Voluntary Decisions Research Articles

How is Clinical Trial Reimbursement Money Spent? South African Trial Participants\u2019 Reported Reimbursement Spending Patterns and Perceptions of Appropriate Reimbursement Amounts

Reimbursement of participants in clinical trials is extensively debated. Guidance recommends that compensation should reflect time, inconvenience and reimbursement of expenses. This study describes how participants spend their reimbursement and perceptions of appropriate reimbursement amounts. This was a sub-study of the evidence for contraceptive options and HIV outcomes (ECHO) trial. Participants were from two sites in KwaZulu-Natal, South Africa. A mixed methods approach was used. 500 participants completed a questionnaire, and 32 participated in one of four focus group discussions (FGD). The majority (81%) used reimbursement for transport to the research site, followed by toiletry purchases (64%). Many described how reimbursement supplemented income, used to cover basic living costs. Some used money to buy luxury items and takeaway foods. The ideal reimbursement amount per visit ranged: ZAR150-ZAR340 (US$10–24). Reimbursement spending and perceptions are in line with local guidance. Reimbursement should consider risk minimization together with ensuring informed, voluntary decision making.

Employee perceptions of hotel CSR activities during the COVID-19 pandemic

PurposeThis study aims to adopt Carroll’s corporate social responsibility (CSR) pyramid framework as a theoretical lens for examining employee perspectives on South Korean hotels operating as quarantine facilities during the COVID-19 pandemic.Design/methodology/approachThe study adopted a qualitative approach consisting of the following components: in-depth interviews with employees and stakeholders of quarantine hotels, including frontline staff, government officials and medical staff, field observations and data from one researcher’s direct experience in a quarantined hotel.FindingsSix themes regarding the experience of operating quarantine hotels emerged from the in-depth interviews and field observations. The findings also showed an interplay between the hotel employees’ perspectives, the four components of the CSR pyramid and the benefits and costs to hotels operating as quarantine facilities.Research limitations/implicationsThis study focusses on the particular case of quarantine hotels in South Korea, and therefore caution is required in generalising the findings.Practical implicationsThe findings suggest that strategic partnerships can help to protect local communities whilst alleviating the hotel industry’s financial difficulties. They also explore an opportunity for business revitalisation in the midst of a global pandemic.Originality/valueThis study finds that the voluntary decision of hotels to operate as coronavirus quarantine facilities is aligned with CSR because its ultimate aim is to protect the community from the risk of coronavirus from overseas arrivals. This study broadens the CSR literature in the fields of COVID-19 and hospitality.

Decision support for computed tomography in the emergency department: a multicenter cluster-randomized controlled trial.

Clinical decision support may facilitate evidence-based imaging, but most studies to date examining the impact of decision support have used non-randomized designs which limit the conclusions that can be drawn from them. This randomized trial examines if decision support can reduce computed tomography (CT) utilization for patients with mild traumatic brain injuries and suspected pulmonary embolism in the emergency department. This study was funded by a competitive public research grant and registered on ClinicalTrials.gov (NCT02410941). Emergency physicians at five urban sites were assigned to voluntary decision support for CT imaging of patients with either head injuries or suspected pulmonary embolism using a cluster-randomized design over a 1-year intervention period. The co-primary outcomes were CT head and CT pulmonary angiography utilization. CT pulmonary angiography diagnostic yield (proportion of studies diagnostic for acute pulmonary embolism) was a secondary outcome. A total of 225 physicians were randomized and studied over a 2-year baseline and 1-year intervention period. Physicians interacted with the decision support in 38.0% and 45.0% of eligible head injury and suspected pulmonary embolism cases, respectively. A mixed effects logistic regression model demonstrated no significant impact of decision support on head CT utilization (OR 0.93, 95% CI 0.79-1.10, p = 0.31), CT pulmonary angiography utilization (OR 0.98, 95% CI 0.88-1.11, p = 0.74) or diagnostic yield (OR 1.23, 95% CI 0.96-1.65, p = 0.10). However, overall CT pulmonary diagnostic yield (17.7%) was almost three times higher than that reported by a recent large US study, suggesting that selective imaging was already being employed. Voluntary decision support addressing many commonly cited barriers to evidence-based imaging did not significantly reduce CT utilization or improve diagnostic yield but was limited by low rates of participation and high baseline rates of selective imaging. Demonstrating value to clinicians through interventions that improve workflow is likely necessary to meaningfully change imaging practices.

