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Sample records for general autonomy score

  1. Desire for autonomy in health care decisions: a general population survey.

    Science.gov (United States)

    Cullati, Stéphane; Courvoisier, Delphine S; Charvet-Bérard, Agathe I; Perneger, Thomas V

    2011-04-01

    To examine factors associated with desire for autonomy in health care decisions in the general population. Mailed survey of 2348 residents of Geneva, Switzerland. Participants answered questions on a scale measuring their desire for autonomy in health care decisions. The scale was scored between 0 (lowest desire for autonomy) and 100 (highest desire for autonomy). On average the respondents favoured shared or active involvement in medical decisions (mean score 62.0, SD 20.9), but attitudes varied considerably. In the multivariate model, factors associated with a higher desire for autonomy included female gender, younger age, higher education, living alone, reporting an excellent global health and - a new observation compared to previous studies - having made several medical decisions in the past 6 months. The attitudes of the general public appear to be consistent with the model of shared decision making. However, people vary considerably in their desire for autonomy. An explicit assessment of each individual's desire for autonomy may improve the decision-making process. Such an assessment should be repeated regularly, as familiarity with medical decisions may increase the desire for autonomy. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  2. [The use of scores in general medicine].

    Science.gov (United States)

    Huber, Ursula; Rösli, Andreas; Ballmer, Peter E; Rippin, Sarah Jane

    2013-10-01

    Scores are tools to combine complex information into a numerical value. In General Medicine, there are scores to assist in making diagnoses and prognoses, scores to assist therapeutic decision making and to evaluate therapeutic results and scores to help physicians when informing and advising patients. We review six of the scoring systems that have the greatest utility for the General Physician in hospital-based care and in General Practice. The Nutritional Risk Screening (NRS 2002) tool is designed to identify hospital patients in danger of malnutrition. The aim is to improve the nutritional status of these patients. The CURB-65 score predicts 30-day mortality in patients with community acquired pneumonia. Patients with a low score can be considered for home treatment, patients with an elevated score require hospitalisation and those with a high score should be treated as having severe pneumonia; treatment in the intensive care unit should be considered. The IAS-AGLA score of the Working Group on Lipids and Atherosclerosis of the Swiss Society of Cardiology calculates the 10-year risk of a myocardial infarction for people living in Switzerland. The working group makes recommendations for preventative treatment according to the calculated risk status. The Body Mass Index, which is calculated by dividing the body weight in kilograms by the height in meters squared and then divided into weight categories, is used to classify people as underweight, of normal weight, overweight or obese. The prognostic value of this classification is discussed. The Mini-Mental State Examination allows the physician to assess important cognitive functions in a simple and standardised form. The Glasgow Coma Scale is used to classify the level of consciousness in patients with head injury. It can be used for triage and correlates with prognosis.

  3. General Introduction: Autonomy and Heteronomy of the Judiciary in Europe

    Directory of Open Access Journals (Sweden)

    Joxerramon Bengoetxea

    2011-12-01

    Full Text Available Judges and the judiciary have always been a subject of debate. The questions of legitimacy, activism v self-restraint; appointment or selection, accountability, the rise of alternatives to formal justice, ADR, are at the heart of the discussion. However, the law-job of dispute resolution is not actually done by the judges on their own, nor in isolation; judges have many different sorts of collaborators and some of these can develop some scope for autonomy. At the same time the judiciary claims to be an independent power, but it is also a basic public service to the citizens; how can the public administration be involved in securing-facilitating this service? Finally, when deciding and interpreting the law judges often need to take into account norms belonging to different but coordinated legal systems and find coherence between them, and it can be questioned whether the method of conform interpretation they resort to might enhance or diminish their autonomy.

  4. The electronic patient record as a meaningful audit tool - Accountability and autonomy in general practitioner work

    DEFF Research Database (Denmark)

    Winthereik, Brit Ross; van der Ploeg, I.; Berg, Marc

    2007-01-01

    Health authorities increasingly request that general practitioners (GPs) use information and communication technologies such as electronic patient records (EPR) for accountability purposes. This article deals with the use of EPRs among general practitioners in Britain. It examines two ways in which...... makes them active in finding ways that turn the EPR into a meaningful tool for them, that is, a tool that helps them provide what they see as good care. The article's main contribution is to show how accountability and autonomy are coproduced; less professional autonomy does not follow from more...... GPs use the EPR for accountability purposes. One way is to generate audit reports on the basis of the information that has been entered into the record. The other is to let the computer intervene in the clinical process through prompts. The article argues that GPs' ambivalence toward using the EPR...

  5. General practitioners, complementary therapies and evidence-based medicine: the defence of clinical autonomy.

    Science.gov (United States)

    Adams, J

    2000-12-01

    Amidst the substantial change currently gripping primary health care are two developments central to contemporary debate regarding the very nature, territory and identity of general practice - the integration of complementary and alternative medicine (CAM) and the rise of evidence-based medicine (EBM). This paper reports findings from a study based upon 25 in-depth interviews with general practitioners (GPs) personally practising complementary therapies alongside more conventional medicine to treat their NHS patients. The paper outlines the GPs' perceptions of EBM, its relationship to their personal development of CAM, and their notions of good clinical practice more generally. Analysis of the GPs' accounts demonstrates how CAM can be seen as a useful resource with which some GPs defend their clinical autonomy from what they perceive to be the threat of EBM. Copyright 2000 Harcourt Publishers Ltd.

  6. How do Perceptions of Autonomy Differ in General Surgery Training Between Faculty, Senior Residents, Hospital Administrators, and the General Public? A Multi-Institutional Study.

    Science.gov (United States)

    Kempenich, Jason W; Willis, Ross E; Rakosi, Robert; Wiersch, John; Schenarts, Paul Joseph

    2015-01-01

    Identify barriers to resident autonomy in today's educational environment as perceived through 4 selected groups: senior surgical residents, teaching faculty, hospital administration, and the general public. Anonymous surveys were created and distributed to senior residents, faculty, and hospital administrators working within 3 residency programs. The opinions of a convenience sample of the general public were also assessed using a similar survey. Keesler Medical Center, Keesler AFB, MS; the University of Texas Health Science of San Antonio, TX; and the University of Nebraska Medical Center, Omaha, NE. A total of 169 responses were collected: 32 residents, 50 faculty, 20 administrators, and 67 general public. Faculty and residents agree that when attending staff grant more autonomy, residents' self-confidence and sense of ownership improve. Faculty felt that residents should have less autonomy than residents did (p autonomy at their institution, 47% of residents felt that they had too little autonomy and 38% of faculty agreed. No resident or faculty felt that residents had too much autonomy at their institution. The general public were more welcoming of resident participation than faculty (p = 0.002) and administrators (p = 0.02) predicted they would be. When the general public were asked regarding their opinions about resident participation with complex procedures, they were less welcoming than faculty, administrators, and residents thought (p autonomy as important for resident development. The general public are more receptive to resident participation than anticipated. However, with increasing procedural complexity and resident independence, they were less inclined to have residents involved. The general public also had more concerns regarding quality of care provided by residents than the other groups had. Published by Elsevier Inc.

  7. Validity of GRE General Test scores and TOEFL scores for graduate admission to a technical university in Western Europe

    Science.gov (United States)

    Zimmermann, Judith; von Davier, Alina A.; Buhmann, Joachim M.; Heinimann, Hans R.

    2018-01-01

    Graduate admission has become a critical process in tertiary education, whereby selecting valid admissions instruments is key. This study assessed the validity of Graduate Record Examination (GRE) General Test scores for admission to Master's programmes at a technical university in Europe. We investigated the indicative value of GRE scores for the Master's programme grade point average (GGPA) with and without the addition of the undergraduate GPA (UGPA) and the TOEFL score, and of GRE scores for study completion and Master's thesis performance. GRE scores explained 20% of the variation in the GGPA, while additional 7% were explained by the TOEFL score and 3% by the UGPA. Contrary to common belief, the GRE quantitative reasoning score showed only little explanatory power. GRE scores were also weakly related to study progress but not to thesis performance. Nevertheless, GRE and TOEFL scores were found to be sensible admissions instruments. Rigorous methodology was used to obtain highly reliable results.

  8. University autonomy as sensemaking

    DEFF Research Database (Denmark)

    Lind, Jonas Krog

    The formal autonomy of universities in Europe has generally increased over recent decades. However, new forms of accountability measures and more indirect state steering have accompanied this development, making it difficult to assess the actual autonomy. The article addresses this problem...... by applying the sensemaking approach to the study of organizational autonomy. Enacted autonomy is suggested as a new conceptualization that challenges the basic assumption in studies on formal autonomy that autonomy is only about external constraints on action. It does so by insisting on the active subjects...... in the enactment of the environment, thereby questioning the validity of a clear distinction between what is internal and what is external to an organization. By acknowledging the subjective dimension of autonomy, a set of stylized identities is developed as a tool for understanding the enactment of autonomy...

  9. Validity of GRE General Test Scores and TOEFL Scores for Graduate Admission to a Technical University in Western Europe

    Science.gov (United States)

    Zimmermann, Judith; von Davier, Alina A.; Buhmann, Joachim M.; Heinimann, Hans R.

    2018-01-01

    Graduate admission has become a critical process in tertiary education, whereby selecting valid admissions instruments is key. This study assessed the validity of Graduate Record Examination (GRE) General Test scores for admission to Master's programmes at a technical university in Europe. We investigated the indicative value of GRE scores for the…

  10. [From the Principle of Beneficence to the Principle of Autonomy. Assessment of Patients' Mental Competency in the General Hospital].

    Science.gov (United States)

    Diana, Restrepo B; Carlos, Cardeño C; Marle, Duque G; Santiago, Jaramillo

    2012-06-01

    Refusing a medical procedure is a valid way of exercising every patient's right to autonomy. From the legal point of view, autonomy is based on the right to privacy. In recent decades the legal right to self-determination has gradually expanded and today patients in full possession of their mental faculties, have the moral and legal right to make their own decisions and these decisions take precedence over physician and family. Often liaison psychiatrists are called in to assess the mental competence of patients in the general hospital. To determine the psychiatrist's role in evaluating these patients. The assessment of a patient's ability to decide and self-determine is a common clinical problem in general hospitals. Evaluation of these patients requires a proper understanding of the philosophical, ethical, and legal issues that guide the appropriate treatment of these complex clinical problems. Copyright © 2012 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  11. Reliability Generalization: Exploring Variation of Reliability Coefficients of MMPI Clinical Scales Scores.

    Science.gov (United States)

    Vacha-Haase, Tammi; Kogan, Lori R.; Tani, Crystal R.; Woodall, Renee A.

    2001-01-01

    Used reliability generalization to explore the variance of scores on 10 Minnesota Multiphasic Personality Inventory (MMPI) clinical scales drawing on 1,972 articles in the literature on the MMPI. Results highlight the premise that scores, not tests, are reliable or unreliable, and they show that study characteristics do influence scores on the…

  12. Applications of Small Area Estimation to Generalization with Subclassification by Propensity Scores

    Science.gov (United States)

    Chan, Wendy

    2018-01-01

    Policymakers have grown increasingly interested in how experimental results may generalize to a larger population. However, recently developed propensity score-based methods are limited by small sample sizes, where the experimental study is generalized to a population that is at least 20 times larger. This is particularly problematic for methods…

  13. A comparison between scores on Kirton's inventory for nursing students and a general student population.

    Science.gov (United States)

    Pettigrew, A C; King, M O

    1993-08-01

    This study compared scores on the Kirton Adaption-Innovation Inventory of 60 first-year nursing students with scores of 73 nonnursing majors of approximately the same age to test the hypothesis that, in general, individuals selecting nursing as a major tend to show a more adaptive style of creativity in problem solving than their nonnursing peers. Analysis indicated the nursing students were significantly more "adaptive" in problem solving and less "innovative" than the nonnursing control group.

  14. Effect of protected research time on ABSITE scores during general surgery residency.

    Science.gov (United States)

    Orkin, Bruce A; Poirier, Jennifer; Kowal-Vern, Areta; Chan, Edie; Ohara, Karen; Mendoza, Brian

    2018-02-01

    Objective - To determine whether residents with one or more years of dedicated research time (Research Residents, RR) improved their ABSITE scores compared to those without (Non-Research Residents, N-RR). A retrospective review of general surgery residents' ABSITE scores from 1995 to 2016 was performed. RR were compared to N-RR. Additional analysis of At Risk (AR) v Not At Risk residents (NAR) (35th percentile as PGY1-2) was also performed. Cohort - 147 residents (34 RR and 113 N-RR). There were no differences in initial ABSITE scores (p = 0.47). By definition, the AR group had lower scores than NAR. Overall, post-research RR v PGY-4 N-RR scores did not differ (p = 0.84). Only the AR residents improved their scores (p = 0.0009 v NAR p = 0.42), regardless of research group (p = 0.70). Protected research time did not improve residents' ABSITE scores, regardless of initial scores. At Risk residents improved regardless of research group status. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Autonomy @ Ames

    Science.gov (United States)

    Van Dalsem, William; Krishnakumar, Kalmanje Srinivas

    2016-01-01

    This is a powerpoint presentation that highlights autonomy across the 15 NASA technology roadmaps, including specific examples of projects (past and present) at NASA Ames Research Center. The NASA technology roadmaps are located here: http:www.nasa.govofficesocthomeroadmapsindex.html

  16. Syntactic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, L.M.

    1998-12-01

    The study of adapting and evolving autonomous agents should be based on a complex systems-theoretic framework which requires both self-organizing and symbolic dimensions. An inclusive framework based on the notions of semiotics and situated action is advanced to build models capable of representing, as well as evolving in their environments.Such undertaking is pursued by discussing the ways in which symbol and self-organization are irreducibly intertwined in evolutionary systems. With this semiotic view of self-organization and symbols, the authors re-think the notion of autonomy of evolving systems, and show that evolutionary systems are characterized by a particular type of syntactic autonomy. Recent developments in emergent computation in cellular automata are discussed as examples of the emergence of syntactic autonomy in computational environments. New experiments emphasizing this syntactic autonomy in cellular automata are presented.

  17. A Reliability Generalization Study of Scores on Rotter's and Nowicki-Strickland's Locus of Control Scales

    Science.gov (United States)

    Beretvas, S. Natasha; Suizzo, Marie-Anne; Durham, Jennifer A.; Yarnell, Lisa M.

    2008-01-01

    The most commonly used measures of locus of control are Rotter's Internality-Externality Scale (I-E) and Nowicki and Strickland's Internality-Externality Scale (NSIE). A reliability generalization study is conducted to explore variability in I-E and NSIE score reliability. Studies are coded for aspects of the scales used (number of response…

  18. A weighted generalized score statistic for comparison of predictive values of diagnostic tests.

    Science.gov (United States)

    Kosinski, Andrzej S

    2013-03-15

    Positive and negative predictive values are important measures of a medical diagnostic test performance. We consider testing equality of two positive or two negative predictive values within a paired design in which all patients receive two diagnostic tests. The existing statistical tests for testing equality of predictive values are either Wald tests based on the multinomial distribution or the empirical Wald and generalized score tests within the generalized estimating equations (GEE) framework. As presented in the literature, these test statistics have considerably complex formulas without clear intuitive insight. We propose their re-formulations that are mathematically equivalent but algebraically simple and intuitive. As is clearly seen with a new re-formulation we presented, the generalized score statistic does not always reduce to the commonly used score statistic in the independent samples case. To alleviate this, we introduce a weighted generalized score (WGS) test statistic that incorporates empirical covariance matrix with newly proposed weights. This statistic is simple to compute, always reduces to the score statistic in the independent samples situation, and preserves type I error better than the other statistics as demonstrated by simulations. Thus, we believe that the proposed WGS statistic is the preferred statistic for testing equality of two predictive values and for corresponding sample size computations. The new formulas of the Wald statistics may be useful for easy computation of confidence intervals for difference of predictive values. The introduced concepts have potential to lead to development of the WGS test statistic in a general GEE setting. Copyright © 2012 John Wiley & Sons, Ltd.

  19. Autonomy and autonomy competencies: a practical and relational approach.

    Science.gov (United States)

    Atkins, Kim

    2006-10-01

    This essay will address a general philosophical concern about autonomy, namely, that a conception of autonomy focused on freedom of the will alone is inadequate, once we consider the effects of oppressive forms of socialization on individuals' formation of choices. In response to this problem, I will present a brief overview of Diana Meyers's account of autonomy as relational and practical. On this view, autonomy consists in a set of socially acquired practical competencies in self-discovery, self-definition, self-knowledge, and self-direction. This account provides a distinction between choices that express unreflectively internalized social norms and those that are the result of a critical 'self-reading'. I conclude that this practical conception of autonomy makes much higher demands upon nurses (and patients) than has previously been thought. In fact, if nurses are to be expected to genuinely promote autonomy, they are going to need specific training in counselling-type communication skills.

  20. BitPAl: a bit-parallel, general integer-scoring sequence alignment algorithm.

    Science.gov (United States)

    Loving, Joshua; Hernandez, Yozen; Benson, Gary

    2014-11-15

    Mapping of high-throughput sequencing data and other bulk sequence comparison applications have motivated a search for high-efficiency sequence alignment algorithms. The bit-parallel approach represents individual cells in an alignment scoring matrix as bits in computer words and emulates the calculation of scores by a series of logic operations composed of AND, OR, XOR, complement, shift and addition. Bit-parallelism has been successfully applied to the longest common subsequence (LCS) and edit-distance problems, producing fast algorithms in practice. We have developed BitPAl, a bit-parallel algorithm for general, integer-scoring global alignment. Integer-scoring schemes assign integer weights for match, mismatch and insertion/deletion. The BitPAl method uses structural properties in the relationship between adjacent scores in the scoring matrix to construct classes of efficient algorithms, each designed for a particular set of weights. In timed tests, we show that BitPAl runs 7-25 times faster than a standard iterative algorithm. Source code is freely available for download at http://lobstah.bu.edu/BitPAl/BitPAl.html. BitPAl is implemented in C and runs on all major operating systems. jloving@bu.edu or yhernand@bu.edu or gbenson@bu.edu Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press.

  1. Scoring the Icecap-a capability instrument. Estimation of a UK general population tariff.

    Science.gov (United States)

    Flynn, Terry N; Huynh, Elisabeth; Peters, Tim J; Al-Janabi, Hareth; Clemens, Sam; Moody, Alison; Coast, Joanna

    2015-03-01

    This paper reports the results of a best-worst scaling (BWS) study to value the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A), a new capability measure among adults, in a UK setting. A main effects plan plus its foldover was used to estimate weights for each of the four levels of all five attributes. The BWS study was administered to 413 randomly sampled individuals, together with sociodemographic and other questions. Scale-adjusted latent class analyses identified two preference and two (variance) scale classes. Ability to characterize preference and scale heterogeneity was limited, but data quality was good, and the final model exhibited a high pseudo-r-squared. After adjusting for heterogeneity, a population tariff was estimated. This showed that 'attachment' and 'stability' each account for around 22% of the space, and 'autonomy', 'achievement' and 'enjoyment' account for around 18% each. Across all attributes, greater value was placed on the difference between the lowest levels of capability than between the highest. This tariff will enable ICECAP-A to be used in economic evaluation both within the field of health and across public policy generally. © 2013 The Authors. Health Economics published by John Wiley & Sons Ltd.

  2. Generalization of the Lord-Wingersky Algorithm to Computing the Distribution of Summed Test Scores Based on Real-Number Item Scores

    Science.gov (United States)

    Kim, Seonghoon

    2013-01-01

    With known item response theory (IRT) item parameters, Lord and Wingersky provided a recursive algorithm for computing the conditional frequency distribution of number-correct test scores, given proficiency. This article presents a generalized algorithm for computing the conditional distribution of summed test scores involving real-number item…

  3. A Comparison between Linear IRT Observed-Score Equating and Levine Observed-Score Equating under the Generalized Kernel Equating Framework

    Science.gov (United States)

    Chen, Haiwen

    2012-01-01

    In this article, linear item response theory (IRT) observed-score equating is compared under a generalized kernel equating framework with Levine observed-score equating for nonequivalent groups with anchor test design. Interestingly, these two equating methods are closely related despite being based on different methodologies. Specifically, when…

  4. Professional autonomy.

    Science.gov (United States)

    Aprile, A E

    1998-02-01

    Professional autonomy may represent the first step to implementing measures that will allow CRNAs to attain a level of independent practice consistent with their clinical and educational training. Autonomy is regarded as an essential ingredient of professionalism and confers independent function at the individual practitioner level. The principle of autonomy refers to the individual's capacity to make independent decisions based on the assumption that he or she possesses the cognitive, psychological, and emotional faculties to make rational decisions. Nursing practice meets the first two criteria of professionalism--competence and dedication to an important social good. The third criterion of professionalism, autonomy, has been a focal point for controversy since the late nineteenth century, in which obedience to supervisors and physicians remained a central focus of nursing ethics teaching until the advent of feminism in the 1970s. This article presents a thorough analysis of these concepts with some thoughts on how understanding the fundamental precepts and further research may not only help maintain the current level of CRNA professional autonomy but serve to guide us to become more autonomous in the future.

  5. s-core network decomposition: A generalization of k-core analysis to weighted networks

    Science.gov (United States)

    Eidsaa, Marius; Almaas, Eivind

    2013-12-01

    A broad range of systems spanning biology, technology, and social phenomena may be represented and analyzed as complex networks. Recent studies of such networks using k-core decomposition have uncovered groups of nodes that play important roles. Here, we present s-core analysis, a generalization of k-core (or k-shell) analysis to complex networks where the links have different strengths or weights. We demonstrate the s-core decomposition approach on two random networks (ER and configuration model with scale-free degree distribution) where the link weights are (i) random, (ii) correlated, and (iii) anticorrelated with the node degrees. Finally, we apply the s-core decomposition approach to the protein-interaction network of the yeast Saccharomyces cerevisiae in the context of two gene-expression experiments: oxidative stress in response to cumene hydroperoxide (CHP), and fermentation stress response (FSR). We find that the innermost s-cores are (i) different from innermost k-cores, (ii) different for the two stress conditions CHP and FSR, and (iii) enriched with proteins whose biological functions give insight into how yeast manages these specific stresses.

  6. Establishment of a general NAFLD scoring system for rodent models and comparison to human liver pathology.

    Directory of Open Access Journals (Sweden)

    Wen Liang

    Full Text Available The recently developed histological scoring system for non-alcoholic fatty liver disease (NAFLD by the NASH Clinical Research Network (NASH-CRN has been widely used in clinical settings, but is increasingly employed in preclinical research as well. However, it has not been systematically analyzed whether the human scoring system can directly be converted to preclinical rodent models. To analyze this, we systematically compared human NAFLD liver pathology, using human liver biopsies, with liver pathology of several NAFLD mouse models. Based upon the features pertaining to mouse NAFLD, we aimed at establishing a modified generic scoring system that is applicable to broad spectrum of rodent models.The histopathology of NAFLD was analyzed in several different mouse models of NAFLD to define generic criteria for histological assessment (preclinical scoring system. For validation of this scoring system, 36 slides of mouse livers, covering the whole spectrum of NAFLD, were blindly analyzed by ten observers. Additionally, the livers were blindly scored by one observer during two separate assessments longer than 3 months apart.The criteria macrovesicular steatosis, microvesicular steatosis, hepatocellular hypertrophy, inflammation and fibrosis were generally applicable to rodent NAFLD. The inter-observer reproducibility (evaluated using the Intraclass Correlation Coefficient between the ten observers was high for the analysis of macrovesicular steatosis and microvesicular steatosis (ICC = 0.784 and 0.776, all p<0.001, respectively and moderate for the analysis of hypertrophy and inflammation (ICC = 0.685 and 0.650, all p<0.001, respectively. The intra-observer reproducibility between the different observations of one observer was high for the analysis of macrovesicular steatosis, microvesicular steatosis and hypertrophy (ICC = 0.871, 0.871 and 0.896, all p<0.001, respectively and very high for the analysis of inflammation (ICC = 0.931, p

  7. The achievement impact of the inclusion model on the standardized test scores of general education students

    Science.gov (United States)

    Garrett-Rainey, Syrena

    The purpose of this study was to compare the achievement of general education students within regular education classes to the achievement of general education students in inclusion/co-teach classes to determine whether there was a significant difference in the achievement between the two groups. The school district's inclusion/co-teach model included ongoing professional development support for teachers and administrators. General education teachers, special education teachers, and teacher assistants collaborated to develop instructional strategies to provide additional remediation to help students to acquire the skills needed to master course content. This quantitative study reviewed the end-of course test (EoCT) scores of Grade 10 physical science and math students within an urban school district. It is not known whether general education students in an inclusive/co-teach science or math course will demonstrate a higher achievement on the EoCT in math or science than students not in an inclusive/co-teach classroom setting. In addition, this study sought to determine if students classified as low socioeconomic status benefited from participating in co-teaching classrooms as evidenced by standardized tests. Inferential statistics were used to determine whether there was a significant difference between the achievements of the treatment group (inclusion/co-teach) and the control group (non-inclusion/co-teach). The findings can be used to provide school districts with optional instructional strategies to implement in the diverse classroom setting in the modern classroom to increase academic performance on state standardized tests.

  8. Portsmouth physiological and operative severity score for the Enumeration of Mortality and morbidity scoring system in general surgical practice and identifying risk factors for poor outcome

    Science.gov (United States)

    Tyagi, Ashish; Nagpal, Nitin; Sidhu, D. S.; Singh, Amandeep; Tyagi, Anjali

    2017-01-01

    Background: Estimation of the outcome is paramount in disease stratification and subsequent management in severely ill surgical patients. Risk scoring helps us quantify the prospects of adverse outcome in a patient. Portsmouth-Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (P-POSSUM) the world over has proved itself as a worthy scoring system and the present study was done to evaluate the feasibility of P-POSSUM as a risk scoring system as a tool in efficacious prediction of mortality and morbidity in our demographic profile. Materials and Methods: Validity of P-POSSUM was assessed prospectively in fifty major general surgeries performed at our hospital from May 2011 to October 2012. Data were collected to obtain P-POSSUM score, and statistical analysis was performed. Results: Majority (72%) of patients was male and mean age was 40.24 ± 18.6 years. Seventy-eight percentage procedures were emergency laparotomies commonly performed for perforation peritonitis. Mean physiological score was 17.56 ± 7.6, and operative score was 17.76 ± 4.5 (total score = 35.3 ± 10.4). The ratio of observed to expected mortality rate was 0.86 and morbidity rate was 0.78. Discussion: P-POSSUM accurately predicted both mortality and morbidity in patients who underwent major surgical procedures in our setup. Thus, it helped us in identifying patients who required preferential attention and aggressive management. Widespread application of this tool can result in better distribution of care among high-risk surgical patients. PMID:28250670

  9. Generalized composite multiscale permutation entropy and Laplacian score based rolling bearing fault diagnosis

    Science.gov (United States)

    Zheng, Jinde; Pan, Haiyang; Yang, Shubao; Cheng, Junsheng

    2018-01-01

    Multiscale permutation entropy (MPE) is a recently proposed nonlinear dynamic method for measuring the randomness and detecting the nonlinear dynamic change of time series and can be used effectively to extract the nonlinear dynamic fault feature from vibration signals of rolling bearing. To solve the drawback of coarse graining process in MPE, an improved MPE method called generalized composite multiscale permutation entropy (GCMPE) was proposed in this paper. Also the influence of parameters on GCMPE and its comparison with the MPE are studied by analyzing simulation data. GCMPE was applied to the fault feature extraction from vibration signal of rolling bearing and then based on the GCMPE, Laplacian score for feature selection and the Particle swarm optimization based support vector machine, a new fault diagnosis method for rolling bearing was put forward in this paper. Finally, the proposed method was applied to analyze the experimental data of rolling bearing. The analysis results show that the proposed method can effectively realize the fault diagnosis of rolling bearing and has a higher fault recognition rate than the existing methods.

  10. Development of a spirometry T-score in the general population.

    Science.gov (United States)

    Lee, Sei Won; Kim, Hyun Kuk; Baek, Seunghee; Jung, Ji-Ye; Kim, Young Sam; Lee, Jae Seung; Lee, Sang-Do; Mannino, David M; Oh, Yeon-Mok

    2016-01-01

    Spirometry values may be expressed as T-scores in standard deviation units relative to a reference in a young, normal population as an analogy to the T-score for bone mineral density. This study was performed to develop the spirometry T-score. T-scores were calculated from lambda-mu-sigma-derived Z-scores using a young, normal age reference. Three outcomes of all-cause death, respiratory death, and COPD death were evaluated in 9,101 US subjects followed for 10 years; an outcome of COPD-related health care utilization (COPD utilization) was evaluated in 1,894 Korean subjects followed for 4 years. The probability of all-cause death appeared to remain nearly zero until -1 of forced expiratory volume in 1 second (FEV1) T-score but increased steeply where FEV1 T-score reached below -2.5. Survival curves for all-cause death, respiratory death, COPD death, and COPD utilization differed significantly among the groups when stratified by FEV1 T-score (Pspirometry T-score could predict all-cause death, respiratory death, COPD death, and COPD utilization.

  11. Autonomy as Aesthetic Practice

    NARCIS (Netherlands)

    Lütticken, S.

