Commission on Innovation Development During the Execution of Merger Control

Problem setting. The research focuses on examining the nature of European Commission’s evaluation practices, concerning the merger agreements, that are conducted by this body on the basis of the EU Merger Regulation. The modern dimension of informational society has led to revolutionary changes in Commission’s policy regarding mergers. The European dimension criteria and quantitative evaluations of an undertaking are the main but not the only tools, provided by the Regulation 139/2004, that define the scope of measures, available to the Commission during the investigation. The problem is, that the modern startups progression pattern leads to the alteration of the nature of the market, where the nonessential undertakings can become extremely essential in a dramatically short period of time. This factors have become an incentive to the European Commission to conduct research not only by taking the past and the present factors into consideration, but also using various methods to evaluate the future outcome of the merger with a company, that falls under the Commission’s jurisdiction, which leads to appearance of serious concerns about the integrity of the subsidiarity principle. Analysis of recent researches and publications. The role of the Commission’s evaluation procedure in the merger agreements between the innovative subjects has been researched by the following scientists: Oskar Törngren, Joseph Bromfield, Matthew Olczak, Thomas Buettner, Giulio Federico, Szabolcs Lorincz, Kyriakos Fountoukakos, Dafni Katrana, Agathe Célarié, Massimo Motta, Martin Peitz. The issue in question has also been duly revised and studied by the lawyers and responsible staff of the European Commission. Target of the research is to study a multidimensional nature of merger evaluation, conducted by the EU Commission towards the deals between the undertakings, that contain innovation. Article’s main body. The main instrument, possessed by the Commission and designed to evaluate a substantial threat of a merger to trade via the EU remains the significant impediment of effective competition (SIEC) test, which outlines, that the merger agreement must maintain the balance between competition hindrance and possible benefits and positive commercial outcomes of the deal. In order to make a distinction between lawful and unlawful agreements, the Commission uses a set of criterions and techniques to make sure that the current and the future position of the parties on a relative market will not become object to abuse of the parties. The criterions are not excessive and may encompass both legal and non-legal approaches. The Commission investigates how the position of the parties, their market share, the innovative nature of their product or the difficulty of access to the relevant market can affect the trade within the Internal Market. One of the most recent techniques, which is being used by the Commission as a response to the emerging power of innovative international corporate structures is the loss of innovation criteria. The European Commission insists on the position, that so-called «acquisition killing» is illegal within the EU competition law framework and has conducted a number of landmark investigations, where the conclusion has been made, that the innovative nature of some companies does not allow them to be a subject of merger because of the objective misgiving about the loss of the innovative product as a result of the merger, which may lead to the stoppage of a valuable research. The fact that most of the «acquisition killings» do not fit neither into the national nor the supranational jurisdiction is continuing to be a huge challenge for the Commission to tackle. Nevertheless, the recent practice alterations, concerning the use of the referral procedure, set in art.22 of the EU Merger Regulation allows the Commission to create at least a temporary decision of the problem by giving the Member States an incentive of voluntary application submission in case when the national competition authorities can’t cope with the issue newly set. Conclusions and prospects for the development. It’s worth noting, that the referral procedure use is neither a complete, nor a permanent decision of the problem. However, these steps from the Commission allow us to think that the new wave of integration concerning competition is still awaiting the EU and its Members. The Commission’s practice is a step forward to entering the new era of information economics, where the cooperative activities and mutual strategies of the national governments and the EU institutions are crucial for maintaining the sustainable development principle without hindering subsidiarity.

