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Machine learning-driven clinical decision support systems (ML-CDSSs) seem impressively promising for future routine and emergency care. However, reflection on their clinical implementation reveals a wide array of ethical challenges. The preferences, concerns and expectations of professional stakeholders remain largely unexplored. Empirical research, however, may help to clarify the conceptual debate and its aspects in terms of their relevance for clinical practice. This study explores, from an ethical point of view, future healthcare professionals’ attitudes to potential changes of responsibility and decision-making authority when using ML-CDSS. Twenty-seven semistructured interviews were conducted with German medical students and nursing trainees. The data were analysed based on qualitative content analysis according to Kuckartz. Interviewees’ reflections are presented under three themes the interviewees describe as closely related: (self-)attribution of responsibility, decision-making authority and need of (professional) experience. The results illustrate the conceptual interconnectedness of professional responsibility and its structural and epistemic preconditions to be able to fulfil clinicians’ responsibility in a meaningful manner. The study also sheds light on the four relata of responsibility understood as a relational concept. The article closes with concrete suggestions for the ethically sound clinical implementation of ML-CDSS.

Dissertation, Rheinisch-Westfälische Technische Hochschule Aachen, 2022; Aachen : RWTH Aachen University 1 Online-Ressource : Illustrationen (2022). = Dissertation, Rheinisch-Westfälische Technische Hochschule Aachen, 2022, Industrial production was faced with increasing challenges in the last years. Market volatility, rising energy costs and disrupted supply networks resulted in an ever-increasing information variability, which decreases productivity and complicates production planning and control (PPC). Moreover, the ever-increasing demand for, and differentiation through customization also makes planning more difficult. At the same time manufacturing networks have seen a further computerization on a machine level by the introduction of cyber-physical systems (CPS). Capable to process information, gather sensor data locally and communicate within a network, these machine provide an enormous increase in potentials for manufacturing networks. Thus, the technical requirements for distributed production control approaches are fulfilled, based on CPS acting as autonomous entities within a manufacturing network. Such distributed production control approaches feature a number of interesting characteristics, which are often quite contrary to established concepts of traditional, centralized production control. In the literature, many research streams are concerned with the advantages and disadvantages of both centralized and distributed control. While many articles provide deep insights into the workings of specialized control approaches for specific manufacturing environments, an overarching framework allowing a holistic comparison between the two fundamental production control approaches is lacking. In this thesis, the term decision-making authority is introduced to describe the level of autonomy an entity is allowed to exhibit with regard to the potential decisions it could make. Furthermore, both centralized and distributed production control approaches for manufacturing networks based on potentially autonomous entities are explored. In the former case, every entity but one central controller is not allowed to exhibit any decision-making authority, acting purely as command recipients. In the latter case, however, the aforementioned entities have a predefined degree of decision-making authority, enabling them to make certain decisions of the production scheduling on their own. Based on environment variables derived by extensive literature review, a sophisticated simulation framework is developed in form of a multi-agent based discrete-event simulation (MAS-DES). This simulation framework represents all objects of a manufacturing network, such as machines and products as agents. These agents can either follow a global plan, derived from a mixed-integer linear program modeling a centralized production control approach, or act autonomously within the scope of their respective decision-making authority in a distributed production control approach. The main part of this thesis consists of five research articles, presented in Chapters II - VI. Chapter II reviews the historic ply between centralized and decentralized control, followed by a structured literature review regarding autonomy in production planning and control, manufacturing and related research streams. Extending this, Chapter III studies the difference in information scopes of different classes of potentially autonomous entities in a manufacturing network. Chapter IV provides guidance to both researchers and practitioners alike by introducing a scheduling complexity framework, based on environment variables derived from the literature. A multi-agent based discrete-event simulation is utilized to validate the framework quantitatively. Following, Chapter V extends the simulations to study the influence of a manufacturing network’s topology on its aptitude for both centralized and distributed production control approaches. Chapter VI explores synergistic potentials between machine learning and distributed production control for manufacturing networks. Lastly, the thesis ends with a conclusion summarizing results, noting limitations and presenting avenues for future research., Published by RWTH Aachen University, Aachen

Among the factors causing workers’ anxiety, job-related factors are important since they can be managed. Therefore, this study aimed to analyze the association between work-related anxiety and job-related factors among Korean wageworkers using data from the Fifth Korean Working Conditions Survey. Participants were 13,600 Korean wageworkers aged &lt, 65 years. We analyzed the association between job-related factors and work-related anxiety, and the moderating effect of decision-making authority. “Meeting precise quality standards,” “Solving unforeseen problems on your own,” “Complex tasks,” “Learning new things,” “Working at very high speed,” and “Working to tight deadlines” were positively associated with work-related anxiety. “Monotonous tasks” was negatively associated with work-related anxiety. The odds ratio (OR) of “Complex tasks” was higher in the group that had insufficient decision-making authority (OR 3.92, 95% confidential interval (CI) 2.40–6.42) compared to that with sufficient decision-making authority (OR 2.74, 95% CI 1.61–4.67). The risk of work-related anxiety was higher when the workers experienced time pressure, carried out tasks with high mental and physical demands, and dealt with unpredictable situations. This association was more pronounced when decision-making authority was insufficient.

