196 resultados para clinical decision-making


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This paper is based on a study examining the impact of young people’s backgrounds and educational experiences on career choice capability with the aim of informing education policy. A total of 706 students from secondary schools (Years 9-12) in New South Wales, Australia took part in an online survey. This paper focuses on the differences found between groups on the basis of their educational experiences. Participants who were uncertain of their future career plans were more likely to attend non-selective, non-metropolitan schools and were more likely to hold negative attitudes towards school. Career ‘uncertain’ students were also less likely to be satisfied with the elective subjects offered at their school and reported less access to career education sessions. It is concluded that timely career information and guidance should be provided to students and their families in order to allow them to more meaningfully make use of the resources and opportunities available to them with a view toward converting these into real world benefits.

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A wide range of decision-making models have been offered to assist in making ethical decisions in the workplace. Those that are based on normative moral frameworks typically include elements of traditional moral philosophy such as consequentialist and/or deontological␣ethics. This paper suggests an alternative model drawing on Jean-Paul Sartre’s existentialism. Accordingly, the model focuses on making decisions in full awareness of one’s freedom and responsibility. The steps of the model are intended to encourage reflection of one’s projects and one’s situation and the possibility of refusing the expectations of others. A case study involving affirmative action in South Africa is used to demonstrate the workings of the model and a number of strengths and weaknesses are identified. Despite several weaknesses that can be raised regarding existential ethics, the model’s success lies in the way that it reframes ethical dilemmas in terms of individual freedom and responsibility, and in its acceptance and analysis of subjective experiences and personal situations

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This chapter examines the challenges and opportunities associated with planning for competitive, smart and healthy cities. The chapter is based on the assumptions that a healthy city is an important prerequisite for a competitive city and a fundamental outcome of smart cities. Thus, it is preeminent to understand the planning decision support system based on local determinants of health, economic and social factors. One of the major decision support systems is e-health and this chapter will focus on the role of e-health planning, by utilising web-based geographic decision support systems. The proposed novel decision support system would provide a powerful and effective platform for stakeholders to access online information for a better decision-making while empowering community participation. The chapter also highlights the need for a comprehensive conceptual framework to guide the decision process of planning for healthy cities in association with opportunities and limitations. In summary, this chapter provides the critical insights of using information science-based framework and suggest online decision support methods, as part of a broader e-health approach for creating a healthy, competitive and smart city.

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The aim of this thesis is to examine how risk tolerance and risk perception, two important but often misunderstood constructs, jointly influence client investment decisions in a financial advice context. By distinguishing the roles of these two risk constructs in client decision-making, in this thesis a new direction in studying financial/investment risks is provided while practice and regulation in the financial services industry is potentially informed. Based on the literature relating to risks and individual decision-making, a theoretical framework is developed and relevant hypotheses are tested in two studies with financial adviser clients in Australia. Results reveal that financial risk tolerance influences asset allocation both directly and indirectly through risk perception. The intervening role of risk perception suggests that risk tolerance affects how clients perceive the riskiness of an investment product which influences client decision-making.

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This chapter explains how customers make purchase decisions and how these decisions are influenced not only by the service marketer but also by the customers own emotions. While decision-making is described from the perspective of purchasing services rather than purchasing goods, we challenge the traditional notion that customers make informed, rational and well-thought-out decisions. Rather customers are often driven by subjective feelings such as emotions. We present evidence of how these emotions influence the behavior of customers, their attitudes and evaluation of the service, as well as final decision-making processes.

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When a household welcomes a new infant a transformation occurs whereby household routines, values and decisions change. This research explores how decision-making is influenced by fluctuating identity subjectivities. We explore longitudinally, using a family identity framework, how the transitioning between self, couple and family self-identities influences the decisions made regarding social issues, in this case infant feeding. Results indicate that decision-making during a period of transformation is not straightforward, relying on a multiplicity of identities that are constantly renegotiated and dependent on other influences. Decisions made conform to the identity-construct-of-the-moment, but are fluid and subject to change, such that pinpointing causal pathways is inappropriate. Implications for influencing the consumption of social behaviors for consumer researchers are one size does not fit all and require an in-depth understanding of the fluidity of decision-making. Consequently, social marketing strategies need to be tailored to constructed identities and flexible across time to remain influential.