‘Why would I want sex now?’ A qualitative study on older women's affirmative narratives on sexual inactivity in later life

AbstractThe existing research tries to understand the reasons for discontinuing sex in later life with the assumption that people want to be sexual. Although the growing body of literature informs that sex remains an integral part of older adults’ lives, a substantial number of older adults declare not being sexually active. This study aimed at exploring motives for deliberately choosing sexual inactivity among older women. Semi-structured interviews with 16 Polish women (aged 65–82) were thematically analysed in relation to the sexual scripts theory and the participants’ specific socio-cultural background. Three main themes regarding the reasons for cessation of their sex life were identified: ‘I am glad that sex does not concern me anymore’, ‘I am satisfied with my memories’ and ‘The right one’ or no one. The results indicate that some women give up sex for good, with no regrets or feeling of a loss; for others, it may be a temporary decision, its duration dependent on meeting the right partner. Developing sexual agency may encourage discontinuing their sex life – a choice perceived as optimal and liberating. Personal factors and the memories of marital relationships seem to shape older women's (a)sexual expectations. Acknowledging these nuances may contribute to a better understanding of older women's sexual functioning; implications for consideration in further research and practice are also discussed.

Life in three scenarios: Plant controversies between Jamamadi gardens and Hi-Merimã patauá palm orchards (Middle Purus River, Amazonas, Brazil)

Inhabiting the middle Purus river basin, a branch of the Amazon river, Arawá-speaking groups have maintained permanent contact with non-indigenous society only in the last century. Here we provide an account of two Arawá subgroups, the Jamamadi and Hi-Merimã, in order to untangle apparent contradictions between their ways of living, respectively based on the predominance of cultivated plants in gardens and of forest plants. This approach is inspired by three / tree scenarios: the Hi-Merimã’s isolation from indigenous and non-indigenous people undertaken in the 1960′s, the report of a “false contact” that they would have began in 2016 and the Jamamadi’s recent and perhaps temporary decision to move into the forest after knowledge of the Covid-19 pandemic. Besides the apparent distance between gardener and gatherer ways of life, we highlight the proximity and fluidity that both share in terms of entanglements with plants, focusing on forms of sociality between groups, gardens and forests. Inspired by recent discussions regarding archaeological perspectives on plant use, ethnographic formulations of other-than-human relations, and historical ecology, we propose that both are cultural and not necessarily static choices. One is contained within and announces the other, and both are entangled in an oscillating movement of fusion and fission.

A Two-Step Test for the Two-Sample Problem of Processes of Ornstein-Uhlenbeck Type

The authors propose a two-step test for the two-sample problem of processes of Ornstein-Uhlenbeck type. In the first step, the authors test the equality of correlation structures, based on the least square estimators of the correlation parameters, and the test statistic follows the standard normal distribution. If the null hypothesis is not rejected in the first step, the authors consider a second step to test the equality of marginal distributions, based on the weighted deviation of the empirical characteristic functions; the test statistic has a complicated asymptotic distribution, so that sequential bootstrap method is applied to reach a temporary decision. Simulation studies and real data analysis suggest that the proposed approach performs well in finite samples.

Application of the descending branch of the lateral circumflex femoral artery in coronary artery bypass grafting

ObjectiveTo investigate a technical method for harvesting and using the descending branch of the lateral circumflex femoral artery (DLCFA) in coronary artery bypass grafting (CABG). MethodsBetween January 2017 and January 2019, 40 patients (36 in the planed selection group and 4 in the temporary decision group) with mean age of 49.1 ± 7.5 years received DLCFA as an arterial conduit in CABG. In all patients, the DLCFA was successfully harvested via an anterior thigh incision. Depending on the location of the target vessel, the DLCFA was used as a free graft or a composite graft. ResultsOf the 44 patients in the planned selection group, DLCFA harvesting was abandoned in 8 patients because computed tomographic angiography revealed anatomical variation or stenosis of the superficial femoral artery. Of the 5 patients in the temporary decision group, harvesting was abandoned in 1 because of short length and thin caliber. On an average, 3.7 ± 0.9 distal anastomoses were created during CABG, with no adverse effects. The length of the harvested DLCFA was 9.9 ± 1.7 cm, with an average proximal lumen diameter of 3.4 ± 0.7 mm. The DLCFA was used as a free graft in 26 patients and as a “Y”-shape composite graft in 14 patients. Total arterial CABG was performed in 75% of the patients. ConclusionsThe DLCFA is an alternative conduit for CABG. It can be harvested easily and safely. However, preoperative computed tomographic angiography examination is necessary for the smooth application of the DLCFA, and an appropriate strategy for graft establishment should be considered.

