470 resultados para Shared-decision


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Objective To describe women’s reports of the model of care options General Practitioners (GPs) discussed with them at the first pregnancy consultation and women’s self-reported role in decisionmaking about model of care. Methods Women who had recently given birth responded to survey items about the models of care GPs discussed, their role in final decision-making, and socio-demographic, obstetric history, and early pregnancy characteristics. Results The proportion of women with whom each model of care was discussed varied between 8.2% (for private midwifery care with home birth) and 64.4% (GP shared care). Only 7.7% of women reported that all seven models were discussed. Exclusive discussion about private obstetric care and about all public models was common, and women’s health insurance status was the strongest predictor of the presence of discussions about each model. Most women (82.6%) reported active involvement in final decision-making about model of care. Conclusion Although most women report involvement in maternity model of care decisions, they remain largely uninformed about the breadth of available model of care options. Practical implications Strategies that facilitate women’s access to information on the differentiating features and outcomes for all models of care should be prioritized to better ensure equitable and quality decisions.

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Although they sit outside the formal education sector, libraries are intrinsically centres of learning where people can engage with knowledge and ideas and acquire the literacy skills that are essential for active participation in an increasingly digital society. In Australia, National and State Libraries Australasia (NSLA) has acknowledged the need to not only better understand the general concept of the library as a learning institution, but also to help the individual NSLA libraries specifically identify their capabilities in this arena. The NSLA Literacy and Learning project aimed to improve the members' organisational comprehension and practice as learning institutions and to help them conceptualise their ability to deliver literacy and learning programmes that will benefit their staff and their communities. The NSLA concept of learning institution encompassed two discrete lenses: the internal lens of the library's own organisational understanding and practice, and the external lens of the clients who engage in the literacy and learning programmes delivered by the library. The ultimate goal was to develop a matrix which could enable libraries to assess their perceived levels of maturity as learning institutions along a continuum of emerging to active capabilities. The matrix should also serve as a tool for shared understanding about the NSLA's own strategic directions in the literacy and learning space. This case study documents the evolving process of developing a learning institution maturity framework for libraries that considers individual, team and organisational learning, as well as clients' interactions with the organisation, with the goal of producing a framework that has the potential to measure the value of learning and growth in both the library's staff and the library's communities

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• Mechanisms to facilitate consent to healthcare for adults who lack capacity are necessary to ensure that these adults can lawfully receive appropriate medical treatment when needed. • In Australia, the common law plays only a limited role in this context, through its recognition of advance directives and through the parens patriae jurisdiction of superior courts. • Substitute decision-making for adults who lack capacity is facilitated primarily by guardianship and other related legislation. This legislation, which has been enacted in all Australian States and Territories, permits a range of decision-makers to make different types of healthcare decisions. • Substitute decision-makers can be appointed by the adult or by a guardianship or other tribunal. Where there is no appointed decision-maker, legislation generally empowers those close to the adult to make the relevant decision. Most Australian jurisdictions have also provided for statutory advance directives. • For the most serious of decisions, such as non-therapeutic sterilisations, consent can only be provided by a tribunal. Other decisions can generally be made by a range of substitute decision-makers. Some treatment, such as very minor treatment or that which is needed in an emergency, can be provided without consent. • Guardianship legislation generally establishes a set of principles and/or other criteria to guide healthcare decisions. Mechanisms have also been established to resolve disputes as to who is the appropriate decision-maker and how a decision should be made.

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This study determined factors which influenced Canadian provincial (state) politicians when making funding decisions for public libraries. Using the case study methodology, Canadian provincial/state-level funding for public libraries in the 2009-2010 fiscal year was examined. The data were analyzed to determine whether Cialdini’s theory of influence and specifically any of the six tactics of influence (i.e., commitment and consistency, authority, liking, social proof, scarcity, and reciprocity) were instrumental in these budgetary decision-making processes. Findings show the principles of “authority,” “consistency and commitment,” and “liking” were relevant, and that “liking” was especially important to these decisions.

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This paper presents our system to address the CogALex-IV 2014 shared task of identifying a single word most semantically related to a group of 5 words (queries). Our system uses an implementation of a neural language model and identifies the answer word by finding the most semantically similar word representation to the sum of the query representations. It is a fully unsupervised system which learns on around 20% of the UkWaC corpus. It correctly identifies 85 exact correct targets out of 2,000 queries, 285 approximate targets in lists of 5 suggestions.

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Purpose – Rapid urbanisation, fragmented governance and recurrent flooding complicates resolution of DKI Jakarta’s chronic housing shortage. Failure to effectively implement planning decisionmaking processes poses potential human rights violations. Contemporary planning policy requires the relocation of households living in floodplains within fifteen metres of DKI Jakarta’s main watercourses; further constraining land availability and potentially requiring increased densification. The purpose of this paper is to re-frame planning decision-making to address risks of flooding and to increase community resilience. Design/methodology/approach – This paper presents a preliminary scoping study for a technologically enhanced participatory planning method, incorporating synthesis of existing information on urbanisation, governance, and flood risk management in Jakarta. Findings – Responsibility for flood risk management in DKI Jakarta is fragmented both within and across administrative boundaries. Decision-making is further complicated by: limited availability of land use data; uncertainty as to the delineated extent of watercourses, floodplains, and flood modelling; unclear risk and liability for infrastructure investments; and technical literacy of both public and government participants. Practical implications – This research provides information to facilitate consultation with government entities tasked with re-framing planning processes to increase public participation. Social implications – Reduction in risk exposure amongst DKI Jakarta’s most vulnerable populations addresses issues of social justice.

