Advancing the discussion about Clinical Decision Support Systems to tackle Adverse Drug Events: a ‘problematizing’ approach

Clinical decision support systems (CDSS) can prevent situations in which doctors prescribe a drug to a patient that causes a harmful reaction with another drug that a patient already takes (adverse drug events (ADE)). This can be achieved through generating medication alerts in the moment that a drug is prescribed. Researchers have paid considerable attention to how to design these alerts in the best possible ways, however, largely with inconclusive results. We tackle this body of literature using a ‘problematizing’ approach that enables to understand why research results are inconclusive by disclosing underlying assumptions in a body of literature that have over time shaped a scholarly debate into a particular direction. We uncover four problematic assumptions, offer alternatives to these assumptions and outline potentials to implement our ideas in future research projects

Poaching and Human-elephant Conflict: A Destructive Duo. How Poaching May Alter Male Elephant Society and Indirectly Influence Human-elephant Conflict

The uncertain future of African elephants (Loxodonta africana) is currently a popular issue in conservation circles, largely due to the ongoing poaching crisis. Compounding the threat of illegal offtake are the added pressures of habitat loss and human-elephant conflict (HEC). HEC specifically is a complex challenge to conservation and a major threat to elephants across their entire range, leading not only to retaliation killings but the erosion of local support for conservation. While the issues of poaching and human-elephant conflict have been considered separate issues, an examination of elephant behaviour and HEC under a political ecology framework highlights the possibility that these processes are becoming increasingly interconnected. Elephant bull society, specifically the influence of mature males, aids not only in proper social development of adolescents but controls musth in younger males. As older males have the largest and thus most desirable tusks, the ivory trade presents a unique challenge to bull society by removing the positive influence of older conspecifics. This stifles the ability of young males to learn proper foraging and leads to early musth. As pre-musth males must forage heavily, and foraging behaviour is learnt by association with older males, the ivory trade may lead to heavy crop raiding by young males and thus exacerbate HEC. When we consider that the social and economic situations that are thought to drive poaching activity are the same as those that both put people at higher risk of HEC and drive retaliation killings, it is likely that poaching influences levels of HEC

Sjálfvirkni þunglyndisþanka í daglegu lífi: Rannsóknir á vanabundnu eðli þunglyndisþanka í úrtökum háskólanema og fólks með endurtekið þunglyndi. Innsýn úr snjallsímamælingum