    2014-01-01

    This essay examines various conceptions of autonomy in relation to recent artistic practices. Starting from the apparent opposition between modernist notions of the autonomy of art and theorizations of political autonomy, the text problematizes the notion of the autonomy of art by using Jacques

  12. Evaluation of the Yale New Haven Readmission Risk Score for Pneumonia in a General Hospital Population.

    Science.gov (United States)

    Schaefer, Gabrielle; El-Kareh, Robert; Quartarolo, Jennifer; Seymann, Gregory

    2017-09-01

    The Yale New Haven Readmission Risk Score (YNHRRS) for pneumonia is a clinical prediction tool developed to assess risk for 30-day readmission. This tool was validated in a cohort of Medicare patients; generalizability to a broader patient population has not been evaluated. In addition, it lacks indicators of functional status or social support, which have been shown in other studies to be predictors of readmission. The objective of this study was to evaluate the generalizability of the YNHRRS for pneumonia in a general population of hospitalized patients, and assess the impact of incorporating measures of functional status and social support on its predictive value. This retrospective chart review comprised all patients admitted to a 563-bed academic medical center with a primary diagnosis of pneumonia between March 2014 and March 2015. Abstraction of clinical variables allowed calculation of the YNHRRS and additional indicators of functional status and social support. The primary outcome was 30-day readmission rate. We created a logistic regression model to predict readmission using the YNHRRS, functional status, and social support as covariates. Among 270 discharges with pneumonia, the observed readmission rate was 23%. The YNHRRS was a significant predictor of readmission in our multivariate model, with an odds ratio of 2.20 (95% confidence interval, 1.29-3.73) for each 10% increase in calculated risk. Indicators of functional status and social support were not significant predictors of readmission. The YNHRRS can be applied to an unselected population as a tool to predict patients with pneumonia at risk for readmission. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Classifying and scoring of molecules with the NGN: new datasets, significance tests, and generalization

    Directory of Open Access Journals (Sweden)

    Cameron Christopher JF

    2010-10-01

    Full Text Available Abstract This paper demonstrates how a Neural Grammar Network learns to classify and score molecules for a variety of tasks in chemistry and toxicology. In addition to a more detailed analysis on datasets previously studied, we introduce three new datasets (BBB, FXa, and toxicology to show the generality of the approach. A new experimental methodology is developed and applied to both the new datasets as well as previously studied datasets. This methodology is rigorous and statistically grounded, and ultimately culminates in a Wilcoxon significance test that proves the effectiveness of the system. We further include a complete generalization of the specific technique to arbitrary grammars and datasets using a mathematical abstraction that allows researchers in different domains to apply the method to their own work. Background Our work can be viewed as an alternative to existing methods to solve the quantitative structure-activity relationship (QSAR problem. To this end, we review a number approaches both from a methodological and also a performance perspective. In addition to these approaches, we also examined a number of chemical properties that can be used by generic classifier systems, such as feed-forward artificial neural networks. In studying these approaches, we identified a set of interesting benchmark problem sets to which many of the above approaches had been applied. These included: ACE, AChE, AR, BBB, BZR, Cox2, DHFR, ER, FXa, GPB, Therm, and Thr. Finally, we developed our own benchmark set by collecting data on toxicology. Results Our results show that our system performs better than, or comparatively to, the existing methods over a broad range of problem types. Our method does not require the expert knowledge that is necessary to apply the other methods to novel problems. Conclusions We conclude that our success is due to the ability of our system to: 1 encode molecules losslessly before presentation to the learning system, and 2

  14. Development of a likelihood of survival scoring system for hospitalized equine neonates using generalized boosted regression modeling.

    Directory of Open Access Journals (Sweden)

    Katarzyna A Dembek

    Full Text Available BACKGROUND: Medical management of critically ill equine neonates (foals can be expensive and labor intensive. Predicting the odds of foal survival using clinical information could facilitate the decision-making process for owners and clinicians. Numerous prognostic indicators and mathematical models to predict outcome in foals have been published; however, a validated scoring method to predict survival in sick foals has not been reported. The goal of this study was to develop and validate a scoring system that can be used by clinicians to predict likelihood of survival of equine neonates based on clinical data obtained on admission. METHODS AND RESULTS: Data from 339 hospitalized foals of less than four days of age admitted to three equine hospitals were included to develop the model. Thirty seven variables including historical information, physical examination and laboratory findings were analyzed by generalized boosted regression modeling (GBM to determine which ones would be included in the survival score. Of these, six variables were retained in the final model. The weight for each variable was calculated using a generalized linear model and the probability of survival for each total score was determined. The highest (7 and the lowest (0 scores represented 97% and 3% probability of survival, respectively. Accuracy of this survival score was validated in a prospective study on data from 283 hospitalized foals from the same three hospitals. Sensitivity, specificity, positive and negative predictive values for the survival score in the prospective population were 96%, 71%, 91%, and 85%, respectively. CONCLUSIONS: The survival score developed in our study was validated in a large number of foals with a wide range of diseases and can be easily implemented using data available in most equine hospitals. GBM was a useful tool to develop the survival score. Further evaluations of this scoring system in field conditions are needed.

  15. The Effects of Teaching Descriptive Geometry in General Engineering 103 on Spatial Relations Tests Scores.

    Science.gov (United States)

    Stallings, William M.

    It was hypothesized that instruction in descriptive geometry produces an increase in SRT scores. The resultant data do not firmly support this hypothesis. It is suggested that this study be replicated with the use of randomly selected control groups. (MS)

  16. Netherlands: Steady decline in job autonomy

    NARCIS (Netherlands)

    Muller, J.; Hooftmann, W.; Houtman, I.L.D.

    2015-01-01

    Research shows that job autonomy has predominantly positive effects, such as the prevention of stress, burnout and cardiovascular disease. Employees with a good deal of autonomy generally report better well-being, are more productive, more creative, have more self-esteem and have higher work

  17. Respect for rational autonomy.

    Science.gov (United States)

    Walker, Rebecca L

    2009-12-01

    The standard notion of autonomy in medical ethics does not require that autonomous choices not be irrational. The paper gives three examples of seemingly irrational patient choices and discusses how a rational autonomy analysis differs from the standard view. It then considers whether a switch to the rational autonomy view would lead to overriding more patient decisions but concludes that this should not be the case. Rather, a determination of whether individual patient decisions are autonomous is much less relevant than usually considered in determining whether health care providers must abide by these decisions. Furthermore, respect for rational autonomy entails strong positive requirements of respect for the autonomy of the person as a rational decision maker. The rationality view of autonomy is conceptually stronger than the standard view, allows for a more nuanced understanding of the practical moral calculus involved in respecting patient autonomy, and promotes positive respect for patient autonomy.

  18. A general equation to obtain multiple cut-off scores on a test from multinomial logistic regression.

    Science.gov (United States)

    Bersabé, Rosa; Rivas, Teresa

    2010-05-01

    The authors derive a general equation to compute multiple cut-offs on a total test score in order to classify individuals into more than two ordinal categories. The equation is derived from the multinomial logistic regression (MLR) model, which is an extension of the binary logistic regression (BLR) model to accommodate polytomous outcome variables. From this analytical procedure, cut-off scores are established at the test score (the predictor variable) at which an individual is as likely to be in category j as in category j+1 of an ordinal outcome variable. The application of the complete procedure is illustrated by an example with data from an actual study on eating disorders. In this example, two cut-off scores on the Eating Attitudes Test (EAT-26) scores are obtained in order to classify individuals into three ordinal categories: asymptomatic, symptomatic and eating disorder. Diagnoses were made from the responses to a self-report (Q-EDD) that operationalises DSM-IV criteria for eating disorders. Alternatives to the MLR model to set multiple cut-off scores are discussed.

  19. Regimes of Autonomy

    NARCIS (Netherlands)

    Anderson, Joel

    2014-01-01

    Like being able to drive a car, being autonomous is a socially attributed, claimed, and contested status. Normative debates about criteria for autonomy (and what autonomy entitles one to) are best understood, not as debates about what autonomy, at core, really is, but rather as debates about the

  20. Autonomy: Life and Being

    Science.gov (United States)

    Williams, Mary-Anne

    This paper uses robot experience to explore key concepts of autonomy, life and being. Unfortunately, there are no widely accepted definitions of autonomy, life or being. Using a new cognitive agent architecture we argue that autonomy is a key ingredient for both life and being, and set about exploring autonomy as a concept and a capability. Some schools of thought regard autonomy as the key characteristic that distinguishes a system from an agent; agents are systems with autonomy, but rarely is a definition of autonomy provided. Living entities are autonomous systems, and autonomy is vital to life. Intelligence presupposes autonomy too; what would it mean for a system to be intelligent but not exhibit any form of genuine autonomy. Our philosophical, scientific and legal understanding of autonomy and its implications is immature and as a result progress towards designing, building, managing, exploiting and regulating autonomous systems is retarded. In response we put forward a framework for exploring autonomy as a concept and capability based on a new cognitive architecture. Using this architecture tools and benchmarks can be developed to analyze and study autonomy in its own right as a means to further our understanding of autonomous systems, life and being. This endeavor would lead to important practical benefits for autonomous systems design and help determine the legal status of autonomous systems. It is only with a new enabling understanding of autonomy that the dream of Artificial Intelligence and Artificial Life can be realized. We argue that designing systems with genuine autonomy capabilities can be achieved by focusing on agent experiences of being rather than attempting to encode human experiences as symbolic knowledge and know-how in the artificial agents we build.

  1. Establishment of a general NAFLD scoring system for rodent models and comparison to human liver pathology

    NARCIS (Netherlands)

    Liang, W.; Menke, A.L.; Driessen, A.; Koek, G.H.; Lindeman, J.H.; Stoop, R.; Havekes, L.M.; Kleemann., R.; Hoek, A.M. van den

    2014-01-01

    Results: The criteria macrovesicular steatosis, microvesicular steatosis, hepatocellular hypertrophy, inflammation and fibrosis were generally applicable to rodent NAFLD. The inter-observer reproducibility (evaluated using the Intraclass Correlation Coefficient) between the ten observers was high

  2. Architecture for autonomy

    Science.gov (United States)

    Broten, Gregory S.; Monckton, Simon P.; Collier, Jack; Giesbrecht, Jared

    2006-05-01

    In 2002 Defence R&D Canada changed research direction from pure tele-operated land vehicles to general autonomy for land, air, and sea craft. The unique constraints of the military environment coupled with the complexity of autonomous systems drove DRDC to carefully plan a research and development infrastructure that would provide state of the art tools without restricting research scope. DRDC's long term objectives for its autonomy program address disparate unmanned ground vehicle (UGV), unattended ground sensor (UGS), air (UAV), and subsea and surface (UUV and USV) vehicles operating together with minimal human oversight. Individually, these systems will range in complexity from simple reconnaissance mini-UAVs streaming video to sophisticated autonomous combat UGVs exploiting embedded and remote sensing. Together, these systems can provide low risk, long endurance, battlefield services assuming they can communicate and cooperate with manned and unmanned systems. A key enabling technology for this new research is a software architecture capable of meeting both DRDC's current and future requirements. DRDC built upon recent advances in the computing science field while developing its software architecture know as the Architecture for Autonomy (AFA). Although a well established practice in computing science, frameworks have only recently entered common use by unmanned vehicles. For industry and government, the complexity, cost, and time to re-implement stable systems often exceeds the perceived benefits of adopting a modern software infrastructure. Thus, most persevere with legacy software, adapting and modifying software when and wherever possible or necessary -- adopting strategic software frameworks only when no justifiable legacy exists. Conversely, academic programs with short one or two year projects frequently exploit strategic software frameworks but with little enduring impact. The open-source movement radically changes this picture. Academic frameworks

  3. The Evolution of Autonomy.

    Science.gov (United States)

    Stammers, Trevor

    2015-01-01

    There can be little doubt, at least in the Western world, that autonomy is theruling principle in contemporary bioethics. In spite of its 'triumph' however,the dominance of the utilitarian concept of autonomy is being increasinglyquestioned. In this paper, I explore the nature of autonomy, how it came todisplace the Hippocratic tradition in medicine and how different conceptsof autonomy have evolved. I argue that the reduction of autonomy to'the exercise of personal choice' in medicine has led to a 'tyranny of autonomy' which can be inimical to ethical medical practice rather than conducive to it.I take the case of Kerrie Wooltorton as an illustration of how misplacedadherence to respect for patient autonomy can lead to tragic consequences.An analysis of autonomy based on the work of Rachel Haliburton isdescribed and applied to the role of autonomy in a recent bioethicaldebate--that arising from Savulescu's proposal that conscientious objection by health-care professionals should not be permitted in the NHS. Inconclusion, I suggest Kukla's concept of conscientious autonomy as onepromising pathway to circumvent both the limitations and adverse effectsof the dominance of current (mis)understandings of autonomy in biomedical ethics.

  4. Are the benefits of autonomy satisfaction and the costs of autonomy frustration dependent on individuals' autonomy strength?

    Science.gov (United States)

    Van Assche, Jasper; van der Kaap-Deeder, Jolene; Audenaert, Elien; De Schryver, Maarten; Vansteenkiste, Maarten

    2018-01-29

    From a self-determination theory perspective, individuals are assumed to benefit and suffer from, respectively, the satisfaction and frustration of the psychological need for autonomy, even if they score low on autonomy strength. Yet, previous studies on need strength are scarce, operationalized need strength differently, and produced inconsistent findings. In two studies among 224 South African adults (M age  = 24.13, SD = 4.25; 54.0% male) and 156 Belgian prisoners (M age  = 38.60, SD = 11.68; 88.5% male), we investigated the moderating role of autonomy valuation and desire in the relations of autonomy satisfaction and frustration with a variety of well-being and ill-being indicators. Study 1 provided some evidence for the moderating role of mostly explicit autonomy desire (rather than explicit autonomy valuation). In Study 2, neither explicit nor implicit autonomy desire played a consistent moderating role. Overall, these findings are congruent with a moderate (albeit not with a strong) interpretation of the universality claim made within self-determination theory, provide initial evidence for a differentiation between deficit-based and growth-oriented interpersonal differences in need strength, and indicate that the potential moderating role of need strength deserves continued attention before any firm conclusions can be drawn. © 2018 Wiley Periodicals, Inc.

  5. THE RELATIONSHIP OF THE GENERAL REACTION SCORE WITH THE NATURAL KILLER CELLS ACTIVITY AMONG WOMEN WITH AIRCRAFT NOISE EXPOSURE IN THE AREA OF ADI SOEMARMO AIRPORT SOLO (Hubungan antara general reaction score dengan aktivitas sel NK pada wanita

    Directory of Open Access Journals (Sweden)

    Hartono Hartono

    2011-07-01

    Full Text Available ABSTRAK Paparan bising pesawat udara dapat berisiko terhadap kesehatan. Terdapat banyak bukti yang menunjukkan bahwa paparan bising pesawat udara dapat menyebabkan gangguan pendengaran, hipertensi, penyakit jantung iskemik, ketergangguan (annoyance, gangguan tidur dan penurunan prestasi sekolah. Sedangkan efek terhadap perubahan pada sistem imun dan lahir cacat, bukti-bukti masih terbatas. Penelitian ini bertujuan untuk mengetahui hubungan antara general reaction score dengan aktivitas sel NK pada wanita yang terpapar bising pesawat udara di sekitar bandara Adi Sumarmo Solo. Penelitian ini diharapkan dapat memberikan manfaat bagi pengembangan ilmu pengetahuan dan bagi masyarakat serta pemerintah daerah khususnya dalam upaya pencegahan terhadap dampak paparan bising pesawat udara. Rancangan penelitian adalah survei analitik dengan pendekatan cross sectional, dengan mengambil lokasi di Desa Dibal dan Gagak Sipat, Kecamatan Ngemplak, Kabupaten Boyolali. Penelitian dilaksanakan dari bulan Juli 2008 sampai dengan bulan Juni 2009. Jumlah keseluruhan sampel 39, terbagi dalam 3 kelompok; kelompok 1 terpapar bising intensitas 92,29 dB (13 responden; kelompok 2 terpapar bising intensitas 71,79 dB (13 responden; kelompok 3 terpapar bising intensitas 52,17dB (13 responden. Pengambilan sampel dengan cara simple random sampling. Data dianalisis menggunakan uji Anova diikuti dengan Post Hoc Test metode LSD dilengkapi dengan Homogenous Subsets. Uji Anova menujukkan ada perbedaan yang signifikan antar kelompok terhadap general reaction score yang ditunjukkan dari nilai p=0,000. Uji Pearson Correlation menunjukkan ada hubungan yang negatif antara general reaction score dengan aktivitas sel NK (r = – 0,631; p < 0,05. ABSTRACT Exposure to noise constitutes a health risk. There is sufficient scientific evidence that aircraft noise exposure can induce hearing impairment, hypertension and ischemic heart disease, annoyance, sleep disturbance, and decreased school

  6. Marine Robot Autonomy

    CERN Document Server

    2013-01-01

    Autonomy for Marine Robots provides a timely and insightful overview of intelligent autonomy in marine robots. A brief history of this emerging field is provided, along with a discussion of the challenges unique to the underwater environment and their impact on the level of intelligent autonomy required.  Topics covered at length examine advanced frameworks, path-planning, fault tolerance, machine learning, and cooperation as relevant to marine robots that need intelligent autonomy.  This book also: Discusses and offers solutions for the unique challenges presented by more complex missions and the dynamic underwater environment when operating autonomous marine robots Includes case studies that demonstrate intelligent autonomy in marine robots to perform underwater simultaneous localization and mapping  Autonomy for Marine Robots is an ideal book for researchers and engineers interested in the field of marine robots.      

  7. Validation of the Framingham general cardiovascular risk score in a multiethnic Asian population: a retrospective cohort study.

    Science.gov (United States)

    Chia, Yook Chin; Gray, Sarah Yu Weng; Ching, Siew Mooi; Lim, Hooi Min; Chinna, Karuthan

    2015-05-19

    This study aims to examine the validity of the Framingham general cardiovascular disease (CVD) risk chart in a primary care setting. This is a 10-year retrospective cohort study. A primary care clinic in a teaching hospital in Malaysia. 967 patients' records were randomly selected from patients who were attending follow-up in the clinic. Baseline demographic data, history of diabetes and smoking, blood pressure (BP), and serum lipids were captured from patient records in 1998. Each patient's Framingham CVD score was computed from these parameters. All atherosclerotic CVD events occurring between 1998 and 2007 were counted. In 1998, mean age was 57 years with 33.8% men, 6.1% smokers, 43.3% diabetics and 59.7% hypertensive. Median BP was 140/80 mm Hg and total cholesterol 6.0 mmol/L (1.3). The predicted median Framingham general CVD risk score for the study population was 21.5% (IQR 1.2-30.0) while the actual CVD events that occurred in the 10 years was 13.1% (127/967). The median CVD points for men was 30.0, giving them a CVD risk of more than 30%; for women it is 18.5, a CVD risk of 21.5%. Our study found that the Framingham general CVD risk score to have moderate discrimination with an area under the receiver operating characteristic curve (AUC) of 0.63. It also discriminates well for Malay (AUC 0.65, p=0.01), Chinese (AUC 0.60, p=0.03), and Indians (AUC 0.65, p=0.001). There was good calibration with Hosmer-Lemeshow test χ(2)=3.25, p=0.78. Taking into account that this cohort of patients were already on treatment, the Framingham General CVD Risk Prediction Score predicts fairly accurately for men and overestimates somewhat for women. In the absence of local risk prediction charts, the Framingham general CVD risk prediction chart is a reasonable alternative for use in a multiethnic group in a primary care setting. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  8. Scoring the Icecap-A Capability Instrument. Estimation of a UK General Population Tariff†

    Science.gov (United States)

    Flynn, Terry N; Huynh, Elisabeth; Peters, Tim J; Al-Janabi, Hareth; Clemens, Sam; Moody, Alison; Coast, Joanna

    2015-01-01

    This paper reports the results of a best–worst scaling (BWS) study to value the Investigating Choice Experiments Capability Measure for Adults (ICECAP-A), a new capability measure among adults, in a UK setting. A main effects plan plus its foldover was used to estimate weights for each of the four levels of all five attributes. The BWS study was administered to 413 randomly sampled individuals, together with sociodemographic and other questions. Scale-adjusted latent class analyses identified two preference and two (variance) scale classes. Ability to characterize preference and scale heterogeneity was limited, but data quality was good, and the final model exhibited a high pseudo-r-squared. After adjusting for heterogeneity, a population tariff was estimated. This showed that ‘attachment’ and ‘stability’ each account for around 22% of the space, and ‘autonomy’, ‘achievement’ and ‘enjoyment’ account for around 18% each. Across all attributes, greater value was placed on the difference between the lowest levels of capability than between the highest. This tariff will enable ICECAP-A to be used in economic evaluation both within the field of health and across public policy generally. © 2013 The Authors. Health Economics published by John Wiley & Sons Ltd. PMID:24254584

  9. Autonomy of State Agencies

    DEFF Research Database (Denmark)

    Hansen, Morten Balle; Niklasson, Birgitta; Roness, Paul

    agencies in four Nordic countries: Denmark, Finland, Norway and Sweden. By using survey data from more than 500 state agencies in the four countries, the article analyses whether there is indeed a Scandinavian style of autonomy and result control and assesses which structural, cultural, and environmental......NPM-doctrines states that ideal-type agencies should have a high level of managerial autonomy, while being controlled through result-based control instruments, like performance contracts. In this article, the authors present a first preliminary attempt to comparatively analyze the autonomy of state...... variables might explain similarities and differences in the autonomy of agencies....

  10. How important is Autonomy to Professional Workers?

    Directory of Open Access Journals (Sweden)

    Arne Mastekaasa

    2011-11-01

    Full Text Available A common assumption is that autonomy is crucial to professional workers. I examine this using survey data on a sample of public sector welfare professionals, viz. medical doctors, nurses, teachers, social workers. Comparisons are made with general population data from the International Social Survey Programme. Two methods of assessing the importance of work autonomy are employed; respondents’ direct ratings and statistical associations between work autonomy (and other job characteristics on the one hand and job satisfaction and organizational commitment on the other. Findings: Autonomy is not rated as more important among the professionals than in the general population, and neither is it more strongly related to job satisfaction. Interesting work and workplace social support appear to be more central.

  11. A general formula for computing maximum proportion correct scores in various psychophysical paradigms with arbitrary probability distributions of stimulus observations.

    Science.gov (United States)

    Dai, Huanping; Micheyl, Christophe

    2015-05-01

    Proportion correct (Pc) is a fundamental measure of task performance in psychophysics. The maximum Pc score that can be achieved by an optimal (maximum-likelihood) observer in a given task is of both theoretical and practical importance, because it sets an upper limit on human performance. Within the framework of signal detection theory, analytical solutions for computing the maximum Pc score have been established for several common experimental paradigms under the assumption of Gaussian additive internal noise. However, as the scope of applications of psychophysical signal detection theory expands, the need is growing for psychophysicists to compute maximum Pc scores for situations involving non-Gaussian (internal or stimulus-induced) noise. In this article, we provide a general formula for computing the maximum Pc in various psychophysical experimental paradigms for arbitrary probability distributions of sensory activity. Moreover, easy-to-use MATLAB code implementing the formula is provided. Practical applications of the formula are illustrated, and its accuracy is evaluated, for two paradigms and two types of probability distributions (uniform and Gaussian). The results demonstrate that Pc scores computed using the formula remain accurate even for continuous probability distributions, as long as the conversion from continuous probability density functions to discrete probability mass functions is supported by a sufficiently high sampling resolution. We hope that the exposition in this article, and the freely available MATLAB code, facilitates calculations of maximum performance for a wider range of experimental situations, as well as explorations of the impact of different assumptions concerning internal-noise distributions on maximum performance in psychophysical experiments.

  12. Autonomy and minority rights

    DEFF Research Database (Denmark)

    Barten, Ulrike

    2008-01-01

    on the content of the syllabus. When autonomy is understood in the literal sense, of giving oneself one's own laws, then there is a clear connection. Autonomy is usually connected to politics and a geographically limited territory. Special political rights of minorities - e.g. is the Danish minority party SSW...

  13. Supervisor Autonomy and Considerate Leadership Style are Associated with Supervisors' Likelihood to Accommodate Back Injured Workers.

    Science.gov (United States)

    McGuire, Connor; Kristman, Vicki L; Shaw, William; Williams-Whitt, Kelly; Reguly, Paula; Soklaridis, Sophie

    2015-09-01

    To determine the association between supervisors' leadership style and autonomy and supervisors' likelihood of supporting job accommodations for back-injured workers. A cross-sectional study of supervisors from Canadian and US employers was conducted using a web-based, self-report questionnaire that included a case vignette of a back-injured worker. Autonomy and two dimensions of leadership style (considerate and initiating structure) were included as exposures. The outcome, supervisors' likeliness to support job accommodation, was measured with the Job Accommodation Scale (JAS). We conducted univariate analyses of all variables and bivariate analyses of the JAS score with each exposure and potential confounding factor. We used multivariable generalized linear models to control for confounding factors. A total of 796 supervisors participated. Considerate leadership style (β = .012; 95% CI .009-.016) and autonomy (β = .066; 95% CI .025-.11) were positively associated with supervisors' likelihood to accommodate after adjusting for appropriate confounding factors. An initiating structure leadership style was not significantly associated with supervisors' likelihood to accommodate (β = .0018; 95% CI -.0026 to .0061) after adjusting for appropriate confounders. Autonomy and a considerate leadership style were positively associated with supervisors' likelihood to accommodate a back-injured worker. Providing supervisors with more autonomy over decisions of accommodation and developing their considerate leadership style may aid in increasing work accommodation for back-injured workers and preventing prolonged work disability.

  14. Supervisor Autonomy and Considerate Leadership Style are Associated with Supervisors’ Likelihood to Accommodate Back Injured Workers

    Science.gov (United States)

    McGuire, Connor; Kristman, Vicki L; Williams-Whitt, Kelly; Reguly, Paula; Shaw, William; Soklaridis, Sophie

    2015-01-01

    PURPOSE To determine the association between supervisors’ leadership style and autonomy and supervisors’ likelihood of supporting job accommodations for back-injured workers. METHODS A cross-sectional study of supervisors from Canadian and US employers was conducted using a web-based, self-report questionnaire that included a case vignette of a back-injured worker. Autonomy and two dimensions of leadership style (considerate and initiating structure) were included as exposures. The outcome, supervisors’ likeliness to support job accommodation, was measured with the Job Accommodation Scale. We conducted univariate analyses of all variables and bivariate analyses of the JAS score with each exposure and potential confounding factor. We used multivariable generalized linear models to control for confounding factors. RESULTS A total of 796 supervisors participated. Considerate leadership style (β= .012; 95% CI: .009–.016) and autonomy (β= .066; 95% CI: .025–.11) were positively associated with supervisors’ likelihood to accommodate after adjusting for appropriate confounding factors. An initiating structure leadership style was not significantly associated with supervisors’ likelihood to accommodate (β = .0018; 95% CI: −.0026–.0061) after adjusting for appropriate confounders. CONCLUSIONS Autonomy and a considerate leadership style were positively associated with supervisors’ likelihood to accommodate a back-injured worker. Providing supervisors with more autonomy over decisions of accommodation and developing their considerate leadership style may aid in increasing work accommodation for back-injured workers and preventing prolonged work disability. PMID:25595332

  15. Experienced job autonomy among maternity care professionals in The Netherlands.

    Science.gov (United States)

    Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G; Verhoeven, Corine J

    2017-11-01

    High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care system and whether they expect a new system of integrated maternity care to affect their experienced job autonomy. A cross-sectional survey. The Leiden Quality of Work Life Questionnaire was used to assess experienced job autonomy among maternity care professionals. Data were collected in the Netherlands in 2015. 799 professionals participated of whom 362 were primary care midwives, 240 obstetricians, 93 clinical midwives and 104 obstetric nurses. The mean score for experienced job autonomy was highest for primary care midwives, followed by obstetricians, clinical midwives and obstetric nurses. Primary care midwives scored highest in expecting to lose their job autonomy in an integrated care system. There are significant differences in experienced job autonomy between maternity care professionals. When changing the maternity care system it will be a challenge to maintain a high level of experienced job autonomy for professionals. A decrease in job autonomy could lead to a reduction in job related wellbeing and in satisfaction with care among pregnant women. Copyright © 2017. Published by Elsevier Ltd.

  16. Predictive value of updating Framingham risk scores with novel risk markers in the U.S. general population.

    Directory of Open Access Journals (Sweden)

    Bart S Ferket

    Full Text Available BACKGROUND: According to population-based cohort studies CT coronary calcium score (CTCS, carotid intima-media thickness (cIMT, high-sensitivity C- reactive protein (CRP, and ankle-brachial index (ABI are promising novel risk markers for improving cardiovascular risk assessment. Their impact in the U.S. general population is however uncertain. Our aim was to estimate the predictive value of four novel cardiovascular risk markers for the U.S. general population. METHODS AND FINDINGS: Risk profiles, CRP and ABI data of 3,736 asymptomatic subjects aged 40 or older from the National Health and Nutrition Examination Survey (NHANES 2003-2004 exam were used along with predicted CTCS and cIMT values. For each subject, we calculated 10-year cardiovascular risks with and without each risk marker. Event rates adjusted for competing risks were obtained by microsimulation. We assessed the impact of updated 10-year risk scores by reclassification and C-statistics. In the study population (mean age 56±11 years, 48% male, 70% (80% were at low (<10%, 19% (14% at intermediate (≥10-<20%, and 11% (6% at high (≥20% 10-year CVD (CHD risk. Net reclassification improvement was highest after updating 10-year CVD risk with CTCS: 0.10 (95%CI 0.02-0.19. The C-statistic for 10-year CVD risk increased from 0.82 by 0.02 (95%CI 0.01-0.03 with CTCS. Reclassification occurred most often in those at intermediate risk: with CTCS, 36% (38% moved to low and 22% (30% to high CVD (CHD risk. Improvements with other novel risk markers were limited. CONCLUSIONS: Only CTCS appeared to have significant incremental predictive value in the U.S. general population, especially in those at intermediate risk. In future research, cost-effectiveness analyses should be considered for evaluating novel cardiovascular risk assessment strategies.

  17. Predictive Value of Updating Framingham Risk Scores with Novel Risk Markers in the U.S. General Population

    Science.gov (United States)

    Hunink, M. G. Myriam; Agarwal, Isha; Kavousi, Maryam; Franco, Oscar H.; Steyerberg, Ewout W.; Max, Wendy; Fleischmann, Kirsten E.