Re-examining the innovation post-adoption process: The case of Twitter discontinuance

This study proposes a conceptual framework for innovation post-adoption behavior. The model emphasizes that innovation discontinuance is not the end of the innovation diffusion process but one of the stages. The post-adoption process is portrayed in a manner analogous to Rogers's innovation adoption process, but depending on the type of discontinuance—intermittent or permanent—the respective decision-making process could be quite different. For intermittent discontinuers, the movement through different stages is cyclical, involving multiple stages: pre-evaluation, evaluation, preparation, discontinuance, post-action, and readoption. To provide support for the applicability of this framework, this study compares the post-adoption behavior between Twitter intermittent discontinuers and permanent discontinuers (N = 253). Survey results show that permanent discontinuers are more likely to seek and try out alternative SNSs, whereas intermittent discontinuers are more likely to search for solutions to reduce disturbance. Also, this study argues that Twitter readoption could be a planned or unplanned action. However, this readoption is generally a temporary decision to fulfill short-term needs and gratifications. It does not generate continuance commitment and loyalty to the platform.

DESAIN TATA LETAK SIRKUIT TERPADU DALAM PERSPEKTIF PERBANDINGAN HUKUM INTEREN

The author discusses the legal protection of integrated circuit layout design as provided by Law 32/2000 and compares it with how the government regulates and protect other sorts of intellectual property rights (copyright, trademarks, patents, etc.). The purpose of this comparison is to reveal shortcomings as well as the strength of each different regulations. This study reveals that Law 32/2000 as compared to other IPR protections has yet to provide legal protection of inventor’s moral rights, priority rights as well as temporary decision. At the same time, all regulations cannot be fully implemented due to the lack of or insufficient implementing regulations.

DESAIN TATA LETAK SIRKUIT TERPADU DALAM PERSPEKTIF PERBANDINGAN HUKUM INTEREN

<p><em>The author discusses the legal protection of integrated circuit layout design as provided by Law 32/2000 and compares it with how the government regulates and protect other sorts of intellectual property rights (copyright, trademarks, patents, etc.). The purpose of this comparison is to reveal shortcomings as well as the strength of each different regulations. This study reveals that Law 32/2000 as compared to other IPR protections has yet to provide legal protection of inventor’s moral rights, priority rights as well as temporary decision. At the same time, all regulations cannot be fully implemented due to the lack of or insufficient implementing regulations. </em></p>

Snow-Retaining System as a Temporary Decision for Providing of the Suitable Temperature and Humidity Level of Pitched Roofs

The roof of the building is the main protective element of the entire structure. First of all, a good roof covering should fully protect the building from possible precipitation in the form of rain, hail or snow. Besides it is desirable for a roof covering to have a sufficient period of operational use. In order to prolong the life of the roof and to increase energy efficiency of buildings it is required to normalize the level of temperature and humidity [1].

TRIPS post-2005 and access to new antiretroviral treatments in southern countries: issues and challenges

Until 2005 some developing countries with pharmaceutical manufacturing capacities especially India used the transitional period allowing local manufacturers to produce and sell generic versions of first-generation ART drugs patented in industrialized countries and originally produced and sold at high prices by Western pharmaceutical companies. Thanks to international competition between generic manufacturers and these companies significant price reductions were achieved for the large majority of these drugs. This was a key factor in the implementation and strengthening of access to AIDS treatment in developing countries and a strategic element in the World Health Organization (WHO) 3by5 plan. However with the end of the extended deadline for TRIPS compliance the scenario is likely to change radically. Considering the end of the transitional period which effectively will prohibit the free manufacture of newer and innovative antiretroviral generations to mark a key episode in the history of the fight against AIDS in developing countries this review will provide an overview of the meaning and consequences of this turning point and to present some of the new challenges of the post-2005 period. (excerpt)