Preoperative prediction score of hepatocellular carcinoma recurrence in living donor liver transplantation: Validation of SNAPP score developed at Asan Medical Center

The previously proposed scoring systems are not readily available due to the lack of simplicity for predicting hepatocellular carcinoma (HCC) recurrence. We aimed to develop and validate the new score system, which can predict HCC recurrence after living donor liver transplantation (LDLT) by using morphologic and biologic data. Predictors for HCC recurrence after LDLT were developed (n = 627) and validated (n = 806) in 1,433 patients who could collect information to date between 2007 and 2016 at Asan Medical Center (AMC) to create the SNAPP score (tumor size and number, alpha-fetoprotein [AFP], vitamin K absence-II [PIVKA-II], positron emission tomography [PET]). On logistic regression based on 3-year recurrence-free survival, the SNAPP factors were independently associated with HCC recurrence. The SNAPP score was highly predictive of HCC recurrence (C statistic, 0.920), and 5-year post-LT recurrence rates were significantly different between low, intermediate, and high SNAPP score groups. The performance of the SNAPP score (C-index [95% CI], 0.840 [0.801-0.876]) on predicting tumor recurrence after LDLT was better than that of the NYCA, the RETREAT, and the MoRAL score. The SNAPP score provides excellent prognostication after LDLT for HCC patients. Hence, we can help voluntary patients' decisions about whether to undergo LDLT or not.

Libertas contractus. Paolo Comitoli SJ (1545–1626) on freedom of contract in light of early modern private law

The paper presents the results of research devoted to the concept of freedom of contract in the writings of an early modern Italian Jesuit, Paolo Comitoli. He claimed that freedom of contract was one of the attributes of contracts and it was essential for the consent of parties entering into a contract. He distinguished between three types of this freedom. Freedom of will was a prerequisite in case of any and all human actions including contracts. Voluntariness was tantamount to a requirement for the will of the parties, which led to the consent to the contract, and it was the result of a voluntary decision which was not disturbed by any vices. Freedom of ownership enabled the parties to conduct a transfer of the object of contract in its broadly understood sense. Comitoli’s concept of contractual freedom was an expression of his belief that voluntary consent of the wills of the parties as the foundation of contractual consent was the basis and the main cause of a contract.

Explorations about the Family’s Role in the German Transplantation System: Epistemic Opacity and Discursive Exclusion

ABSTRACT With regard to organ donation, Germany is an ‘opt-in’ country, which requires explicit consent from donors. The relatives are either asked to decide on behalf of the donors’ preferences, if these are unknown or if the potential donor has explicitly transferred the decision to them. At the core of this policy lies the sociocultural and moral premise of a rational, autonomous individual, whose rights require legal protection in order to guarantee a voluntary decision. In concrete transplantation practices, the family plays an even more important role. Potential donors and their families decide while being embedded in relations, a point which does still not gain full recognition. This particular discrepancy between policy and practice creates conflicts, which remain taboos of academic inquiry and public discourse. Our analysis shows a plurality of the family’s role in the transplantation process, which reveals an inner tension of the organ donation system. This tension provokes epistemic opacity on the one hand and different collective strategies as responses to discursive exclusion on the other. In future deliberations about organ donation, it is important to create spaces for open discussion, but also practices of communicative engagement, which take care of the needs and emotions attached to taboos.