    2014-01-01

    Background According to population-based cohort studies CT coronary calcium score (CTCS), carotid intima-media thickness (cIMT), high-sensitivity C- reactive protein (CRP), and ankle-brachial index (ABI) are promising novel risk markers for improving cardiovascular risk assessment. Their impact in the U.S. general population is however uncertain. Our aim was to estimate the predictive value of four novel cardiovascular risk markers for the U.S. general population. Methods and Findings Risk profiles, CRP and ABI data of 3,736 asymptomatic subjects aged 40 or older from the National Health and Nutrition Examination Survey (NHANES) 2003–2004 exam were used along with predicted CTCS and cIMT values. For each subject, we calculated 10-year cardiovascular risks with and without each risk marker. Event rates adjusted for competing risks were obtained by microsimulation. We assessed the impact of updated 10-year risk scores by reclassification and C-statistics. In the study population (mean age 56±11 years, 48% male), 70% (80%) were at low (risk. Net reclassification improvement was highest after updating 10-year CVD risk with CTCS: 0.10 (95%CI 0.02–0.19). The C-statistic for 10-year CVD risk increased from 0.82 by 0.02 (95%CI 0.01–0.03) with CTCS. Reclassification occurred most often in those at intermediate risk: with CTCS, 36% (38%) moved to low and 22% (30%) to high CVD (CHD) risk. Improvements with other novel risk markers were limited. Conclusions Only CTCS appeared to have significant incremental predictive value in the U.S. general population, especially in those at intermediate risk. In future research, cost-effectiveness analyses should be considered for evaluating novel cardiovascular risk assessment strategies. PMID:24558385

  18. Estimating the palliative effect of percutaneous endoscopic gastrostomy in an observational registry using principal stratification and generalized propensity scores

    Science.gov (United States)

    Mishra-Kalyani, Pallavi S.; Johnson, Brent A.; Glass, Jonathan D.; Long, Qi

    2016-09-01

    Clinical disease registries offer a rich collection of valuable patient information but also pose challenges that require special care and attention in statistical analyses. The goal of this paper is to propose a statistical framework that allows for estimating the effect of surgical insertion of a percutaneous endogastrostomy (PEG) tube for patients living with amyotrophic lateral sclerosis (ALS) using data from a clinical registry. Although all ALS patients are informed about PEG, only some patients agree to the procedure which, leads to the potential for selection bias. Assessing the effect of PEG is further complicated by the aggressively fatal disease, such that time to death competes directly with both the opportunity to receive PEG and clinical outcome measurements. Our proposed methodology handles the “censoring by death” phenomenon through principal stratification and selection bias for PEG treatment through generalized propensity scores. We develop a fully Bayesian modeling approach to estimate the survivor average causal effect (SACE) of PEG on BMI, a surrogate outcome measure of nutrition and quality of life. The use of propensity score methods within the principal stratification framework demonstrates a significant and positive effect of PEG treatment, particularly when time of treatment is included in the treatment definition.

  19. Autonomy and social functioning of recently admitted nursing home residents.

    Science.gov (United States)

    Paque, Kristel; Goossens, Katrien; Elseviers, Monique; Van Bogaert, Peter; Dilles, Tinne

    2017-09-01

    This paper examines recently admitted nursing home residents' practical autonomy, their remaining social environment and their social functioning. In a cross-sectional design, 391 newly admitted residents of 67 nursing homes participated. All respondents were ≥65 years old, had mini-mental state examination ≥18 and were living in the nursing home for at least 1 month. Data were collected using a structured questionnaire and validated measuring tools. The mean age was 84, 64% were female, 23% had a partner, 80% children, 75% grandchildren and 59% siblings. The mean social functioning score was 3/9 (or 33%) and the autonomy and importance of autonomy score 6/9 (or 67%). More autonomy was observed when residents could perform activities of daily living more independently, and cognitive functioning, quality of life and social functioning were high. Residents with depressive feelings scored lower on autonomy and social functioning compared to those without depressive feelings. Having siblings and the frequency of visits positively correlated with social functioning. In turn, social functioning correlated positively with quality of life. Moreover, a higher score on social functioning lowered the probability of depression. Autonomy or self-determination and maintaining remaining social relationships were considered to be important by the new residents. The remaining social environment, social functioning, quality of life, autonomy and depressive feelings influenced each other, but the cause--effect relation was not clear.

  20. Entrepreneurial autonomy and its dynamics

    NARCIS (Netherlands)

    van Gelderen, M.W.

    2016-01-01

    Founding and owning an independent business does not automatically provide the owner/founder with autonomy. Autonomy-motivated entrepreneurs must often make an effort to achieve and maintain autonomy. The aim of this research is to investigate the experience of autonomy, its variations over time,

  1. Changing professional autonomy?

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh

    The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway......The paper presents a typology for the analysis for professional autonomy and an application of the typology in realation to discourses of quality development in the 'Health Care sector in Denmark and Norway...

  2. Anagogy of autonomy.

    Science.gov (United States)

    Boyd, A L

    2000-07-01

    The philosophical and ethical concept of autonomy is herein examined, ex post facto, using an existential lens to examine the process of a personal friend's dying. Anagogy, defined as interpretation of a word, passage, or text that finds beyond the literal, allegorical, and moral senses a fourth and ultimate spiritual or mystical sense, is intended to enlarge the understanding of the use of autonomy in this case. The idea of personhood linked inextricably to reason is, therefore, understood as empowering an individual to choose among various actions, to define and redefine life goals, and to give priority to selected values and moral tenants, which reveal a moral hermeneutic. Conditions and circumstances, existentially exposed, limit choice in unexpected ways, such that the predicted value of autonomy is vulnerable to misuse or misunderstanding. The intent to respect the dignity of every person is central to the philosophy of Respect for Persons ethics, and assumes that autonomy, as freedom of the moral agent, is a moral duty. Implicit reality of freedom is, in a practical sense, essential to being rational agents who can thereby exercise informed choice. The moral law, law of freedom, involves the autonomy of the will and an ultimate end to which all action is directed. Defined as the highest good, morality unites virtue and happiness by ascribing the ultimate end sought as God. The freedom to use rational will finds principles within its own rational nature. The ability to create maxims is autonomy of the will, which equates with the dignity of persons. My recent experience as a companion to a personal friend with a terminal illness inspired me to re-evaluate the concept of autonomy as it is too often interpreted in modern ethical discourse as a individualistic right of choice as opposed to the hermeneutic of dignity of person. This paper describes a shift of position in understanding the paradox of autonomy in this existential context.

  3. Autonomy and hyperthyroidism

    International Nuclear Information System (INIS)

    Emrich, D.; Schicha, H.; Baehre, M.

    1986-01-01

    The significance of autonomy in iodine-deficiency goiter for the development of hyperthyroidism was investigated. (1) In 171 of 426 consecutive patients high-resolution quantitative scintiscans showed signs suggestive of autonomy. With increasing 99mTc uptake by the thyroid their TT3 levels were found to rise progressively during suppression, while their pre-suppression TSH levels dropped progressively. This suggests global sup(99m)Tc uptake by the thyroid during suppression to be a useful indicator of the functional significance of autonomy. (2) Based on 326 patients with hyperthyroidism a system for differentiating between autonomy-related and immunogenic disease was developed and validated prospectively in another 162 patients with hyperthyroidism by assaying for thyroid stimulating antibodies (TSAb). TSAb was found to be present in 82% of the 77 patients diagnosed as having immunogenic hyperthyroidism and in only 8% of the 85 patients with autonomy-related hyperthyroidism. Our results support the assumption that autonomy in iodine-deficiency goiter plays a major role in the development of hyperthyroidism, while autoimmune processes appear to be of secondary importance. (Author)

  4. Risk stratification with the risk chart from the European Society of Hypertension compared with SCORE in the general population

    DEFF Research Database (Denmark)

    Sehestedt, Thomas; Jeppesen, Jørgen; Hansen, Tine W

    2009-01-01

    to higher-risk categories than SCORE (P smokers. However, ESH risk chart agreed with ESC guidelines for antihypertensive treatment using SCORE in 89% (634/713) of the patients recommended treatment and produced...... similar sensitivities (79 vs. 79%), specificities (46 vs. 50%), positive (14 vs. 15%) and negative (95 vs. 96%) predictive values for CEP. CONCLUSION: Although SCORE did not use subclinical organ damage, the guidelines by ESH and ESC using SCORE recommended antihypertensive treatment in almost the same...

  5. Social Autonomy and Heteronomy in the Age of ICT: The Digital Pharmakon and the (Dis)Empowerment of the General Intellect.

    Science.gov (United States)

    Lemmens, Pieter

    2017-01-01

    'The art of living with ICTs (information and communication technologies)' today not only means finding new ways to cope, interact and create new lifestyles on the basis of the new digital (network) technologies individually , as 'consumer-citizens'. It also means inventing new modes of living, producing and, not in the least place, struggling collectively , as workers and producers. As the so-called digital revolution unfolds in the context of a neoliberal cognitive and consumerist capitalism, its 'innovations' are predominantly employed to modulate and control both production processes and consumer behavior in view of the overall goal of extracting surplus value. Today, the digital networks overwhelmingly destroy social autonomy, instead engendering increasing social heteronomy and proletarianization. Yet it is these very networks themselves, as technical pharmaka in the sense of French 'technophilosopher' Bernard Stiegler, that can be employed as no other to struggle against this tendency. This paper briefly explores this possibility by reflecting upon current diagnoses of our 'technological situation' by some exemplary post-operaist Marxists from a Stieglerian, pharmacological perspective.

  6. Performance scores in general practice: a comparison between the clinical versus medication-based approach to identify target populations.

    Directory of Open Access Journals (Sweden)

    Olivier Saint-Lary

    Full Text Available CONTEXT: From one country to another, the pay-for-performance mechanisms differ on one significant point: the identification of target populations, that is, populations which serve as a basis for calculating the indicators. The aim of this study was to compare clinical versus medication-based identification of populations of patients with diabetes and hypertension over the age of 50 (for men or 60 (for women, and any consequences this may have on the calculation of P4P indicators. METHODS: A comparative, retrospective, observational study was carried out with clinical and prescription data from a panel of general practitioners (GPs, the Observatory of General Medicine (OMG for the year 2007. Two indicators regarding the prescription for statins and aspirin in these populations were calculated. RESULTS: We analyzed data from 21.690 patients collected by 61 GPs via electronic medical files. Following the clinical-based approach, 2.278 patients were diabetic, 8,271 had hypertension and 1.539 had both against respectively 1.730, 8.511 and 1.304 following the medication-based approach (% agreement = 96%, kappa = 0.69. The main reasons for these differences were: forgetting to code the morbidities in the clinical approach, not taking into account the population of patients who were given life style and diet rules only or taking into account patients for whom morbidities other than hypertension could justify the use of antihypertensive drugs in the medication-based approach. The mean (confidence interval per doctor was 33.7% (31.5-35.9 for statin indicator and 38.4% (35.4-41.4 for aspirin indicator when the target populations were identified on the basis of clinical criteria whereas they were 37.9% (36.3-39.4 and 43.8% (41.4-46.3 on the basis of treatment criteria. CONCLUSION: The two approaches yield very "similar" scores but these scores cover different realities and offer food for thought on the possible usage of these indicators in the

  7. Monitoring vital signs: development of a modified early warning scoring (MEWS system for general wards in a developing country.

    Directory of Open Access Journals (Sweden)

    Una Kyriacos

    Full Text Available OBJECTIVE: The aim of the study was to develop and validate, by consensus, the construct and content of an observations chart for nurses incorporating a modified early warning scoring (MEWS system for physiological parameters to be used for bedside monitoring on general wards in a public hospital in South Africa. METHODS: Delphi and modified face-to-face nominal group consensus methods were used to develop and validate a prototype observations chart that incorporated an existing UK MEWS. This informed the development of the Cape Town ward MEWS chart. PARTICIPANTS: One specialist anaesthesiologist, one emergency medicine specialist, two critical care nurses and eight senior ward nurses with expertise in bedside monitoring (N = 12 were purposively sampled for consensus development of the MEWS. One general surgeon declined and one neurosurgeon replaced the emergency medicine specialist in the final round. RESULTS: Five consensus rounds achieved ≥70% agreement for cut points in five of seven physiological parameters respiratory and heart rates, systolic BP, temperature and urine output. For conscious level and oxygen saturation a relaxed rule of <70% agreement was applied. A reporting algorithm was established and incorporated in the MEWS chart representing decision rules determining the degree of urgency. Parameters and cut points differed from those in MEWS used in developed countries. CONCLUSIONS: A MEWS for developing countries should record at least seven parameters. Experts from developing countries are best placed to stipulate cut points in physiological parameters. Further research is needed to explore the ability of the MEWS chart to identify physiological and clinical deterioration.

  8. The impact of patient autonomy on older adults with asthma.

    Science.gov (United States)

    Karamched, Keerthi R; Hao, Wei; Song, Peter X; Carpenter, Laurie; Steinberg, Joel; Baptist, Alan P

    2018-05-03

    Understanding patient preferences and desire for involvement in making medical decisions is important when managing chronic conditions. Previous studies have utilized the Autonomy Preference Index (API) in younger asthmatic patients to evaluate these preferences. To identify factors associated with autonomy, and to determine if autonomy is related to asthma outcomes among older adults. 189 older adults (>55 yr) with persistent asthma were included. Preferences for autonomy were assessed using the API, with a higher score indicating higher desire for autonomy. Scores were separated into two domains of 'information seeking' and 'decision making' preferences. The separated scores were correlated with asthma outcomes and demographic variables. To control for confounding factors, a linear regression analysis was performed. Higher 'decision making' preference scores correlated with female gender (p=0.007), higher education level (p=0.01), and lower depression scores (p=0.04). Regarding outcomes, 'decision making' scores positively correlated with asthma quality of life questionnaire (AQLQ) scores (p=0.01). On linear regression analysis, the AQLQ score remained significantly associated with 'decision making' preference scores (p=0.03). There was no association with asthma control test scores, spirometry values, and healthcare utilization. 'Information seeking' preference scores correlated with education level (p=0.03), but there was no correlation with asthma outcomes. Older asthmatic adults with a greater desire for involvement in decision making have a higher asthma related quality of life. Future studies with the intention to increase patient autonomy may help establish a causal relationship. Copyright © 2018. Published by Elsevier Inc.

  9. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI

    Directory of Open Access Journals (Sweden)

    Carlos Eugênio Lira Tenório

    Full Text Available ABSTRACT Objective To evaluate risk factors for mortality in patients with Fournier's gangrene (FG, with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI. Materials and Methods This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Results Of the 124 patients, 99 were men (79.8%, the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%. The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03, hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission.

  10. Risk factors for mortality in fournier's gangrene in a general hospital: use of simplified founier gangrene severe index score (SFGSI).

    Science.gov (United States)

    Tenório, Carlos Eugênio Lira; Lima, Salvador Vilar Correia; Albuquerque, Amanda Vasconcelos de; Cavalcanti, Mariana Pauferro; Teles, Flávio

    2018-01-01

    To evaluate risk factors for mortality in patients with Fournier's gangrene (FG), with emphasis in the Simplified Fournier Gangrene Severe Index Score (SFGSI). This was a cross-sectional study that was carried out from January 2010 to December 2014, with 124 patients treated for FG in a General Hospital. Several clinical and laboratory variables, including SFGSI, were evaluated and correlated with mortality through univariate analysis and logistic regression. Of the 124 patients, 99 were men (79.8%), the mean age was 50.8±19.5 years and the main comorbidity was diabetes mellitus (51.6%). The mortality rate was 25.8%. Variables that presented independent correlation with mortality were the extension of the lesion to the abdomen (OR=4.0, CI=1.10-14.68, p=0.03), hematocrit (OR=0.81, CI=0.73-0.90, p2 result was the largest of the independent predictors of mortality (OR=50.2; CI=13.18-191.47; p2 presented a higher correlation with mortality than any variable tested alone. It seems to be a promising alternative to evaluate predictors of mortality in Fournier's gangrene. The main advantage is easy applicability because it contains only three parameters and can be used immediately after patient's admission. Copyright® by the International Brazilian Journal of Urology.

  11. Understanding nurse practitioner autonomy.

    Science.gov (United States)

    Weiland, Sandra A

    2015-02-01

    This Gadamerian hermeneutic study was undertaken to understand the meaning of autonomy as interpreted by nurse practitioners (NPs) through their lived experiences of everyday practice in primary health care. A purposive sample of nine NPs practicing in primary health care was used. Network sampling achieved a broad swath of primary care NPs and practice settings. Data were collected by face-to-face interviews. Because NP autonomy is concerned with gender and marginalization, Gilligan's feminist perspective was utilized during interpretive analysis. Having Genuine NP Practice was the major theme, reflecting the participants' overall meaning of their autonomy. Practicing alone with the patient provided the context within which participants shaped the meaning of Having Genuine NP Practice. Having Genuine NP Practice had four subthemes: relationships, self-reliance, self-empowerment, and defending the NP role. The understanding of Having Genuine NP Practice will enable NPs to articulate their autonomy clearly and better influence healthcare reform. Implications for advanced practice nursing education include integrating findings into classroom discussion to prompt self-reflection of what autonomy means and socialization to the NP role. ©2014 American Association of Nurse Practitioners.

  12. Autonomy in chimpanzees.

    Science.gov (United States)

    Beauchamp, Tom L; Wobber, Victoria

    2014-04-01

    Literature on the mental capacities and cognitive mechanisms of the great apes has been silent about whether they can act autonomously. This paper provides a philosophical theory of autonomy supported by psychological studies of the cognitive mechanisms that underlie chimpanzee behavior to argue that chimpanzees can act autonomously even though their psychological mechanisms differ from those of humans. Chimpanzees satisfy the two basic conditions of autonomy: (1) liberty (the absence of controlling influences) and (2) agency (self-initiated intentional action), each of which is specified here in terms of conditions of understanding, intention, and self-control. In this account, chimpanzees make knowledge-based choices reflecting a richly information-based and socially sophisticated understanding of the world. Finally, two major theories of autonomy (Kantian theory and two-level theory) are rejected as too narrow to adequately address these issues, necessitating the modifications made in the present approach.

  13. [What is patient autonomy?

    Science.gov (United States)

    Durand, Guillaume

    What does patient autonomy mean? If an autonomous choice is defined as an objective and rational choice, is the doctor's prescription not always the best route? Our contemporary democracies are marked by moral and religious pluralism which obliges society to respect a multiplicity of choices of existence. Three levels are important in terms of autonomy: a range of intellectual capacities, freedom with regard to constraints (external and internal), the capacity to be in control of one's existence. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  14. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

    Science.gov (United States)

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

    2016-01-01

    Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

  15. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2016-10-01

    Full Text Available Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items. The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an

  16. Physical activity counseling intervention at a federally qualified health center: improves autonomy-supportiveness, but not patients' perceived competence.

    Science.gov (United States)

    Carroll, Jennifer K; Fiscella, Kevin; Epstein, Ronald M; Sanders, Mechelle R; Winters, Paul C; Moorhead, S Anne; van Osch, Liesbeth; Williams, Geoffrey C

    2013-09-01

    To assess the effect of a pilot intervention to promote clinician-patient communication about physical activity on patient ratings of their perceived competence for physical activity and their clinicians' autonomy-supportiveness. Family medicine clinicians (n=13) at two urban community health centers were randomized to early or delayed (8 months later) communication training groups. The goal of the training was to teach the 5As (Ask, Advise, Agree, Assist, Arrange) for physical activity counseling. Outcome measures were changes in patient perceptions of autonomy support (modified Health Care Climate Questionnaire, mHCCQ) and perceived competence (Perceived Competence Scale for physical activity, PCS) completed via surveys at baseline, post-intervention and six-month follow-up. Patients (n=326) were mostly female (70%) and low income. Using a generalized estimating equations model (GEE) with patients nested within clinician, patient perceived autonomy support increased at post-intervention compared to baseline (mean HCCQ scores 3.68-4.06, p=0.03). There was no significant change in patient perceived competence for physical activity. A clinician-directed intervention increased patient perceptions of clinician autonomy support but not patient perceived competence for physical activity. Clinicians working with underserved populations can be taught to improve their autonomy supportiveness, according to patient assessments of their clinicians. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Educating for Well-Being and Autonomy

    Science.gov (United States)

    Cuypers, Stefaan E.; Haji, Ishtiyaque

    2008-01-01

    Liberals champion the view that promoting autonomy--seeing to it that our children develop into individuals who are self-governing in the conduct of their lives--is a vital aim of education, though one generally accredited as being subsidiary to well-being. Our prime goal in this article is to provide a partial validation of this liberal ideal…

  18. Introducing, Defining and Balancing 'Autonomy vs. Paternalism'

    NARCIS (Netherlands)

    W.H. van Boom (Willem); A.I. Ogus (Anthony)

    2010-01-01

    textabstractAutonomy is generally regarded as the fundamental right of individuals to shape their own future through voluntary action. In private law, it is associated with freedom of contract and the concept of casum sentit dominus (the loss lies where it falls). As such, it is opposed to legal

  19. FMS Scores Change With Performers' Knowledge of the Grading Criteria-Are General Whole-Body Movement Screens Capturing "Dysfunction"?

    Science.gov (United States)

    Frost, David M; Beach, Tyson A C; Callaghan, Jack P; McGill, Stuart M

    2015-11-01

    Deficits in joint mobility and stability could certainly impact individuals' Functional Movement Screen (FMS) scores; however, it is also plausible that the movement patterns observed are influenced by the performers' knowledge of the grading criteria. Twenty-one firefighters volunteered to participate, and their FMS scores were graded before and immediately after receiving knowledge of the movement patterns required to achieve a perfect score on the FMS. Standardized verbal instructions were used to administer both screens, and the participants were not provided with any coaching or feedback. Time-synchronized sagittal and frontal plane videos were used to grade the FMS. The firefighters significantly (p injury risk.

  20. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

    2016-01-01

    discussion of challenges. The other outcome is the extent to which academic colleagues in a wide-range of disciplines and not directly engaged with research on university autonomy may not perceive or engage with the wider autonomy outcomes of their work and as a result their own case studies may not fully...... identify the autonomy impact real or potential. Many academic staff take for granted university autonomy without questioning its sometimes contradictory assumptions and impacts....

  1. Finding Autonomy in Birth*

    Science.gov (United States)

    Kukla, Rebecca; Kuppermann, Miriam; Little, Margaret; Lyerly, Anne Drapkin; Mitchell, Lisa M; Armstrong, Elizabeth M.; Harris, Lisa

    2009-01-01

    Over the last several years, as cesarean deliveries have grown increasingly common, there has been a great deal of public and professional interest in the phenomenon of women ‘choosing’ to deliver by cesarean section in the absence of any specific medical indication. The issue has sparked intense conversation, as it raises questions about the nature of autonomy in birth. Whereas mainstream bioethical discourse is used to associating autonomy with having a large array of choices, this conception of autonomy does not seem adequate to capture concerns and intuitions that have a strong grip outside of this discourse. An empirical and conceptual exploration of how delivery decisions ought to be negotiated must be guided by a rich understanding of women’s agency and its placement within a complicated set of cultural meanings and pressures surrounding birth. It is too early to be ‘for’ or ‘against’ women’s access to cesarean delivery in the absence of traditional medical indications - and indeed, a simple pro- or con- position is never going to do justice to the subtlety of the issue. The right question is not whether women ought to be allowed to choose their delivery approach, but rather, taking the value of women’s autonomy in decision-making around birth as a given, what sorts of guidelines, practices, and social conditions will best promote and protect women’s full inclusion in a safe and positive birth process. PMID:19076937

  2. Om evalueringsforskningens relative autonomi

    DEFF Research Database (Denmark)

    Nørholm, Morten

    2008-01-01

    Det empiriske udgangspunkt for artiklen "Om evalueringsforskningens relative autonomi - dansk normal evalueringsforskning som et ikke-autonomt (sub)felt i magtens felt" er en række tekster af fire dominerende danske evalueringsforskere. Det teoretiske udgangspunkt er især Pierre Bourdieus teori om...

  3. The economic value of autonomy

    NARCIS (Netherlands)

    Boot, A.W.A.; Thakor, A.V.

    2003-01-01

    We develop an economic theory of "autonomy", which we interpret as the discretion or ability to make a decision that others disagree with. We show that autonomy is essentially an option for the decisionmaker, and can be valued as such. The value of the autonomy option is decreasing in the extent to

  4. Senegal : School Autonomy and Accountability

    OpenAIRE

    World Bank

    2012-01-01

    Senegal has accelerated the decentralization of education since 1996. Budgetary autonomy is latent. Autonomy over the management of operational budgets has been delegated to the communes, but salaries for teachers are managed at the central level. Autonomy in personnel management is latent. Both school directors and teachers are appointed at the central level. The role of the school counci...

  5. Compulsory Autonomy-Promoting Education

    Science.gov (United States)

    Schinkel, Anders

    2010-01-01

    Today, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the development of autonomy in children, but also that this aim should…

  6. Autonomy and the principle of respect for autonomy.

    Science.gov (United States)

    Gillon, R

    1985-06-15

    Autonomy is defined as the capacity to think, decide, and act freely and independently on the basis of such thought and decisions. Three types of autonomy are distinguished: autonomy of thought, which embraces the wide range of human intellectual activities called "thinking for oneself"; autonomy of will, or the capacity to decide to do things on the basis of one's deliberations; and autonomy of action, the absence of which is illustrated by the situation of a patient whose voluntary muscles are paralyzed by curariform drugs and who thus cannot tell the surgeon that the anesthetist has forgotten the nitrous oxide. Autonomy is viewed as a prerequisite for all the virtues, rather than as a virtue in its own right. The arguments of Immanuel Kant and John Stuart Mill concerning the principle of respect for autonomy are summarized as exemplars respectively of the deontological and utilitarian philosophical approaches.

  7. Physicians’ Perceptions of Autonomy across Practice Types: Is Autonomy in Solo Practice a Myth?

    Science.gov (United States)

    Lin, Katherine Y.

    2013-01-01

    Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians’ autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked “spell” data constructed from the Community Tracking Study (CTS) Physician Survey (1996–2005) (n=16,519) I examine how physicians’ perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. PMID:24444835

  8. Physicians' perceptions of autonomy across practice types: Is autonomy in solo practice a myth?

    Science.gov (United States)

    Lin, Katherine Y

    2014-01-01

    Physicians in the United States are now less likely to practice in smaller, more traditional, solo practices, and more likely to practice in larger group practices. Though older theory predicts conflict between bureaucracy and professional autonomy, studies have shown that professions in general, and physicians in particular, have adapted to organizational constraints. However, much work remains in clarifying the nature of this relationship and how exactly physicians have adapted to various organizational settings. To this end, the present study examines physicians' autonomy experiences in different decision types between organization sizes. Specifically, I ask: In what kinds of decisions do doctors perceive autonomous control? How does this vary by organizational size? Using stacked "spell" data constructed from the Community Tracking Study (CTS) Physician Survey (1996-2005) (n = 16,519) I examine how physicians' perceptions of autonomy vary between solo/two physician practices, small group practices with three to ten physicians, and large practices with ten or more physicians, in two kinds of decisions: logistic-based and knowledge-based decisions. Capitalizing on the longitudinal nature of the data I estimate how changes in practice size are associated with perceptions of autonomy, accounting for previous reports of autonomy. I also test whether managed care involvement, practice ownership, and salaried employment help explain part of this relationship. I find that while physicians practicing in larger group practices reported lower levels of autonomy in logistic-based decisions, physicians in solo/two physician practices reported lower levels of autonomy in knowledge-based decisions. Managed care involvement and ownership explain some, but not all, of the associations. These findings suggest that professional adaptation to various organizational settings can lead to varying levels of perceived autonomy across different kinds of decisions. Copyright © 2013

  9. Law, autonomy and advance directives.

    Science.gov (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben

    2010-12-01

    The principle of autonomy underpins legal regulation of advance directives that refuse life-sustaining medical treatment. The primacy of autonomy in this domain is recognised expressly in the case law, through judicial pronouncement, and implicitly in most Australian jurisdictions, through enactment into statute of the right to make an advance directive. This article seeks to justify autonomy as an appropriate principle for regulating advance directives and relies on three arguments: the necessity of autonomy in a liberal democracy; the primacy of autonomy in medical ethics discourse; and the uncontested importance of autonomy in the law on contemporaneous refusal of medical treatment. This article also responds to key criticisms that autonomy is not an appropriate organising principle to underpin legal regulation of advance directives.

  10. Autonomy and Automation

    Science.gov (United States)

    Shively, Jay

    2017-01-01

    A significant level of debate and confusion has surrounded the meaning of the terms autonomy and automation. Automation is a multi-dimensional concept, and we propose that Remotely Piloted Aircraft Systems (RPAS) automation should be described with reference to the specific system and task that has been automated, the context in which the automation functions, and other relevant dimensions. In this paper, we present definitions of automation, pilot in the loop, pilot on the loop and pilot out of the loop. We further propose that in future, the International Civil Aviation Organization (ICAO) RPAS Panel avoids the use of the terms autonomy and autonomous when referring to automated systems on board RPA. Work Group 7 proposes to develop, in consultation with other workgroups, a taxonomy of Levels of Automation for RPAS.

  11. Autonomy and the emotions

    OpenAIRE

    Tappolet, Christine

    2006-01-01

    Can actions caused by emotions be free and autonomous? The rationalist conception of autonomy denies this. Only actions done in the light of reflective choices can be autonomous and hence free. I argue that the rationalist conception does not make room for akratic actions, that is, free and intentional actions performed against the agent’s best judgement. I then develop an account inspired by Harry Frankfurt and David Shoemaker, according to which an action is autonomous when it is determined...

