Disruptive medical patients. Forensically informed decision making.

Patients who disrupt medical care create problems for physicians. The risks are not entirely clinical. Although these patients may compromise sound clinical judgment, some are also litigious and express their dissatisfaction in legal or other forums. It then becomes necessary for treating physicians to be aware of the legal and ethical boundaries of their patient care responsibilities. Some disruptive patients are treated by setting limits, which is usually affirmed by health care agreements. A hospital review board may advise clinicians on these agreements and on the management of disruptive patients. If termination of the physician-patient relationship is considered, physicians must follow proper protocol. We examine these forensic considerations and place them in the context of malpractice. Communication, consultation, and documentation are the key elements in reducing liability.     

A framework for SLA management in cloud computing for informed decision making

In cloud computing, service providers offer cost-effective and on-demand IT services to service users on the basis of Service Level Agreements (SLAs). However the effective management of SLAs in cloud computing is essential for the service users to ensure that they achieve the desired outcomes from the formed service. In this paper, we introduce a SLA management framework that will enable service users to select the best available service provider on the basis of its reputation and then monitor the run time performance of the service provider to determine whether or not it will fulfill its promise defined in the SLA. Such analysis will assist the service user to make an informed decision about the continuation of service with the service provider.     

Assessment of a decision aid to assist genetic testing research participants in the informed consent process

Limited attention has been given to applying decision-making theories from psychology to the content and process of informed consent in genetic testing research. Data are presented from a study that developed and assessed a psychological theory-based decision aid as part of the informed consent process. This innovative approach assisted at-risk women in assessing the consequences of participating in a research project that offered them free hemophilia A genetic carrier testing. Results suggest: (1) the decision aid can be incorporated into the consent process with few problems; (2) women of varying educational backgrounds can complete the decision aid; (3) while women consider many consequences of genetic testing, their primary focus is on the implications for their family; and (4) this is in marked contrast to the typical benefit-harm statements prepared by researchers for genetic testing.     

The ecology of information: an overview on the ecological significance of making informed decisions

Information is characterized as the reduction of uncertainty and by a change in the state of a receiving organism. Thus, organisms can acquire information about their environment that reduces uncertainty and increases their likelihood of choosing a best‐matching strategy. We define the ecology of information as the study of how organisms acquire and use information in decision‐making and its significance for populations, communities, landscapes and ecosystems. As a whole, it encompasses the reception and processing of information, decision‐making, and the ecological consequences of making informed decisions. The first two stages constitute the domains of, e.g. sensory ecology and behavioral ecology. The exploration of the consequences of information use at larger spatial and temporal scales in ecology has lagged behind these other disciplines. In our overview we characterize information, discuss statistical decision theory as a quantitative framework to analyze information and decision‐making, and discuss potential ecological ramifications. Rather than attempt a cursory review of the enormity of the scope of information we highlight information use in development, breeding habitat selection, and interceptive eavesdropping on alarm calls. Through these topics we discuss specific examples of ecological information use and the emerging ecological consequences. We emphasize recurring themes: information is collected from multiple sources, over varying temporal and spatial scales, and in many cases links heterospecifics to one another. We conclude by breaking from specific ecological contexts to explore implications of information as a central organizing principle, including: information webs, information as a component of the niche concept, and information as an ecosystem process. With information having such an enormous reach in ecology we further cast a spotlight on the potential harmful effects of anthropogenic noise and info‐disruption.     

Behavior-analytic approaches to decision making

Behavior analysis has much to offer the study of phenomena in the area of judgement and decision making. We review several research areas that should continue to profit from a behavior-analytic approach, including the relative merit of contingency-based and rule-governed instruction of solving algebra and analogy problems, and the role of conditioned reinforcement and the inter-trial interval in a type of Prisoner's Dilemma Game. We focus on two additional areas: (1) the study of base-rate neglect, a notorious reasoning fallacy and (2) the study of the sunk-cost effect, which characterizes ill-conceived investment decisions. In each of these two cases we review studies with humans and pigeons as subjects.     

Management and rehabilitation of peatlands: The role of water chemistry,hydrology, policy,and emerging monitoring methods to ensure informed decision making

As the world's most abundant source of terrestrial carbon, peatlands provide numerous ecosystem services, including habitat biodiversity and freshwater quality. Land and water management practices in relation to peatlands, for either exploitation or rehabilitation, are complicated by several factors: spatial diversity in geochemistry; laborious survey methods that may be subject to confounding factors; regional and irregular climate variations; a lack of generalizability regarding appropriate strategies; and, in some countries, by non-implementation of water quality assessment policies for pollution control and land use. Such factors raise uncertainty in the effectiveness of restoration and rehabilitation strategies, while modern peatland management looks to develop land use schemes that offer minimal risk to the environment. The aims of this paper were to (1) investigate the disparate factors influencing peatland management which confound appropriate interventions for enhanced water quality (2) examine how non-implementation of national policies for water pollution control may result in adverse environmental impacts, and (3) propose an innovative peatland management methodology for a detailed and robust land analysis with water quality being the primary consideration. The paper suggests that optical, radar, and radiometric remote sensing methods may be used to identify management zones within a peatland, that may require variable management strategies during restoration. Satellite remote sensing and Earth observation methodologies are well documented; hence, the prospect and properties of a less documented airborne electromagnetic approach may present an opportunity for improved management of peatlands.     

Spatial trypanosomosis management: from data-layers to decision making

The use of geographical information systems (GIS) in the management of African animal trypanosomosis in sub-Saharan Africa offers potential in assisting decisions on allocation of resources, prioritization of control areas, and planning and management of field operations. Here, Guy Hendrickx and colleagues review approaches being used to develop reliable data-layers and to incorporate these data into GIS models. They argue that techniques should be further refined to produce more-detailed data layers and to include a dynamic element, a problem rarely addressed until now.     

Cellular decision making and biological noise: from microbes to mammals

Cellular decision making is the process whereby cells assume different, functionally important and heritable fates without an associated genetic or environmental difference. Such stochastic cell fate decisions generate nongenetic cellular diversity, which may be critical for metazoan development as well as optimized microbial resource utilization and survival in a fluctuating, frequently stressful environment. Here, we review several examples of cellular decision making from viruses, bacteria, yeast, lower metazoans, and mammals, highlighting the role of regulatory network structure and molecular noise. We propose that cellular decision making is one of at least three key processes underlying development at various scales of biological organization.