On the standard view we assess a person’s competence by considering her relevant abilities without reference to the actual decision she is about to make. If she is deemed to satisfy certain threshold conditions of competence, it is still an open question whether her decision could ever be overruled on account of its harmful consequences for her (‘hard paternalism’). In practice, however, one normally uses a variable, risk dependent conception of competence, which really means that in considering whether or not to respect a person’s decision-making authority we weigh her decision on several relevant dimensions at the same time: its harmful consequences, its importance in terms of the person’s own relevant values, the infringement of her autonomy involved in overruling it, and her decision-making abilities. I argue that we should openly recognize the multi-dimensional nature of this judgment. This implies rejecting both the threshold conception of competence and the categorical distinction between hard and soft paternalism.

Since 2003, the Philippines have been striving to implement reforms aimed at improving audit quality. Oversight of the audit profession is a key control over the financial reporting architecture of a country’s private sector. A Quality Assurance Review system over audit practitioners is a subset of oversight which serves as a key monitoring control over the integrity of financial reporting. In keeping with the country’s strategic priority of boosting private sector development by improving the investment climate for firms of all sizes, including greater access to finance, legislation was enacted to support the objective of increasing the integrity of private sector financial reporting through improved audit quality. Accordingly, the Board of Accountancy was mandated with the power to conduct oversight into the quality of audits of financial statements through a review of the quality control measures instituted by auditors in order to ensure compliance with the accounting and auditing standards and practices. . However, the injunction remains in place and, accordingly, implementation of the mandated Quality Assurance Review Program may not move forward. Several concrete steps should be taken in order to effectively move forward with the rollout of a comprehensive system of public oversight including audit quality assurance in the Philippines. These include (1) reforming the legal framework to establish an effective audit oversight system with sufficient legal power and authority (2) rationalizing the statutory audit threshold to minimize the conditions contributing to low quality audits, (3) building support among key stakeholder groups by properly addressing their concerns to the extent possible, (4) ensuring coordination of efforts among regulators to eliminate gaps and overlaps and foster collaboration among the group, and (5) establishing a dedicated Project Management Office to oversee the rollout of a Quality Assurance Review Program over audit practitioners.

This thesis examines how having authority to make decisions in different levels of an organization affects performance. The homeland security implications of this study are that the agencies responsible for homeland security are commonly structured along a rigid hierarchy with authorities accumulated at the top. This slow-moving structure is compared to more decentralized and flexible organizations found in private industry and in some foreign governments. Organizational performance can be predicted by examining how the level of operating environment instability is matched to an organization’s decision-making authorities. Using case study analysis, coupled with an extensive literature review, this thesis concludes that the more turbulent the potential environment, such as in the case of a terrorist threat or natural disaster, the more decentralized the organizations should be. The conclusion recognizes the political reality that Congress and executive leaders are not going to easily devolve authority to lower levels in organizations. Therefore, the study concludes with recommendations that agencies dealing in uncertain and changing environments be more loosely coupled at lower levels, allowing more decision-making authority to street-level operators while maintaining ultimate authority at upper levels. Finally, the thesis also recommends additional study of decentralizing strategies specific to homeland security agencies. http://archive.org/details/thebuckstopswher1094547881 Deputy Chief, Valley Regional Fire Authority Approved for public release; distribution is unlimited.

Over the past decade, decentralization of fiscal and policy-making authority has become a cornerstone of development organizations’ recommendations for good governance. Yet the institutional design of multilayered government can create tensions as new elites attempt to fill governing spaces long occupied by traditional patrons. This paper uses the case of post-conflict Sierra Leone to explore the power-sharing dynamics between traditional hereditary chiefs and newly elected community councilors, and how these dynamics affect the provision of local public goods. The paper uses data on several measures of local service provision and finds that councilor/chief relationships defined by competition are associated with higher levels of public goods provision as well as greater improvements in these goods between council areas over time. Relationships defined by frequent contact in the absence of disputes as well as higher frequencies of familial ties between the two sets of actors are associated with worse local development outcomes. This evidence suggests that greater competition between elite groups is beneficial for local development, whereas collusion or cooption between old and new elites harms the provision of local public goods.