  12. The Autonomy of Deportation

    Directory of Open Access Journals (Sweden)

    Nicholas de Genova

    2017-06-01

    Full Text Available As ostensibly unwanted or undesirable non-citizens, the utter disposability of deportees appears to be finally and conclusively verified by deportation as a sovereign state power’s perfunctory and mundane act of 'taking out the trash.' Hence, it is no accident that, etymologically, the origins of the very word 'deportation' would indicate a carrying away, a removal, a disposal. The eradication of deportees’ individual lives — their personal identities and life trajectories — emerges as a frightfully routine and prosaic fact of deportation. In spite of the sheer violence of the ruptures inflicted though deportation, however, those who have been rendered the objects of this power persistently reassert their own subjectivity. Ethnographic insights into the lived struggles of the deported (as well as their loved ones and communities elucidates the enduring subjectivity of those who have been made the objects of such sovereign acts of state power and subjected to deportation's techniques of eradication, and illustrates the stubborn incorrigibility of human life against the myriad forces that would seek to enforce its precarity and disposability. In the post-deportation condition, we confront anew the elementary and elemental human freedom of movement, and the incorrigibility of the autonomy and subjectivity of migration. Much as the autonomy of migration instigates a contest in which state power never has the first word, what we may now conceive as the autonomy of deportation — an autonomy and subjectivity of the deported within and against their predicaments of deportation — similarly ensures that state power never has the last word, either.

  13. Perspectives on autonomy.

    Science.gov (United States)

    Keys, Yolanda

    2009-09-01

    This department, sponsored by the AONE, presents information to assist nurse leaders in shaping the future of healthcare through creative and innovative leadership. The strategic priorities of AONE anchor the editorial content. They reflect contemporary healthcare and nursing practice issues that challenge nurse executives as they strive to meet the needs of patients. This article describes how 9 Magnet-hospital, chief nursing officers perceive their autonomy and its importance in accomplishing their work.

  14. Autonomy, Trust, and Respect.

    Science.gov (United States)

    Nys, Thomas

    2016-02-01

    This article seeks to explore and analyze the relationship between autonomy and trust, and to show how these findings could be relevant to medical ethics. First, I will argue that the way in which so-called "relational autonomy theories" tie the notions of autonomy and trust together is not entirely satisfying Then, I will introduce the so-called Encapsulated Interest Account as developed by Russell Hardin. This will bring out the importance of the reasons for trust. What good reasons do we have for trusting someone? I will criticize Hardin's business model as insufficiently robust, especially in the context of health care, and then turn to another source of trust, namely, love. It may seem that trust-through-love is much better suited for the vulnerability that is often involved in health care, but I will also show that it has its own deficiencies. Good health care should therefore pay attention to both models of trust, and I will offer some tentative remarks on how to do this. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  15. Autonomy, recognition and education

    Directory of Open Access Journals (Sweden)

    Angelo Vitório Cenci

    2015-01-01

    Full Text Available This paper addresses Honneth’s concept of autonomy from two dimensions of his work, distinct, though inseparable. The first one is suggested through the subject’s positive practical self-relation linked to the patterns of reciprocal recognition of love, right and social esteem; the second is formulated as non-centered autonomy opposed to the present-day criticism of the modern autonomous subject encompassing three levels, namely: the capacity of linguistic articulation, the narrative coherence of life and the complementation of being guided by principles with some criteria of moral sensitivity to the context. We defend the position that, by metaphysically anchoring the concept of autonomy onto the intersubjective assumptions of his/her theory of the subject, and exploring it linked to the subject’s positive practical self-relation and to a non-centered meaning, Honneth has managed to renew it, which allows drawing important consequences of such effort to the field of education.

  16. Ignorance, information and autonomy.

    Science.gov (United States)

    Harris, J; Keywood, K

    2001-09-01

    People have a powerful interest in genetic privacy and its associated claim to ignorance, and some equally powerful desires to be shielded from disturbing information are often voiced. We argue, however, that there is no such thing as a right to remain in ignorance, where a fight is understood as an entitlement that trumps competing claims. This does not of course mean that information must always be forced upon unwilling recipients, only that there is no prima facie entitlement to be protected from true or honest information about oneself. Any claims to be shielded from information about the self must compete on equal terms with claims based in the rights and interests of others. In balancing the weight and importance of rival considerations about giving or withholding information, if rights claims have any place, rights are more likely to be defensible on the side of honest communication of information rather than in defence of ignorance. The right to free speech and the right to decline to accept responsibility to take decisions for others imposed by those others seem to us more plausible candidates for fully fledged rights in this field than any purported right to ignorance. Finally, and most importantly, if the right to autonomy is invoked, a proper understanding of the distinction between claims to liberty and claims to autonomy show that the principle of autonomy, as it is understood in contemporary social ethics and English law, supports the giving rather than the withholding of information in most circumstances.

  17. Effects of General and Epidural Anaesthesia in Newborn’s Stres Hormones, Blood Gases, and Apgar Scores in Elective Cesarean Section

    Directory of Open Access Journals (Sweden)

    Meral Ezberci

    2005-12-01

    Full Text Available OBJECTIVE: The aim of this study was to evaluate the effects of general and epidural anaesthesia in newborn’s stres hormones, blood gases, and Apgar scores in elective cesarean section. MATERIALS-METHODS: 50 patients in ASA II (American Society of Anesthesiology class who would undergo elective cesarean section in University of Kahramanmaras Sutcuimam, Department of Anaesthesiology and Reanimation included in the study and randomized into two equal groups (General anaesthesia: Group G and Epidural anaesthesia: Group E. In both groups, newborn stres hormones (TSH, cortisol, and insulin, blood gases, and Apgar scores were studued. All patients received famotidine and granisetron iv 30 min before operations in premedication room. In the general anaesthesia group; aritmal, propofol, and succinylcholine was used for induction and muscle relaxation. Following the induction, positive pressure ventilation of the lungs was started immediately using a 50% N2O + O2 mixture. After delivery of the baby, anaesthesia and muscle relaxation was maintained by 50% N2O +O2, 0,5-1% MAC isoflurane, and cisatracurium. In the epidural anaesthesia group; epidural anaesthesia was performed with 0,375% bupivacaine. The epidural needle inserted through L2-3 or L3-4 interspace. After achieving T4-5 neural blockade, the operation was started. Blood samples for newborn stres hormones and blood gases were taken from umblical vein. The Apgar scores were recorded at 1 min and again at 5 min after the delivery by same person. RESULTS: There were no differences in newborn stress hormones between two groups. In newborn blood gases analyses, only SO2 changes were statistically significant between two groups. There were no differences in newborn Apgar scores between two groups. CONCLUSION: With these results, we concluded that each of the general and epidural anaesthesia techniques have similar effects on newborn blood gases, stress hormones and Apgar scores and can be acceptable

  18. University Internationalization and University Autonomy

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Gulieva, Valeria

    2016-01-01

    Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability are d......, dissimilar, and sometimes conflicting dimensions of the financial, legal, organisational, staffing, and academic autonomy of the host country, are compromising key aspects of their own autonomy and core mission?......Turcan and Gulieva deepen our theoretical understanding of the process of university internationalisation by exploring the relationship between university internationalisation and university autonomy. They conjecture that the process of university internationalisation and its sustainability...... are determined by the structure and exercise of university autonomy settings at home and in the host countries, and that the process itself cannot be successfully achieved and maintained without changes in the autonomy settings. The key question the authors ask is to what degree universities, in embracing new...

  19. Autonomy, Social Interactions and Culture

    OpenAIRE

    Marini, Annalisa; Navarra, Pietro

    2016-01-01

    The present paper, using a social interactions model, studies the impact of culture on autonomy of immigrants. The results suggest that: (i) immigrants' autonomy is largely influenced by the autonomy of individuals living in a host country; (ii) some immigrants are better off in countries and regions with better institutional environments. The results are robust to sensitivity checks. The contributions of the paper are as follows. First, we estimate a social interactions model that models bot...

  20. The impact of financial constraints and incentives on professional autonomy.

    Science.gov (United States)

    Lewis, Jenny M; Marjoribanks, Tim

    2003-01-01

    General practice has been the subject of extensive reforms over the 1990s in Australia as elsewhere. Reforms have attempted to improve quality and contain the overall cost of health care, and have often been seen as reducing the autonomy of medical professionals. This paper examines the impact of financial constraints and incentives introduced during the 1990s on Australian GPs' perceptions of autonomy. An existing seven component definition of autonomy and six themes that emerged from reviewing publications were used to construct focus group questions. A total of 25 GPs participated in four focus groups. Those who participated believe that their financial autonomy has been diminished by policy changes and consumer expectations. They also perceive that their ability to control clinical decisions, which they regard as the most important aspect of professional autonomy, has been reduced along with financial autonomy. Organized medicine in Australia sees financial accountability and clinical decision making as polar opposites, and has continued to argue that fee-for-service payment is the only appropriate method of remuneration, despite increasing evidence that this does not guarantee clinical autonomy. Major changes to the financing of general practice in Australia are required to address the concerns of GPs, governments and patients.

  1. Nurses caring for ENT patients in a district general hospital without a dedicated ENT ward score significantly less in a test of knowledge than nurses caring for ENT patients in a dedicated ENT ward in a comparable district general hospital.

    Science.gov (United States)

    Foxton, C R; Black, D; Muhlschlegel, J; Jardine, A

    2014-12-01

    To assess whether there is a difference in ENT knowledge amongst nurses caring for patients on a dedicated ENT ward and nurses caring for ENT patients in a similar hospital without a dedicated ENT ward. A test of theoretical knowledge of ENT nursing care was devised and administered to nurses working on a dedicated ENT ward and then to nurses working on generic non-subspecialist wards regularly caring for ENT patients in a hospital without a dedicated ENT ward. The test scores were then compared. A single specialist ENT/Maxillo-Facial/Opthalmology ward in hospital A and 3 generic surgical wards in hospital B. Both hospitals are comparable district general hospitals in the south west of England. Nursing staff working in hospital A and hospital B on the relevant wards were approached during the working day. 11 nurses on ward 1, 10 nurses on ward 2, 11 nurses on ward 3 and 10 nurses on ward 4 (the dedicated ENT ward). Each individual test score was used to generate an average score per ward and these scores compared to see if there was a significant difference. The average score out of 10 on ward 1 was 6.8 (+/-1.6). The average score on ward two was 4.8 (+/-1.6). The average score on ward three was 5.5 (+/-2.1). The average score on ward 4, which is the dedicated ENT ward, was 9.7 (+/-0.5). The differences in average test score between the dedicated ENT ward and all of the other wards are statistically significant. Nurses working on a dedicated ENT ward have an average higher score in a test of knowledge than nurses working on generic surgical wards. This difference is statistically significant and persists despite banding or training. © 2014 John Wiley & Sons Ltd.

  2. Perceived Autonomy Support in the NIMH RAISE Early Treatment Program.

    Science.gov (United States)

    Browne, Julia; Penn, David L; Bauer, Daniel J; Meyer-Kalos, Piper; Mueser, Kim T; Robinson, Delbert G; Addington, Jean; Schooler, Nina R; Glynn, Shirley M; Gingerich, Susan; Marcy, Patricia; Kane, John M

    2017-09-01

    This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

  3. Cognitive Architectures and Autonomy: A Comparative Review

    Science.gov (United States)

    Thórisson, Kristinn; Helgasson, Helgi

    2012-05-01

    One of the original goals of artificial intelligence (AI) research was to create machines with very general cognitive capabilities and a relatively high level of autonomy. It has taken the field longer than many had expected to achieve even a fraction of this goal; the community has focused on building specific, targeted cognitive processes in isolation, and as of yet no system exists that integrates a broad range of capabilities or presents a general solution to autonomous acquisition of a large set of skills. Among the reasons for this are the highly limited machine learning and adaptation techniques available, and the inherent complexity of integrating numerous cognitive and learning capabilities in a coherent architecture. In this paper we review selected systems and architectures built expressly to address integrated skills. We highlight principles and features of these systems that seem promising for creating generally intelligent systems with some level of autonomy, and discuss them in the context of the development of future cognitive architectures. Autonomy is a key property for any system to be considered generally intelligent, in our view; we use this concept as an organizing principle for comparing the reviewed systems. Features that remain largely unaddressed in present research, but seem nevertheless necessary for such efforts to succeed, are also discussed.

  4. Autonomy and exclusion among Danish prisoners in education

    DEFF Research Database (Denmark)

    Riis, Anita Holm

    2018-01-01

    A prison sentence necessarily means that the person receiving the sentence is in essential ways excluded from the surrounding society. This exclusion means fewer choices and, in the long run, this may affect the person’s ability to actively make choices – therefore, autonomy is an important theme...... choices as well as a high degree of autonomy on the part of the individual inmate. This article focuses on the interplay between exclusion and autonomy in relation to Danish prison inmates who are in education. Alongside this, a more general insight into the educational life of Danish prisoners...

  5. Health equality, social justice and the poverty of autonomy.

    Science.gov (United States)

    Newdick, Christopher

    2017-10-01

    How does the concept of autonomy assist public responses to 'lifestyle' diseases? Autonomy is fundamental to bioethics, but its emphasis on self-determination and individuality hardly supports public health policies to eat and drink less and take more exercise. Autonomy rejects a 'nanny' state. Yet, the cost of non-communicable diseases is increasing to individuals personally and to public health systems generally. Health care systems are under mounting and unsustainable pressure. What is the proper responsibility of individuals, governments and corporate interests working within a global trading environment? When public health care resources are unlikely to increase, we cannot afford to be so diffident to the cost of avoidable diseases.

  6. Characterizing the Relationship Between Surgical Resident and Faculty Perceptions of Autonomy in the Operating Room.

    Science.gov (United States)

    Young, Katelyn A; Lane, Samantha M; Widger, John E; Neuhaus, Nina M; Dove, James T; Fluck, Marcus; Hunsinger, Marie A; Blansfield, Joseph A; Shabahang, Mohsen M

    Characterize the concordance among faculty and resident perceptions of surgical case complexity, resident technical performance, and autonomy in a diverse sample of general surgery procedures using case-specific evaluations. A prospective study was conducted in which a faculty surgeon and surgical resident independently completed a postoperative assessment examining case complexity, resident operative performance (Milestone assessment) and autonomy (Zwisch model). Pearson correlation coefficients (r) reaching statistical significance (p autonomy demonstrated a moderate correlation (r = 0.56, p autonomy and operative performance, respectively. General surgery residents generally demonstrated high correlations with faculty perceptions of case complexity, technical performance, and operative autonomy. This generalized accord supports the use of the Milestone and Zwisch assessments in residency programs. However, discordance among perceptions of midlevel resident autonomy and chief resident operative performance suggests that these trainees may need more direct communication from the faculty. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  7. High Flow Nasal Cannula Oxygen Therapy can be used safely in the general paediatric ward using Paediatric Early Warning Scores

    NARCIS (Netherlands)

    Morsing, IE; Tinnevelt, Marcel; Jansen, Nicolaas J.G.; Koomen, E

    2015-01-01

    High Flow Nasal Cannula oxygen therapy (HFNC) is nowadays widely used at paediatric intensive care units (PICU) to provide a safe and comfortable (warm and humidified) oxygen delivery in children with respiratory distress. At general paediatric wards HFNC is hardly used because intensive observation

  8. Polygenic scores for schizophrenia and educational attainment are associated with behavioural problems in early childhood in the general population

    NARCIS (Netherlands)

    Jansen, Philip R; Polderman, Tinca J C; Bolhuis, Koen; van der Ende, Jan; Jaddoe, Vincent W V; Verhulst, Frank C; White, Tonya; Posthuma, Danielle; Tiemeier, Henning

    BACKGROUND: Genome-wide association studies in adults have identified numerous genetic variants related to psychiatric disorders and related traits, such as schizophrenia and educational attainment. However, the effects of these genetic variants on behaviour in the general population remain to be

  9. Autonomy, Automation, and Systems

    Science.gov (United States)

    Turner, Philip R.

    1987-02-01

    Aerospace industry interest in autonomy and automation, given fresh impetus by the national goal of establishing a Space Station, is becoming a major item of research and technology development. The promise of new technology arising from research in Artificial Intelligence (AI) has focused much attention on its potential in autonomy and automation. These technologies can improve performance in autonomous control functions that involve planning, scheduling, and fault diagnosis of complex systems. There are, however, many aspects of system and subsystem design in an autonomous system that impact AI applications, but do not directly involve AI technology. Development of a system control architecture, establishment of an operating system within the design, providing command and sensory data collection features appropriate to automated operation, and the use of design analysis tools to support system engineering are specific examples of major design issues. Aspects such as these must also receive attention and technology development support if we are to implement complex autonomous systems within the realistic limitations of mass, power, cost, and available flight-qualified technology that are all-important to a flight project.

  10. LEARNER AUTONOMY IN THE INDONESIAN EFL SETTINGS

    Directory of Open Access Journals (Sweden)

    Nenden Sri Lengkanawati

    2017-01-01

    Full Text Available Learner autonomy in Indonesian educational institutions has not commonly been listed as a teaching-learning objective, and most teachers seem to be hardly acquainted with learner autonomy (LA.  Therefore, it is very essential  to conduct a study of LA as perceived and experienced by school teachers and to find out the importance of LA training for professional development. A questionnaire was used to collect the data about English teachers’ perceptions regarding LA and LA-based practices. In addition, an LA training was conducted to see its significance for professional development.  After the data were qualitatively and quantitatively analyzed, it was found that the participating teachers tended to maintain that autonomy should be inculcated among learners, and that the LA concept should not be misinterpreted as learning without a teacher. Concerning choices and decisions by  the learners, it was believed that learners’ making choices about how they learned and what activities they did, and involving them to decide what and how to learn could promote autonomy among learners. As regards LA-based teaching-learning practices, it was revealed that most teachers desired to implement LA principles in their teaching-learning contexts, although they identified that many of the LA principles were not that feasible to apply in their situation. It was also found that LA training could improve the teachers’ perceptions regarding LA concepts and principles. There were some constraints which could make learner autonomy difficult to develop among Indonesian learners in general: limited time allotted for the implementation of the curriculum, learners’ lack of autonomous learning experience, too much focus on national examinations, and insufficient proficiency of English.  LA-based teaching-learning practices were most desired; however, many were considered as having insufficient feasibility. In this respect, commitment is certainly the key to

  11. Compulsory autonomy-promoting education

    NARCIS (Netherlands)

    A. Schinkel (Anders)

    2010-01-01

    textabstractToday, many liberal philosophers of education worry that certain kinds of education may frustrate the development of personal autonomy, with negative consequences for the individuals concerned, the liberal state, or both. Autonomy liberals hold not only that we should promote the

  12. Autonomy, Vulnerability, Recognition, and Justice

    NARCIS (Netherlands)

    Anderson, J.H.; Honneth, A.

    2005-01-01

    One of liberalism’s core commitments is to safeguarding individuals’ autonomy. And a central aspect of liberal social justice is the commitment to protecting the vulnerable. Taken together, and combined with an understanding of autonomy as an acquired set of capacities to lead one’s own life,

  13. Personal Autonomy and Rational Suicide.

    Science.gov (United States)

    Webber, May A.; Shulman, Ernest

    That certain suicides (which can be designated as rational) ought not to be interfered with is closely tied to the notion of the "right to autonomy." Specifically it is because the individual in question has this right that interference is prohibited. A proper understanding of the right to autonomy, while essential to understanding why…

  14. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter-re...

  15. The Principalship, Autonomy, and After

    Science.gov (United States)

    Eacott, Scott

    2015-01-01

    Contemporary discourses in educational administration have exponentially grown the number of adjectival leaderships, challenged traditional organisational structures, and offered autonomy as a solution to performance issues. In this theoretical paper, I ask "what does the principalship look like after autonomy?" Despite the range of…

  16. Teacher Autonomy: Power or Control?

    Science.gov (United States)

    Lawson, Tony

    2004-01-01

    The article explores the issue of teacher autonomy in relation to its potential for freedom or control. It examines the concept of empowerment as applied to education, arguing that, although it is traditionally cast as a means of achieving autonomy, an alternative approach sees empowerment as part of the disciplinary apparatus of late modern…

  17. Authenticity and autonomy in deep-brain stimulation.

    Science.gov (United States)

    Wardrope, Alistair

    2014-08-01

    Felicitas Kraemer draws on the experiences of patients undergoing deep-brain stimulation (DBS) to propose two distinct and potentially conflicting principles of respect: for an individual's autonomy (interpreted as mental competence), and for their authenticity. I argue instead that, according to commonly-invoked justifications of respect for autonomy, authenticity is itself in part constitutive of an analysis of autonomy worthy of respect; Kraemer's argument thus highlights the shortcomings of practical applications of respect for autonomy that emphasise competence while neglecting other important dimensions of autonomy such as authenticity, since it shows that competence alone cannot be interpreted as a reliable indicator of an individual's capacity for exercising autonomy. I draw from relational accounts to suggest how respect for a more expansive conception of autonomy might be interpreted for individuals undergoing DBS and in general. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  18. The More, the Better? Curvilinear Effects of Job Autonomy on Well-Being From Vitamin Model and PE-Fit Theory Perspectives.

    Science.gov (United States)

    Stiglbauer, Barbara; Kovacs, Carrie

    2017-12-28

    In organizational psychology research, autonomy is generally seen as a job resource with a monotone positive relationship with desired occupational outcomes such as well-being. However, both Warr's vitamin model and person-environment (PE) fit theory suggest that negative outcomes may result from excesses of some job resources, including autonomy. Thus, the current studies used survey methodology to explore cross-sectional relationships between environmental autonomy, person-environment autonomy (mis)fit, and well-being. We found that autonomy and autonomy (mis)fit explained between 6% and 22% of variance in well-being, depending on type of autonomy (scheduling, method, or decision-making) and type of (mis)fit operationalization (atomistic operationalization through the separate assessment of actual and ideal autonomy levels vs. molecular operationalization through the direct assessment of perceived autonomy (mis)fit). Autonomy (mis)fit (PE-fit perspective) explained more unique variance in well-being than environmental autonomy itself (vitamin model perspective). Detrimental effects of autonomy excess on well-being were most evident for method autonomy and least consistent for decision-making autonomy. We argue that too-much-of-a-good-thing effects of job autonomy on well-being exist, but suggest that these may be dependent upon sample characteristics (range of autonomy levels), type of operationalization (molecular vs. atomistic fit), autonomy facet (method, scheduling, or decision-making), as well as individual and organizational moderators. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  19. Intention, autonomy, and brain events.

    Science.gov (United States)

    Gillett, Grant

    2009-07-01

    Informed consent is the practical expression of the doctrine of autonomy. But the very idea of autonomy and conscious free choice is undercut by the view that human beings react as their unconscious brain centres dictate, depending on factors that may or may not be under rational control and reflection. This worry is, however, based on a faulty model of human autonomy and consciousness and needs close neurophilosophical scrutiny. A critique of the ethics implied by the model takes us towards a 'care of the self' view of autonomy and the subject's attunement to the truth as the crux of reasoning rather than the inner mental/neural state views of autonomy and human choice on offer at present.

  20. The Challenge of University Autonomy

    DEFF Research Database (Denmark)

    Reilly, John; Turcan, Romeo V.; Bugaian, Larisa

    2016-01-01

    The authors introduce the reader to the book, providing a historical perspective and a current understanding of university autonomy. While appreciating the central role of the four dimensions of university autonomy – organisational, financial, human resource, and academic – the authors conjecture...... that a fuller understanding of university autonomy can only be obtained through a holistic view of the complex inter-relationships between stakeholders and policies which can reinforce and, equally, pull in opposite directions. This holistic view is represented in a model of institutional university autonomy......, which is discussed at length in the chapter. The authors conclude by presenting international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are genuinely global....

  1. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

    This book challenges traditional approach to university autonomy which is based on four pillars: organisational, financial, human resource, and academic. The main thesis is that a fuller understanding of university autonomy can only be obtained through a more holistic view of the complex inter......-relationships between stakeholders and policies which can reinforce and equally pull in opposite directions. The holistic view is expressed in a model of institutional university autonomy that brings together the traditional basic four pillars of autonomy, and five interfaces: government–university; university......–university staff; academic staff–students; university–business; and university–internationalisation. This model is explored through international case studies that give new insights and reinforce our understanding that the issues relating to institutional university autonomy are complex, interactive and genuinely...

  2. Collectivists' contingency and autonomy as predictors of buffet preferences among Taiwanese adolescents.

    Science.gov (United States)

    Chiou, Wen-Bin

    2006-01-01

    In a culture or society with high collectivism, contingent orientation and constrained autonomy are the prominent characteristics of adolescents' self-construal. This article examined whether Taiwanese adolescents' contingency and autonomy were associated with their prevalent preferences for buffet consumption. Findings in a panel survey indicated that contingency was positively correlated with adolescents' buffet preference, whereas autonomy was negatively correlated. Moreover, the results showed that adolescents' contingent orientation and perceived autonomy could predict their subsequent buffet preference over a half-year period. A laboratory experiment showed that adolescents who perceived lower autonomy exhibited greater preferences for buffet over the other diet consumption. In general, the results suggest that collectivist adolescents' contingency and autonomy were related to their trait-like preferences for buffet, and the state-like preferences for buffet were affected by their perceived levels of autonomy. Findings provide further insights into the impact of adolescents' self-construal on their diet consumption.

  3. [Impact analysis of shuxuetong injection on abnormal changes of ALT based on generalized boosted models propensity score weighting].

    Science.gov (United States)

    Yang, Wei; Yi, Dan-Hui; Xie, Yan-Ming; Yang, Wei; Dai, Yi; Zhi, Ying-Jie; Zhuang, Yan; Yang, Hu

    2013-09-01

    To estimate treatment effects of Shuxuetong injection on abnormal changes on ALT index, that is, to explore whether the Shuxuetong injection harms liver function in clinical settings and to provide clinical guidance for its safe application. Clinical information of traditional Chinese medicine (TCM) injections is gathered from hospital information system (HIS) of eighteen general hospitals. This is a retrospective cohort study, using abnormal changes in ALT index as an outcome. A large number of confounding biases are taken into account through the generalized boosted models (GBM) and multiple logistic regression model (MLRM) to estimate the treatment effects of Shuxuetong injections on abnormal changes in ALT index and to explore possible influencing factors. The advantages and process of application of GBM has been demonstrated with examples which eliminate the biases from most confounding variables between groups. This serves to modify the estimation of treatment effects of Shuxuetong injection on ALT index making the results more reliable. Based on large scale clinical observational data from HIS database, significant effects of Shuxuetong injection on abnormal changes in ALT have not been found.

  4. Neuromodulation, agency and autonomy.

    Science.gov (United States)

    Glannon, Walter

    2014-01-01

    Neuromodulation consists in altering brain activity to restore mental and physical functions in individuals with neuropsychiatric disorders and brain and spinal cord injuries. This can be achieved by delivering electrical stimulation that excites or inhibits neural tissue, by using electrical signals in the brain to move computer cursors or robotic arms, or by displaying brain activity to subjects who regulate that activity by their own responses to it. As enabling prostheses, deep-brain stimulation and brain-computer interfaces (BCIs) are forms of extended embodiment that become integrated into the individual's conception of himself as an autonomous agent. In BCIs and neurofeedback, the success or failure of the techniques depends on the interaction between the learner and the trainer. The restoration of agency and autonomy through neuromodulation thus involves neurophysiological, psychological and social factors.

  5. Autonomy, Independence, Inclusion

    Directory of Open Access Journals (Sweden)

    Filippo Angelucci

    2015-04-01

    Full Text Available The living environment must not only meet the primary needs of living, but also the expectations of improvement of life and social relations and people’s work. The need for a living environment that responds to the needs of users with their different abilities, outside of standardizations, is increasingly felt as autonomy, independence and well-being are the result of real usability and adaptability of the spaces. The project to improve the inclusivity of living space and to promote the rehabilitation of fragile users need to be characterized as an interdisciplinary process in which the integration of specialized contributions leads to adaptive customization of space solutions and technological that evolve with the changing needs, functional capacities and abilities of individuals.