Background: Major depression is the most common psychiatric disorder, associated with the highest disease burden worldwide when it comes to years lost to disability. Efforts to identify indicators of depression risk have strongly implicated depressive rumination, a negative thinking style characterized by repetitive and passive thoughts about the causes, meanings, and consequences of one's feelings and distress. An increasingly popular theoretical perspective posits that over time depressive rumination becomes a mental habit that is initiated automatically without conscious awareness or intent in response to downward shifts in mood, making it persistent and difficult to control. However, the rumination as-a-habit account has rarely been directly tested and it is still unknown whether depression vulnerability is characterized by elevated levels of mood-reactive habitual rumination at the level of short-term dynamics. Aims: The aim of the current research project was to address gaps in the current knowledge on depression vulnerability by utilizing a combination of experimental and novel mobile in-the-moment assessment strategies to better understand the dynamic interplay between mood and ruminative thinking and its habitual characteristics. Three studies were designed to test specific hypotheses involving: a) effects that fluctuations in mood have on subsequent ruminative thinking, b) the degree to which habitual characteristics of negative thinking predict such mood-reactive rumination, and c) whether mood-reactive rumination varies according to the depression-risk spectrum in line with theoretical accounts of depression vulnerability. Methods: In study 1, a total of 115 university students completed self-report measures and participated in an experimental rumination-induction task and outcome-devaluation task measuring habit vs. goal-directed behaviour control. In study 2, a total of 97 participants recorded affect and rumination ten times daily over six days using Ecological Momentary Assessment, after completing measures of trait ruminative brooding and habitual characteristics of negative thinking (e.g., automaticity, lack of conscious awareness, intent, and control). In study 3, formerly depressed individuals with a recurrent history of depression (n = 94) and non-clinical controls (n = 55) recorded in-the-moment affect and rumination ten times daily over six days, after completing baseline measures of trait ruminative brooding, habitual characteristics of negative thinking, and early-life stress. Results: In study 1, greater habitual characteristics of negative thinking were associated with ruminative brooding but not ruminative reflection, and predicted more persistent dysphoric mood following rumination-induction. Rumination was not, however, consistently associated with an imbalance in habit vs. goal-directed behaviour control. In study 2, momentary fluctuations in negative (increased) and positive (decreased) affect was prospectively associated with greater rumination at the next sampling occasion. The degree to which affect triggered a subsequent ruminative response was moderated by habitual characteristics of negative thinking in a theoretically consistent way. Stronger temporal pairing of negative affect and rumination was also associated with greater emotional inertia but less carry-over of rumination from one moment to the next. In study 3, momentary fluctuations in negative affect were prospectively associated with greater rumination at the next sampling occasion in formerly depressed participants whereas this pattern of mood-reactive rumination was not observed in healthy never-depressed participants. In formerly depressed participants, habitual characteristics of negative thinking were associated with greater mood-reactivity of rumination, particularly among those with a history of early-life stress. Mood-reactive rumination was not, however, associated with depression course nor trait ruminative brooding. Conclusions: The findings of the studies demonstrate that fluctuations in affect can trigger ruminative thinking as a function of habit consistent with recent theoretical frameworks of depression vulnerability. Mood-reactive rumination may be a potential vulnerability marker for depression, with rumination being habitually triggered in response to momentary fluctuations in negative affect with a high degree of automaticity, and with a deleterious effect on mood. The current thesis suggests ways depression vulnerability may emerge as a dynamic relationship between negative affect and rumination across time, not captured by traditional trait measures of rumination frequency. Ecological momentary assessment may be a valuable measurement paradigm to test predictions derived from habit-accounts of depressive rumination, that have rarely been investigated until now, and might provide new insights into research on depression risk.This research was sponsored by the Icelandic Center for Research and the Eimskip Fund of The University of Iceland (Rannís Grant 173803-052, 173803-053)

Tort conflicts rules in cross-border multi-party litigation:Which law has a closer or the closest connection?

This article compares Owen v. Galgey under Article 4 Rome II Regulation and YANG Shuying v. British Carnival Cruise under Article 44 Chinese Conflicts Act in the context of cross-border multi-party litigation on tort liability. The questions raised in these two cases include how to interpret the tort conflicts rules of lex loci delicti, lex domicilii communis and the closer/closest connection test when determining the applicable law. In particular, as regards the meaning of lex loci delicti, the notion of ‘damage’, the common habitual residence of the parties and the criteria to determine the closer/closest connection, different interpretations were provided in these two cases. In order to clarify certain ambiguity of tortious applicable law rules in cross-border multi-party litigation, a comparative study of Chinese and European tort conflicts rules is conducted. This article does not intend to make a conclusion, between Rome II Regulation and Chinese Conflicts Act, which law is better, but rather highlights on a common challenge faced by both Chinese courts and English courts in the field of international tortious litigation on personal injury and how to tackle such challenge in an efficient way under current legislation