The Incentive Study in the Blockchain Era: A Two-Period Strategic Inventory Game

In this paper, we conduct an incentive study on the adoption of the blockchain technology in a two-period model with retailer’s use of strategic inventory. Without the adoption of the blockchain technology, the retailer has private information regarding the market size. We investigate the retailer’s voluntary signaling decisions via his pricing and strategic inventory decisions. We determine the retailer’s equilibrium price and the manufacturer’s optimal wholesale price. Both separating and pooling equilibria are discussed, and the unique lexicographically maximum sequential equilibrium is identified. With the adoption of the blockchain technology, there is no information asymmetric between the supply chain members. We find that the manufacturer has the incentive to adopt the blockchain technology when the demand uncertainty is moderate to high, and the retailer has the incentive to adopt the blockchain technology when the demand uncertainty is low or high. When the manufacturer and the retailer have a misalignment in the adoption of the technology, a central planner can help to achieve coordination.

Significant career change to software development. A life-course perspective

T The present study, based on qualitative data, investigates the significant career change through the life-course lens. Biographical interviews were conducted with people who changed their profession and the findings were characteristically reflective and subjective, foregrounding the participants’ interpretations of their layers of reality. Different type of resources: individual (Agency), community (Networking), and society (Labour market) were taken into account and the endeavour enabled to capture the triggers involved in career change process. The distinction between voluntary and involuntary career change decision helps to understand the reasons for which the change is chosen. There are major differences between those who leave involuntary their desired profession and those who discover that they have a calling for the software development. Moreover, the results advocate for the importance of early vocational counselling. On the other hand, evidence of discrimination encountered by new programmers could be addressed by HR departments in the IT organizations

Adequacy of measures of informed consent in medical practice: A systematic review.

As a critical component of medical practice, it is alarming that patient informed consent does not always reflect (1) adequate information provision, (2) comprehension of provided information, and (3) a voluntary decision. Consequences of poor informed consent include low patient satisfaction, compromised treatment adherence, and litigation against medical practitioners. To ensure a well-informed, well-comprehended, and voluntary consent process, the objective and replicable measurement of these domains via psychometrically sound self-report measures is critical. This systematic review aimed to evaluate the adequacy of existing measures in terms of the extent to which they assess the three domains of informed consent, are psychometrically sound and acceptable for use by patients. Extensive searching of multiple databases (PsychINFO, PubMed, Sociological s, CINAHL, AMED) yielded 10,000 potential studies, with 16 relevant scales identified. No existing scale was found to measure all three consent domains, with most only narrowly assessing aspects of any one domain. Information provision was the most frequently assessed domain, followed by comprehension, and then voluntariness. None of the identified scales were found to have adequate evidence for either high quality psychometric properties or patient user acceptability. No existing scale is fit for purpose in comprehensively assessing all domains of informed consent. In the absence of any existing measure meeting the necessary criteria relating to information, comprehension and voluntariness, there is an urgent need for a new measure of medical consent to be developed that is psychometrically sound, spans all three domains and is acceptable to patients and clinicians alike. These findings provide the impetus and justification for the redesign of the informed consent process, with the aim to provide a robust, reliable and replicable process that will in turn improve the quality of the patient experience and care provided.

Information acquisition and voluntary disclosure with supply chain and capital market interaction

We investigate a firm’s information acquisition and voluntary disclosure decisions regarding demand forecast information. We study the interaction among the firm, its supplier, and the external capital market investors who assess the firm’s interim equity price. We first analyze when it is beneficial for the firm to acquire demand forecast information, and if such information is acquired, when the firm should disclose it to the supplier and investors. Then, we investigate how the firm’s information acquisition and disclosure decisions influence the investors’ and the supplier’s pricing strategies. We show that the optimal information disclosure policy for the firm is highly dependent on the corporate myopia level (CML): when the CML is low, the firm discloses low demand information only; when the CML is medium, the firm always withholds demand information; and when the CML is high, the firm discloses high demand information only. Our findings provide a novel plausible explanation to firms’ non-disclosure behaviors commonly observed in practice and highlight the importance of considering the interaction between the supply chain and the capital market.