  6. Effects of women's autonomy on maternal healthcare utilization in Bangladesh: Evidence from a national survey.

    Science.gov (United States)

    Haider, Mohammad Rifat; Qureshi, Zaina P; Khan, M Mahmud

    2017-12-01

    This study aims to construct an index of women's autonomy to analyze its effect on maternal healthcare utilization in Bangladesh. Empirical modeling of the study used instrumental variable (IV) approach to correct for possible endogeneity of women's autonomy variable. Data from the Bangladesh Demographic and Health Survey (BDHS) 2011 was used for the study. Women's autonomy variable was obtained through factor analysis of variables related to autonomy in decision making regarding healthcare, financial autonomy and freedom of movement. Conditional mixed process (CMP) models were fitted for three maternal healthcare indicators: at least four antenatal care (ANC) by trained personnel, institutional delivery and postnatal care (PNC) by trained personnel. Study sample consisted of 8753 women with 5.5 mean years of schooling. Women with no formal education, of Islamic faith, from poorest wealth quintile, residing in rural areas and with low autonomy used the maternal healthcare least. Marginal effect shows that if women's autonomy score is increased by one unit, probability of maternal healthcare utilization will increase by 0.14 for ANC, 0.14 for institutional delivery, and 0.13 for PNC. Women's autonomy is an important driver of maternal healthcare utilization in Bangladesh. Results suggest that women participating in social and economic activities enhances their autonomy. Other factors affecting women's autonomy are female literacy, educational attainment and households' economic status. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. A Study of the Use of the "e-rater"® Scoring Engine for the Analytical Writing Measure of the "GRE"® revised General Test. Research Report. ETS RR-14-24

    Science.gov (United States)

    Breyer, F. Jay; Attali, Yigal; Williamson, David M.; Ridolfi-McCulla, Laura; Ramineni, Chaitanya; Duchnowski, Matthew; Harris, April

    2014-01-01

    In this research, we investigated the feasibility of implementing the "e-rater"® scoring engine as a check score in place of all-human scoring for the "Graduate Record Examinations"® ("GRE"®) revised General Test (rGRE) Analytical Writing measure. This report provides the scientific basis for the use of e-rater as a…

  8. Assessment of coronary calcification using calibrated mass score with two different multidetector computed tomography scanners in the Copenhagen General Population Study

    Energy Technology Data Exchange (ETDEWEB)

    Fuchs, Andreas [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Groen, Jaap M. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Department of Medical Physics, OLVG, Amsterdam (Netherlands); Arnold, Ben A. [Image Analysis, 1380 Burkesville Road, Columbia, KY (United States); Nikolovski, Sasho [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Knudsen, Andreas D., E-mail: dehlbaek@gmail.com [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Kühl, J. Tobias [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Nordestgaard, Børge G. [Department of Clinical Biochemistry and the Copenhagen General Population Study, Herlev Hospital, University of Copenhagen (Denmark); Greuter, Marcel J.W. [Department of Radiology, University of Groningen, University Medical Center Groningen (Netherlands); Kofoed, Klaus F. [Department of Cardiology, The Heart Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark); Department of Radiology, The Diagnostic Centre, Rigshospitalet, University of Copenhagen, Copenhagen (Denmark)

    2017-03-15

    Objective: Population studies have shown coronary calcium score to improve risk stratification in subjects suspected for cardiovascular disease. The aim of this work was to assess the validity of multidetector computed tomography (MDCT) for measurement of calibrated mass scores (MS) in a phantom study, and to investigate inter-scanner variability for MS and Agaston score (AS) recorded in a population study on two different high-end MDCT scanners. Materials and methods: A calcium phantom was scanned by a first (A) and second (B) generation 320-MDCT. MS was measured for each calcium deposit from repeated measurements in each scanner and compared to known physical phantom mass. Random samples of human subjects from the Copenhagen General Population Study were scanned with scanner A (N = 254) and scanner B (N = 253) where MS and AS distributions of these two groups were compared. Results: The mean total MS of the phantom was 32.9 ± 0.8 mg and 33.1 ± 0.9 mg (p = 0.43) assessed by scanner A and B respectively – the physical calcium mass was 34.0 mg. Correlation between measured MS and physical calcium mass was R{sup 2} = 0.99 in both scanners. In the population study the median total MS was 16.8 mg (interquartile range (IQR): 3.5–81.1) and 15.8 mg (IQR: 3.8–63.4) in scanner A and B (p = 0.88). The corresponding median total AS were 92 (IQR: 23–471) and 89 (IQR: 40–384) (p = 0.64). Conclusion: Calibrated calcium mass score may be assessed with very high accuracy in a calcium phantom by different generations of 320-MDCT scanners. In population studies, it appears acceptable to pool calcium scores acquired on different 320-MDCT scanners.

  9. The Discriminant Analysis: an Exploratory Study Concerning the Degree of Financial Autonomy of Companies in the Context of the Romanian Business Environment

    OpenAIRE

    Marinela Mironiuc; Mihaela Robu; Ion Robu

    2010-01-01

    This study aims at analyzing the evolution of financial autonomy on a sample of 80 companies quoted in the Bucharest Stock Exchange, between 2006-2008. Classically, financial autonomy is measured using the global and day-to-day rates of financial autonomy. However, this study has tested the dependency between the global rate of financial autonomy (Own Capital/ Total debts) and a series of economic and financial indicators, with the purpose of obtaining both a score function that would help ma...

  10. Longitudinal Associations of Autonomy, Relatedness, and Competence with the Well-being of Nursing Home Residents.

    Science.gov (United States)

    Kloos, Noortje; Trompetter, Hester R; Bohlmeijer, Ernst T; Westerhof, Gerben J

    2018-02-24

    As proposed by the self-determination theory, satisfying nursing home residents' needs for autonomy, relatedness, and competence may improve their well-being. This is the first study to test the longitudinal relations of the satisfaction of these three basic psychological needs to the subjective well-being of nursing home residents and to determine whether a balance among the satisfaction of the three needs is important for well-being. Participants in this longitudinal survey study included 128 physically frail residents (mean age 85 years) at four Dutch nursing homes. Satisfaction of the three basic psychological needs was measured at baseline, and depressive feelings and life satisfaction 5-8 months later. Absolute differences between the three basic need satisfaction scores were summed to create a score of need satisfaction balance. All three needs were related to both well-being measures over time, although autonomy had the strongest relationships. Only autonomy and competence were uniquely associated with depressive feelings, and only autonomy was uniquely associated with life satisfaction. The need satisfaction balance score was related to well-being independent of the autonomy and relatedness scores. These results confirm that all three basic psychological needs are important for nursing home residents' well-being, with autonomy having the strongest and most consistent relationship to their well-being. Additionally, high satisfaction of one need does not compensate for low satisfaction of another. Supporting residents' needs for autonomy, relatedness, and competence should, therefore, have a central role in nursing home culture-change interventions.

  11. Radioiodine therapy of thyroid autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Reiners, Christoph; Schneider, Peter [Clinic and Policlinic for Nuclear Medicine, University of Wuerzburg, Josef-Schneider-Strasse 2, 97080 Wuerzburg (Germany)

    2002-08-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. {sup 131}I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  12. Subsidiary Autonomy and Knowledge Transfer

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Wæhrens, Brian Vejrum

    2015-01-01

    Purpose: This paper explores the effect of subsidiary autonomy on knowledge transfers during captive R&D offshoring to emerging markets. Design/methodology/approach: A framework to this end is developed and illustrated in relation to four cases of captive R&D offshoring to emerging markets....... Findings: Subsidiary autonomy has a mainly negative effect on primary knowledge transfer and a mainly positive effect on reverse knowledge transfer. Newly established R&D subsidiaries in emerging markets need primary knowledge transfer in order to build up their competence before they can add...... to the knowledge level of the MNE. Originality: A dual role of subsidiary autonomy is identified. Gradual increase in R&D subsidiary autonomy is beneficial for subsidiary innovation performance....

  13. Radioiodine therapy of thyroid autonomy

    International Nuclear Information System (INIS)

    Reiners, Christoph; Schneider, Peter

    2002-01-01

    Over half a century, treatment of thyroid autonomy with an oral dose of iodine-131 has proven to be effective. The optimum management strategy for the patient is, however, still a matter of debate. The article provides an overview of the pathogenesis of functional autonomy and its clinical relevance. According to the guidelines on both sides of the Atlantic, radioiodine treatment is considered the most comfortable and economical approach to the treatment of the toxic nodular goitre. Some differences in the preparation procedures in the guidelines of the American and the German Society of Nuclear Medicine are discussed with respect to therapy results and the subtypes of thyroid autonomy. The results of studies are summarised concerning changes in thyroid function and thyroid volume after a course of radioiodine treatment. Therapy-related risks, such as immunogenic hypothyroidism or thyroid cancer, are discussed. 131 I treatment of functional autonomy and hyperthyroidism is considered an effective and safe procedure. (orig.)

  14. Intramitochondrial autonomy in rat tissues

    International Nuclear Information System (INIS)

    Subramanian, M.; Rajwade, M.S.; Satav, J.G.; Katyare, S.S.; Fatterpaker, P.; Sreenivasan, A.

    1974-01-01

    The biogenesis of mitochondria in rat liver and their protein turnover has been investigated using 1- 14 C leucine. The results indicate that intramitochondrial autonomy exists both with respect to their genesis and turnover. (M.G.B.)

  15. Institutional Financial Autonomy in Practice

    DEFF Research Database (Denmark)

    Szwebs, Witold

    2016-01-01

    The article reveals how university autonomy may in practice prove to be restrictive for units within the university. The need to implement and interpret external regulations and protect the institution may, argued in the paper, lead to a risk averse, conservative approach which is experienced...... by departments as bureaucratic and hampering effective research. Thus autonomy has produced new internal tensions between the central management/administration and the departments which it is argued is counter-productive and not beneficial for research and could be seen as a perverse aspect of greater autonomy....... Indeed because university policy and ‘interference’ is much closer to the researcher than in former less autonomous times and the university may now exercise other direct incentives through resource allocation, promotion and salary enhancement, the department and the individual may view autonomy...

  16. The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups.

    Science.gov (United States)

    Little, Matthew H R; Reitmeir, Peter; Peters, Annette; Leidl, Reiner

    2014-06-01

    Health states can be valued by those who currently experience a health state (experienced health states [EHS]) or by the general public, who value a set of given health states (GHS) described to them. There has been debate over which method is more appropriate when making resource allocation decisions. This article informs this debate by assessing whether differences between these methods have an effect on the mean EQ-5D-3L tariff scores of different patient groups. The European tariff based on GHS valuations was compared with a German EHS tariff. Comparison was made in the context of EQ-5D-3L health states describing a number of diagnosed chronic diseases (stroke, diabetes, myocardial infarction, and cancer) taken from the Cooperative Health Research in the Augsburg Region population surveys. Comparison was made of both the difference in weighting of the dimensions of the EQ-5D-3L and differences in mean tariff scores for patient groups. Weighting of the dimensions of the EQ-5D-3L were found to be systematically different. The EHS tariff gave significantly lower mean scores for most, but not all, patient groups despite tariff scores being lower for 213 of 243 EQ-5D-3L health states using the GHS tariff. Differences were found to vary between groups, with the largest change in difference being 5.45 in the multiple stoke group. The two tariffs have systematic differences that in certain patient groups could drive the results of an economic evaluation. Therefore, the choice as to which is used may be critical when making resource allocation decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  17. Learning for autonomy

    Science.gov (United States)

    Rivero, Jose

    1989-12-01

    There is a need for a new concept of post-literacy which goes beyond the learning of codes. The target population is defined on the basis of their need to be given the capacity to take decisions on essential economic, civic, political and day-to-day aspects of their lives. The main arena of post-literacy lies in the countries of the Third World, where the economic crisis has serious effects on the quality of life and impairs the motivation to learn. Particular reference is made to the concept of participation and to the ability to determine four types of basic educational need: fundamental needs, productivity needs, social service needs and community organization needs. Four Latin American programmes linked to these four types of need are presented and discussed in terms of their particular features: popular participation in decision making; the search for methods and techniques which give the population a certain degree of autonomy; and respect for the cultures and world visions of the communities in the conduct of post-literacy, educational innovation and other activities. The programmes are: post-literacy in Nicaragua (fundamental education needs); research on post-literacy and employment in 13 countries (productivity needs); the CIPCA project for peasants in Piura, on the northern coast of Peru (social service needs); and the `Talking Maps' project developed with the Paez community in Cauca, Colombia (community organization needs).

  18. Autonomy among physically frail older people in nursing home settings

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

    BACKGROUND: Experiencing autonomy is recognised to promote health and well-being for all age groups. Perceived lack of control has been found to be detrimental to physical and mental health. There is a lack of evidence-based knowledge elucidating how frail older people in nursing home settings...... participants aged 65 years or older were included in the study. All the participants were restricted in performing at least one P-ADL activity unassisted and had a Mini Mental State Examination-score above 16. Perceived autonomy was measured at baseline, after 12 weeks and after 24 weeks by The Autonomy Sub......-dimension in the Measure of Actualisation of Potential test. Programmes were based on participants' individual assessment of their most important daily activities. Staff at all nursing homes who usually organize physical training, social or creative activities carried out individually tailored programmes using their usual...

  19. Association between women's autonomy and family planning outcome in couples residing in Isfahan

    Science.gov (United States)

    Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

    2014-01-01

    Background: One of the important factors in the prediction of family planning outcome is paying attention to women's role in decision making concerning fertility and household affairs. With the improvement of women's status and autonomy, their control over fertility is expected to increase. The present study aimed to investigate the association between women's autonomy and family planning outcome of the couples residing in Isfahan. Materials and Methods: This is cross-sectional study. Two hundred and seventy women of childbearing age, eligible for family planning and residing in Isfahan, were selected through random cluster sampling and they filled a researcher-made questionnaire. Women's autonomy was measured with the questions on their decision-making autonomy concerning household affairs and physical mobility autonomy. The association between women's autonomy and family planning outcome was analyzed through statistical methods. Results: The results showed that the mean of women's decision-making, physical mobility, and general autonomy was 50. Women's autonomy had a direct significant association with the type of contraception method (P = 0.01) and the length of usage of their present contraception method (P = 0.04) as well as where they received family planning services (P = 0.02). Conclusions: Analysis of data revealed women with higher autonomy used a more efficient contraception method and continued their contraception method for a longer time, which leads to improvement of couples’ family planning outcome. Therefore, family planning services should be planned and provided with women's autonomy under consideration. PMID:25400671

  20. Planned change or emergent change implementation approach and nurses' professional clinical autonomy.

    Science.gov (United States)

    Luiking, Marie-Louise; Aarts, Leon; Bras, Leo; Grypdonck, Maria; van Linge, Roland

    2017-11-01

    Nurses' clinical autonomy is considered important for patients' outcome and influenced by the implementation approach of innovations. Emergent change approach with participation in the implementation process is thought to increase clinical autonomy. Planned change approach without this participation is thought not to increase clinical autonomy. Evidence of these effects on clinical autonomy is however limited. To examine the changes in clinical autonomy and in personal norms and values for a planned change and emergent change implementation of an innovation, e.g. intensive insulin therapy. Prospective comparative study with two geographically separated nurses' teams on one intensive care unit (ICU), randomly assigned to the experimental conditions. Data were collected from March 2008 to January 2009. Pre-existing differences in perception of team and innovation characteristics were excluded using instruments based on the innovation contingency model. The Nursing Activity Scale was used to measure clinical autonomy. The Personal Values and Norms instrument was used to assess orientation towards nursing activities and the Team Learning Processes instrument to assess learning as a team. Pre-implementation the measurements did not differ. Post-implementation, clinical autonomy was increased in the emergent change team and decreased in the planned change team. The Personal Values and Norms instrument showed in the emergent change team a decreased hierarchic score and increased developmental and rational scores. In the planned change team the hierarchical and group scores were increased. Learning as a team did not differ between the teams. In both teams there was a change in clinical autonomy and orientation towards nursing activities, in line with the experimental conditions. Emergent change implementation resulted in more clinical autonomy than planned change implementation. If an innovation requires the nurses to make their own clinical decisions, an emergent change

  1. Women's Autonomy and Its Correlates in Western Nepal: A Demographic Study.

    Science.gov (United States)

    Bhandari, Tulsi Ram; Kutty, V Raman; Ravindran, T K Sundari

    2016-01-01

    Despite various efforts for enhancing women's autonomy in developing countries, many women are deprived of their capacity in decision-making on their household affairs as well as social issues. This paper aimed to examine women's autonomy and its associated factors in the Kapilvastu district of Nepal. We measured women's autonomy using a recently developed women's autonomy measurement scale from June to October 2014. Descriptive statistics, chi-square test and logistic multivariate modeling technique were applied for assessing the association of demographic and socio-economic characteristics of women and their autonomy. Mean score for women's autonomy was 23.34 ± 8.06 out of the possible maximum 48. It was found to be positively associated with higher age difference at marriage, advantaged caste/ethnicity, better employment for the husband, couple's education more than 10 years schooling, and higher economic status of the household. We found strong direct effect of women's education (OR = 8.14, CI = 3.77-17.57), husband's education (OR = 2.63, CI = 1.69-4.10) and economic status of household (OR = 1.42, CI = 1.01-2.03) on women's autonomy. When we adjusted women's education for husband's education, the odds ratio decreased by around 22% {from (OR = 8.14, CI = 3.77-17.57) to (OR = 6.32, CI = 2.77-14.46)} and was a mediator effect. The economic status of household also had mediator effect on women's autonomy through their education. Education status of women is a key predictor of women's autonomy in Kapilvastu district. Husband's education and economic status of the household are other important predictors of women's autonomy which have a mediator effect on women's autonomy. Improving educational status and economic conditions of both women and their husbands may be the best solution to promote women's autonomy.

  2. Body Condition Scores and Evaluation of Feeding Habits of Dogs and Cats at a Low Cost Veterinary Clinic and a General Practice

    Directory of Open Access Journals (Sweden)

    Stephanie A. Sapowicz

    2016-01-01

    Full Text Available This study assessed body condition scores (BCS and feeding habits for dogs and cats. Eighty-six cats and 229 dogs (and their owners were enrolled from 2 clinics: a low cost clinic (n=149 and a general practice (n=166. BCS and body weight were recorded. Owners completed a survey which included animal age, sex, and breed; owner demographics; and feeding practices (e.g., diet, rationale for feeding practices. Owners from the low cost clinic had a significantly lower income (P<0.001 and education (P<0.001 compared to those from the general practice. Animals from the low cost clinic were younger (P<0.001 and dogs were less likely to be neutered (P<0.001. Overweight prevalence was 55% overall (P=0.083, with a significantly higher prevalence in the general practice for cats (44% versus 66%; P=0.046, but not for dogs (58% versus 53%; P=0.230. Multivariate analysis showed that only neuter status was significantly associated with BCS (P=0.004. Veterinarians were the most common source of nutritional information, though lack of accurate nutrition knowledge was common among all participants. These findings support the need for enhanced communication about optimal BCS and nutrition regardless of socioeconomic status.

  3. THE CHALLENGE OF AUTONOMY: AN EMPIRICAL STUDY OF THE VARIOUS DIMENSIONS OF AUTONOMY

    OpenAIRE

    Cristi IFTENE

    2009-01-01

    There are various dimensions of autonomy (policy, financial, structural, personnel, legal, institutional) as different scholars demonstrated (Christensen 2001, Verhoest et. al. 2004). In the present paper we will focus only on political and financial autonomy. As Yesilkagit and van Thiel demonstrated there is a difference between formal and de facto autonomy. They found that formal autonomy does not reinforce de facto autonomy and that organizations with less autonomy report higher levels of ...

  4. A Social Recognition Approach to Autonomy: The Role of Equality-Based Respect.

    Science.gov (United States)

    Renger, Daniela; Renger, Sophus; Miché, Marcel; Simon, Bernd

    2017-04-01

    Inspired by philosophical reasoning about the connection between equality and freedom, we examined whether experiences of (equality-based) respect increase perceived autonomy. This link was tested with generalized experiences of respect and autonomy people make in their daily lives (Study 1) and with more specific experiences of employees at the workplace (Study 2). In both studies, respect strongly and independently contributed to perceived autonomy over and above other forms of social recognition (need-based care and achievement-based social esteem) and further affected (life/work) satisfaction. Study 3 experimentally confirmed the hypothesized causal influence of respect on perceived autonomy and demonstrated that this effect further translates into social cooperation. The respect-cooperation link was simultaneously mediated by perceived autonomy and superordinate collective identification. We discuss how the recognition approach, which differentiates between respect, care, and social esteem, can enrich research on autonomy.

  5. Relations among Grade 4 Students' Perceptions of Autonomy, Engagement in Science, and Reading Motivation

    Science.gov (United States)

    Taboada Barber, Ana; Buehl, Michelle M.

    2013-01-01

    The authors extend previous work on students' perceptions of teachers' autonomy-enhancing and autonomy-suppressing behaviors in relation to students' engagement to a more situated context (i.e., two Grade 4 science instructional conditions instead of school in general) and a linguistically diverse population (i.e., Hispanic students). They also…

  6. Models, controls, and levels of semiotic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Joslyn, C.

    1998-12-01

    In this paper the authors consider forms of autonomy, forms of semiotic systems, and any necessary relations among them. Levels of autonomy are identified as levels of system identity, from adiabatic closure to disintegration. Forms of autonomy or closure in systems are also recognized, including physical, dynamical, functional, and semiotic. Models and controls are canonical linear and circular (closed) semiotic relations respectively. They conclude that only at higher levels of autonomy do semiotic properties become necessary. In particular, all control systems display at least a minimal degree of semiotic autonomy; and all systems with sufficiently interesting functional autonomy are semiotically related to their environments.

  7. The Ideal of Moral Autonomy

    Directory of Open Access Journals (Sweden)

    Ricardo Marquisio Aguirre

    2017-10-01

    Full Text Available Some elements of the ideal of moral autonomy are discussed in this paper. Such ideal is a key assumption in social practices focused on normative imputation, particularly morality and law. First, a constructivist conception of normativity is introduced, taking reasons as an essential and non-reducible element, and focused on the conceptual features of moral reasons within the normative domain. Then, an idea of moral autonomy based on the self-constitution is developed including three key features: the possibility of responding to reasons based on shared social expectations; the responsibility for certain scope of actions, according to a set of reasons available to the individual and to their maximum extent of expansion; and the need to preserve autonomy as a purpose unifying the set of autonomous actions of moral agents.

  8. Mental health as rational autonomy.

    Science.gov (United States)

    Edwards, R B

    1981-08-01

    Rather than eliminate the terms "mental health and illness" because of the grave moral consequences of psychiatric labeling, conservative definitions are proposed and defended. Mental health is rational autonomy, and mental illness is the sustained loss of such. Key terms are explained, advantages are explored, and alternative concepts are criticized. The value and descriptive components of all such definitions are consciously acknowledged. Where rational autonomy is intact, mental hospitals and psychotherapists should not think of themselves as treating an illness. Instead, they are functioning as applied axiologists, moral educators, spiritual mentors, etc. They deal with what Szasz has called "personal, social, and ethical problems in living." But mental illness is real.

  9. Effect of Job Autonomy Upon Organizational Commitment of Employees at Different Hierarchical Level

    Directory of Open Access Journals (Sweden)

    Shalini Sisodia

    2013-10-01

    Full Text Available The main aim of the present study was to examine the effect of job autonomy upon organizational commitment of employees at different hierarchical level. A study was made on randomly selected 100 male employees who work in different organizations in Agra, who were administered Organizational Commitment Scale (by Allen & Meyer, 1990 and Job Autonomy Scale (by Das, Arora, & Singhal, 2000. On the basis of median of the job autonomy scores, the sample was divided into two groups (1 high job autonomy group and (2 low job autonomy group and on the basis of hierarchical level, the employees were divided into two groups (1 50 high hierarchical level employees’ including managers, etc. and (2 50 low hierarchical level employees, e.g. clerical staff, etc. The 2x2 factorial design was formed for this purpose and four groups of employees were formed (1 high hierarchy, high autonomy group (2 high hierarchy, low autonomy group(3 low hierarchy, high autonomy group and (4 low hierarchy, low autonomy group. A two-way analysis of variance was employed to compare the level of organizational commitment of each of the four groups. There is a significant difference found between job commitment of employees with high and low job autonomy (F = 4.670, p < .05. There is a significant difference found between job commitment of employees of high hierarchical group and those of low hierarchical group (F = 40.691, p < .01 and significant interaction effect found between job autonomy and hierarchical level upon organizational commitment of employees (F = 6.114, p < .05.

  10. Female autonomy as a contributing factor to women's HIV-related knowledge and behaviour in three culturally contrasting States in India.

    Science.gov (United States)

    Bloom, Shelah S; Griffiths, Paula L

    2007-07-01

    Factors contributing to India's vulnerability to the AIDS epidemic include pervasive poverty, low levels of education and high gender stratification. This study uses data collected in the 1998-99 National Family Health Survey-2 (NFHS-2) to investigate the relationship between aspects of women's autonomy and four measures of HIV-related knowledge and behaviour--awareness and knowledge of HIV/AIDS, condom awareness and condom use--in three culturally contrasting states in India: Kerala (n=2884), Karnataka (n=4357) and Uttar Pradesh (n=8981). The NFHS-2 is a nationally representative survey of India, with a sampling scheme that was designed such that each state sample can be generalized back to represent ever-married women aged 15-49 living in the state. Kerala scores highest in the four health outcome measures, followed by Karnataka and then Uttar Pradesh, but condom use is lowest in Karnataka. Kerala also leads in the four dimensions of autonomy examined and in socio-demographic status, followed again by Karnataka and Uttar Pradesh. Despite these observed differences, in all three states, women with greater autonomy as measured by this study were more likely to be knowledgeable about AIDS and condoms and to use condoms, after controlling for socio-demographic factors. These results concur with other studies focusing on women's autonomy and health outcomes around the world, and point to the importance of incorporating a gender-based approach to AIDS prevention programmes in India.

  11. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    OpenAIRE

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

    2016-01-01

    [Background]Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item th...

  12. The ADEPT Framework for Intelligent Autonomy

    National Research Council Canada - National Science Library

    Ricard, Michael; Kolitz, Stephan

    2003-01-01

    ...) architecture for intelligent autonomy. Intelligent autonomy is the ability to plan and execute complex activities in a manner that provides rapid, effective response to stochastic and dynamic mission events...

  13. Professional autonomy and job satisfaction: survey of critical care nurses in mainland Greece.

    Science.gov (United States)

    Iliopoulou, Katerina K; While, Alison E

    2010-11-01

    This paper is a report of a study conducted to describe Greek critical care nurses' views on professional autonomy and its relationship with job satisfaction and other work-related variables. Professional autonomy is generally considered a highly desirable nursing attribute and a major factor in nurse job satisfaction. In the critical care environment, a high level of accountability, responsibility and autonomy are required to optimize outcomes of critically unstable patients. A questionnaire survey was conducted with a convenience sample of Greek critical care nurses (n = 431; response rate 70%) in 2007. Data were collected on professional autonomy, job satisfaction, role conflict and role ambiguity. Overall, nurses reported acting moderately autonomously. Younger nurses reported statistically significant lower levels of autonomy. Higher levels of autonomy were reported by female nurses. Multiple logistic regression revealed that appointment level, type of critical care unit and registration with a professional organization were independently associated with autonomy. A positive moderate association was found between reported autonomy, job satisfaction, role conflict and role ambiguity, but there was no relationship between job satisfaction and reported role conflict and role ambiguity. Further education, role enhancement and support are required for nurses working in critical care in Greece if they are to achieve the maximum potential of their professional role. Failure to address the perceptions of professional autonomy may have an impact on staff retention, because of job dissatisfaction. © 2010 Blackwell Publishing Ltd.

  14. Trajectories of autonomy development across the adolescent transition in children with spina bifida.

    Science.gov (United States)

    Friedman, Deborah; Holmbeck, Grayson N; DeLucia, Christian; Jandasek, Barbara; Zebracki, Kathy

    2009-02-01

    The current study investigated individual growth in autonomy development across the adolescent transition, comparing the trajectories of children with and without spina bifida. Individual growth curve modeling procedures were utilized to describe the developmental course of autonomy across four waves of data collection, from ages 9 to 15, and to test whether illness status [spina bifida vs. matched comparison group (N = 68 for both groups at Time 1)] would significantly predict individual variability in autonomy development. Potential moderators [child gender, SES, and Peabody Picture Vocabulary Test (PPVT) score] of the association between illness status and autonomy development were also examined. Children with spina bifida demonstrated distinct developmental trajectories, though the nature of the group differences varied by type of autonomy development (emotional vs. behavioral), context (i.e. school vs. family), and reporter. Significant interactions with PPVT score and child gender were found. Overall, children with spina bifida show considerable developmental resiliency, but may lag behind their peers in specific areas of autonomy. Boys with spina bifida, and children with spina bifida who have lower than average levels of verbal intelligence, appear to be at greater risk for exhibiting delays in autonomy development.

  15. The autonomy of religions from the state: the normative framework

    OpenAIRE

    Carp, Radu

    2010-01-01

    The principle of the autonomy of religious cults from the state is found in many of the Constitutions of European states and it has also been asserted by ECHR. In the case of Romania, this principle was noted for the first time by the 1869 Organic Statute of the Romanian Greek Orthodox Church of Hungary and Transylvania. This was not the case after 1918 when the term autonomy cannot be found in the 1923 Constitution, the 1928 Law on the general regime of religions or in the 1925 Statute of th...

  16. Full autonomy; Autarkie im Komplettpaket

    Energy Technology Data Exchange (ETDEWEB)

    Augsten, Eva

    2011-05-31

    Normally, those who talk of full solar autonomy refer to the annual balance of a house. Now, architect Timo Leukefeld and Helma Eigenheimbau AG presented a really autonomous solar house which is available on a turnkey basis for 363,000 Euros.

  17. Privatization, convergence, and institutional autonomy

    NARCIS (Netherlands)

    Rooijen, van M.

    2011-01-01

    Some of the trends incoming for 2011 – greater institutional autonomy, public/private convergence, entrepreneurial management, civic engagement – suggest innovation for hard times, with socio-economic and political rationales increasingly driving borderless developments. Others – open learning and

  18. Autonomy and dignity: a discussion on contingency and dominance.

    Science.gov (United States)

    Van Brussel, Leen

    2014-06-01

    With dying increasingly becoming a medicalised experience in old age, we are witnessing a shift from concern over death itself to an interest in dying 'well'. Fierce discussions about end-of-life decision making and the permissibility of medical intervention in dying, discursively structured around the notion of a 'good' death, are evidence of this shift. This article focuses on 'autonomy' and 'dignity' as key signifiers in these discussions. Rather than being fully fixed and stable, both signifiers are contingent and carry a variety of meanings within different discursive projects. The article aims to distinguish the varieties of these signifiers by elaborating existing theoretical perspectives on autonomy and dignity, and also, starting from a perspective on mass media as sites of meaning production and contestation, to study the contingency of autonomy and dignity in Belgian newspaper coverage of four prominent euthanasia cases. By means of a discourse-theoretical textual analysis, this study exposes a dominant--yet contested--articulation of rational-personal autonomy and of dignity in external terms as something that can be obtained, retained or lost, rather than in terms of intrinsic human integrity. These logics of representation reflect a more general late modern dominance of liberal autonomy and of dignity as being closely connected to self-identity, but at the same time result in limited visibility of alternative ways of experiencing an autonomous and dignified death.