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The need for better and more accurate assessments of testamentary and decision-making capacity grows as Australian society ages and incidences of mentally disabling conditions increase. Capacity is a legal determination, but one on which medical opinion is increasingly being sought. The difficulties inherent within capacity assessments are exacerbated by the ad hoc approaches adopted by legal and medical professionals based on individual knowledge and skill, as well as the numerous assessment paradigms that exist. This can negatively affect the quality of assessments, and results in confusion as to the best way to assess capacity. This article begins by assessing the nature of capacity. The most common general assessment models used in Australia are then discussed, as are the practical challenges associated with capacity assessment. The article concludes by suggesting a way forward to satisfactorily assess legal capacity given the significant ramifications of getting it wrong.

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In recent years accounting education has seen numerous changes to the way financial accounting is taught. These changes reflect the demands of an ever-changing business world, opportunities created by new technology and instructional technologies, and an increased understanding of how students learn. The foundation of Financial Accounting is based on a number of unique principles and innovations in accounting education. The objective of Financial Accounting is to provide students with an understanding of those concepts that are fundamental to the preparation and use of accounting information. Most students will forget procedural details within a short period of time. On the other hand, concepts, if well taught, should be remembered for a lifetime. Concepts are especially important in a world where the details are constantly changing. Students learn best when they are actively engaged. The overriding pedagogical objective of Financial Accounting is to provide students with continual opportunities for active learning. One of the best tools for active learning is strategically placed questions. Discussions are framed by questions, often beginning with rhetorical questions and ending with review questions, and our analytical devices, called decision-making toolkits, use key questions to demonstrate the purpose of each.

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Background Chronic cough (a cough lasting longer than four weeks) is a common problem internationally. Chronic cough has associated economic costs and is distressing to the child and to parents; ignoring cough may lead to delayed diagnosis and progression of serious underlying respiratory disease. Clinical guidelines have been shown to lead to efficient and effective patient care and can facilitate clinical decision making. Cough guidelines have been designed to facilitate the management of chronic cough. However, treatment recommendations vary, and specific clinical pathways for the treatment of chronic cough in children are important, as causes of and treatments for cough vary significantly from those in adults. Therefore, systematic evaluation of the use of evidence-based clinical pathways for the management of chronic cough in children would be beneficial for clinical practice and for patient care. Use of a management algorithm can improve clinical outcomes; such management guidelines can be found in the guidelines for cough provided by the American College of Chest Physicians (ACCP) and the British Thoracic Society (BTS). Objectives To evaluate the effectiveness of using a clinical pathway in the management of children with chronic cough. Search methods The Cochrane Register of Controlled Trials (CENTRAL), the Cochrane Airways Group Specialised Register, MEDLINE, EMBASE, review articles and reference lists of re levant articles were searched. The latest search was conducted in January 2014. Selection criteria All randomised controlled trials of parallel-group design comparing use versus non-use of a clinical pathway for treatment of chronic cough in children (< 18 years of age). Data collection and analysis Results of searches were reviewed against predetermined cr iteria for inclusion. Two review authors independently selected studies and performed data extraction in duplicate. Main results One study was included in the review. This multi-centre trial was based in five Australian hospitals and recruited 272 children with chronic cough. Children were randomly assigned to early (two weeks) or delayed (six weeks) referral to respiratory specialists who used a cough management pathway. When an intention-to-treat analysis was performed, clinical failure at six wee ks post randomisation (defined as < 75% improvement in cough score, or total resolution for fewer than three consecutive days) was significantly less in the early pathway arm compared with the control arm (odds ratio (OR) 0.35, 95% confidence interval (CI) 0.21 to 0.58). These results indicate that one additional child will be cured for e very five children treated via th e cough pathway (number needed to treat for an additional beneficial outcome (NNTB) = 5, 95% CI 3 to 9) at six weeks. Cough-specific parent-reported quality of life scores were significantly better in th e early-pathway group; the mean difference (MD) between groups was 0.60 (95% CI 0.19 to 1.01). Duration of cough post randomisation was significantly shorter in the intervention group (early-pathway arm) compared with the control group (delayed-pathway arm) (MD -2.70 weeks, 95% CI -4.26 to -1.14). Authors’ conclusions. Current evidence suggests that using a clinical algorithm for the management of children with ch r onic cough in h ospital outpatient settings is more effective than providing wait-list care. Futher high-quality randomised controlled trials are needed to perform ongoing evaluation of cough management pathways in general practitioner and other primary care settings.