Temporarily Divide to Conquer: Centralized, Decentralized, and Reintegrated Organizational Approaches to Exploration and Adaptation

To create a competitive advantage, firms need to find activity configurations that are not only internally consistent, but also appropriate given the firm's current environment. This challenge is particularly acute after firms have experienced an environmental change that has shifted the existing competitive landscape and created new, high-performing sets of activity choices. How should firms organize to explore and search such an altered performance landscape? While it has been noted that adaptive entities need to maintain a balance of exploration and exploitation, little is known about how different organizational structures moderate this balance. With the help of an agentbased simulation model, we study the value of three different organizational structures: a centralized organization, in which decisions are made only at the level of the firm as a whole; a decentralized organization, in which decisions are made independently in two divisions; and a temporarily decentralized firm, which starts out with a decentralized structure and later reintegrates.We find that if interactions among a firm's activities are pervasive, neither the centralized nor the permanently decentralized organizational structure leads to high performance. In this case, temporary decentralization—an organizational structure that has not found much attention in the literature—yields the highest long-term performance. This organizational structure allows the firm both to avoid low-performing activity configurations and to eventually coordinate across its divisions. Thus, even if the decision problem a .rm faces is not fully decomposable, a temporary bifurcation can lead to a higher long-term performance outcome. Initial decentralized exploration is, however, costly in the short run, as compared to centralized exploration. As a result, a tradeoff exists between the short-term costs of decentralized exploration and the longterm benefits of reaching higher performance. As interactions across and within divisions increase, the optimal length of decentralized exploration tends to grow.Paralleling our first result, we further show that even if a decision problem is decomposable, that is, can be perfectly modularized, it can be beneficial to create a temporary decision allocation that creates "unnecessary" interdependencies across the subsystems. This benefit arises in particular when the modules are complex by themselves. In both cases, an initial phase of exploration, enabled by an appropriate organizational structure, followed by refinement and coordination, enabled by a different structure, leads to high performance. To illustrate our general model, we focus on incumbent firms' responses to the Internet and discuss implications for the product design process.

Temporarily Divide to Conquer: Centralized, Decentralized, and Reintegrated Organizational Approaches to Exploration and Adaptation

To create a competitive advantage, firms need to find activity configurations that are not only internally consistent, but also appropriate given the firm's current environment. This challenge is particularly acute after firms have experienced an environmental change that has shifted the existing competitive landscape and created new, high-performing sets of activity choices. How should firms organize to explore and search such an altered performance landscape? While it has been noted that adaptive entities need to maintain a balance of exploration and exploitation, little is known about how different organizational structures moderate this balance. With the help of an agentbased simulation model, we study the value of three different organizational structures: a centralized organization, in which decisions are made only at the level of the firm as a whole; a decentralized organization, in which decisions are made independently in two divisions; and a temporarily decentralized firm, which starts out with a decentralized structure and later reintegrates.We find that if interactions among a firm's activities are pervasive, neither the centralized nor the permanently decentralized organizational structure leads to high performance. In this case, temporary decentralization--an organizational structure that has not found much attention in the literature--yields the highest long-term performance. This organizational structure allows the firm both to avoid low-performing activity configurations and to eventually coordinate across its divisions. Thus, even if the decision problem a .rm faces is not fully decomposable, a temporary bifurcation can lead to a higher long-term performance outcome. Initial decentralized exploration is, however, costly in the short run, as compared to centralized exploration. As a result, a tradeoff exists between the short-term costs of decentralized exploration and the longterm benefits of reaching higher performance. As interactions across and within divisions increase, the optimal length of decentralized exploration tends to grow.Paralleling our first result, we further show that even if a decision problem is decomposable, that is, can be perfectly modularized, it can be beneficial to create a temporary decision allocation that creates unnecessary interdependencies across the subsystems. This benefit arises in particular when the modules are complex by themselves. In both cases, an initial phase of exploration, enabled by an appropriate organizational structure, followed by refinement and coordination, enabled by a different structure, leads to high performance. To illustrate our general model, we focus on incumbent firms' responses to the Internet and discuss implications for the product design process.

