Showing papers on "Dilemma published in 2022"

Implementing Alternatives to Coercion in Mental Health Care

Abstract: Abstract Body The use of coercive measures in Medicine represents a controversial issue. Even when they comply with all rules and procedures and are enacted with the intention to address the health needs of the patient, and/or protect the patient and/or others, they always represent an infringement of fundamental personal rights and require strong ethical justification. In Psychiatry the debate around coercive measures has led to a theoretical impasse, as the attempt to solve an ethical dilemma may expose mental health care to other ethical challenges and questions of competing rights. At the same time, the ongoing debate has contributed to raise the awareness that coercive practices are over-used, and mental health care is in need of a profound transformation towards recovery-oriented systems of care. The implementation and dissemination of alternatives to coercive practices is an essential component of such transformation. Relevant research has provided tools and documented successful practices, and initiatives aimed at making these resources available and adapted to different contexts are being promoted by international organizations, professional associations and associations of users and carers.1 The profound transformation of current mental health care towards recovery-oriented systems of care requires resources and shared goals among the different stakeholders. Integrated and personalised care pathways, respect of human rights, shared decision making, and involvement of users and carers are essential components of this transformation. Disclosure No significant relationships.

A review of tourism sustainability in the era of Covid-19

Abstract: Abstract In the era of COVID-19, most of the countries are in a dilemma about the recovery of the loss of tourism industry due to the lockdown or to change the track from the disaster to a rare, invaluable, and unexpected opportunity as a glimpse of hope in future through the emergence of new paths. During this pandemic, as per UNWTO, the tourism industry is the most affected globally. The purpose of the study is to review some dimensions to come back with preventive measures so that the tourism sector can recover the loss as soon as possible and to reset a better pathway towards the sustainable development of the tourism industry. This paper is designed based on a literature review. The research methodology technique is based on a previous literature review on the various dimensions of tourism sustainability in the era of Covid-19. The results of this systematic literature review-based discussion reveal the dimensions of tourism sustainability in the era of Covid-19 and help the tourism sector in prospective recovery with some transformations. Various stakeholders of the tourism industry are offered practical recommendations to rethink, revive and reset the tourism sector for maintaining sustainability during and after this unexpected critical situation.

Re-focusing explainability in medicine

Abstract: Using artificial intelligence to improve patient care is a cutting-edge methodology, but its implementation in clinical routine has been limited due to significant concerns about understanding its behavior. One major barrier is the explainability dilemma and how much explanation is required to use artificial intelligence safely in healthcare. A key issue is the lack of consensus on the definition of explainability by experts, regulators, and healthcare professionals, resulting in a wide variety of terminology and expectations. This paper aims to fill the gap by defining minimal explainability standards to serve the views and needs of essential stakeholders in healthcare. In that sense, we propose to define minimal explainability criteria that can support doctors’ understanding, meet patients’ needs, and fulfill legal requirements. Therefore, explainability need not to be exhaustive but sufficient for doctors and patients to comprehend the artificial intelligence models’ clinical implications and be integrated safely into clinical practice. Thus, minimally acceptable standards for explainability are context-dependent and should respond to the specific need and potential risks of each clinical scenario for a responsible and ethical implementation of artificial intelligence.

Fetal bovine serum—a cell culture dilemma

Abstract: Description Ethical and possible reproducibility issues arise when using fetal bovine serum in cell culture media Fetal bovine serum [FBS, also known as fetal calf serum (FCS)] is a popular supplement to the basal medium used in cell and tissue culture. FBS is sourced from unborn calves at the slaughterhouse, raising ethical concerns about animal welfare. Recently, two different laboratories performed in vitro experiments that applied an identical experimental procedure and used cells and FBS from the same suppliers (1). The results they obtained were very different. Further analyses revealed that one cause for the difference in cell response was the supplementation of the cell culture medium with FBS, which had originated from different batches. Given the ubiquitous use of cell culture throughout research, it is important to ensure reproducibility as well as ethical sourcing of research products, such as the development of synthetic media.