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Research into boards traditionally focuses on independent monitoring of management, with studies focused on the effect of board independence on firm performance. This thesis aims to broaden the research tradition by consolidating prior research and investigating how agents may circumvent independent monitoring. Meta-analysis of previous board independence-firm performance studies indicated no systematic relationship between board independence and firm performance. Next, a series of experiments demonstrated that the presentation of recommendations to directors may bias decision making irrespective of other information presented and the independence of the decision maker. Together, results suggest that independence may be less important than the agent's motivation to misdirect the monitoring process.

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Choosing a mate is one of the largest (economic) decisions humans make. This thesis investigates this large scale decision and how the process is changing with the advent of the internet and the growing market for online informal sperm donation. This research identifies individual factors that influence female mating preferences. It explores the roles of behavioural traits and physical appearance, preferences for homogamy and hypergamy, and personality, and how these impact the decision to choose a donor. Overall, this thesis makes contributions to both the literature on human behaviour, and that on decision-making in extreme and highly important situations.

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The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c)not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia.

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This article builds on our ongoing work in conceptualising an ‘evaluative stance’ framework to assist in understanding how leaders in the field of early childhood education and care (ECEC) make decisions about the selection of professional development options for themselves and their staff. It introduces the notion that evaluative mindsets can be considered in terms of attitudes towards decision-making that are based on personal epistemologies. Drawing on data from semi-structured interviews, it explores the mindsets of six experienced leaders in two long-established ECEC organisations in Australia with respect to their decision-making about professional development. The article concludes with a consideration of the potential utility of the framework and the coding template used in this exploratory study.

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The use of UAVs for remote sensing tasks; e.g. agriculture, search and rescue is increasing. The ability for UAVs to autonomously find a target and perform on-board decision making, such as descending to a new altitude or landing next to a target is a desired capability. Computer-vision functionality allows the Unmanned Aerial Vehicle (UAV) to follow a designated flight plan, detect an object of interest, and change its planned path. In this paper we describe a low cost and an open source system where all image processing is achieved on-board the UAV using a Raspberry Pi 2 microprocessor interfaced with a camera. The Raspberry Pi and the autopilot are physically connected through serial and communicate via MAVProxy. The Raspberry Pi continuously monitors the flight path in real time through USB camera module. The algorithm checks whether the target is captured or not. If the target is detected, the position of the object in frame is represented in Cartesian coordinates and converted into estimate GPS coordinates. In parallel, the autopilot receives the target location approximate GPS and makes a decision to guide the UAV to a new location. This system also has potential uses in the field of Precision Agriculture, plant pest detection and disease outbreaks which cause detrimental financial damage to crop yields if not detected early on. Results show the algorithm is accurate to detect 99% of object of interest and the UAV is capable of navigation and doing on-board decision making.

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The role of the coroner in common law countries such as Australia, England, Canada and New Zealand is to preside over death investigations where there is uncertainty as to the manner of death, a need to identify the deceased, a death of unknown cause, or a violent or unnatural death. The vast majority of these deaths are not suspicious and thus require coroners to engage with grieving families who have been thrust into a legal process through the misfortune of a loved one's sudden or unexpected death. In this research, 10 experienced coroners discussed how they negotiated the grief and trauma evident in a death investigation. In doing so, they articulated two distinct ways in which legal officers engaged with emotions, which are also evident in the literature. The first engages the script of judicial dispassion, articulating a hierarchical relationship between reason and emotion, while the second introduces an ethic of care via the principles of therapeutic jurisprudence, and thus offers a challenge to the role of emotion in the personae of the professional judicial officer. By using Hochschild's work on the sociology of emotions, this article discusses the various ways in which coroners manage the emotion of a death investigation through emotion work. While emotional distance may be an understandable response by coroners to the grief and trauma experienced by families and directed at cleaner coronial decision-making, the article concludes that coroners may be better served by offering emotions such as sympathy, consideration and compassion directly to the family in those situations where families are struggling to accept, or are resistant to, coroners' decisions.