(What We Talk About When We Talk About) Judicial Temperament

Judicial temperament is simultaneously the thing we think all judges must have and the thing that no one can quite put a finger on. Extant accounts are scattered and thin, and either present a laundry list of desirable judicial qualities without articulating what (if anything) unifies the list or treat temperament as a fundamentally mysterious quality that a judge either does or does not have. Resting so much—selection, evaluation, discipline, even removal—on such an indeterminate concept is intellectually and practically intolerable. Polarized debates over Justice Kavanaugh’s fitness to sit on the Supreme Court made clear just how badly we need a common vocabulary to guide our discourse on judicial temperament. This Article—the first extended scholarly treatment of the topic—posits that, because judicial temperament is a psychological construct, we ought to draw upon psychology to understand it. It therefore taps a deep well of scientific research to construct a new psycho-legal theory of judicial temperament. It conceives judicial temperament as a deep-seated, relatively stable set of specific personal traits—separable from intellect, training, and ideology—that, in dialectic with specific judicial environments and the predictable demands of judging, drive behaviors that affect how justice is delivered and perceived. The critical trait dimensions of a judge’s temperament are positive emotionality, negative emotionality, kindness, and self-regulation. The combination of these traits determines how well or poorly her temperament will fit with any given judicial assignment. Although judicial temperament is somewhat malleable, potential for change is constrained. This scientifically grounded theory shows why some seldom-mentioned attributes—like courage—are temperamental, and other commonly-cited ones—such as commitments to equality and diversity—are not. This Article provides a principled alternative to the folk-wisdom manner in which judicial temperament traditionally has been defined and assessed. Setting the theoretical terms for empirical testing of its claims—and with the potential to transform processes for judicial selection, evaluation, and support—the psycho-legal theory posited here shows what we should be talking about when we talk about judicial temperament

When is truth relevant?

We argue that the experience of knowing and having the truth about oneself known in the context of therapy is not an end in itself; rather, it is important because the trust engendered by this experience (epistemic trust or trust in new knowledge) opens one up to learning about one’s social world and finding better ways to live in it. We consider the consequences of a lack of epistemic trust in terms of psychopatholog

Sustainable Transformation of Individuals and Families: Design and Implementation of Holistic Personalised Socially Driven Persuasive Systems

Sustainability is a topic that has matured and has evolved from organisational sustain ability to societal sustainability and more recently to individual sustainability. As an individual is the core, basic component of society, and plays a critical role in societal transformation, there is growing interest and discussions on individual sustainability and wellbeing. Since the publication of Our Common Future – the report commis sioned by the UN General Assembly in tackling environmental and natural resources issues – the concept of ‘sustainable development’ has taken root in firms and govern ments, both in optimising their supply chain and in the planning of the sustainability of the society. However, counterintuitively, the fabric of the society – individuals and families – has been neglected in this journey of understanding their roles in sustaina bility, as well as in the nexus between their decisions and social outcomes. This thesis bridges the gap. Sustainability is a transformative process of improving the quality of lives by balancing various of our life aspects, such as economic, ecological, and societal dimensions. In this process, information systems often take a critical part as an analytical tool, which provides insightful decision support and recommendations based on collected data and information. In contrast to systems employed by corporates and governments, the development of sustainability systems for individuals and families is still in its infancy. Existing systems mostly are only focusing on one aspect of life and prescribe a single dimensional solution, without regard to the contextual and circumstantial complexi ties of life. In this light, this thesis aims to design and implement systems that adopt a holistic approach in understanding users’ individualistic needs, and in synthesising their life status and goals. The vision is to recognise the multifaceted aspirations of the users, and to nudge them toward a lifestyle that is sustainable, practical, and, above all, enjoyable. To realise this vision, the thesis adopts the multimethodological design science approaches (Hevner, March, Park, & Ram, 2004; Nunamaker, Chen, & Purdin, 1991) with the design eval uation methods from Hevner, March, Park, and Ram (2004) to address the challenges. ii First, the thesis defines individual and family sustainability and a set of nine principles named SSHARRPPP (Sustainable, Social, Holistic, Adaptive, Real-time, Real-world, Precise, Personalised, Persuasive). Based on these principles, the thesis develops sus tainable transformative processes that are applied to key activities and can bring fun damental changes for one’s life. From these conceptual and procedural foundations, the thesis designs system architectures and implements four systems as proof of con cepts. They are, namely, the SSHARRPPP Measurement, Shopping, Modelling, and Games. SSHARRPPP systems support individual and family sustainability holistically as they work together seamlessly. SSHARRPPP Measurement and Shopping measure key ac tivities that are performed by individuals and families. Based on the measured data, SSHARRPPP Modelling grasps causal effect relationships of one’s life dimensions and develops models. Lastly, SSHARRPPP Games helps people to stick with sustainable lives by making their journey enjoyable. All systems are designed to educate people to transform their lives. During the research, all of these conceptual, procedural, and sys tem artefacts are validated through publications, presentations and peer-review pro cesses. This thesis fills the gap in individual and family sustainability by bringing understand ing of human nature and systems together. Taken as a whole, it provides holistic un derstanding on sustainable life transformation and benefits researchers in both infor mation systems and sustainability. The thesis also lays the ground for future work in health and self-management, as it provides system solutions by synthesising core ideas from purposes of life and values, various human processes, and mechanisms to trans form our lives. At the practical level, the system architecture and the applications guide the system developers to design and implement systems for the sustainable transfor mation of individuals and families. Importantly, this thesis benefits individuals and families by making their sustainable life transformations holistic