IRBs and the Protection-Inclusion Dilemma: Finding a Balance

Abstract: Abstract Institutional review boards, tasked with facilitating ethical research, are often pulled in competing directions. In what we call the protection-inclusion dilemma, we acknowledge the tensions IRBs face in aiming to both protect potential research participants from harm and include under-represented populations in research. In this manuscript, we examine the history of protectionism that has dominated research ethics oversight in the United States, as well as two responses to such protectionism: inclusion initiatives and critiques of the term vulnerability. We look at what we know about IRB decision-making in relation to protecting and including “vulnerable” groups in research and examine the lack of regulatory guidance related to this dilemma, which encourages protection over inclusion within IRB practice. Finally, we offer recommendations related to how IRBs might strike a better balance between inclusion and protection in research ethics oversight.

Reducing Food Waste at Retail Stores—An Explorative Study

Abstract: Grocery retailers are in a dilemma. They often prioritize availability over other aspects due to strong competition in this sector and the imperative of realizing sales. The target for many grocery retailers has been high on-shelf availability and large variety to increase customer satisfaction. However, this policy contributes to a significant share of overstock. The economic pressure of unsold products, the environmental impact of wasted resources, and the ethical questions arising from discarding edible food, have increasingly thrown the spotlight on grocery retailers to change their strategies. Grocery retailers are thus facing a trade-off between increasing attractiveness via high availability on the one hand, and the environmental, social, and financial impacts of overstock, on the other. One common practice in dealing with overstock is mainly being reactive to mitigate the impact, using initiatives such as price promotions or donations. This explorative study investigates options for how grocery retailers can proactively reduce food waste via better planning of their store operations. Seven case companies participated in this qualitative study, where we focused on ultra-fresh products as the most important waste category. Face-to-face interviews with managers were the primary source for data collection. The heterogeneity of our sample enabled us to build a common understanding of proactive options to reduce food waste with enhanced operations. The analysis reveals six coherent and distinct topics. A basis for all proactive operational planning processes is (1) the use of a comprehensive database and information systems. This builds the foundation for (2) tailored demand forecasts related to perishable product-specific requirements. Subsequently, consideration is needed of (3) the enhanced planning of assortment sizes, (4) the definitions of differentiated service levels and (5) the tailored ordering and replenishment processes that impact food waste. Finally, (6) salvage options, such as dynamic pricing, secondary usage, and sustainable waste streams constitute valuable mitigation strategies. We formulated 15 propositions that could support the decisions of grocery retailers developing proactive food waste reduction practices. These propositions will guide future research, as they provide a coherent and cohesive picture of related topics in grocery retail operations.

Tactical cooperation of defectors in a multi-stage public goods game

Abstract: The basic social dilemma is frequently captured by a public goods game where participants decide simultaneously whether to support a common pool or not and after the enhanced contributions are distributed uniformly among all competitors. What if the result of common efforts is not distributed immediately, but it is reinvested and added to the pool for a next round? This extension may not only result in an enhanced benefit for group members but also opens new strategies for involved players because they may act in distinct rounds differently. In this work we focus on the simplest case when two rounds are considered, but the applied multiplication factors dedicated to a certain round can be different. We show that in structured populations the winning strategy may depend sensitively on the ratio of these factors and the last round has a special importance to reach a fully cooperative state. We also observe that it may pay for defectors to support the first round and after enjoy the extra benefit of accumulated contributions. Full cooperator strategy is only viable if the second round ensures a premium benefit of investments.

Eco-evolutionary dynamics of multigames with mutations

Abstract: Most environments favor defection over cooperation due to natural selection. Nonetheless, the emergence of cooperation is omnipresent in many biological, social, and economic systems, quite contrary to the well-celebrated Darwinian theory of evolution. Much research has been devoted to better understanding how and why cooperation persists among self-interested individuals despite their competition for limited resources. Here we go beyond a single social dilemma since individuals usually encounter various social challenges. In particular, we propose and study a mathematical model incorporating both the prisoner’s dilemma and the snowdrift game. We further extend this model by considering ecological signatures like mutation and selfless one-sided contribution of altruist free space. The nonlinear evolutionary dynamics that results from these upgrades offer a broader range of equilibrium outcomes, and it also often favors cooperation over defection. With the help of analytical and numerical calculations, our theoretical model sheds light on the mechanisms that maintain biodiversity, and it helps to explain the evolution of social order in human societies.