  19. Post-sterilization autonomy among young mothers in South India.

    Science.gov (United States)

    Pallikadavath, Saseendran; Rajan, Irudaya; Singh, Abhishek; Ogollah, Reuben; Page, Samantha

    2015-01-01

    This study examined the post-sterilization autonomy of women in south India in the context of early sterilization and low fertility. Quantitative data were taken from the third round of the National Family Health Survey (NFHS-3) carried out in 2005-06, and qualitative data from one village each in Kerala and Tamil Nadu during 2010-11. The incident rate ratios and thematic analysis showed that among currently married women under the age of 30 years, those who had been sterilized had significantly higher autonomy in household decision-making and freedom of mobility compared with women who had never used any modern family planning method. Early age at sterilization and low fertility enables women to achieve the social status that is generally attained at later stages in the life-cycle. Policies to capitalize on women's autonomy and free time resulting from early sterilization and low fertility should be adopted in south India.

  20. Student Perceptions of Their Autonomy at University

    Science.gov (United States)

    Henri, D. C.; Morrell, L. J.; Scott, G. W.

    2018-01-01

    Learner autonomy is a primary learning outcome of Higher Education in many countries. However, empirical evaluation of how student autonomy progresses during undergraduate degrees is limited. We surveyed a total of 636 students' self-perceived autonomy during a period of two academic years using the Autonomous Learning Scale. Our analysis suggests…

  1. School Autonomy, Leadership and Learning: A Reconceptualisation

    Science.gov (United States)

    Cheng, Yin Cheong; Ko, James; Lee, Theodore Tai Hoi

    2016-01-01

    Purpose: The purpose of this paper is to develop a framework for reconceptualising research on school autonomy to redress the limitations of traditional research, strengthen the conceptual links between school autonomy and learning outcomes and offer a range of new strategies for studying the interplay of school autonomy, leadership and learning.…

  2. Respect for autonomy and technological risks

    NARCIS (Netherlands)

    Asveld, L.

    2008-01-01

    Technological developments can undermine the autonomy of the individual. Autonomy is one's ability to make and act upon decisions according to one's own moral framework. Respect for autonomy dictates that risks should not be imposed on the individual without her consent. Technological developments

  3. Rawls: The Problem of Autonomy and Coherentism

    Directory of Open Access Journals (Sweden)

    Elnora Gondim

    2010-12-01

    Full Text Available The transformation of the idea of autonomy into that of justice as equality modifies the work of Rawls taken as a whole. Thus, while in the Theory of Justice, a Kantian- type of autonomy is adopted, in Political Liberalism, autonomy is extended to the sphere of the political.

  4. The Connotations of Language Teacher Autonomy

    Science.gov (United States)

    Han, Ligang

    2017-01-01

    With the research on the development of learner autonomy in foreign language education, teacher autonomy has become a hot topic in the research of foreign language teacher education. However, it is the most difficult question to define language teacher autonomy and any answer to it is likely to be subjective. On the basis of expounding upon the…

  5. Autonomy of image and use of single or multiple sense modalities in original verbal image production.

    Science.gov (United States)

    Khatena, J

    1978-06-01

    The use of a single or of multiple sense modalities in the production of original verbal images as related to autonomy of imagery was explored. 72 college adults were administered Onomatopoeia and Images and the Gordon Test of Visual Imagery Control. A modified scoring procedure for the Gordon scale differentiated imagers who were moderate or low in autonomy. The two groups produced original verbal images using multiple sense modalities more frequently than a single modality.

  6. LEARNER AUTONOMY ON ESSAY WRITING ACCURACY

    Directory of Open Access Journals (Sweden)

    Mohammad Hafidz

    2018-01-01

    Full Text Available Abstract: Learner autonomy on writing is independently teaching and learning that keeps students’ control to explore their knowledge and experiences in written language, find out and evaluate their errors based on the conceptual courses to make accurately simple essay. The aim was to know the effectiveness of the learner autonomy on writing accuracy. This quantitative research conducted in one group pretest and posttest design. The number of samples was 21 students in Bangkalan. The instrument were tests to gain students’ writing score before and after treatment. Researcher statistically analyzed the data using SPSS 23 version by running a Paired Samples Test. The result shown the means of pretes score was 66,83 and posttest score was 74,57, Paired Samples Correlations was 0,614 (strong correlation. Significance was 0,005, it means that  a (0,05 is higher than r value (0,005 with high variance of mean value (14,091. As a result, the hypothesis (H1­ was received that learner autonomy contributed effectively to learners’ in organizing own ideas (Ene, 2006 such as making a topic  map becomes some explanable sub-topics, writing down main and supporting idea, clustering some objects, editing next and learners  absolutely accumulate some selected vocabularies inappropriate topics  (Chengping W, 2008. Keyword: Learner Autonomy, Learning process, outcomes Absrak: Pembelajaran otonomi  adalah pembelajaran mandiri yang mengontrol mahasiswa untuk menyampaikan gagasan dan pengalamannya, mencatat dan mengevaluasi kesalahan yang terjadi dalam penulisan esai sederhana berdasarkan pembelajaran yang tersetruktur. Tujuan adalah untuk mengetahui efektifitas pembelajaran otonomi terhadap akurasi tulisan secara statistik. Penelitian ini dilakukan dengan menggunakan desain tes awal dan akhir. Jumlah sampel terdiri dari 21 siswa di Bangkalan. Isntrumen yang digunakan adalah tes untuk mengetahui hasil nilai mahasiswa sebelum dan sesudah melakukan

  7. Glucose intolerance and General Health Questionnaire 12-item version scores of male two-shift workers stratified by precariousness of work.

    Science.gov (United States)

    Kawada, Tomoyuki

    2016-01-01

    This study examined the relationship between precariousness of work, glucose intolerance and psychological wellbeing for male workers, stratified by age. I recruited 2542 manufacturing two-shift workers, aged from 35 to 54 years. Glucose intolerance was defined as fasting plasma glucose of ≥100mg/dL or current medication of diabetes mellitus. The rating scale of General Health Questionnaire 12-item version (GHQ-12) was used for evaluating psychological well-being. There was a significant increase in the prevalence of glucose intolerance by aging in permanent workers. In addition, the prevalence of glucose intolerance except 30s and the prevalence of positive GHQ-12 scores except 50s of permanent workers were both significantly higher than that of temporary workers in each age class. Temporary workers in this study sign contracts for 3 years, and heather worker's effect, compared with permanent workers, would be reflected in this study. Copyright © 2015 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  8. Public Health Autonomy: A Critical Reappraisal.

    Science.gov (United States)

    Zimmerman, Frederick J

    2017-11-01

    The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

  9. Enhancing autonomy in paid surrogacy.

    Science.gov (United States)

    Damelio, Jennifer; Sorensen, Kelly

    2008-06-01

    The gestational surrogate--and her economic and educational vulnerability in particular--is the focus of many of the most persistent worries about paid surrogacy. Those who employ her, and those who broker and organize her services, usually have an advantage over her in resources and information. That asymmetry exposes her to the possibility of exploitation and abuse. Accordingly, some argue for banning paid surrogacy. Others defend legal permission on grounds of surrogate autonomy, but often retain concerns about the surrogate. In response to the dilemma of a ban versus bald permission, we propose a 'soft law' approach: states should require several hours of education of surrogates--education aimed at informing and enhancing surrogate autonomy.

  10. Epistemic merit, autonomy, and testimony

    Directory of Open Access Journals (Sweden)

    Jesús VEGA ENCABO

    2008-01-01

    Full Text Available In this paper, it is argued that both the informer and the hearer in a testimonial situation deserve epistemic merit insofar as they contribute to the collaborative achievement of sharing knowledge. The paper introduces a distinction between the ideals of self-sufficiency and epistemic autonomy. The autonomous exercise of our epistemic agency is very often carried out under strong conditions of epistemic dependence. Testimony exhibits a kind of social dependence that does not threaten the autonomy of the subjects that need to consider their own epistemic capacities. When involved in a testimonial situation, both speaker and hearer declare, at least implicitly, the standings they occupy in an epistemic space and are obliged to recognise certain epistemic requirements.

  11. Autonomy and the akratic patient.

    Science.gov (United States)

    McKnight, C J

    1993-01-01

    I argue that the distinction which is current in much writing on medical ethics between autonomous and non-autonomous patients cannot cope comfortably with weak-willed (incontinent) patients. I describe a case involving a patient who refuses a blood transfusion even though he or she agrees that it would be in his or her best interests. The case is discussed in the light of the treatment of autonomy by B Brody and R Gillon. These writers appear to force us to treat an incontinent patient either as autonomous, just like a rational agent whose decisions are in accordance with his beliefs or as non-autonomous, like comatose patients or children. Though neither is entirely satisfactory I opt for describing such patients as autonomous but point out that in cases like this the principle of respect for autonomy does not give a determinate answer about how the patient ought to be treated. PMID:8308874

  12. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  13. The Effects of an Autonomy-Supportive Teaching Intervention on Chinese Physics Students and their Teacher

    Science.gov (United States)

    Zhang, Danhui; Bobis, Janette; Wu, Xiaolu; Cui, Yiran

    2018-04-01

    Increasing student exposure to autonomy-supportive teaching approaches has been linked to enhanced student intrinsic motivation to learn. However, such approaches are rare in mainland Chinese science classrooms. An intervention-based study with quasi-experimental design and mixed methods was conducted to explore the impact of a 9-month-long autonomy-supportive teaching intervention on a physics teacher and 147 grade 8 students attending a middle school in China. Data collected through questionnaires, interviews, and observations were analyzed to elicit and track shifts in teacher practices and students' perceptions of learning physics at pre-, post-, and follow-up intervention phases. General linear modeling confirmed significant changes in students' perceptions of their learning environment over time in terms autonomy, satisfaction of autonomy needs, and agentic engagement. Interview and observational data analyses confirmed increased use of autonomy-supportive teaching behaviors and provided further insights into teacher and students' perceptions of the impact on student learning.

  14. Market liberalism in health care: a dysfunctional view of respecting "consumer" autonomy.

    Science.gov (United States)

    Kekewich, Michael A

    2014-03-01

    The unfortunately vast history of paternalism in both medicine and clinical research has resulted in perpetually increasing respect for patient autonomy and free choice in Western health care systems. Beginning with the negative right to informed consent, the principle of respect for autonomy has for many patients evolved into a positive right to request treatments and expect accommodation. This evolution of patient autonomy has mirrored a more general social attitude of market liberalism where increasing numbers of patients have come to embody the role of the "consumer." This paper explores this transformation and critiques the current way in which respect for patient autonomy is put into practice. Ultimately, this paper concludes that the consumer view of patient autonomy is dysfunctional. Moreover, this paper argues that, based on the inherent goals of medicine, some form of paternalism is required in any meaningfully therapeutic relationship.

  15. Reproductive autonomy: A case study

    Directory of Open Access Journals (Sweden)

    David R Hall

    2016-11-01

    Full Text Available Reproductive autonomy (RA has been challenged by the availability of genetic information, disability and the ethics of selective reproduction. Utilitarian and rights-based approaches, as well as procreative beneficence (PB fail to provide compelling reasons for infringing RA, and may even be likened to dangerous eugenics. Parents are not morally obliged to prevent the birth of a disabled child. Society should rather adopt inclusivity, recognising and providing persons with disabilities opportunities for capability and worthwhile lives.

  16. The many faces of autonomy.

    Science.gov (United States)

    Gracia, Diego

    2012-02-01

    What does autonomy mean from a moral point of view? Throughout Western history, autonomy has had no less than four different meanings. The first is political: the capacity of old cities and modern states to give themselves their own laws. The second is metaphysical, and was introduced by Kant in the second half of the 18th century. In this meaning, autonomy is understood as an intrinsic characteristic of all rational beings. Opposed to this is the legal meaning, in which actions are called autonomous when performed with due information and competency and without coercion. This last meaning, the most frequently used in bioethics, is primarily legal instead of moral. Is there a proper moral meaning of the word autonomy? If so, this would be a fourth meaning. Acts can only be called moral when they are postconventional (using the terminology coined by Lawrence Kohlberg), inner-directed (as expressed by David Riesman), and responsible (according to Hannah Arendt). Such acts are autonomous in this new, fourth, and to my mind, the only one proper, moral meaning. The goal of ethics cannot be other than forming human beings capable of making autonomous and responsible decisions, and doing so because they think this is their duty and not because of any other nonmoral motivation, like comfort, convenience, or satisfaction. The goal of ethics is to promote postconventional and mature human beings. This was what Socrates tried to do with the young people of Athens. And it is also the objective of every course of ethics and of any process of training.

  17. Validation of the German Diabetes Risk Score among the general adult population: findings from the German Health Interview and Examination Surveys

    Science.gov (United States)

    Paprott, Rebecca; Mühlenbruch, Kristin; Mensink, Gert B M; Thiele, Silke; Schulze, Matthias B; Scheidt-Nave, Christa; Heidemann, Christin

    2016-01-01

    Objective To evaluate the German Diabetes Risk Score (GDRS) among the general adult German population for prediction of incident type 2 diabetes and detection of prevalent undiagnosed diabetes. Methods The longitudinal sample for prediction of incident diagnosed type 2 diabetes included 3625 persons who participated both in the examination survey in 1997–1999 and the examination survey in 2008–2011. Incident diagnosed type 2 diabetes was defined as first-time physician diagnosis or antidiabetic medication during 5 years of follow-up excluding potential incident type 1 and gestational diabetes. The cross-sectional sample for detection of prevalent undiagnosed diabetes included 6048 participants without diagnosed diabetes of the examination survey in 2008–2011. Prevalent undiagnosed diabetes was defined as glycated haemoglobin ≥6.5% (48 mmol/mol). We assessed discrimination as area under the receiver operating characteristic curve (ROC-AUC (95% CI)) and calibration through calibration plots. Results In longitudinal analyses, 82 subjects with incident diagnosed type 2 diabetes were identified after 5 years of follow-up. For prediction of incident diagnosed diabetes, the GDRS yielded an ROC-AUC of 0.87 (0.83 to 0.90). Calibration plots indicated excellent prediction for low diabetes risk and overestimation for intermediate and high diabetes risk. When considering the entire follow-up period of 11.9 years (ROC-AUC: 0.84 (0.82 to 0.86)) and including incident undiagnosed diabetes (ROC-AUC: 0.81 (0.78 to 0.84)), discrimination decreased somewhat. A previously simplified paper version of the GDRS yielded a similar predictive ability (ROC-AUC: 0.86 (0.82 to 0.89)). In cross-sectional analyses, 128 subjects with undiagnosed diabetes were identified. For detection of prevalent undiagnosed diabetes, the ROC-AUC was 0.84 (0.81 to 0.86). Again, the simplified version yielded a similar result (ROC-AUC: 0.83 (0.80 to 0.86)). Conclusions The GDRS might be applied

  18. Autonomy and Just Health

    Directory of Open Access Journals (Sweden)

    Jean-Pierre Wils

    2016-12-01

    Full Text Available In the last quarter of the 20th century medical ethics underwent a kind of renaissance:developments in biotechnology, in pharmacy, but, overall, increased possibilities in lifestylesand life-extension due to advanced technological approaches captured our attention and ledto a rehabilitation of ethics in general and medical ethics in particular. Initially these ethicsoperated with relatively simple principles. These principles, as they have been formulated byTom L. Beauchamp and James F. Childress (1994, sound like a mantra to our ears: ‘Autonomy’,‘Nonmaleficence’, ‘Beneficence’, and ‘Justice’. Compared to the other three, the last namedprinciple, ‘Justice’, has led and, until the present day, continues to lead a shadowy existence.The question of what ‘just healthcare’ means, and especially what ‘just health’ is, is hardly everraised. In addition to this, the social characteristics of ‘health’ have been forgotten in areprehensible way. A future medical ethics must deal with two key challenges. First, what isthe good of health and how is it constituted? Second, what can ‘just health’ mean if we view itagainst the background of the social causes of health and disease.

  19. What factors influence attending surgeon decisions about resident autonomy in the operating room?

    Science.gov (United States)

    Williams, Reed G; George, Brian C; Meyerson, Shari L; Bohnen, Jordan D; Dunnington, Gary L; Schuller, Mary C; Torbeck, Laura; Mullen, John T; Auyang, Edward; Chipman, Jeffrey G; Choi, Jennifer; Choti, Michael; Endean, Eric; Foley, Eugene F; Mandell, Samuel; Meier, Andreas; Smink, Douglas S; Terhune, Kyla P; Wise, Paul; DaRosa, Debra; Soper, Nathaniel; Zwischenberger, Joseph B; Lillemoe, Keith D; Fryer, Jonathan P

    2017-12-01

    Educating residents in the operating room requires balancing patient safety, operating room efficiency demands, and resident learning needs. This study explores 4 factors that influence the amount of autonomy supervising surgeons afford to residents. We evaluated 7,297 operations performed by 487 general surgery residents and evaluated by 424 supervising surgeons from 14 training programs. The primary outcome measure was supervising surgeon autonomy granted to the resident during the operative procedure. Predictor variables included resident performance on that case, supervising surgeon history with granting autonomy, resident training level, and case difficulty. Resident performance was the strongest predictor of autonomy granted. Typical autonomy by supervising surgeon was the second most important predictor. Each additional factor led to a smaller but still significant improvement in ability to predict the supervising surgeon's autonomy decision. The 4 factors together accounted for 54% of decision variance (r = 0.74). Residents' operative performance in each case was the strongest predictor of how much autonomy was allowed in that case. Typical autonomy granted by the supervising surgeon, the second most important predictor, is unrelated to resident proficiency and warrants efforts to ensure that residents perform each procedure with many different supervisors. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. The Degree of Autonomy of the Romanian Local Public Expenditures

    Directory of Open Access Journals (Sweden)

    Maria Letitia Andronic (Bratulescu

    2016-04-01

    Full Text Available The process of local public spending optimization is extensively studied by those who have the power of decision towards saving. Even if the goal is to adjust the imbalance revenues/expenditures, the trend to spend more than accumulated is still a matter of concern. Our objective is that of analyzing the local governments’ functional expenditures by measuring the degree of decentralization/autonomy. The value of the paper is given by the model we applied for Romania which is based on spending management. By analyzing different types of expenses, we have highlighted that local expenditures represent instruments of strengthening or weakening local autonomy. The indicators measure the effectiveness of local expenditures by using the model published by The World Bank in 2006. We gathered information through interviewing different Town-Hall representatives from Brasov County and then we gave scores and established ranks. As the degree of autonomy reached a score of about 3 on a scale of 1-4, we identified that the class in which Romania is placed (B is mostly defined in terms of delegated powers and not decentralized competences. The study is significant for politicians, for those responsible for implementing decentralization, but also for the taxpayers who deserve the best public services.

  1. Effects of perceived autonomy support and basic need satisfaction on quality of life in hemodialysis patients.

    Science.gov (United States)

    Chen, Mei-Fang; Chang, Ray-E; Tsai, Hung-Bin; Hou, Ying-Hui

    2018-03-01

    Despite a growing understanding of health-related quality of life (HRQOL) and its determinants in hemodialysis (HD) patients, little is known about the effects and interrelationships concerning the perception of autonomy support and basic need satisfaction of HD patients on their HRQOL. Based on self-determination theory (SDT), this study examines whether HD patients' perceived autonomy support from health care practitioners (physicians and nurses) relates to the satisfaction of HD patients' basic needs and in turn influences their HRQOL. A questionnaire was administered to 250 Taiwanese HD patients recruited from multiclinical centers and regional hospitals in northern Taiwan. Structural equation modeling (SEM) analysis was conducted to examine the causal relationships between patient perceptions of autonomy support and HRQOL through basic need satisfaction. The empirical results of SEM indicated that the HD patients' perceived autonomy support increased the satisfaction of their basic needs (autonomy, competency, and relatedness), as expected. The higher degree of basic need satisfaction led to higher HRQOL, as measured by physical and mental component scores. Autonomy support from physicians and nurses contributes to improving HD patients' HRQOL through basic need satisfaction. This indicates that staff caring for patients with severe chronic diseases should offer considerable support for patient autonomy.

  2. Promoting an active form of learning out-of-class via answering online “study questions” leads to higher than expected exam scores in General Biology

    Directory of Open Access Journals (Sweden)

    Susan I. Gibson

    2015-10-01

    Full Text Available A rising need for workers in science, technology, engineering and mathematics (STEM fields has fueled interest in improving teaching within STEM disciplines. Numerous studies have demonstrated the benefits of active learning approaches on student learning outcomes. However, many of these studies have been conducted in experimental, rather than real-life class, settings. In addition, most of these studies have focused on in-class active learning exercises. This study tested the effects of answering questions outside of class on exam performance for General Biology students at the University of Minnesota. An online database of 1,020 multiple-choice questions covering material from the first half of the course was generated. Students in seven course sections (with an average of ∼265 students per section were given unlimited access to the online study questions. These students made extensive use of the online questions, with students answering an average of 1,323 questions covering material from the half of the semester for which the questions were available. After students answered a set of questions, they were shown the correct answers for those questions. More specific feedback describing how to arrive at the correct answer was provided for the 73% of the questions for which the correct answers were not deemed to be self-explanatory. The extent to which access to the online study questions improved student learning outcomes was assessed by comparing the performance on exam questions of students in the seven course sections with access to the online study questions with the performance of students in course sections without access to the online study questions. Student performance was analyzed for a total of 89 different exams questions that were not included in the study questions, but that covered the same material covered by the study questions. Each of these 89 questions was used on one to five exams given to students in course sections that

  3. Promoting an active form of learning out-of-class via answering online "study questions" leads to higher than expected exam scores in General Biology.

    Science.gov (United States)

    Gibson, Susan I

    2015-01-01

    A rising need for workers in science, technology, engineering and mathematics (STEM) fields has fueled interest in improving teaching within STEM disciplines. Numerous studies have demonstrated the benefits of active learning approaches on student learning outcomes. However, many of these studies have been conducted in experimental, rather than real-life class, settings. In addition, most of these studies have focused on in-class active learning exercises. This study tested the effects of answering questions outside of class on exam performance for General Biology students at the University of Minnesota. An online database of 1,020 multiple-choice questions covering material from the first half of the course was generated. Students in seven course sections (with an average of ∼265 students per section) were given unlimited access to the online study questions. These students made extensive use of the online questions, with students answering an average of 1,323 questions covering material from the half of the semester for which the questions were available. After students answered a set of questions, they were shown the correct answers for those questions. More specific feedback describing how to arrive at the correct answer was provided for the 73% of the questions for which the correct answers were not deemed to be self-explanatory. The extent to which access to the online study questions improved student learning outcomes was assessed by comparing the performance on exam questions of students in the seven course sections with access to the online study questions with the performance of students in course sections without access to the online study questions. Student performance was analyzed for a total of 89 different exams questions that were not included in the study questions, but that covered the same material covered by the study questions. Each of these 89 questions was used on one to five exams given to students in course sections that had access to the

  4. Item Response Theory analysis of the Autonomy over Tobacco Scale (AUTOS).

    Science.gov (United States)

    Wellman, Robert J; Edelen, Maria Orlando; DiFranza, Joseph R

    2015-06-01

    The Autonomy over Tobacco Scale (AUTOS) is composed of 12-symptoms of nicotine dependence. While it has demonstrated excellent reliability and validity, several psychometric properties have yet to be investigated. We aimed to determine (1) whether items functioned differently across demographic groups, (2) the likelihood that individual symptoms would be endorsed by smokers at different levels of diminished autonomy, and (3) the degree of information provided by each item and the reliability of the full AUTOS across the range of diminished autonomy. Data for this study come from two convenience samples of American adult current smokers (n=777; 69% female; 88% white; Mage=34 years, range: 18-78), of whom 66% were daily smokers (Mcigarettes/smoking day=10.1, range: AUTOS online as part of "a research study about the experiences people have when they smoke." After p value correction, items remained invariant across sex and minority status, while two items functioned differently according to age, with minimal impact on the total AUTOS score. Discriminative power of the items was high. The greatest amount of information is provided at just under one-half SD above the mean and the least at the extremes of diminished autonomy. The AUTOS maintains acceptable reliability (>0.70) across the range of diminished autonomy within which more than 95% of smokers' scores could be anticipated to fall. The AUTOS is a versatile and psychometrically sound instrument for measuring the loss of autonomy over tobacco use. Copyright © 2015 Elsevier Ltd. All rights reserved.

  5. Nurses' autonomy level in teaching hospitals and its relationship with the underlying factors.

    Science.gov (United States)

    Amini, Kourosh; Negarandeh, Reza; Ramezani-Badr, Farhad; Moosaeifard, Mahdi; Fallah, Ramezan

    2015-02-01

    This study aimed to determine the autonomy level of nurses in hospitals affiliated to Zanjan University of Medical Sciences, Iran. In this descriptive cross-sectional study, 252 subjects were recruited using systematic random sampling method. The data were collected using questionnaire including Dempster Practice Behavior Scale. For data analysis, descriptive statistics and to compare the overall score and its subscales according to the demographic variables, t-test and analysis of variance test were used. The nurses in this study had medium professional autonomy. Statistical tests showed significant differences in the research sample according to age, gender, work experience, working position and place of work. The results of this study revealed that most of the nurses who participated in the study compared with western societies have lower professional autonomy. More studies are needed to determine the factors related to this difference and how we can promote Iranian nurses' autonomy. © 2013 Wiley Publishing Asia Pty Ltd.

  6. Perceived environmental barriers to outdoor mobility and changes in sense of autonomy in participation outdoors among older people: a prospective two-year cohort study.

    Science.gov (United States)

    Rantakokko, Merja; Portegijs, Erja; Viljanen, Anne; Iwarsson, Susanne; Kauppinen, Markku; Rantanen, Taina

    2017-08-01

    The aim was to study whether perceived environmental barriers to outdoor mobility affect changes in sense of autonomy in participation outdoors among community-dwelling older people over a two-year period. Community-dwelling people aged 75-90 years (n = 848) in central Finland were interviewed on two occasions, face-to-face at baseline and over the telephone two years later. Perceived environmental barriers to outdoor mobility were assessed using a 15-item structured questionnaire, and the sum scores categorized into tertiles (0, 1 and 2 or more barriers). Autonomy in participation outdoors was assessed with the 'Impact on Participation and Autonomy' (IPA) questionnaire using the autonomy outdoors subscale (score range 0-20, higher scores indicating more restricted autonomy). Scores for autonomy in participation outdoors were available for 848 participants at baseline (mean 6.2, SD = 3.8) and for 748 participants at the two-year follow-up (mean 6.7, SD = 3.9). At baseline, those reporting multiple environmental barriers had the most restricted autonomy, while those reporting no environmental barriers had the least restricted autonomy (p autonomy in participation outdoors declined more among those reporting multiple environmental barriers compared to those reporting none (age- and sex-adjusted group*time β = .629, s.e. = .277, p = .023). Adjustment for cognitive functioning, education, number of chronic conditions and change in walking difficulty did not influence the association. Perceived environmental barriers to outdoor mobility accelerate the decline in autonomy in participation outdoors among older community-dwelling people. Understanding factors affecting autonomy can help in finding ways to support the sense of autonomy as people age.

  7. Autonomy and Firefighting: Perceived Competence and Stress.

    Science.gov (United States)

    Chiang, Evelyn S; Baley, John; Ponder, Joy; Padilla, Miguel A

    2016-12-01

    In workplace settings, autonomy is implicated in employee motivation as well as supervisor autonomy support. As a profession of risk, firefighters may experience greater levels of stress. A self-determination paradigm was applied to the firefighter workplace. Of particular interest were perceived competence (to perform job duties) and the experience of stress. Firefighters' levels of autonomous and controlled regulation were surveyed, along with their perceptions of the autonomy support of their immediate supervisor. Autonomous regulation was positively related to perceived competence, whereas controlled regulation was negatively related. Higher levels of controlled regulation were also connected with greater stress. In contrast, greater perceived autonomy support was associated with decreased stress. Both perceived competence and stress are related to firefighter motivation and autonomy support. Recommendations are offered to increase autonomy support by chief officers.

  8. Autonomy and the Sources of Political Normativity

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    Contemporary political liberals argue for extending the scope of reasonable disagreement to include also the principle of autonomy that was central in classical liberal theory. I take outset in Charles Larmore, The Autonomy of Morality (2008), which argues that liberal theory can dispense...... with the commitment to autonomy that one finds in Locke, Kant, and Mill, because "the essential convictions of liberal thought lie at a more fundamental level," namely in the principle of respect for persons. The main question I address is whether we can see the commitment to respect for persons as separable from...... the commitment to autonomy. My focus is the Kantian conception of autonomy, and I argue for understanding this conception practically and politically, rather than metaphysically and theoretically. In this way we can separate the principle of respect for persons from the metaphysical idea of autonomy as self...

  9. Freedom of Expression, Deliberation, Autonomy and Respect

    OpenAIRE

    Rostbøll, Christian F.

    2011-01-01

    This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms w...

  10. A Reconfigurable Testbed Environment for Spacecraft Autonomy

    Science.gov (United States)

    Biesiadecki, Jeffrey; Jain, Abhinandan

    1996-01-01

    A key goal of NASA's New Millennium Program is the development of technology for increased spacecraft on-board autonomy. Achievement of this objective requires the development of a new class of ground-based automony testbeds that can enable the low-cost and rapid design, test, and integration of the spacecraft autonomy software. This paper describes the development of an Autonomy Testbed Environment (ATBE) for the NMP Deep Space I comet/asteroid rendezvous mission.

  11. From solidarity to autonomy: towards a redefinition of the parameters of the notion of autonomy.

    Science.gov (United States)

    Fainzang, Sylvie

    2016-12-01

    Starting from examples of concrete situations in France, I show that autonomy and solidarity can coexist only if the parameters of autonomy are redefined. I show on the one hand that in situations where autonomy is encouraged, solidarity nevertheless remains at the foundation of their practices. On the other hand, in situations largely infused with family solidarity, the individual autonomy may be put in danger. Yet, based on my ethnographic observations regarding clinical encounters and medical secrecy, I show that while solidarity may endanger individual autonomy, it does not necessarily endanger autonomy itself. The social practices observable in France reflect the reality of an autonomy that goes beyond the individual, a reality that involves a collective subject and includes solidarity. The opposition between these two values can then be resolved if the content of the notion of autonomy is understood to be dependent on its cultural context of application and on its social use.

