This paper contributes to the foundations of a theory of rational choice for artificial agents in dynamic environments. Our work is developed within a theoretical framework, originally due to Bratman, that models resource-bounded agents as operating against the background of some current set of intentions, which helps to frame their subsequent reasoning. In contrast to the standard theory of rational choice, where options are evaluated in isolation, we therefore provide an analysis of situations in which the options presented to an (...) agent are evaluated against a background context provided by the agent’s current plans—commitments to future activities, which may themselves be only partially specified. The interactions between the new options and the background context can complicate the task of evaluating the option, rendering it either more or less desirable in context than it would have been in isolation.  2001 Elsevier Science B.V. All rights reserved. (shrink)

Total knee arthroplasty (TKA) is a commonly implemented elective surgical treatment for end-stage osteoarthritis of the knee, demonstrating high success rates when assessed by objective medical outcomes. However, a considerable proportion of TKA patients report significant dissatisfaction postoperatively, related to enduring pain, functional limitations, and diminished quality of life. In this conceptual analysis, we highlight the importance of assessing patient-centred outcomes routinely in clinical practice, as these measures provide important information regarding whether surgery and postoperative rehabilitation interventions have effectively remediated (...) patients’ real-world “quality of life” experiences. We propose a novel precision medicine approach to improving patient-centred TKA outcomes through the development of a multivariate machine-learning model. The primary aim of this model is to predict individual postoperative recovery trajectories. Uniquely, this model will be developed using an interdisciplinary methodology involving non-linear analysis of the unique contributions of a range of preoperative risk and resilience factors to patient-centred TKA outcomes. Of particular importance to the model’s predictive power is the inclusion of a comprehensive assessment of modifiable psychological risk and resilience factors that have demonstrated relationships with TKA and other conditions in some studies. Despite the potential for patient psychological factors to limit recovery, they are typically not routinely assessed preoperatively in this patient group, and thus can be overlooked in rehabilitative referral and intervention decision-making. This represents a research-to-practice gap that may contribute to adverse patient-centred outcomes. Incorporating psychological risk and resilience factors into a multivariate prediction model could improve the detection of patients at risk of sub-optimal outcomes following TKA. This could provide surgeons and rehabilitation providers with a simplified tool to inform postoperative referral and intervention decision-making related to a range of interdisciplinary domains outside their usual purview. The proposed approach could facilitate the development and provision of more targeted rehabilitative interventions on the basis of identified individual needs. The roles of several modifiable psychological risk and resilience factors in recovery are summarised, and intervention options are briefly presented. While focusing on rehabilitation following TKA, we advocate for the broader utilisation of multivariate prediction models to inform individually-tailored interventions targeting a range of health conditions. (shrink)

This article seeks to explain the variable implementation of gender mainstreaming as a `policy frame' over time and across various international organisations (I.O.s). In the years since the U.N. Fourth World Women's Conference in Beijing (1995),mainstreaming has been endorsed and adopted by a wide range of international organisations, and we compare the adoption and implementation of mainstreaming in four specific I.O.s: the World Bank, the United Nations Development Programme, the Organisation for Security and Cooperation in Europe, and the European Union. (...) The rhetorical acceptance of mainstreaming by various international organisations, however, obscures considerable variation in both the timing and the nature of the mainstreaming process within and among organisations. This variation, in turn, can be explained in terms of the categories of political opportunity, mobilising structures and strategic framing, which have been put forward by social movement theorists. (shrink)