Situation on the Crude Oil Market in Q1 2021

One of the main factors behind the reduction in oil supply and, consequently, theincrease in oil prices in Q1 2021 was the voluntary decision of Saudi Arabia underthe OPEC+ agreement to further reduce its production by 1 mbpd. This fact resultedin a record overall conformity with the original decision, which came to 115% in February 2021. A potential risk factor for the oil prices dynamic is the decision taken at the 15th OPEC+ meeting to raise production targets in Q2 2021, coupled with a rapid increase in the number of coronavirus cases reported in Asian countries.

Bottom-up influences on voluntary task switching in different reward contexts?

In humans, voluntary task switching is susceptible to bottom-up influences like a switch of the target stimulus identity (Mayr & Bell, 2006). A recent study with ants (Czaczkes, Koch, Fröber, & Dreisbach, 2018) has shown that even irrelevant cue changes increase switching behavior, but only if they are presented within a high-reward context. To investigate whether a reward context would also increase switching behavior in response to meaningless cue changes in humans, we conducted two voluntary task switching experiments. On each trial, participants chose between two tasks preceded by one of two different color cues. Reward prospect was manipulated between blocks (Experiment 1: no vs. high reward; Experiment 2: low vs. high reward). In both experiments, the cue change did not modulate the voluntary switch rate. However, the voluntary switch rate was significantly lower in high-reward blocks as compared to no-reward or low-reward blocks. This suggests that bottom-up influences on deliberate task switching in humans are limited to task-relevant information. Moreover, the finding of a decreased voluntary switch rate within a high-reward context further supports the claim that unchanged high reward prospect promotes cognitive stability.

Assessment of Factors Associated With Parental Perceptions of Voluntary Decisions About Child Participation in Leukemia Clinical Trials

Obtaining voluntary informed consent prior to enrollment in clinical trials is a fundamental ethical requirement. To assess whether health literacy, contextual factors, or sociodemographic characteristics are associated with perception of voluntariness among parents who had consented for their child's participation in a leukemia therapeutic clinical trial. This cross-sectional study prospectively enrolled 97 parents of children diagnosed as having leukemia at Rady Children's Hospital San Diego, a large tertiary academic center in California, from 2014 to 2017. Health literacy, contextual factors (acculturation, decisional regret, and satisfaction with informed consent), sociodemographic characteristics, and perception of voluntariness after consenting for a therapeutic clinical trial were measured. Univariable and multivariable regression were used to determine significant associations. The analyses for the present study were conducted from May 2019 to May 2020. Informed consent for a therapeutic leukemia clinical trial. The primary outcome of interest was perception of voluntariness and its associations with health literacy and other contextual factors (acculturation, decisional regret, and satisfaction with informed consent) and sociodemographic characteristics, including age, race/ethnicity, parental language, educational level, insurance type, marital status, and socioeconomic status. Of 97 parents included, the majority were women (65 [67%]), married (71 [73%]), and of self-reported Hispanic ethnicity (50 [52%]). Lower perception of voluntariness was significantly associated with lower health literacy (r = 0.30; 95% CI, 0.11-0.47; P = .004), Spanish language (x̅ = -4.50, P = .05), lower acculturation if of Hispanic ethnicity (r = 0.30; 95% CI, 0.02-0.54; P = .05), greater decisional regret (r = -0.54; 95% CI, -0.67 to -0.38; P < .001), and lower satisfaction with informed consent (r = 0.39; 95% CI, 0.21-0.54; P < .001) in univariable analysis. Lower health literacy remained significantly associated with lower perception of voluntariness in multivariable analysis after adjustment for contextual factors and sociodemographic characteristics (β = 4.06; 95% CI, 1.60-6.53; P = .001). Lower health literacy was significantly associated with Hispanic ethnicity (mean, 4.16; 95% CI, 3.75-4.57; P < .001), Spanish language spoken at home (mean, 3.17; 95% CI, 1.94-4.40; P < .001), high school or less educational level (mean, 3.41; 95% CI, 2.83-3.99; P < .001), public insurance (mean, 4.00; 95% CI, 3.55-4.45; P < .001), and unmarried status (mean, 3.71; 95% CI, 2.91-4.51; P = .03). Among parents of children with newly diagnosed leukemia who had consented for their child's participation in a therapeutic clinical trial, lower perception of voluntariness was significantly associated with lower health literacy. These results suggest that parents with low health literacy may perceive external influences in their decision for their child's participation in clinical trials. This finding highlights the potential role of recruitment interventions tailored to the participant's health literacy level to improve voluntary informed consent in underserved populations.