  12. Shared Mind: Communication, Decision Making, and Autonomy in Serious Illness

    Science.gov (United States)

    Epstein, Ronald M.; Street, Richard L.

    2011-01-01

    In the context of serious illness, individuals usually rely on others to help them think and feel their way through difficult decisions. To help us to understand why, when, and how individuals involve trusted others in sharing information, deliberation, and decision making, we offer the concept of shared mind—ways in which new ideas and perspectives can emerge through the sharing of thoughts, feelings, perceptions, meanings, and intentions among 2 or more people. We consider how shared mind manifests in relationships and organizations in general, building on studies of collaborative cognition, attunement, and sensemaking. Then, we explore how shared mind might be promoted through communication, when appropriate, and the implications of shared mind for decision making and patient autonomy. Next, we consider a continuum of patient-centered approaches to patient-clinician interactions. At one end of the continuum, an interactional approach promotes knowing the patient as a person, tailoring information, constructing preferences, achieving consensus, and promoting relational autonomy. At the other end, a transactional approach focuses on knowledge about the patient, information-as-commodity, negotiation, consent, and individual autonomy. Finally, we propose that autonomy and decision making should consider not only the individual perspectives of patients, their families, and members of the health care team, but also the perspectives that emerge from the interactions among them. By drawing attention to shared mind, clinicians can observe in what ways they can promote it through bidirectional sharing of information and engaging in shared deliberation. PMID:21911765

  13. The Future of Reproductive Autonomy.

    Science.gov (United States)

    Johnston, Josephine; Zacharias, Rachel L

    2017-12-01

    In a project The Hastings Center is now running on the future of prenatal testing, we are encountering clear examples, both in established law and in the practices of individual providers, of failures to respect women's reproductive autonomy: when testing is not offered to certain demographics of women, for instance, or when the choices of women to terminate or continue pregnancies are prohibited or otherwise not supported. But this project also raises puzzles for reproductive autonomy. We have learned that some clinicians and patients do not discuss the fact that prenatal testing can lead to a decision about whether to terminate a pregnancy-they just don't talk about it. And while the decision whether to agree to prenatal screening and diagnostic testing is to be made with women's free and informed consent, many screening tests have been routinized in such a way that some women do not even recall agreeing to testing, while others feel that agreeing to testing is what their clinicians expect of them or that the testing is necessary to protect themselves and their families from the significant financial hardship of raising a child with a disability. In the face of these pressures, can one really say that women are freely choosing to undergo testing or are freely choosing to continue or terminate a pregnancy following receipt of test results? The reality of these pressures is requiring us to consider expanding the scope of our investigation beyond the clinical encounter to the broader context-to think harder about what reproductive autonomy means and how best to enhance it. © 2017 The Hastings Center.

  14. Adolescents, Graduated Autonomy, and Genetic Testing

    Directory of Open Access Journals (Sweden)

    Susan Fox

    2012-01-01

    Full Text Available Autonomy takes many shapes. The concept of “graduated autonomy” is conceived as comprising several unique features: (1 it is incremental, (2 it is proportional, and (3 it is related to the telos of the life stage during which it occurs. This paper focuses on graduated autonomy in the context of genetic testing during adolescence. Questions can be raised about other life stages as well, and some of these questions will be addressed by discussing a possible fourth characteristic of graduated autonomy, that is, its elasticity. Further scholarship and analysis is needed to refine the concept of graduated autonomy and examine its applications.

  15. Characteristics of Law-Autonomy Foreign Subsidiaries

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; McDonald, Frank; Stephan, Andreas

    2012-01-01

    This paper examines several characteristics of foreign subsidiaries with low autonomy. Data derived from a survey of 381 MNC subsidiaries located in Denmark, Germany and the UK demonstrate that low-autonomy subsidiaries are highly embedded in their respective MNC networks and that they establish ...... relationship between lower autonomy and the production activities carried out by the subsidiary. In fact, low-autonomy subsidiaries appear to be specialized in that they focus on a few value-chain activities and they typically serve as marketing outlets....

  16. An intercultural nursing perspective on autonomy.

    Science.gov (United States)

    Hanssen, Ingrid

    2004-01-01

    This article is based on an empirical study regarding ethical challenges in intercultural nursing. The focus is on autonomy and disclosure. Autonomy is a human capacity that has become an important ethical principle in nursing. Although the relationship between autonomy and patients' possibly harmful choices is discussed, the focus is on 'forced' autonomy. Nurses seem to equate respect with autonomy; it seems to be hard to cope with the fact that there are patients who voluntarily undergo treatment but who actively participate neither in the treatment offered nor in making choices regarding that treatment. Nurses' demand for patients to be autonomous may in some cases jeopardize the respect, integrity and human worth that the ethical principle of autonomy is meant to ensure. Even though respect for a person's autonomy is also respect for the person, one's respect for the person in question should not depend on his or her capacity or aptitude to act autonomously. Is autonomy necessarily a universal ethical principle? This article negates this question and, through the issues of culture, individualism versus collectivism, first- and second-order autonomy, communication and the use of family interpreters, and respect, an attempt is made to explain why.

  17. Professional Autonomy versus Corporate Control

    Directory of Open Access Journals (Sweden)

    Pål Nygaard

    2012-06-01

    Full Text Available Professionalism and bureaucracy tend to be understood as incompatible systems of work organization, represented by the ideals of collegiality and auton-omy versus control and supervision. I present a historical case study from early 20th century Norway examining the potential clash between efforts made toward professionalization and bureaucratization in industry. Based on my findings, I argue that there is neither an inherent conflict between professionalism and bureaucracy nor static national trajectories at the level of professional versus bureaucratic work organization.

  18. Autonomy and Acceptance of Long-Term Care

    Science.gov (United States)

    Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin

    2009-01-01

    This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…

  19. Teachers' Perspectives of their roles and student autonomy in a PBL context in China

    DEFF Research Database (Denmark)

    Li, Huichun; Du, Xiangyun

    2015-01-01

    in a PBL context. In particular, we are mainly concerned with teachers’ attitudes towards student learning autonomy in PBL contexts. The data is mainly relied upon in-depth interviews of the teachers who participate in PBL practice from the two cases. When focusing on how teachers perceive student learning...... autonomy, we can note three major patterns. In general, Chinese teachers have a tendency to maintain high interference in student learning process even though they admit the value of giving student learning autonomy. This study further indicates a dilemma between teachers’ intention to encourage students...

  20. Motivating Proteges' Personal Learning in Teams: A Multilevel Investigation of Autonomy Support and Autonomy Orientation

    Science.gov (United States)

    Liu, Dong; Fu, Ping-ping

    2011-01-01

    This study examined the roles of 3 multilevel motivational predictors in proteges' personal learning in teams: an autonomy-supportive team climate, mentors' autonomy support, and proteges' autonomy orientation. The authors followed 305 proteges in 58 teams for 12 weeks and found that all 3 predictors were positively related to the proteges'…

  1. Individual autonomy in work teams : the role of team autonomy, self-efficacy, and social support

    NARCIS (Netherlands)

    Mierlo, van H.; Rutte, C.G.; Vermunt, J.K.; Kompier, M.A.J.; Doorewaard, J.A.C.M.

    2006-01-01

    Task autonomy is long recognized as a means to improve functioning of individuals and teams. Taking a multilevel approach, we unravelled the constructs of team and individual autonomy and studied the interplay between team autonomy, self-efficacy, and social support in determining individual

  2. University Reform and Institutional Autonomy: A Framework for Analysing the Living Autonomy

    Science.gov (United States)

    Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana

    2017-01-01

    In this article we discuss recent university reforms aimed at enhancing university autonomy, highlighting various tensions in the underlying reform ideologies. We examine how the traditional interpretation of university autonomy has been expanded in the reform rationales. An analytical framework for studying how autonomy is interpreted and used…

  3. Why Are Teachers Afraid of Curricular Autonomy? Contradictory Effects of the New National Curriculum in South Korea

    Science.gov (United States)

    Hong, Won-Pyo; Youngs, Peter

    2016-01-01

    Using interview data from secondary teachers, this study examines conflicting perspectives on the effects of the new national curriculum in South Korea, which was intended to grant more autonomy to individual schools and teachers. Contrary to the general belief that teachers want more autonomy to customize their curricula to meet students' needs,…

  4. Reconceptualizing Autonomy: A Relational Turn in Bioethics.

    Science.gov (United States)

    Jennings, Bruce

    2016-05-01

    History's judgment on the success of bioethics will not depend solely on the conceptual creativity and innovation in the field at the level of ethical and political theory, but this intellectual work is not insignificant. One important new development is what I shall refer to as the relational turn in bioethics. This development represents a renewed emphasis on the ideographic approach, which interprets the meaning of right and wrong in human actions as they are inscribed in social and cultural practices and in structures of lived meaning and interdependence; in an ideographic approach, the task of bioethics is to bring practice into theory, not the other way around. The relational turn in bioethics may profoundly affect the critical questions that the field asks and the ethical guidance it offers society, politics, and policy. The relational turn provides a way of correcting the excessive atomism of many individualistic perspectives that have been, and continue to be, influential in bioethics. Nonetheless, I would argue that most of the work reflecting the relational turn remains distinctively liberal in its respect for the ethical significance of the human individual. It moves away from individualism, but not from the value of individuality.In this review essay, I shall focus on how the relational turn has manifested itself in work on core concepts in bioethics, especially liberty and autonomy. Following a general review, I conclude with a brief consideration of two important recent books in this area: Jennifer Nedelsky's Law's Relations and Rachel Haliburton's Autonomy and the Situated Self. © 2016 The Hastings Center.

  5. Agency is Distinct from Autonomy

    Directory of Open Access Journals (Sweden)

    Fred Cummins

    2014-11-01

    Full Text Available Both autonomy and agency play central roles in the emerging enactive vocabulary. Although some treat these concepts as practically synonymous, others have sought to be more explicit about the conditions required for agency over and above autonomy. I attempt to be self-conscious about the role of the observer (or scientist in such discussions, and emphasise that the concept of agency, in particular, is deeply entwined with the nature of the observer and the framing of the observation. This is probably well known to enactivists, but runs the risk of being badly misunderstood if it is not made explicit. A heightened awareness of the role of the observer in the attribution of agency may allow us to make advances in questions in which progress is hindered by assuming a single split between subject and object. I argue that human experience is characterized by our embedding in webs of meaning arising from our participation in systems of many sorts, and that this richness demands a corresponding lightness of touch with respect to the identification of agentive subjects.

  6. Autopoiesis: Autology, Autotranscendence and Autonomy

    DEFF Research Database (Denmark)

    and 1990s – particularly in a French context. While his work has remained (to date) at distance from the rising number of suggestions, especi- ally regarding social and cultural theory, that have come out of these debates on self-organization, Castoriadis made a speci¿c and original contribution to them...... ‘reality-modeling’ (John Casti) – whether via cognitive frameworks or models of society and culture. Secondly, attempts to adapt debates within the humanities, e.g. in philosophy, social theory and cultural studies, have tended to end in anti-humanism, ranging from Deleuze and Guattari’s ‘abstract machine......’s philosophy. She argues that a focus on the self-organization of the living being implies not only a distinct move towards an ontology of radical physis in Castoriadis’s later work, but also, along with it, a revised version of his project of autonomy. Autonomy, like autology and the other theme of this issue...

  7. Women's autonomy and maternal healthcare service utilization in Ethiopia.

    Science.gov (United States)

    Tiruneh, Fentanesh Nibret; Chuang, Kun-Yang; Chuang, Ying-Chih

    2017-11-13

    Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women's autonomy. We assessed whether women's autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively) for measuring women's decision-making power and permissive gender norms associated with wife beating. We used Spearman's correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women's autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively). In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14). The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Our study shows that women's autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman empowerment in national policies and programs would be the optimal solution.

  8. Autonomy and Substitute Decision-Making with People with Intellectual Disabilities. Ethical Perspective

    OpenAIRE

    Xabier ETXEBERRIA MAULEON

    2016-01-01

    The text deals with the existing ethical tension between decision-making on behalf of people with intellectual disabilities and substitute decision-making, and the duty-bound respect for the person’s autonomy. The work begins by distinguishing decision- making on behalf of someone and substitute decision-making, consequently favoring the latter, as well as relating autonomy to interdependence. This first clarification leads to the construction of a basic and general criterion for substitute d...

  9. The support of autonomy and the control of behavior.

    Science.gov (United States)

    Deci, E L; Ryan, R M

    1987-12-01

    In this article we suggest that events and contexts relevant to the initiation and regulation of intentional behavior can function either to support autonomy (i.e., to promote choice) or to control behavior (i.e., to pressure one toward specific outcomes). Research herein reviewed indicates that this distinction is relevant to specific external events and to general interpersonal contexts as well as to specific internal events and to general personality orientations. That is, the distinction is relevant whether one's analysis focuses on social psychological variables or on personality variables. The research review details those contextual and person factors that tend to promote autonomy and those that tend to control. Furthermore, it shows that autonomy support has generally been associated with more intrinsic motivation, greater interest, less pressure and tension, more creativity, more cognitive flexibility, better conceptual learning, a more positive emotional tone, higher self-esteem, more trust, greater persistence of behavior change, and better physical and psychological health than has control. Also, these results have converged across different assessment procedures, different research methods, and different subject populations. On the basis of these results, we present an organismic perspective in which we argue that the regulation of intentional behavior varies along a continuum from autonomous (i.e., self-determined) to controlled. The relation of this organismic perspective to historical developments in empirical psychology is discussed, with a particular emphasis on its implications for the study of social psychology and personality.

  10. Epistemic Autonomy: A Criterion for Virtue?

    Science.gov (United States)

    Mudd, Sasha

    2013-01-01

    Catherine Elgin proposes a novel principle for identifying epistemic virtue. Based loosely on Kant's Categorical Imperative, it identifies autonomy as our fundamental epistemic responsibility, and defines the epistemic virtues as those traits of character needed to exercise epistemic autonomy. I argue that Elgin's principle fails as a…

  11. Scaffolding Learner Autonomy in Online University Courses

    Science.gov (United States)

    Ribbe, Elisa; Bezanilla, María José

    2013-01-01

    This paper deals with the question in what ways teachers and course designers can support the development and exertion of learner autonomy among online university students. It advocates that a greater attention to learner autonomy could help more students to complete their course successfully and thus contribute the decrease of the high dropout…

  12. Becoming Autonomous: Nonideal Theory and Educational Autonomy

    Science.gov (United States)

    Wilson, Terri S.; Ryg, Matthew A.

    2015-01-01

    Autonomy operates as a key term in debates about the rights of families to choose distinct approaches to education. Yet, what autonomy means is often complicated by the actual circumstances and contexts of schools, families, and children. In this essay, Terri S. Wilson and Matthew A. Ryg focus on the challenges involved in translating an ideal of…

  13. On the Compatibility of Autonomy and Relatedness.

    Science.gov (United States)

    Hodgins, Holley S.; And Others

    1996-01-01

    Investigates the relation of autonomy to naturally occurring social interactions in two studies: the first investigated college students' interactions with parents, and the second examined interactions across all relationships. Autonomy was significantly related to more positive and naturally occurring interaction, whereas control related more to…

  14. Stories of Human Autonomy, Law, and Technology

    Science.gov (United States)

    Tranter, Kieran

    2010-01-01

    Considering the relationship between human autonomy, law and technology has deep origins. Both technology studies and legal theory tell origin stories about human autonomy as the prize from either a foundational technological or jurisprudential event. In these narratives either law is considered a second order consequence of technology or…

  15. Changing Light Bulbs: Practice, Motivation, and Autonomy

    Science.gov (United States)

    Carter, Jean A.

    2011-01-01

    The comment on the Ryan, Lynch, Vansteenkiste, and Deci (2011) article on motivation and autonomy in psychotherapy considers motivation and its role as prerequisite, process variable, or appropriate outcome, speculating that all are appropriate ways to conceptualize motivation in the behavior change process. Autonomy, as a useful addition, refers…

  16. Progress in medicine: autonomy, oughtonomy and nudging.

    Science.gov (United States)

    Devisch, Ignaas

    2011-10-01

    In this article, I argue that we need a new perspective in the debate on autonomy in medicine, to understand many of the problems we face today - dilemmas that are situated at the intersection of autonomy and heteronomy, such as why well informed and autonomous people make unhealthy lifestyle choices. If people do not choose what they want, this is not simply caused by their lack of character or capability, but also by the fact that absolute autonomy is impossible; autonomous individuals are 'contaminated' by heteronymous aspects, by influences from 'outside'. Consequently, there are many good reasons to question the widely accepted hierarchical opposition of autonomy (progress) versus heteronomy (paternalism) in medicine. In an earlier article an analysis is made of the neologism 'oughtonomy' to support the thesis that when it comes down to human existence, autonomy and heteronomy are intertwined, rather than being merely opposites. In this article, I reflect upon how social conditions might improve our 'choice architecture', what Thaler & Sunstein have called 'nudging': how to change individual health choices without being paternalistic? I explore the extent to which both oughtonomy and nudging are able to challenge the question of autonomy in today's medicine. Autonomy may and should be a shared target in today's medicine, but we should never forget that it is always intertwined with heteronomy. Starting from this perspective, progress in medicine demands far more than the increase of autonomy. © 2011 Blackwell Publishing Ltd.

  17. Buddhism and Autonomy-Facilitating Education

    Science.gov (United States)

    Morgan, Jeffrey

    2013-01-01

    This article argues that Buddhists can consistently support autonomy as an educational ideal. The article defines autonomy as a matter of thinking and acting according to principles that one has oneself endorsed, showing the relationship between this ideal and the possession of an enduring self. Three central Buddhist doctrines of conditioned…

  18. The role of sex, attachment and autonomy-connectedness in personality functioning.

    Science.gov (United States)

    Bachrach, Nathan; Croon, Marcel A; Bekker, Marrie H J

    2015-11-01

    Previous studies have found significant relationships among sex, attachment and autonomy-connectedness and DSM-IV personality characteristics. In the present study, we aimed to add to the current knowledge about attachment-related aspects of personality pathology, by examining the relationships of these same variables with dimensions of pathological personality structure as conceptualized by Kernberg. The study was performed among 106 ambulatory patients from a Dutch mental healthcare institute. A path model based upon neo-analytical object relation theory and attachment theory was tested. We expected significant associations among sex, attachment, autonomy and aspects of personality functioning. Both insecure attachment styles as well as the autonomy-connectedness components of sensitivity to others (SO) and capacity of managing new situations predicted general personality dysfunctioning significantly. More specifically, reality testing was negatively predicted by the autonomy component of capacity of managing new situations, and aggression was significantly predicted by sex as well as both insecure attachment styles. We advise scientists as well as clinicians to be alert on sex differences in autonomy-connectedness and aspects of personality dysfunctioning. Taking sex-specific variations in attachment and autonomy into account next to a more explicit focus on insecure attachment styles and autonomy problems may enhance, the current relatively low, treatment effectiveness for personality pathology. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Protecting autonomy as authenticity using Ulysses contracts.

    Science.gov (United States)

    van Willigenburg, Theo; Delaere, Patrick

    2005-08-01

    Pre-commitment directives or Ulysses contracts are often defended as instruments that may strengthen the autonomous self-control of episodically disordered psychiatric patients. Autonomy is understood in this context in terms of sovereignty ("governing" or "managing" oneself). After critically analyzing this idea of autonomy in the context of various forms of self-commitment and pre-commitment, we argue that what is at stake in using Ulysses contracts in psychiatry is not autonomy as sovereignty, but autonomy as authenticity. Pre-commitment directives do not function to protect autonomous self-control. They serve in upholding the guidance that is provided by one's deepest identity conferring concerns. We elucidate this concept of autonomy as authenticity, by showing how Ulysses contracts protect the possibility of being "a self."

  20. Autonomy and independence in language learning

    CERN Document Server

    Benson, Phil

    2014-01-01

    The topics of autonomy and independence play an increasingly important role in language education. They raise issues such as learners' responsibility for their own learning, and their right to determine the direction of their own learning, the skills which can be learned and applied in self-directed learning and capacity for independent learning and the extents to which this can be suppressed by institutional education. This volume offers new insights into the principles of autonomy and independence and the practices associated with them focusing on the area of EFL teaching. The editors' introduction provides the context and outlines the main issues involved in autonomy and independence. Later chapters discuss the social and political implications of autonomy and independence and their effects on educational structures. The consequences for the design of learner-centred materials and methods is discussed, together with an exploration of the practical ways of implementing autonomy and independence in language ...

  1. Indications for treatment of thyroid autonomy

    International Nuclear Information System (INIS)

    Emrich, D.

    1989-01-01

    Based on pathophysiological findings and considerations it is attempted to review critically the present state of indications and therapeutic modalities in cases of thyroid autonomy. If hyperthyroidism occurs or has occurred in autonomy, definitive treatment with radioiodine or surgery is indicated. In cases of autonomy with euthyroidism, treatment planning and indication of definite therapy are difficult still today, because the risk to develop hyperthyroidism cannot as yet be sufficiently estimated. A useful indicator in such cases seems to be the percentage of global thyreoidal uptake of 99m-technetium under supression. If autonomy is severe surgical treatment today is superior to radio-iodine therapy, but is associated with a higher rate of manifest hypothyroidism. Further research into both the risk of hyperthyroidism in thyroid autonomy and the optimization of radio-iodine therapy are needed. (orig./MG) [de

  2. Integrated System Health Management (ISHM) and Autonomy

    Science.gov (United States)

    Figueroa, Fernando; Walker, Mark G.

    2018-01-01

    Systems capabilities on ISHM (Integrated System Health Management) and autonomy have traditionally been addressed separately. This means that ISHM functions, such as anomaly detection, diagnostics, prognostics, and comprehensive system awareness have not been considered traditionally in the context of autonomy functions such as planning, scheduling, and mission execution. One key reason is that although they address systems capabilities, both ISHM and autonomy have traditionally individually been approached as independent strategies and models for analysis. Additionally, to some degree, a unified paradigm for ISHM and autonomy has been difficult to implement due to limitations of hardware and software. This paper explores a unified treatment of ISHM and autonomy in the context of distributed hierarchical autonomous operations.

  3. The Autonomy Activity Status of Multinational Subsidiaries

    DEFF Research Database (Denmark)

    Dzikowska, Marlena; Gammelgaard, Jens; Jindra, Björn

    Research concerning the autonomy of subsidiaries has been concentrated on the possession of decision-making rights. Building on the definitional and empirical argumentation, we claim that so understood autonomy has a prospective character, is not equal to the implementation of actual actions (or...... lack of thereof) and neglects the issue of the scope of potential actions. This paper aims to fill in the current literature gap by offering a holistic stance in which we assert that subsidiaries can be meaningfully differentiated according to their levels of autonomy and corresponding actions. We base...... this argumentation on the findings of real option theory and competitive dynamics perspective, develop a typology specific to a subsidiary’s autonomy activity status (the position of a subsidiary in terms of its autonomy level confronted with the extent of actions taken in a corresponding area). We evaluate...

  4. Freedom of Expression, Deliberation, Autonomy, and Respect

    DEFF Research Database (Denmark)

    Rostbøll, Christian Fogh

    for freedom of expression in terms of its relationship to different dimensions of autonomy. In response to the objection that Enlightenment theories pose a threat to cultures that reject autonomy, it is argued that autonomy-based democracy is not only compatible with but necessary for respect for cultural......The strongest versions of the democracy argument for freedom of expression rely on the deliberative conception of democracy. Deliberative democracy entails both an ideal of political autonomy and of autonomous preference formation. This paper elaborates the deliberative democracy argument...... diversity. On the basis of an intersubjective epistemology, I argue that citizens cannot know how to live on mutually respectful terms without engaging in public deliberation. Moreover, to be successful deliberation must foster some degree of personal autonomy, at least the ability to distinguish what...

  5. Freedom of Expression, Deliberation, Autonomy and Respect

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2011-01-01

    This paper elaborates on the deliberative democracy argument for freedom of expression in terms of its relationship to different dimensions of autonomy. It engages the objection that Enlightenment theories pose a threat to cultures that reject autonomy and argues that autonomy-based democracy...... is not only compatible with but necessary for respect for cultural diversity. On the basis of an intersubjective epistemology, it argues that people cannot know how to live on mutually respectful terms without engaging in public deliberation and develop some degree of personal autonomy. While freedom...... of expression is indispensable for deliberation and autonomy, this does not mean that people have no obligations regarding how they speak to each other. The moral insights provided by deliberation depend on the participants in the process treating one another with respect. The argument is related to the Danish...

  6. [Is autonomy ground of human dignity?].

    Science.gov (United States)

    Gordillo Alvarez-Valdés, Lourdes

    2008-01-01

    This paper considers the conditions of autonomy if this is to be the foundation of human dignity. Since Kant Modernity has dissociated nature from morality and has tried to support autonomy in its purely formal aspect. To forget nature has voluntarist consequences that affect the way in which autonomy is understand. But autonomy does not consist of not having links, but of knowing how to assume one's own links freely and to be conscious of one's own limits. Autonomy and liberty are the very thing of the rational being, capable of discerning good and bad, and this must direct our actions. Reason directs as and distances us from reality to recognize the advisable thing in the human being.

  7. [A pilot study of the professional autonomy, job satisfaction, and related factors of nurses at a regional hospital].

    Science.gov (United States)

    Wu, Lin-Chu; Maa, Suh-Hwa; Chung, Tieh-Chi; Huang, Kuei-Hsiang; Hsieh, Ming-Chu; Chen, Chiung-Hua

    2014-10-01

    Professional autonomy often causes confusion in nursing staffs that limit their ability to perform to the best of their professional capabilities. Moreover, heavy and busy workloads reduce the energy available for work resulting in lower working efficiency and lower job satisfaction. This study explores the status and factors related to professional autonomy and job satisfaction in nurses. A cross-sectional design was used to target the nurses employed at a regional hospital in southern Taiwan. Data on locus of control, professional autonomy, and job satisfaction were collected for analysis. Data were collected from 207 nurses, with 196 valid responses (response rate: 94.69%). One hundred and forty-six subjects (74.5%) were found to have an internal locus of control personality type. Scores for both professional autonomy and job satisfaction were above the "moderate" level (averages: 3.37 and 3.32, respectively, on a maximum scale of 5). Social demographic differences contributed to the variance in professional autonomy and job satisfaction among participants. Professional autonomy was found to be positively associated with job satisfaction. The findings of this study indicate that nurses with an internal locus of control personality exhibit higher professional autonomy and job satisfaction and that higher professional autonomy is associated with higher job satisfaction.

  8. Autonomy of imagery and production of original verbal images.

    Science.gov (United States)

    Khatena, J

    1976-08-01

    90 college students (31 men and 59 women) were categorized as moderately autonomous, less autonomous (less highly controlled) and non-autonomous (high controlled) imagers according to the Gordon Test of Visual Imagery Control Moderately autonomous imagers produced significantly more original verbal images than less autonomous and non-autonomous imagers with less autonomous imagers scoring higher than non-autonomous imagers as measured by Onomatopoeia and Images. There were no significant sex main effects of interaction of autonomy of imagery level X sex.

  9. A Reliability Generalization Study on the Survey of Perceived Organizational Support: The Effects of Mean Age and Number of Items on Score Reliability

    Science.gov (United States)

    Hellman, Chan M.; Fuqua, Dale R.; Worley, Jody

    2006-01-01

    The Survey of Perceived Organizational Support (SPOS) is a unidimensional measure of the general belief held by an employee that the organization is committed to him or her, values his or her continued membership, and is generally concerned about the employee's well-being. In the interest of efficiency, researchers are often compelled to use a…

  10. Turkish adaptation and psychometric characteristics of the Nursing Authority and Autonomy Scale.

    Science.gov (United States)

    Basaran Acil, Seher; Dinç, Leyla

    2018-04-14

    To adapt the Nursing Authority and Autonomy Scale (NAAS) into Turkish the Nursing Authority and Autonomy Scale (NAAS) to Turkish and assess its psychometric properties for Turkish nurses and nurse managers. The NAAS is a tool that specifically measures nursing authority and autonomy from the perspectives of nurses and nurse managers. The study sample consisted of 160 nurse managers and 266 staff nurses. Content validity was assessed using expert approval. Construct validity was assessed using confirmatory factor analysis. Internal consistency was assessed using Cronbach's α, and the test-retest reliability was assessed using Pearson's correlation coefficients. The model achieved a good fit. The internal reliability of the NAAS' authority and autonomy in nursing practice and importance of nursing practice subscales were .84. The Cronbach's α of the instrument was .88. The test-retest scores within an interval of 3 weeks were statistically not significant. The Turkish version of the NAAS has good psychometric properties and this scale can be employed to measure nurses' authority and autonomy. Nurse managers and educators should use an appropriate scale such as NAAS in order to assess nurses' clinical authority and autonomy to improve patient outcomes and develop nurses. © 2018 John Wiley & Sons Ltd.

  11. Examination of the Relationship Between Autonomy and English Achievement as Mediated by Foreign Language Classroom Anxiety.