Décision séquentielle et principe de précaution

Sequential decision-making and Precautionary Principle. The Precautionary Principle (Rio Conference, Maastricht Treaty) is becoming increasingly prominent in the environmental protection law or on health safety issues. Given the important literature on the Precautionary Principle in social sciences in general, this paper provides an economic approach to the Precautionary Principle. In crude terms, the Precautionary Principle encourages the prevention of a risk before that full scientific information is available about it. Since this Principle implies that a decision should be taken in advance, even if it may be revised later on, it implies that the decision process is sequential. As a result, this paper proposes an interpretation of the Precautionary Principle based on the sequential decision theory. We report some insights from sequential investment theory (Dixit and Pindyck, 1994) in order to bring closer the notion of option value to that of precaution. We then introduce formally the notion of irreversibility and that of information structure. We also reinterpret the Bayes' rule as a rule that accounts for scientific progress in decision-making. This allows us to distinguish between a preventive and a precautionary strategy. Prevention is a static concept that refers to the management of a risk at a given time and given a stable probability distribution. Precaution is a dynamic concept that recognizes the evolution of scientific knowledge. A precautionary measure is defined as a prudent and temporary decision that permits to manage the current lack of scientific information. In order to examine the efficiency of the Precautionary Principle, we raise the following question : does more scientific uncertainty lead to bias decisions in favor of less current risk exposure ? We show that the Precautionary Principle may be justified on the grounds of irreversibility alone (Henry, 1974). We also generalize this pure "irreversibility effect" to integrate risk aversion and consumption externalities (Gollier et al., 2000). We finally report some empirical results from macroeconomic models that recently assessed the impact of scientific uncertainty on optimal climate policy (Nordhaus, 1994).

Technology assessment: relationship to coverage issues--a case for temporary coverage decisions.

Making appropriate coverage decisions has the potential of impacting patient outcomes. In both the public and private sectors, great diversity exists in the methodology and process used to make coverage decisions. Because definitional issues are important, they are described in this article. The underpinning of coverage decisions are a commitment to certain methodological principles, including embracing evidence-based medicine. The role of the federal government and local entities in regard to evidence production and process as well as methodology used to formulate policy decisions is complex and requires resolution. A temporary coverage decision can be a helpful tool when no consensus exists.

Improvement of bit-error-rate in decision feedback equalizer by preventing decision-error propagation

A technique for reducing the influence of a phenomenon known as error propagation through the decision feedback equalizer is proposed. An error threshold may be defined to compare with the decision estimation error. If the estimation error is less than the threshold, an assumption is made that the DFE is functioning correctly; otherwise, the decision is classified as unreliable and replaced by a temporary decision. The temporary decision is chosen to prevent further, self-sustained incorrect decisions. The estimation error caused by adopting the temporary decision is used to determine the correct decision, which replaces the temporary decision. Statistical analysis indicates that the performance of the algorithm critically depends on the value of the first postcursor and the accompanying noise level.

Diversity for noncoherent DPSK direct-sequence CDMA over a shadowed Rician-fading satellite channel

Spatial-diversity schemes with distributed detection combining are analysed and compared with selection and maximal-ratio for noncoherent DPSK direct-sequence CDMA (DS-CDMA) in a shadowed Rician-fading land-mobile satellite channel. To evaluate the performance of the distributed-detection combining scheme, the Chernoff upper bound on its bit error probability is employed. In the distributed-detection combining system, two schemes are considered. In the first scheme, each branch sends its temporary decision to the combiner in which the demodulated signals of individual diversity branches are independent. In the second scheme, the demodulated signals are independent when conditioned on the channel state, and the combiner collects the detection results of the branches with the channel state information. Numerical results are presented for performance comparisons between the distributed detection, selection and maximal ratio combining for the DPSK DS-CDMA under light, average and heavy shadowing.