Abstract Background An analysis of Accident Compensation Corporation claims shows “inconsistent and inadequate diagnoses” by health care providers. Diagnostic performance is a result of two independent parameters, namely discrimination (accuracy) and decision (bias). Bias is related to the medical practitioner’s perception of the costs and benefits of making one choice over another. Bias may be statistical, sociological, political, biological or psychological in nature. This study investigated the factors that potentially bias diagnostic decision-making by general practitioners and the subjective value placed on these factors by different stakeholder groups in society. Methods Phase 1 of the study used focus groups of standard setters for general practitioners to identify factors that influenced diagnostic decision-making in general practice. These factors were evaluated for importance and desirability using standard Delphi methodology and Rasch analysis. Phase 2 of the study evaluated the importance and desirability of the factors identified in Phase 1 for influencing decision making as judged by significant health care stakeholder groups in New Zealand. Participant response was via questionnaire analysed by the Rasch Model. Results Thirty-nine factors were identified that potentially biased diagnostic decision-making in general practice. The measurements of, particularly, desirability have high reproducibility across stakeholder groups and high positive loading for the first principal component consistent with construct validity. No stakeholder group identifies factors consistent with Bayes’ theorem of diagnostic reasoning as being the only desirable influence on diagnosis. There is considerable categorical homogeneity between the stakeholder groups GP, GPACC, P, RACCSLT and RACCSST. Conclusions The findings of this and other studies challenge the current biomedical paradigm, indicating a less than Bayesian approach to medical decision-making. A social constructivist model, incorporating non-Bayesian factors into the definition of “illness” versus “disease”, may be more representative of reality. A social constructivist model of medicine is incompatible with the current legislatory and administrative framework within which the Accident Compensation Corporation and a number of other medical organisations operate. / Accident Compensation Corporation of New Zealand

Abstract Background An analysis of Accident Compensation Corporation claims shows “inconsistent and inadequate diagnoses” by health care providers. Diagnostic performance is a result of two independent parameters, namely discrimination (accuracy) and decision (bias). Bias is related to the medical practitioner’s perception of the costs and benefits of making one choice over another. Bias may be statistical, sociological, political, biological or psychological in nature. This study investigated the factors that potentially bias diagnostic decision-making by general practitioners and the subjective value placed on these factors by different stakeholder groups in society. Methods Phase 1 of the study used focus groups of standard setters for general practitioners to identify factors that influenced diagnostic decision-making in general practice. These factors were evaluated for importance and desirability using standard Delphi methodology and Rasch analysis. Phase 2 of the study evaluated the importance and desirability of the factors identified in Phase 1 for influencing decision making as judged by significant health care stakeholder groups in New Zealand. Participant response was via questionnaire analysed by the Rasch Model. Results Thirty-nine factors were identified that potentially biased diagnostic decision-making in general practice. The measurements of, particularly, desirability have high reproducibility across stakeholder groups and high positive loading for the first principal component consistent with construct validity. No stakeholder group identifies factors consistent with Bayes’ theorem of diagnostic reasoning as being the only desirable influence on diagnosis. There is considerable categorical homogeneity between the stakeholder groups GP, GPACC, P, RACCSLT and RACCSST. Conclusions The findings of this and other studies challenge the current biomedical paradigm, indicating a less than Bayesian approach to medical decision-making. A social constructivist model, incorporating non-Bayesian factors into the definition of “illness” versus “disease”, may be more representative of reality. A social constructivist model of medicine is incompatible with the current legislatory and administrative framework within which the Accident Compensation Corporation and a number of other medical organisations operate. / Accident Compensation Corporation of New Zealand

Abstract Background An analysis of Accident Compensation Corporation claims shows “inconsistent and inadequate diagnoses” by health care providers. Diagnostic performance is a result of two independent parameters, namely discrimination (accuracy) and decision (bias). Bias is related to the medical practitioner’s perception of the costs and benefits of making one choice over another. Bias may be statistical, sociological, political, biological or psychological in nature. This study investigated the factors that potentially bias diagnostic decision-making by general practitioners and the subjective value placed on these factors by different stakeholder groups in society. Methods Phase 1 of the study used focus groups of standard setters for general practitioners to identify factors that influenced diagnostic decision-making in general practice. These factors were evaluated for importance and desirability using standard Delphi methodology and Rasch analysis. Phase 2 of the study evaluated the importance and desirability of the factors identified in Phase 1 for influencing decision making as judged by significant health care stakeholder groups in New Zealand. Participant response was via questionnaire analysed by the Rasch Model. Results Thirty-nine factors were identified that potentially biased diagnostic decision-making in general practice. The measurements of, particularly, desirability have high reproducibility across stakeholder groups and high positive loading for the first principal component consistent with construct validity. No stakeholder group identifies factors consistent with Bayes’ theorem of diagnostic reasoning as being the only desirable influence on diagnosis. There is considerable categorical homogeneity between the stakeholder groups GP, GPACC, P, RACCSLT and RACCSST. Conclusions The findings of this and other studies challenge the current biomedical paradigm, indicating a less than Bayesian approach to medical decision-making. A social constructivist model, incorporating non-Bayesian factors into the definition of “illness” versus “disease”, may be more representative of reality. A social constructivist model of medicine is incompatible with the current legislatory and administrative framework within which the Accident Compensation Corporation and a number of other medical organisations operate. / Accident Compensation Corporation of New Zealand

