470 resultados para Shared-decision


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Recent developments in genetic science will potentially have a significant impact on reproductive decision-making by adding to the list of conditions which can be diagnosed through prenatal diagnosis. This article analyses the jurisdictional variations that exist in Australian abortion laws and examines the extent to which Australian abortion laws specifically provide for termination of pregnancy on the grounds of fetal disability. The article also examines the potential impact of pre-implantation genetic diagnosis on reproductive decision-making and considers the meaning of reproductive autonomy in the context of the new genetics.

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We explored whether teams develop shared perceptions regarding the quantity and quality of information and the extent of participation in decision making provided in an environment of continuous change. In addition, we examined whether change climate strength moderated relationships between change climate level and team outcomes. We examined relationships among aggregated change information and change participation and aggregated team outcomes, including two role stressors (i.e., role ambiguity and role overload) and two indicators of well-being (i.e., quality of worklife and distress). Questionnaires were distributed in an Australian law enforcement agency and data were used from 178 teams. Structural equation modelling analyses, controlling for a marker variable, were conducted to examine the main effects of aggregated change information and aggregated change participation on aggregated team outcomes. Results provided support for a model that included method effects due to a marker variable. In this model, change information climate was significantly negatively associated with role ambiguity, role overload, and distress, and significantly positively associated with quality of worklife. Change participation climate was significantly positively associated with quality of worklife. Change climate strength did not moderate relationships among change climate level and team outcomes.

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Karasek's Job Demand-Control model proposes that control mitigates the positive effects of work stressors on employee strain. Evidence to date remains mixed and, although a number of individual-level moderators have been examined, the role of broader, contextual, group factors has been largely overlooked. In this study, the extent to which control buffered or exacerbated the effects of demands on strain at the individual level was hypothesized to be influenced by perceptions of collective efficacy at the group level. Data from 544 employees in Australian organizations, nested within 23 workgroups, revealed significant three-way cross-level interactions among demands, control and collective efficacy on anxiety and job satisfaction. When the group perceived high levels of collective efficacy, high control buffered the negative consequences of high demands on anxiety and satisfaction. Conversely, when the group perceived low levels of collective efficacy, high control exacerbated the negative consequences of high demands on anxiety, but not satisfaction. In addition, a stress-exacerbating effect for high demands on anxiety and satisfaction was found when there was a mismatch between collective efficacy and control (i.e. combined high collective efficacy and low control). These results provide support for the notion that the stressor-strain relationship is moderated by both individual- and group-level factors.

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This paper addresses the topic of real-time decision making for autonomous city vehicles, i.e., the autonomous vehicles' ability to make appropriate driving decisions in city road traffic situations. The paper explains the overall controls system architecture, the decision making task decomposition, and focuses on how Multiple Criteria Decision Making (MCDM) is used in the process of selecting the most appropriate driving maneuver from the set of feasible ones. Experimental tests show that MCDM is suitable for this new application area.

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This paper elaborates on the Cybercars-2 Wireless Communication Framework for driverless city vehicles, which is used for Vehicle-to-Vehicle and Vehicle-to-Infrastructure communication. The developed framework improves the safety and efficiency of driverless city vehicles. Furthermore, this paper also elaborates on the vehicle control software architecture. On-road tests of both the communication framework and its application for real-time decision making show that the communication framework is reliable and useful for improving the safe operation of driverless city vehicles.

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This work elaborates on the topic of decision making for driverless city vehicles, particularly focusing on the aspects on how to develop a reliable approach which meets the requirements of safe city traffic. Decision making in this context refers to the problem of identifying the most appropriate driving maneuver to be performed in a given traffic situation. The overall decision making problem is decomposed into two consecutive stages. The first stage is safety-crucial, representing the decision regarding the set of feasible driving maneuvers. The second stage represents the decision regarding the most appropriate driving maneuver from the set of feasible ones. The developed decision making approach has been implemented in C++ and initially tested in a 3D simulation environment and, thereafter, in real-world experiments. The real-world experiments also included the integration of wireless communication between vehicles.