놀이중심 교육과정 실현을 위한 보육교사의 ‘교사 협의’ 경험 및 반성적 사고와 실천변화

This study is conducted to improve the expertise of child care teachers and to achieve true child-centered education practices for the realization of the play-centered curriculum in line with the 2019 Revised Nuri Curriculum. The child care teachers’ experiences of voluntary ‘teacher consultation’ and in the process, the changes in their reflective thinking and practice were examined. The study participants were 11 child care teachers from S daycare center located in S city, Chungcheongnam-do. Based on the voluntary decision and participation of the child care teachers, the 'teacher consultation' was conducted by dividing into two groups, the infant class and the child class. The child care teachers, through the 'teacher consultation', reflected and shared their experiences of conflicts and troubles when supporting children's play, which was the starting point of learning to grow. They grew together by exploring better coaching and teaching-learning methods. The child care teachers deeply observed and recorded the play in order to discover the meaning of the play that infants and toddlers immersed in during the ‘teacher consultation’ process. Based on this, the teachers built mutual trust and respect through the process of consulting and coaching with fellow teachers. In addition, this became a driving force for the change to respect for infants and young children, and the child care teachers changed their teaching-learning practices boldly into the direction of recognizing the child-leading plays and of providing new spaces and materials in a new way that supported the children in detail.

Mediacja w sprawach nieletnich – wymiar wychowawczy

&lt;p&gt;Wprowadzenie: Jednym ze sposobów rozwiązywania konfliktów są mediacje, w trakcie których strony dążą, przy pomocy mediatora, do osiągnięcia obopólnie korzystnego porozumienia. Mediacja znajduje swoje zastosowanie także w kontekście spraw karnych, których sprawcami są nieletni. W wyniku mediacji mogą zostać wypracowane satysfakcjonujące obie strony warunki zadośćuczynienia i naprawienia wyrządzonej szkody. Stwarza to szanse na wychowawcze oddziaływanie na młodzież łamiącą normy prawne.&lt;/p&gt;&lt;p&gt;Cel badań: W artykule dokonano analizy literatury przedmiotu z zakresu mediacji karnych oraz aktów prawnych dotyczących mediacji w sprawach nieletnich, skupiając się na ukazaniu specyfiki mediacji z udziałem nieletnich sprawców czynów karalnych oraz korzyściach wychowawczych związanych z prowadzeniem postępowania mediacyjnego w tego rodzaju sprawach.&lt;/p&gt;&lt;p&gt;Stan wiedzy: Literatura przedmiotu zwraca uwagę na liczne korzyści związane z prowadzeniem mediacji w sprawach nieletnich, podkreślając zwłaszcza jej wymiar wychowawczy i pozytywny wpływ na rozwój osobowości młodego człowieka. Udział w spotkaniu mediacyjnym pozwala bowiem osiągnąć nie tylko wzajemnie satysfakcjonujące porozumienie, ale także dzięki dobrowolnym i samodzielnym decyzjom podejmowanym przez młodego sprawcę w trakcie mediacji ma on szansę na zmianę swojego postępowania w kierunku pożądanym społecznie. &lt;/p&gt;&lt;p&gt;Podsumowanie: Mediacja jako sposób rozwiązywania sporów będących wynikiem czynu karalnego pozwala na wypracowanie porozumienia w kwestii zadośćuczynienia i naprawienia przez sprawcę wyrządzanych przez niego krzywd. Ze względu na wychowawczy potencjał mediacji warto byłoby propagować jej szersze wykorzystanie w pracy z młodzieżą, w tym z nieletnimi sprawcami czynów karalnych.&lt;/p&gt;

Cross-cultural differences in voluntary payment decisions. Evidence from guided tours