How short or long should be a questionnaire for any research? Researchers dilemma in deciding the appropriate questionnaire length

Abstract: A questionnaire plays a pivotal role in various surveys. Within the realm of biomedical research, questionnaires serve a role in epidemiological surveys and mental health surveys and to obtain information about knowledge, attitude, and practice (KAP) on various topics of interest. Questionnaire in border perspective can be of different types like self-administered or professionally administered and according to the mode of delivery paper-based or electronic media–based. Various studies have been conducted to assess the appropriateness of a questionnaire in a particular field and methods to translate and validate them. But very little is known regarding the appropriate length and number of questions in a questionnaire and what role it has in data quality, reliability, and response rates. Hence, this narrative review is to explore the critical issue of appropriate length and number of questions in a questionnaire while questionnaire designing.

Intermediaries for the greater good: How entrepreneurial support organizations can embed constrained sustainable development startups in entrepreneurial ecosystems

Abstract: Sustainable development startups (SDSs) are important to help overcome societal challenges. However, starting an SDS or investing in them is a high-risk endeavor. Hence, policymakers are trying to make entrepreneurial ecosystems (EEs) more favorable for SDSs. A critical component of any EE is a financial support network, through which startups receive investments and business knowledge most importantly from private venture capitalists (VCs), among other finance providers. To be successful, SDSs thus need to become embedded in the financial support network. This embeddedness also allows SDSs to serve as network brokers between VCs and other startups, which is beneficial for the entire EE. Entrepreneurial support organizations (ESOs) can help build a sufficiently dense financial support network by introducing startups to other actors. However, there are often not enough promising SDSs in an EE to meaningfully influence the financial support network. This places ESOs that promote SDSs in the dilemma of which startups to admit: they can either focus their efforts exclusively on SDSs or give their unfilled spots to non-SDSs, with the latter facilitating network brokering among startups. Therefore, this paper answers the following research question: What is the effect from ESOs’ support mechanisms and admission regimes on the number of investments in SDSs? Using an agent-based model, I demonstrate that ESOs are a necessity for EEs with many constrained SDSs, particularly when the constraints are technology-based. Without ESOs, the presence of such SDSs negatively influences the entire EE due to a loss of brokering in the financial support network. ESOs can help repair this damage by having the right admission regimes and helping tenant SDSs overcome some of their constraints. Ultimately, the most effective way to do this is to have an admission regime under which only SDSs are accepted and receive twice as much support from the ESO.

Why Paternalists Must Endorse Epistocracy

Abstract: Recent findings from psychology and behavioral economics suggest that we are “predictably irrational” in the pursuit of our interests. Paternalists from both the social sciences and philosophy use these findings to defend interfering with people's consumption choices for their own good. We should tax soda, ban cigarettes, and mandate retirement savings to make people healthier and wealthier than they’d be on their own. Our thesis is that the standard arguments offered in support of restricting people’s consumption choices for their own good also imply support for “epistocratic” restrictions on people’s voting choices for their own good. Indeed, the philosophical case for paternalistic restrictions on voting choices may be stronger than the case for restricting personal consumption choices. So, paternalists face a dilemma: either endorse less interference with consumption choices or more interference with voting choices.

Strategic Inventories Under Supply Chain Competition

Abstract: Problem definition: We consider the effects of strategic inventory (SI) in the presence of chain-to-chain competition in a two-period model. Academic/practical relevance: Established findings suggest that SI may alleviate double marginalization and improve the efficiency of a decentralized distribution channel. However, no studies consider the role of SI under chain-to-chain competition. Methodology: We build a two-period model consisting of two competing supply chains, each with an upstream manufacturer and an exclusive retailer. The retailers compete on either price or quantity. We characterize the firms’ strategies under the concept of perfect Bayesian equilibrium. We consider cases where contracts are either observable or unobservable across supply chains. Results: (1) SI still exists under chain-to-chain competition. Retailers may carry more inventory when the competition becomes fiercer, which further intensifies the supply chain competition. (2) Different from the existing findings, SI may backfire and hurt all firms. Interestingly, firms may benefit from a higher inventory holding cost. (3) Under supply chain competition, the prisoner’s dilemma can arise if competition intensity is intermediate; in other words, manufacturers are better off without strategic inventory, and yet they cannot help allowing strategic inventory, which is the unique equilibrium. Managerial implications: Despite its appeal among firms of a single supply chain, the role of SI is altered or even reversed by chain-to-chain competition. Conventional wisdom on SI should be applied with caution.