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A commitment in 2010 by the Australian Federal Government to spend $466.7 million dollars on the implementation of personally controlled electronic health records (PCEHR) heralded a shift to a more effective and safer patient centric eHealth system. However, deployment of the PCEHR has met with much criticism, emphasised by poor adoption rates over the first 12 months of operation. An indifferent response by the public and healthcare providers largely sceptical of its utility and safety speaks to the complex sociotechnical drivers and obstacles inherent in the embedding of large (national) scale eHealth projects. With government efforts to inflate consumer and practitioner engagement numbers giving rise to further consumer disillusionment, broader utilitarian opportunities available with the PCEHR are at risk. This paper discusses the implications of establishing the PCEHR as the cornerstone of a holistic eHealth strategy for the aggregation of longitudinal patient information. A viewpoint is offered that the real value in patient data lies not just in the collection of data but in the integration of this information into clinical processes within the framework of a commoditised data-driven approach. Consideration is given to the eHealth-as-a-Service (eHaaS) construct as a disruptive next step for co-ordinated individualised healthcare in the Australian context.

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This paper uses a nonstructural, ordered discrete choice model to measure the effects of various parent and child characteristics upon the independent caregiving decisions of the adult children of elderly parents sampled in the 1982 and 1984 National Long Term Care Survey (NLTCS). While significant effects are noted, emphasis is placed on test statistics constructed to measure the independence of caregiving decisions. The test statistic results are conclusive: The caregiving decisions of adult children are dependent across time and family members. Structural models taking dependencies among family members into account note effects similar to those in the nonstructural model.

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We use the 1993 wave of the Assets and Health Dynamics Among the Oldest Old (AHEAD) data set to estimate a game-theoretic model of families' decisions concerning the provision of informal and formal care for elderly individuals. The outcome is the Nash equilibrium where each family member jointly determines her consumption, transfers for formal care, and allocation of time to informal care, market work, and leisure. We use the estimates to decompose the effects of adult children's opportunity costs, quality of care, and caregiving burden on their propensities to provide informal care. We also simulate the effects of a broad range of policies of current interest. © (2009) by the Economics Department of the University of Pennsylvania and the Osaka University Institute of Social and Economic Research Association.

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1. An emergency department attendance represents an opportunity to set goals for care during the attendance and beyond. 2. End of life discussions and advance care planning assist early decision-making about treatment goals and end of life care. 3. Knowledge of the law assists decision-making at the end of life. 4. Not all dying patients require the skill set of a palliative care specialist but every dying patient will benefit from a palliative approach. 5. Palliative care does not preclude active treatment where the intent is understood by patient and family. 6. Failure to diagnose dying can compromise patient care. 7. The emergency department should foster close relationships with local specialist palliative care providers to improve and ensure timely access for patients and families and so that emergency staff have access to the knowledge and skills provided.

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In Crypto’95, Micali and Sidney proposed a method for shared generation of a pseudo-random function f(·) among n players in such a way that for all the inputs x, any u players can compute f(x) while t or fewer players fail to do so, where 0⩽t

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In Crypto’95, Micali and Sidney proposed a method for shared generation of a pseudo-random function f(·) among n players in such a way that for all the inputs x, any u players can compute f(x) while t or fewer players fail to do so, where 0 ≤ t < u ≤ n. The idea behind the Micali-Sidney scheme is to generate and distribute secret seeds S = s1, . . . , sd of a poly-random collection of functions, among the n players, each player gets a subset of S, in such a way that any u players together hold all the secret seeds in S while any t or fewer players will lack at least one element from S. The pseudo-random function is then computed as where f s i (·)’s are poly-random functions. One question raised by Micali and Sidney is how to distribute the secret seeds satisfying the above condition such that the number of seeds, d, is as small as possible. In this paper, we continue the work of Micali and Sidney. We first provide a general framework for shared generation of pseudo-random function using cumulative maps. We demonstrate that the Micali-Sidney scheme is a special case of this general construction.We then derive an upper and a lower bound for d. Finally we give a simple, yet efficient, approximation greedy algorithm for generating the secret seeds S in which d is close to the optimum by a factor of at most u ln 2.

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This paper provides a preliminary analysis of an autonomous uncooperative collision avoidance strategy for unmanned aircraft using image-based visual control. Assuming target detection, the approach consists of three parts. First, a novel decision strategy is used to determine appropriate reference image features to track for safe avoidance. This is achieved by considering the current rules of the air (regulations), the properties of spiral motion and the expected visual tracking errors. Second, a spherical visual predictive control (VPC) scheme is used to guide the aircraft along a safe spiral-like trajectory about the object. Lastly, a stopping decision based on thresholding a cost function is used to determine when to stop the avoidance behaviour. The approach does not require estimation of range or time to collision, and instead relies on tuning two mutually exclusive decision thresholds to ensure satisfactory performance.