This thesis investigates the representation of operational decision makers within simulation modelling. Artificial Intelligence concepts, such as expert systems focus on the problem of representing, in high-level code, complex real-world decision making problems. The author therefore proposes that the use of expert system technology may provide an improved means of representing operational decision tasks and that as a consequence, apriori possibilities may exist in the context of model experimentation based on alternative operational policies. The thesis further investigates the nature of operational decision making and the potential need to represent within a model, inter-dependencies between decision makers. A prototype system called ESSIM is developed which comprises of two interlinked components, a discrete event simulation module and expert system module. The benefits of the proposed approach are then assessed by comparing the functionally of ESSIM with conventional modelling techniques. The comparison is carried out by developing three alternative models of an automated container port, one of these using ESSIM. Experiments were then devised and executed which seek to draw conclusions on the thesis proposal.

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Male circumcision is one of the most common paediatric surgeries. Most research has concentrated on assessing medical risks versus benefits, yet the majority of infant circumcisions are performed for social reasons. A few studies have surveyed reasons for circumcising/not circumcising. However, they have not revealed the decision-making process. Drawing upon embodiment theories, this study explored expectant parents’ decision-making about circumcision. Interviews were conducted with six individuals. Interpretative Phenomenological Analysis was utilized to identify themes. Findings revealed eight major themes, including ‘gender jurisdiction’ (whether fathers should have more decision-making power than mothers). Another centred on deciding whose body was the focus – the baby’s or the father’s. All participants perceived bias, both pro- and anti-circumcision, in the information they received from health professionals. They expressed a strong need for objective information and support. The findings may be helpful to obstetricians, paediatricians, and midwives – as well as individuals and families facing this decision.

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Context: Rectal cancer treatment decisions involve tradeoffs between outcomes like living with a permanent stoma versus long-term bowel dysfunction. The needs of rectal cancer patients and practitioners to partake in shared decision making are unknown. For such a complex decision, a patient decision aid that prepares patients to make informed, values-based decisions is warranted. Methods: 1) A systematic review, to characterize the prevalence of long-term dysfunction 2) Needs assessments, conducted with rectal cancer patients and practitioners, 3) Development of a decision aid. Results: 1) Significant variability exists in reporting rectal cancer outcomes. The rate of bowel dysfunction is high. 2) Rectal cancer patients recall little of the outcomes discussed preoperatively. They do not perceive having any surgical options. Practitioners are inconsistently engaging patients in shared decision-making. 3) A patient decision aid was developed that a) incorporated systematic review results and; b) addressed the needs, barriers and facilitators raised. Conclusions: Shared decision-making in rectal cancer surgery is limited. A decision aid to improve patient decision-making was developed.

The purpose of this study was to answer the question: how do children influence attraction choice while on vacation? A cross-sectional, self-administered, web-based survey of 99 adult facilitators visiting one of three tourist attractions in Winnipeg, Canada with at least one child between the ages of six and 17 was used to: 1) gain insight on how groups with a child/children prefer to travel; 2) understand the reasons why groups with a child/children choose to visit a select type of attraction; 3) examine the views of adult facilitators who travel with a child/children on the child/children’s participation with regards to the selection of tourist attractions; and 4) investigate which attraction characteristics adult facilitators believe provide their entire group with the most satisfying experience. Results indicate that children have relatively little direct influence within the family or group unit on attraction choice.

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