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Age-related macular degeneration (AMD) affects the central vision and subsequently may lead to visual loss in people over 60 years of age. There is no permanent cure for AMD, but early detection and successive treatment may improve the visual acuity. AMD is mainly classified into dry and wet type; however, dry AMD is more common in aging population. AMD is characterized by drusen, yellow pigmentation, and neovascularization. These lesions are examined through visual inspection of retinal fundus images by ophthalmologists. It is laborious, time-consuming, and resource-intensive. Hence, in this study, we have proposed an automated AMD detection system using discrete wavelet transform (DWT) and feature ranking strategies. The first four-order statistical moments (mean, variance, skewness, and kurtosis), energy, entropy, and Gini index-based features are extracted from DWT coefficients. We have used five (t test, Kullback–Lieber Divergence (KLD), Chernoff Bound and Bhattacharyya Distance, receiver operating characteristics curve-based, and Wilcoxon) feature ranking strategies to identify optimal feature set. A set of supervised classifiers namely support vector machine (SVM), decision tree, k -nearest neighbor ( k -NN), Naive Bayes, and probabilistic neural network were used to evaluate the highest performance measure using minimum number of features in classifying normal and dry AMD classes. The proposed framework obtained an average accuracy of 93.70 %, sensitivity of 91.11 %, and specificity of 96.30 % using KLD ranking and SVM classifier. We have also formulated an AMD Risk Index using selected features to classify the normal and dry AMD classes using one number. The proposed system can be used to assist the clinicians and also for mass AMD screening programs.

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This thesis deals with the issues of quantifying economic values of coastal and marine ecosystem services and assessing their use in decision-making. The first analytical part of the thesis focuses on estimating non-market use and non-use values, with an application in New-Caledonia using Discrete Choice Experiment. The second part examines how and to what extent the economic valuation of ecosystem services is used in coastal management decision-making with an application in Australia. Using a multi-criteria analysis, the relative importance of ecological, social and economic evaluation criteria is also assessed in the context of coastal development.

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This paper presents a case study for the application of a Linear Engineering Asset Renewal decision support software tool (LinEAR) at a water distribution network in Australia. This case study examines how the LinEAR can assist water utilities to minimise their total pipeline management cost, to make a long-term budget based on mathematically predicted expenditure, and to present calculated evidence for supporting their expenditure requirements. The outcomes from the study on pipeline renewal decision support demonstrate that LinEAR can help water utilities to improve the decision process and save renewal costs over a long-term by providing an optimum renewal schedules. This software can help organisation to accumulate technical knowledge and prediction future impact of the decision using what-if analysis.

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This paper addresses the topic of real-time decision making by autonomous city vehicles. Beginning with an overview of the state of research, the paper presents the vehicle decision making & control systemarchitecture, explains the subcomponents which are relevant for decision making (World Model and Driving Maneuver subsystem), and presents the decision making process. Experimental test results confirmthe suitability of the developed approach to deal with the complex real-world urban traffic.

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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. After decomposing the problem into two consecutive decision making stages, and giving a short overview about previous work, the paper explains how Multiple Criteria Decision Making (MCDM) can be used in the process of selecting the most appropriate driving maneuver.

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This thesis addresses the topic of real-time decision making by driverless (autonomous) city vehicles, i.e. their ability to make appropriate driving decisions in non-simplified urban traffic conditions. After addressing the state of research, and explaining the research question, the thesis presents solutions for the subcomponents which are relevant for decision making with respect to information input (World Model), information output (Driving Maneuvers), and the real-time decision making process. TheWorld Model is a software component developed to fulfill the purpose of collecting information from perception and communication subsystems, maintaining an up-to-date view of the vehicle’s environment, and providing the required input information to the Real-Time Decision Making subsystem in a well-defined, and structured way. The real-time decision making process consists of two consecutive stages. While the first decision making stage uses a Petri net to model the safetycritical selection of feasible driving maneuvers, the second stage uses Multiple Criteria Decision Making (MCDM) methods to select the most appropriate driving maneuver, focusing on fulfilling objectives related to efficiency and comfort. The complex task of autonomous driving is subdivided into subtasks, called driving maneuvers, which represent the output (i.e. decision alternatives) of the real-time decision making process. Driving maneuvers are considered as implementations of closed-loop control algorithms, each capable of maneuvering the autonomous vehicle in a specific traffic situation. Experimental tests in both a 3D simulation and real-world experiments attest that the developed approach is suitable to deal with the complexity of real-world urban traffic situations.

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This paper critically examines research on consumer attitudes and behavior towards solar photovoltaic (PV) and renewable energy technology in Australia. The uptake of renewable energy technology by residential consumers in Australia in the past decade has transformed the electricity supply and demand paradigm. Thus, this paper reviews Australian research on consumer behavior, understanding and choices in order to identify gaps in knowledge. As the role of the consumer transforms there is a critical need to understand the ways consumers may respond to future energy policies to mitigate unforeseen negative social and economic consequence of programs designed to achieve positive environmental outcomes.