Abstract Background An analysis of Accident Compensation Corporation claims shows “inconsistent and inadequate diagnoses” by health care providers. Diagnostic performance is a result of two independent parameters, namely discrimination (accuracy) and decision (bias). Bias is related to the medical practitioner’s perception of the costs and benefits of making one choice over another. Bias may be statistical, sociological, political, biological or psychological in nature. This study investigated the factors that potentially bias diagnostic decision-making by general practitioners and the subjective value placed on these factors by different stakeholder groups in society. Methods Phase 1 of the study used focus groups of standard setters for general practitioners to identify factors that influenced diagnostic decision-making in general practice. These factors were evaluated for importance and desirability using standard Delphi methodology and Rasch analysis. Phase 2 of the study evaluated the importance and desirability of the factors identified in Phase 1 for influencing decision making as judged by significant health care stakeholder groups in New Zealand. Participant response was via questionnaire analysed by the Rasch Model. Results Thirty-nine factors were identified that potentially biased diagnostic decision-making in general practice. The measurements of, particularly, desirability have high reproducibility across stakeholder groups and high positive loading for the first principal component consistent with construct validity. No stakeholder group identifies factors consistent with Bayes’ theorem of diagnostic reasoning as being the only desirable influence on diagnosis. There is considerable categorical homogeneity between the stakeholder groups GP, GPACC, P, RACCSLT and RACCSST. Conclusions The findings of this and other studies challenge the current biomedical paradigm, indicating a less than Bayesian approach to medical decision-making. A social constructivist model, incorporating non-Bayesian factors into the definition of “illness” versus “disease”, may be more representative of reality. A social constructivist model of medicine is incompatible with the current legislatory and administrative framework within which the Accident Compensation Corporation and a number of other medical organisations operate. / Accident Compensation Corporation of New Zealand

There are many pieces of flight deck research on general use of written English language technical information and problem solving using technical documentation. Contributory causes of aircraft accidents have been due to misunderstandings of crew alerts and procedural divergence by English as-a-second language flight crewmembers (ESL). Research was conducted to understand impact of written English language technical information on ESL flight crewmembers’ performance. Two types of systems were evaluated, technical documentation and crew alerting systems that contain technical information, with respect to their impact on ESL flight crewmember performance. Preliminary analysis results indicated written English language technical information can be confusing, difficult to read and interpret, and leads to misunderstandings by ESL flight crewmembers during aircraft nonnormal conditions. English as-a-second language flight crewmembers indicated they often experience problems executing written English language technical procedures after outset of crew alerts. Conversely, experimental trials revealed ESL flight crewmembers did not experience many cognitive performance issues with use of crew alerting systems and technical information designed with an English language emphasis. English as-a second language flight crewmembers’ English language proficiency, background knowledge, and use of use of metacognitive strategies to read and comprehend written English language on crew alerting and information systems, indicated they utilized written English technical information with ease. Particularly, ESL flight crewmembers’ workload was low, they had fast response times to system faults, and they experienced minimal procedural deviations. On the contrary, when ESL flight crewmembers utilized written English language technical procedures translated into their native language during non-normal conditions, they experienced several cognitive performance challenges. English as-a second language flight crewmembers’ background knowledge of written English language technical information translated into their native language, use of metacognitive strategies to read and comprehend written English language translated into their native language, indicated they experienced difficulties with reading and comprehending translated technical information on information systems. Particularly, ESL flight crewmembers were challenged cognitively when they responded to crew alerts through execution of decision-making processes. They indicated translation of written English language technical information into their native language was a pre-cursor to procedural deviation, long response times to system issues, as well as high workload during experimental trials. It is recommended that further research focus on design and use of written English language technical documentation by ESL flight crewmembers during non-normal conditions. It is also recommended that if deemed practical by the aviation industry, further research should focus on design, integration, and utilization of technical documentation in a language(s) other than English, and measurement of ESL flight crewmembers performance on the flight deck.