This report is the second in a program of evaluations that the independent evaluation group (IEG) is conducting on the learning that takes place through World Bank projects. Learning and knowledge are treated as parts of a whole and are presumed to be mutually reinforcing. The evaluation program addresses the following overarching questions: how well has the World Bank learned in its lending operations?; and what is the scope for improving how it generates, accesses, and uses learning and knowledge in these operations? Evaluation two includes findings from seven country case studies and interviews with Bank staff about their early experience of working within the Bank’s new global practices structure, which became operational on July 1, 2014. The aim is to assess the pre-FY2015 evidence in light of the new structure and roles, and to ask how long-term trends are likely to be modified as reforms evolve. Surveys and interviews reveal that, when it comes to managing projects, Bank staff rely first and foremost on a process of informal learning, leading to a gradual accumulation of tacit knowledge. Informal learning and tacit knowledge are built on the behaviors that flow from mindsets and from the characteristics and operating rules of the groups that individuals belong to. These behavioral underpinnings are mediated by incentives that institutions like the Bank provide to staff. The Bank has launched several important learning initiatives, such as the operational core curriculum. Chapter one presents approach. Chapter two mines the academic and management literature to examine the behavioral underpinnings of informal learning and tacit knowledge. Chapter three examines how individual and team behavior is mediated by the incentives that the Bank offers staff. Chapters four, five, and six examine three operational orientations of particular relevance to the new Bank: balancing of global and local focus, adaptiveness, and results focus. Chapter seven presents recommendations.

This diploma thesis deals with examining the economic literacy of a headmaster. The topic has been chosen because of the belief that a good financial management is important for the development of a school. Another reason for the choice is the fact that there is virtually no set of unambiguously defined responsibilities and no set of suggested knowledge in the economic area which would provide guidance for headmaster in his work. The aim of the theoretical part is to find the necessary information, to define the key terms and to place the economics of the school management into the legislative framework. The practical (research) part examines the actual state of knowledge and the activity of headmasters in the financial management of the school. The difficulty, the risk of financial management in relation to other managerial activities and the comparability of different types and sizes of schools are also examined here. The outcome of this thesis is to give the definition and the content of the economic and financial literacy of a headmaster. It is also to determine the level of the financial literacy of the interviewed headmasters. KEYWORDS: Headmaster, economic literacy, financial literacy, decision-making authority, responsibilities of the headmaster, delegation of responsibilities, financial...

This report is the final product of a project financed by a grant from the World Bank's Youth Innovation Fund developed in conjunction with representatives of the Government of Sierra Leone (GoSL) spanning the period December 2011-June 2012. The report is an advisory document to assist the GoSL in advancement of its Public Sector Reform Program, particularly the initiative improving productivity through management and pay reforms. It provides the Public Service Commission (PSC) and Human Resource Management Office (HRMO) with options for the design and implementation of an entry-level leadership development program (ELDP) for the civil service, currently slated for implementation in 2014 as per government timelines. This program is herein referred to as the Sierra Leone Public Service Fellowship (SLPSF). The purpose of this document is address the identified organizational gap by offering technical guidance on the creation of a civil service fellowship that cultivates promising young professionals as future leaders. The proposed program targets university students in their final year of study and entices them to apply for graduate entry-level positions through a dedicated outreach effort and series of incentives. It selects candidates through a rigorous multi-stage assessment and matches successful candidate's interests with the needs of the Ministry, Department, or Agency (MDAs). It trains selected fellows in core civil service knowledge as well as a range of generalist functions and technical skills. It also offers fellows the opportunity to rotate in three different MDAs throughout the two-year period to develop a whole of government perspective. Throughout this initiative, the program offers fellows access to senior Government leaders and opportunities to grow professionally building a strong foundation for a successful career as a civil servant. Additionally, the program is bolstered by a number of public relations opportunities to raise its profile and showcase its achievements to Sierra Leoneans within and outside of Government.

This case study summarizes the findings of desk reviews and a field visit carried out in January 2011 as part of IEG's evaluation of the 2007 Governance and Anticorruption (GAC) strategy. The case study sought to evaluate the relevance and effectiveness of Bank support for GAC efforts over the FY2004-10 period, to assess the contributions of 2007 strategy implementation, and to identify early outcomes and lessons. This Background Paper is based on findings of the mission that visited Liberia in January 2011. The team is particularly grateful for informative meetings with officials from the Government of Liberia, Bank staff, and members of civil society. The evaluation aims to help enhance the Bank's approach to governance and anticorruption and to improve its effectiveness in helping countries develop capable and accountable states that create opportunities for the poor. Pursuant to this objective, the evaluation assessed the relevance of the 2007 GAC strategy and implementation plan, as well as the efficiency and effectiveness of implementation efforts in making Bank engagement with countries and other development partners more responsive to GAC concerns. It also sought to identify early lessons about what works and what does not in helping to promote good governance and reduce corruption. The Liberia case study is based on an extensive desk review as well as a field visit to Monrovia from January 17-22, 2011. It evaluates the relevance and effectiveness of Bank support for governance and anticorruption efforts since the launch of the Bank's GAC strategy in 2007. It elaborates on a desk review of the GAC responsiveness of the Bank's Liberia program and reviews the following GAC entry points: core public sector reform (public financial management and decentralization); demand for good governance (including social accountability issues); GAC in the road sector; and the investment climate. The case study also examines the extent to which the Bank's GAC Strategy has made a difference in staff attitudes toward addressing GAC issues in their operational work. The mission interviewed government, Bank, donor, and nongovernmental organization (NGO) staff based in Washington and in Monrovia.