Everyday Criticality : Questioning, Expertise, and the Embodiment of Critical Judgment

The development of critical disposition, and particularly the disposition to question assertions, has long been viewed as an essential goal of education. Its importance is expressed not only in numerous normative educational visions, but by contemporary policy documents, studies of teacher attitudes, and even popular educational literature. Indeed, the movement to educate for higher-order, critical thinking that has developed over the past four decades views questioning as perhaps the central activity of skilled cognition. As such, the disposition to question assertions – or what I have come to call “criticality” - transcends both the classroom and any specific academic or vocational discipline. It is essential to all good thinking, whether such thinking concerns scientific research, workplace decision making, or the navigation of everyday life. While there has been little conceptual analysis of criticality per se, there exists a substantial and relevant literature concerning the nature of critical disposition. In this dissertation, I analyze the two dominant conceptions in the literature as they relate to criticality, evaluating them with regard to both our held critical ideal of appropriate questioning, as well as a paradox that arises from the nature of the critical act itself – what I call the paradox of criticality. I argue that both conceptions fail to justify our critical ideal and offer little insight into how we can end the iterative questioning of critical behavior without paradoxically engaging in an “acritical” act. I propose that any understanding of criticality capable of supporting a commitment to appropriate questioning must view critical behavior as a form of judgment. With this in mind, I incorporate Hubert Dreyfus’ theory of expertise into a phenomenological analysis of critical recognition to develop a conception of criticality that views such recognition as an act of judgment that itself relies on the embodiment of previous judgment. I then turn to the literature on neurocognition and consciousness for empirical backing of this conception, arguing that both dual cognition and global workspace theory provide substantial justification for a commitment to it. I conclude with a discussion of the educational ramifications of the expertise conception and the role that didactic philosophy might play in an education for criticality

Agency

"There is agency in all we do: thinking, doing, or making. We invent a tune, play, or use it to celebrate an occasion. Or we make a conceptual leap and ask more abstract questions about the conditions for agency. They include autonomy and self-appraisal, each contested by arguments immersing us in circumstances we don’t control. But can it be true we that have no personal responsibility for all we think and do? Agency: Moral Identity and Free Will proposes that deliberation, choice, and free will emerged within the evolutionary history of animals with a physical advantage: organisms having cell walls or exoskeletons had an internal space within which to protect themselves from external threats or encounters. This defense was both structural and active: such organisms could ignore intrusions or inhibit risky behavior. Their capacities evolved with time: inhibition became the power to deliberate and choose the manner of one’s responses. Hence the ability of humans and some other animals to determine their reactions to problematic situations or to information that alters values and choices. This is free will as a material power, not as the conclusion to a conceptual argument. Having it makes us morally responsible for much we do. It prefigures moral identity. Closely argued but plainly written, Agency: Moral Identity and Free Will speaks for autonomy and responsibility when both are eclipsed by ideas that embed us in history or tradition. Our sense of moral choice and freedom is accurate. We are not altogether the creatures of our circumstances.