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior / Risk management constitutes a basis for decision making since it creates a view that allows to identify and control risks that can compromise the assets of a given organization. The standard ISO 27005:2011 states that one of the fundamental steps on a risk management plan is the definition of security policies with the usage of risk assessment to estimate the severity of the threats that a given organization faces. Despite the existence of several methodologies to achieve successful risk assessments, preview evidence has demonstrated that the presence of human data sources for risk assessments can produce biased results, thus compromising the business continuity as a result of unnecessary or wrong investments. Using the confidence level of human sources to give emphasis to individuals considered as more reliable, this work presents a proposal to reduce biases by using weights in risk assessments. The concept of trust used is a function of trust among coworkers and performance evaluations, which allowed to create an evolutionary process that refines the notions of trust through the execution of continuum cycles of risk management . A validation of the evolution of the process of risk management during various periods of time showed that the use of coefficients of trust in risk assessment can effectively improve the accuracy of risk estimates. As a result the developed model for quantification of trust enabled the creation of a tool to minimize deviations of results due human causes. / A gestão de riscos constitui uma base para a tomada de decisão, uma vez que cria uma visão que permite identificar e controlar os riscos que podem comprometer os ativos de uma determinada organização. A norma ISO 27005:2011 afirma que um dos passos fundamentais em um plano de gerenciamento de risco é a definição de políticas de segurança mediante o uso de avaliação de riscos para estimar a gravidade das ameaças que uma determinada organização enfrenta. Apesar da existência de várias metodologias para realizar avaliações de risco exitosas, evidência prévia tem demonstrado que a presença de fontes de dados humanas podem produzir desvios nos resultados, podendo comprometer a continuidade dos negócios com investimentos realizados de forma desnecessária ou equivocada. Utilizando-se o nível de confiança das fontes humanas para dar ênfase aos indivíduos considerados como mais confiáveis, este trabalho apresenta uma proposta para reduzir desvios mediante o uso de ponderações nas avaliações de risco. O conceito de confiança utilizado é uma função de confiança entre os colegas de trabalho e de avaliações de desempenho, o que permite criar um processo evolutivo que refina as noções de confiança a partir da execução continua dos ciclos de gestão de risco. A avaliação da evolução do processo de gestão do risco ao longo de diversos períodos de tempo demonstrou que o uso de coeficientes de confiança em análise/avaliação de riscos pode efetivamente aumentar a precisão das estimativas de riscos. Como resultado o modelo de quantificação de confiança desenvolvido possibilitou a criação de uma ferramenta para minimizar desvios de resultados por causas humanas.

Background: Risky security behaviour displayed by end-users has the potential to leave devices vulnerable to compromise, despite the availability of security tools designed to aid users in defending themselves against potential online threats. This indicates a need to modify the behaviour of end-users, allowing them to consider the security implications of their actions online. Previous research has indicated affective feedback may serve as a successful method of educating users about risky security behaviours. Thus, by influencing end-users via affective feedback it may be possible to engage users, improving their security awareness. Aims: Develop and apply knowledge of monitoring techniques and affective feedback, establishing if this changes users’ awareness of risky security behaviour in the context of a browser-based environment. Methodology: The methodology employs the use of log files derived from the monitoring solution, and information provided by users during the experiments. Questionnaire data was compared against log files and information provided during experiments, providing an overall quantitative approach. Results: In the case of the log files and questionnaires, participants were found to have engaged in instances of risky security behaviours, which they were unaware of, and this indicated a low-level of awareness of risky security behaviour. Whilst the results indicate the affective feedback did not make a difference to behaviour during the course of the experiments, participants felt that the affective feedback delivered had an impact, raising their security awareness, encouraging them to learn about online security. Conclusions: This body of research has made a novel contribution to the field of affective feedback and usable security. Whilst the results indicate the affective feedback made no difference to behaviour, users felt it had an impact on them, persuading them to consider their security behaviours online, and encouraging them to increase their knowledge of risky security behaviours. The research highlights the potential application of affective feedback in the field of usable security. Future work seeks to explore different ways in which affective feedback can be positioned on-screen, and how feedback can be tailored to target specific groups, such as children, or elderly people, with the aim of raising security awareness.

Made available in DSpace on 2014-10-09T12:51:42Z (GMT). No. of bitstreams: 0 / Made available in DSpace on 2014-10-09T14:10:15Z (GMT). No. of bitstreams: 0 / Tese (Doutoramento) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN/CNEN-SP

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2015-03-03T14:44:05Z No. of bitstreams: 0 / Made available in DSpace on 2015-03-03T14:44:05Z (GMT). No. of bitstreams: 0 / Dissertação (Mestrado em Tecnologia Nuclear) / IPEN/D / Instituto de Pesquisas Tecnológicas do Estado de São Paulo, São Paulo

Submitted by Claudinei Pracidelli (cpracide@ipen.br) on 2015-12-22T09:33:02Z No. of bitstreams: 0 / Made available in DSpace on 2015-12-22T09:33:02Z (GMT). No. of bitstreams: 0 / Tese (Doutorado em Tecnologia Nuclear) / IPEN/T / Instituto de Pesquisas Energeticas e Nucleares - IPEN-CNEN/SP