ABSTRACT We provide an experimental investigation of empirical phenomena of free tours – city tours after which tourists remunerate the guide with voluntary Pay-What-You-Want payments. Using a sample of 471 international travellers from 50 nations, we analyse cross-country differences in the size of the voluntary payments. We explain differences in average payment sizes in relationship to cultural values defined by Hofstede’s Cultural Dimensions [1983. National cultures in four dimensions: A research-based theory of cultural differences among nations. International Studies of Management & Organization, 13(1–2), 46–74] and selected from the World Value Survey. We show that the cultural factors have stronger impact on payments when the decision about the amount to be paid is made before the tour. We discuss practical, managerial implications of our findings and discuss consequences of the voluntary payments introduction to the tourism sector.

Care as a Border‐Crossing Language: The Webtoon Reader Discussion Forum as Mediascape

AbstractDrawing from Appadurai’s notion of mediascape, in which global cultural flows simultaneously construct local/global perspectives, I explored how youth and young adults across the globe make sense of digitally shared space, with a specific focus on the Webtoon reader discussion forum. Findings illustrated that the participants constructed the notion of care as standing up for others, raised awareness of social justice, and mobilized transcultural values to construct a cross‐cultural community with multimodal engagements. By understanding the reader discussion forum as a mutually constitutive negotiated space, the voluntary decision of these young individuals to engage in Korean Webtoon digital space underscores how they construct literacy practices across the globe while transcending demarcated categories of race, gender, language, culture, and other essentialized identity markers.

Voluntary Participation in International Environmental Agreements and Authority Structures in a Federation: A Note

We examine how a voluntary participation decision in international environmental negotiations affects the endogenous authority structure in a federation. In our model, the federal government of each country decides whether to delegate both the decision to participate in a negotiation that determines the abatement level of pollution (the level of the public good), and the negotiation itself, to a regional government of the polluter region. We show that there exists a subgame perfect equilibrium in which none of the federal governments chooses delegation, which is quite different from the authority structure in the absence of a voluntary participation decision. The main contribution is to explain why the federal government has an incentive not to delegate decisions to a regional government

Revising A Voluntary Disclosure Decision

ABSTRACTPublic information that becomes available after a manager's initial voluntary disclosure decision creates incentives for her to reconsider and possibly change that decision. We show that if she has private information that is value-relevant or that impacts the firm's ability to compete in its product market, the option to revise an initial disclosure decision in the face of a public release of information alters both the initial decision and the overall frequency of disclosure. These effects are amplified if she believes that public information arrival is more likely or if the firm's value is more sensitive to it. We also show that an increase in the initial disclosure cost reduces the probability of an initial disclosure and increases the probability of a subsequent disclosure. These effects are reversed if the cost of a subsequent disclosure increases.

Preoperative Prediction Score of Hepatocellular Carcinoma Recurrence in Living Donor Liver Transplantation: Validation of SNAPP Score Developed at Asan Medical Center

The application of the previously proposed scoring systems is not readily available due to the lack of simplicity for predicting hepatocellular carcinoma (HCC) recurrence. We aimed to develop and validate the new score system, which can predict HCC recurrence after living donor liver transplantation (LDLT) by using morphologic and biologic data. Predictors for HCC recurrence after LDLT were developed (n = 627) and validated (n = 806) in 1433 patients between 2007 and 2016 at Asan Medical center (AMC) to create the SNAPP score [tumor Size and Number, alpha-fetoprotein (AFP), vitamin K absence-II (PIVKA-II), positron emission tomography (PET)]. On multivariable Cox proportional hazards regression, the SNAPP factors were independently associated with HCC recurrence. The SNAPP score was highly predictive of HCC recurrence (C statistic, 0.802), and 5-year post-LT recurrence rates were significantly different between low, intermediate, and high SNAPP score groups. The performance of the SNAPP score (C-index [95%CI], 0.903 [0.820-0.987]) on predicting tumor recurrence after LDLT was better than that of the NYCA, the RETREAT, and the MoRAL score. The SNAPP score provides excellent prognostication after LDLT for HCC patients. Hence, we can help voluntary patients' decisions about whether to undergo LDLT or not.