    Science.gov (United States)

    Ghorbandordinejad, Farhad; Ahmadabad, Roghayyeh Moradian

    2016-06-01

    This study investigated the relationship between autonomy and English language achievement among third-grade high school students as mediated by foreign language classroom anxiety in a city in the north-west of Iran. A sample of 400 students (187 males, and 213 females) was assessed for their levels of autonomy and foreign language anxiety using the Autonomy Questionnaire and Foreign Language Classroom Anxiety Scale (FLCAS), respectively. Participants' scores on their final English exam were also used as the measurement of their English achievement. The results of Pearson correlation revealed a strong correlation between learners' autonomy and their English achievement (r [Formula: see text] .406, n [Formula: see text] 400, [Formula: see text]). Also, foreign language classroom anxiety was found to be significantly and negatively correlated with English achievement (r [Formula: see text] [Formula: see text].472, n [Formula: see text] 400, [Formula: see text]). Hierarchical multiple regression was used to assess the ability of autonomy to predict language learning achievement, after controlling for the influence of anxiety. In sum, the results of hierarchical multiple regressions revealed that foreign language classroom anxiety significantly mediates the relationship between autonomy and English language achievement. Implications for both teachers and learners, and suggestions for further research are provided.

  12. Relationship of Autonomy Social Support to Quitting Motivation in Diverse Smokers.

    Science.gov (United States)

    Patten, Christi A; Clinic, Mayo; Goggin, Kathy; Harris, Kari Jo; Richter, Kimber; Williams, Karen; Decker, Paul A; Clinic, Mayo; Bradley-Ewing, Andrea; Catley, Delwyn

    2016-01-01

    Research examining relationships between social support and smoking cessation has paid little attention to non-treatment seeking smokers and not considered the role of autonomy support for fostering quitting motivation. This study examined if autonomy support received from family and friends was associated with quitting motivation and making a quit attempt among diverse smokers with varying levels of quitting motivation. Demographic characteristics associated with autonomy support were explored. Participants (N=312) responded to advertisements seeking smokers "not quite ready to quit," and were primarily Black, low-income, and unemployed. Most (255) enrolled in a clinical trial of smoking cessation induction strategies (treatment sample). An additional 57 not meeting the trial eligibility criteria of low quitting motivation enrolled for baseline assessments only. Participants completed baseline measures of autonomy support received from friends and autonomous quitting motivation. In the treatment sample, quit attempts were assessed at 6-months follow-up. Females reported higher levels than males of autonomy support from friends (p=0.003). Participants with a high school diploma/GED reported higher levels of support from family (pautonomy support scores were significantly, albeit weakly, associated with autonomous quitting motivation. Autonomy support was not associated with making a quit attempt. Support from family and friends may promote autonomous reasons to quit among diverse smokers. Research is needed to assess the role of social support in the pre-quitting phases among racial and socio-economically diverse populations.

  13. Associations between women's autonomy and child nutritional status: a review of the literature.

    Science.gov (United States)

    Carlson, Gwen J; Kordas, Katarzyna; Murray-Kolb, Laura E

    2015-10-01

    Around the world, many women continue to experience low levels of autonomy. Recent literature has reported that the health consequences of low maternal autonomy extend beyond mothers and translate into health consequences for their children, and may be an important causal factor in child malnutrition. This review summarises the current knowledge of the relationship between maternal autonomy and children's nutritional status (defined as any measure that reflects the nutritional state of the body, such as birthweight or anthropometric scores) and child-feeding practices. The review also includes both discussion of the limitations found in the literature and directions for future research. A systematic review of the literature was conducted. Results of the studies included in the review strongly suggest that raising maternal autonomy is an important goal for improving children's nutritional status, yet gaps in the current knowledge exist, further confounded by issues with how autonomy is measured and limitations of cross-cultural comparability. A thorough understanding of the consequences of restricting women's autonomy will inform programmes and policy worldwide, and speed progress towards both empowering women and alleviating the global burden of child malnutrition. © 2014 John Wiley & Sons Ltd.

  14. Effective means of planning for and implementing autonomy

    DEFF Research Database (Denmark)

    Rehof, Lars Adam

    1991-01-01

    Autonomy, self-government, indigenous people, human rights, minority protection, minority rights......Autonomy, self-government, indigenous people, human rights, minority protection, minority rights...

  15. Challenging the bioethical application of the autonomy principle within multicultural societies.

    Science.gov (United States)

    Fagan, Andrew

    2004-01-01

    This article critically re-examines the application of the principle of patient autonomy within bioethics. In complex societies such as those found in North America and Europe health care professionals are increasingly confronted by patients from diverse ethnic, cultural, and religious backgrounds. This affects the relationship between clinicians and patients to the extent that patients' deliberations upon the proposed courses of treatment can, in various ways and to varying extents, be influenced by their ethnic, cultural, and religious commitments. The principle of patient autonomy is the main normative constraint imposed upon medical treatment. Bioethicists typically appeal to the principle of patient autonomy as a means for generally attempting to resolve conflict between patients and clinicians. In recent years a number of bioethicists have responded to the condition of multiculturalism by arguing that the autonomy principle provides the basis for a common moral discourse capable of regulating the relationship between clinicians and patients in those situations where patients' beliefs and commitments do or may contradict the ethos of biomedicine. This article challenges that claim. I argue that the precise manner in which the autonomy principle is philosophically formulated within such accounts prohibits bioethicists' deployment of autonomy as a core ideal for a common moral discourse within multicultural societies. The formulation of autonomy underlying such accounts cannot be extended to simply assimilate individuals' most fundamental religious and cultural commitments and affiliations per se. I challenge the assumption that respecting prospective patients' fundamental religious and cultural commitments is necessarily always compatible with respecting their autonomy. I argue that the character of some peoples' relationship with their cultural or religious community acts to significantly constrain the possibilities for acting autonomously. The implication is

  16. Mission Level Autonomy for USSV

    Science.gov (United States)

    Huntsberger, Terry; Stirb, Robert C.; Brizzolara, Robert

    2011-01-01

    On-water demonstration of a wide range of mission-proven, advanced technologies at TRL 5+ that provide a total integrated, modular approach to effectively address the majority of the key needs for full mission-level autonomous, cross-platform control of USV s. Wide baseline stereo system mounted on the ONR USSV was shown to be an effective sensing modality for tracking of dynamic contacts as a first step to automated retrieval operations. CASPER onboard planner/replanner successfully demonstrated realtime, on-water resource-based analysis for mission-level goal achievement and on-the-fly opportunistic replanning. Full mixed mode autonomy was demonstrated on-water with a seamless transition between operator over-ride and return to current mission plan. Autonomous cooperative operations for fixed asset protection and High Value Unit escort using 2 USVs (AMN1 & 14m RHIB) were demonstrated during Trident Warrior 2010 in JUN 2010

  17. University Institutional Autonomy in Moldova

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Bugaian, Larisa

    This book introduces four evaluation studies in which the current status of university institutional autonomy in Moldova is evaluated. For the purpose of these evaluation studies, a research methodology was developed by the EUniAM project team and used by the Task Force teams to collect and analy...... in Moldova. Preliminary findings of the evaluation studies were presented at the International Conference on “A Quest to (Re)define University Autonomy” organized by the EUniAM project. At the same time, these findings had an impact on the context of the new Code of Education....... the data. Unobtrusive data in the form of laws regulating directly or indirectly the higher education system in Moldova, governmental and ministerial decrees, university chapters and organizational structures, and education records were collected and analysed. A total number of 144 documents have been...

  18. Marked differences in core beliefs about self and others, between sociotropy and autonomy: personality vulnerabilities in the cognitive model of depression

    Directory of Open Access Journals (Sweden)

    Otani K

    2018-03-01

    Full Text Available Koichi Otani, Akihito Suzuki, Yoshihiko Matsumoto, Toshinori Shirata Department of Psychiatry, Yamagata University School of Medicine, Yamagata, Japan Objective: The cognitive model of depression posits two distinctive personality vulnerabilities termed sociotropy and autonomy, each of which is composed of a cluster of maladaptive self-schemas. It is postulated that negative core beliefs about self underlie maladaptive self-schemas as a whole, whereas those about others may be implicated in the autonomous self-schemas. Therefore, the present study examined the relations of sociotropy and autonomy with core beliefs about self and others.Methods: The sample of this study consisted of 321 healthy Japanese volunteers. Sociotropy and autonomy were evaluated by the corresponding subscales of the Sociotropy–Autonomy Scale. Core beliefs about self and others were assessed by the negative-self, positive-self, negative-other and positive-other subscales of the Brief Core Schema Scales.Results: In the forced multiple regression analysis, sociotropy scores were correlated with negative-self scores (β = 0.389, P < 0.001. Meanwhile, autonomy scores were correlated with positive-self scores (β = 0.199, P < 0.01 and negative-other scores (β = 0.191, P < 0.01.Conclusion: The present study suggests marked differences in core beliefs about self and others between sociotropy and autonomy, further contrasting the two personality vulnerabilities to depression. Keywords: sociotropy, autonomy, core belief, self, other, personality, cognitive vulnerability

  19. Cognitive Personality Characteristics Impact the Course of Depression: A Prospective Test of Sociotropy, Autonomy and Domain-Specific Life Events

    OpenAIRE

    Iacoviello, Brian M.; Grant, David A.; Alloy, Lauren B.; Abramson, Lyn Y.

    2009-01-01

    Prospective tests of the impact of sociotropy and autonomy on the course of depression are lacking. In a sample of 97 cognitive high-risk and 62 cognitive low-risk undergraduates who experienced at least one prospective depressive episode, the interactions of sociotropy and interpersonal life events and autonomy and achievement-related life events were examined as predictors of four indicators of the course of depression. Initial analyses failed to support the hypothesis that global scores fo...

  20. Noncoronary Measures Enhance the Predictive Value of Cardiac CT Above Traditional Risk Factors and CAC Score in the General Population.

    Science.gov (United States)

    Mahabadi, Amir A; Lehmann, Nils; Möhlenkamp, Stefan; Pundt, Noreen; Dykun, Iryna; Roggenbuck, Ulla; Moebus, Susanne; Jöckel, Karl-Heinz; Erbel, Raimund; Kälsch, Hagen

    2016-10-01

    The aim of this study was to determine whether noncoronary measures from cardiac computed tomography (CT) may enhance the prognostic value of this imaging technology. When cardiac CT is performed for quantification of coronary artery calcium (CAC) score, information on other cardiac and thoracic structures is available. Participants without known cardiovascular disease from the prospective population based Heinz Nixdorf Recall study underwent noncontrast cardiac CT for CAC score quantification. From CT, epicardial adipose tissue (EAT) volume, left ventricular and left atrial (LA) axial area index, ascending and descending aortic diameters, as well as aortic valve, mitral ring, and thoracic aortic calcification (TAC) were assessed. Incident cardiovascular events included myocardial infarction, stroke, and cardiovascular death. The prognostic value of CT-derived parameters was assessed by Cox regression analysis, receiver operating characteristics, and net reclassification improvement. From 3,630 subjects (59 ± 8 years of age, 46% male), 241 (6.6%) developed a cardiovascular event during 9.9 ± 2.6 years of follow-up. In multivariable Cox regression analysis including Framingham Risk Score, CAC (as log[CAC + 1]), and CT parameters, LA index (hazard ratio [HR]: 1.22 [95% confidence interval [CI]: 1.05 to 1.41] per SD; p = 0.010) and EAT volume (HR: 1.15 [95% CI: 1.01 to 1.30] per SD; p = 0.031) were significantly associated with incident events. In addition, presence of TAC showed an elevated event rate (HR: 1.33 [95% CI: 0.97 to 1.81]; p = 0.08), whereas all other CT-derived parameters showed no relevant association. The LA index, EAT volume, and presence of TAC together improved the prediction of events over Framingham Risk Score and CAC in receiver operating characteristics analysis (area under the curve: 0.749 to 0.764; p = 0.011), and let to a significant net reclassification improvement (HR: 38.0%; 95% CI: 25.1% to 50.8%). Assessment of LA index, EAT

  1. Medical practice in organized settings. Redefining medical autonomy.

    Science.gov (United States)

    Astrachan, J H; Astrachan, B M

    1989-07-01

    Physicians are perplexed by the ongoing erosion of their individual professional autonomy. While the economic forces underlying such change have received much attention, the evolution of new organizational forms that modify and often diminish medical autonomy is less well understood. The practice of medicine is becoming more organized and more hierarchical. We emphasize the importance of organized medical groups, including the medical staff organization, as structures for appropriate peer monitoring, and for counterbalancing the burgeoning influence of governance and administrative constraints on practice. There is an ongoing tension within organizations between management, governance, and physicians. Over time one or another of these groups achieves some measure of dominance, but good management requires a balance of power. The role of the medical staff, which is poorly represented in some health care institutions and under threat in others, is considered. In general, we find that medical work is becoming more hierarchical, and that physician "leaders" do not substitute for collegial processes.

  2. Standby-battery autonomy versus power quality

    Science.gov (United States)

    Bitterlin, Ian F.

    Batteries are used in a wide variety of applications as an energy store to bridge gaps in the primary source of supplied power for a given period of time. In some cases this bridging time, the battery's "autonomy", is fixed by local legislation but it is also often set by historically common practices. However, even if common practice dictates a long autonomy time, we are entering a new era of "cost and benefit realism" underpinned by environmentally friendly policies and we should challenge these historical practices at every opportunity if it can lead to resource and cost savings. In some cases the application engineer has no choice in the design autonomy; either follow a piece of local legislation (e.g. 4 h autonomy for a "life safety" application), or actually work out what is needed! An example of the latter would be for a remote site, off-grid, using integrated wind/solar power (without emergency generator back-up) where you may have to design-in several days' battery autonomy. This short paper proposes that a battery's autonomy should be related to the time expected for the system to be without the primary power source, balanced by the capital costs and commercial risk of power failure. To discuss this we shall consider the factors in selecting the autonomy time and other related aspects for high voltage battery systems used in facility-wide uninterruptible power supply (UPS) systems.

  3. Shared decision-making and patient autonomy.

    Science.gov (United States)

    Sandman, Lars; Munthe, Christian

    2009-01-01

    In patient-centred care, shared decision-making is advocated as the preferred form of medical decision-making. Shared decision-making is supported with reference to patient autonomy without abandoning the patient or giving up the possibility of influencing how the patient is benefited. It is, however, not transparent how shared decision-making is related to autonomy and, in effect, what support autonomy can give shared decision-making. In the article, different forms of shared decision-making are analysed in relation to five different aspects of autonomy: (1) self-realisation; (2) preference satisfaction; (3) self-direction; (4) binary autonomy of the person; (5) gradual autonomy of the person. It is argued that both individually and jointly these aspects will support the models called shared rational deliberative patient choice and joint decision as the preferred versions from an autonomy perspective. Acknowledging that both of these models may fail, the professionally driven best interest compromise model is held out as a satisfactory second-best choice.

  4. The Influence of Education and Depression on Autonomy of Women with Chronic Pelvic Pain: A Cross-sectional Study.

    Science.gov (United States)

    Barbosa, Hermes de Freitas; Nogueira, Antonio Alberto; e Silva, Júlio César Rosa; Poli Neto, Omero Benedicto; dos Reis, Francisco José Candido

    2016-01-01

    Patient autonomy has great importance for a valid informed consent in clinical practice. Our objectives were to quantify the domains of patient autonomy and to evaluate the variables that can affect patient autonomy in women with chronic pelvic pain. This study is a cross sectional survey performed in a tertiary care University Hospital. Fifty-two consecutive women scheduled for laparoscopic management of chronic pelvic were included. Three major components of autonomy (competence, information or freedom) were evaluated using a Likert scale with 24 validated affirmatives. Competence scores (0.85 vs 0.92; p = 0.006) and information scores (0.90 vs 0.93; p = 0.02) were low for women with less than eight years of school attendance. Information scores were low in the presence of anxiety (0.91 vs 0.93; p = 0.05) or depression (0.90 vs 0.93; p = 0.01). Our data show that systematic evaluation of patient autonomy can provide clinical relevant information in gynecology. Low educational level, anxiety and depression might reduce the patient autonomy in women with chronic pelvic pain.

  5. Markets & Myths: Autonomy in Public & Private Schools

    Directory of Open Access Journals (Sweden)

    Sandra Rubin Glass

    1997-01-01

    Full Text Available

    School choice is the most controversial education policy issue of the 1990s. John Chubb and Terry Moe's Politics, Markets and America's Schools stimulated this investigation. They concluded that teacher and administrator autonomy was the most important influence on student achievement. They assumed that the organization of private schools offered greater autonomy resulting in higher student achievement and that the bureaucracy of public schools stifles autonomy limiting student achievement. The research undertaken here elaborates, elucidates, and fills in the framework of teacher and principal autonomy in public and private secondary schools. Interviews of more than thirty teachers and administrators in six high schools, observations, field notes, and analysis of documents collected in the field form the empirical base of this work. The sites included three private, independent, nondenominational secondary schools which are college preparatory and three public secondary schools noted for high graduation rates and offering numerous advanced placement courses.

    The feelings expressed by both public and private school participants in this study testify to equally high degrees of autonomy. Issues that emerged from data analysis in this study which mitigate and shape autonomy include the following: conflicting and contradictory demands, shared beliefs, layers of protection, a system of laws, funding constraints and matters of size of the institution. These issues challenge oversimplified assertions that differences of any importance exist between the autonomy experienced by professionals in public and private high schools. This study reveals the complexity of the concept of autonomy and challenges the myth that teachers and principals in private schools enjoy autonomy and freedom from democratic bureaucracy that their public school counterparts do not.

  6. Patient autonomy and advance care planning: a qualitative study of oncologist and palliative care physicians' perspectives.

    Science.gov (United States)

    Johnson, Stephanie B; Butow, Phyllis N; Kerridge, Ian; Tattersall, Martin H N

    2018-02-01

    Patients' are encouraged to participate in advance care planning (ACP) in order to enhance their autonomy. However, controversy exists as to what it means to be autonomous and there is limited understanding of how social and structural factors may influence cancer patients' ability to exercise their autonomy. The objective of this study is to explore oncologists' and palliative care physicians' understanding of patient autonomy, how this influences reported enactment of decision-making at the end of life (EOL), and the role of ACP in EOL care. Qualitative semi-structured interviews were conducted with consultant oncologists (n = 11) and palliative medicine doctors (n = 7) working in oncology centres and palliative care units across Australia. We found that doctors generally conceptualized autonomy in terms of freedom from interference but that there was a profound disconnect between this understanding of autonomy and clinical practice in EOL decision-making. The clinicians in our study privileged care, relationships and a 'good death' above patient autonomy, and in practice were reluctant to 'abandon' their patients to total non-interference in decision-making. Patient autonomy in healthcare is bounded, as while patients were generally encouraged to express their preferences for care, medical norms about the quality and 'reasonableness' of care, the availability of services and the patients' family relationships act to enhance or limit patients' capacity to realize their preferences. While for many, this disconnect between theory and practice did not diminish the rhetorical appeal of ACP; for others, this undermined the integrity of ACP, as well as its relevance to care. For some, ACP had little to do with patient autonomy and served numerous other ethical, practical and political functions. The ethical assumptions regarding patient autonomy embedded in academic literature and policy documents relating to ACP are disconnected from the realities of clinical care

  7. Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community.

    Science.gov (United States)

    Zeal, Carley; Higgins, Jenny A; Newton, Shaunna R

    2018-01-01

    Long-acting reversible contraceptives (LARCs) are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC.

  8. Patient-Perceived Autonomy and Long-Acting Reversible Contraceptive Use: A Qualitative Assessment in a Midwestern, University Community

    Directory of Open Access Journals (Sweden)

    Carley Zeal

    2018-03-01

    Full Text Available Long-acting reversible contraceptives (LARCs are the most effective contraceptives and are first-line recommendations for most women. However, young women use these methods at relatively low rates. Given concern with contraceptive coercion, an underexamined factor contributing to LARC attitudes is women's perceived reproductive and bodily autonomy in regard to LARC. We conducted focus group discussions and interviews regarding LARC perceptions and knowledge with 50 women between the ages of 18 and 29. We used a modified grounded theory approach to analyze young women's impressions of autonomy in relation to contraceptives more generally and LARC more specifically, both among ever-users and never-users. Four themes emerged regarding women's perceived autonomy with LARC. Control over pregnancy, active participation versus external agent, control over bleeding patterns, and autonomy in the provider/patient relationship. Within most themes, women made both positive and negative associations between perceived autonomy and LARC. The provider/patient relationship was a modifier of other themes, in that cooperative relationships may overshadow other perceived reductions in autonomy, and more unbalanced relationships may heighten perceived reductions in autonomy. Ever-users were more likely to report increased autonomy with LARC use, whereas never-users were more likely to express concerns about loss of autonomy with LARC. This study suggests that perceived autonomy may influence women's perceptions of LARC as well as their uptake of these contraceptive methods, with several factors both positively and negatively related to women's perceived autonomy. We encourage the integration of these findings into patient-centered counseling as well as educational materials for LARC.

  9. A general approach for developing system-specific functions to score protein-ligand docked complexes using support vector inductive logic programming.

    Science.gov (United States)

    Amini, Ata; Shrimpton, Paul J; Muggleton, Stephen H; Sternberg, Michael J E

    2007-12-01

    Despite the increased recent use of protein-ligand and protein-protein docking in the drug discovery process due to the increases in computational power, the difficulty of accurately ranking the binding affinities of a series of ligands or a series of proteins docked to a protein receptor remains largely unsolved. This problem is of major concern in lead optimization procedures and has lead to the development of scoring functions tailored to rank the binding affinities of a series of ligands to a specific system. However, such methods can take a long time to develop and their transferability to other systems remains open to question. Here we demonstrate that given a suitable amount of background information a new approach using support vector inductive logic programming (SVILP) can be used to produce system-specific scoring functions. Inductive logic programming (ILP) learns logic-based rules for a given dataset that can be used to describe properties of each member of the set in a qualitative manner. By combining ILP with support vector machine regression, a quantitative set of rules can be obtained. SVILP has previously been used in a biological context to examine datasets containing a series of singular molecular structures and properties. Here we describe the use of SVILP to produce binding affinity predictions of a series of ligands to a particular protein. We also for the first time examine the applicability of SVILP techniques to datasets consisting of protein-ligand complexes. Our results show that SVILP performs comparably with other state-of-the-art methods on five protein-ligand systems as judged by similar cross-validated squares of their correlation coefficients. A McNemar test comparing SVILP to CoMFA and CoMSIA across the five systems indicates our method to be significantly better on one occasion. The ability to graphically display and understand the SVILP-produced rules is demonstrated and this feature of ILP can be used to derive hypothesis for

  10. Oppression, Autonomy and the Impossibility of the Inner Citadel

    Science.gov (United States)

    Nelsen, Peter

    2010-01-01

    This paper argues for a conception of autonomy that takes social oppression seriously without sapping autonomy of its valuable focus on individual self-direction. Building on recent work in relational accounts of autonomy, the paper argues that current conceptions of autonomy from liberal, feminist and critical theorists do not adequately account…

  11. Heteronomous Citizenship: Civic Virtue and the Chains of Autonomy

    Science.gov (United States)

    Swaine, Lucas

    2010-01-01

    In this article, I distinguish personal autonomy from heteronomy, and consider whether autonomy provides a suitable basis for liberalism. I argue that liberal government should not promote autonomy in all its citizens, on the grounds that not all members of liberal democracies require autonomy for a good life. I then outline an alternative option…

  12. Autonomy, nudging and post-truth politics.

    Science.gov (United States)

    Keeling, Geoff

    2017-11-16

    In his excellent essay, 'Nudges in a post-truth world', Neil Levy argues that 'nudges to reason', or nudges which aim to make us more receptive to evidence, are morally permissible. A strong argument against the moral permissibility of nudging is that nudges fail to respect the autonomy of the individuals affected by them. Levy argues that nudges to reason do respect individual autonomy, such that the standard autonomy objection fails against nudges to reason. In this paper, I argue that Levy fails to show that nudges to reason respect individual autonomy. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Emotional autonomy and depression among Chinese adolescents.

    Science.gov (United States)

    Chou, K L

    2000-06-01

    Depression is quite common among young people in Hong Kong Chinese society. This study examined the association between emotional autonomy and depressive symptomatology among Chinese young people in Hong Kong. The respondents were 512 young people between 16 and 18 years of age from a cross-sectional study in Hong Kong. Significant bivariate relationships were found between depressive symptomatology and three dimensions of emotional autonomy (individuation, nondependency on parents, and deidealization of parents). Using multiple regression models, the author found that depressive symptomatology was associated with two aspects of emotional autonomy: individuation and deidealization of parents. Results indicate that the relationships between depressive symptomatology and these three aspects of emotional autonomy are similar in both individualistic and collectivistic societies.

  14. [The medical autonomy of elderly in Taiwan].

    Science.gov (United States)

    Chen, Kai-Li; Chen, Ching-Huey

    2014-10-01

    The elderly population is increasing rapidly in Taiwan. With the average life expectancy on the rise, the elderly have become major consumers of healthcare products and services. Factors that influence respect for autonomy, a core value of medical ethics, may be related to family, society, and the medical culture. Especially in patients who are already elderly, aging causes declines in physical, mental and societal capacities. Practicing a respect for patient autonomy is particularly challenging for healthcare professionals in Taiwan due the unique culture background of elderly Taiwanese patients. This article reviews and integrates the literature related to the issue of patient autonomy and elaborates on medical decision-making among elderly patients in Taiwan in the contexts of: the disadvantages faced by the elderly, the background of Chinese culture, and the current medical decision-making environment. A few suggestions are proposed to help preserve the medical-decision-making autonomy of elderly patients in Taiwan.

  15. Decision-Making Autonomy and Subsidiary Innovation

    DEFF Research Database (Denmark)

    Van Vo, Dut; Beugelsdijk, Sjoerd; de Jong, Gjalt

    2013-01-01

    This paper investigates how decision-making autonomy affects the possibility and intensity of innovation in subsidiaries of multinational enterprises (MNEs). Subsidiaries are increasingly identified as sources of innovation and as vehicles for cross-border transfer of new competences. The question...... of how much decision-making autonomy subsidiaries should have is a core issue in the management of headquarters-subsidiary relationships. Using two complementary theoretical perspectives, we hypothesize a non-linear relationship between subsidiary’s decision-making autonomy and innovation. We test our...... hypothesis in a multi-country and multiindustry database based on survey evidence of 134 subsidiaries located in five Central and Eastern European countries from 23 home countries. The empirical results provide support for a non-linear U shaped relationship between subsidiary decision-making autonomy...

  16. Fiscal autonomy of urban councils in Zimbabwe

    African Journals Online (AJOL)

    LAW

    current system of decentralisation entrenches the financial autonomy of urban ..... of the UCA to deploy auditors to inspect the accounts of urban councils ..... Act; the payment of compensation; the liquidation of the principal monies owing on.

  17. Futility, autonomy, and informed consent.

    Science.gov (United States)

    Trau, J M

    1994-03-01

    If clinicians deem a treatment medically futile, is it appropriate to mention such a treatment to patients? Do healthcare professionals violate informed consent if they do not offer patients an opportunity to decline futile treatments? The notion of futility involves an assessment of patient best interest--both short-term and long-term therapeutic benefit for a patient and the community in which he or she intends to survive and flourish. Although survival interests may be construed as long term, a treatment that offers survival without any promise of flourishing is not the goal of medicine and is futile. Flourishing requires some cognitive and affective function. The goal of informed consent practices is to ensure that patients accept the benefits of treatment with cognizance of the burdens and risks. Given the impact of illness on the emotional and psychological states of patients and their families and their resultant vulnerability, the omission of futile options from treatment plans is logical and exemplifies the best of paternalistic behavior. The claim that requests for futile treatment must be honored is based on a perverse understanding of patient autonomy. Rational medicine demands that patients' requests be reasonable from a clinical perspective, as well as from a subjective one. The practice of informed consent can be implemented as a balance between these two interests.

  18. Autonomy in place of birth: a concept analysis.

    Science.gov (United States)

    Halfdansdottir, Berglind; Wilson, Margaret E; Hildingsson, Ingegerd; Olafsdottir, Olof A; Smarason, Alexander Kr; Sveinsdottir, Herdis

    2015-11-01

    This article examines one of the relevant concepts in the current debate on home birth-autonomy in place of birth-and its uses in general language, ethics, and childbirth health care literature. International discussion on childbirth services. A concept analysis guided by the model of Walker and Avant. The authors suggest that autonomy in the context of choosing place of birth is defined by three main attributes: information, capacity and freedom; given the antecedent of not harming others, and the consequences of accountability for the outcome. Model, borderline and contrary cases of autonomy in place of birth are presented. A woman choosing place of birth is autonomous if she receives all relevant information on available choices, risks and benefits, is capable of understanding and processing the information and choosing place of birth in the absence of coercion, provided she intends no harm to others and is accountable for the outcome. The attributes of the definition can serve as a useful tool for pregnant women, midwives, and other health professionals in contemplating their moral status and discussing place of birth.

  19. Job autonomy and job satisfaction: new evidence

    OpenAIRE

    Taylor, J; Bradley, S; Nguyen, A N

    2003-01-01

    This paper investigates the impact of perceived job autonomy on job satisfaction. We use the fifth sweep of the National Educational Longitudinal Study (1988-2000), which contains personally reported job satisfaction data for a sample of individuals eight years after the end of compulsory education. After controlling for a wide range of personal and job-related variables, perceived job autonomy is found to be a highly significant determinant of five separate domains of job satisfaction (pay, ...

  20. Autonomy, Competence and Non-interference

    OpenAIRE

    Roberts, Joseph T.F.

    2017-01-01

    In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights ...

  1. The Changing Scope of Professional Autonomy

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh; Wrede, Sirpa

    2009-01-01

    Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter.......Kapitlet undersøger hvordan lægeprofessionens autonomi ændres i relation til ledelse i sygehuse i Danmark, Norge, Sverige og Finland i tiden fra 1970 og fremefter....

  2. SOCIOTROPY AND AUTONOMY IN EATING DISORDERS

    OpenAIRE

    Radziwiłłowicz, Wioletta; Czarniak, Katarzyna

    2014-01-01

    Objectives: Studies of development psychopathology and psychia try have shown that personality variables are greatly associated with eating disorders. Sociotropy and autonomy may be features that facilitate the occurrence and persistence of the eating disturbances. Theoretical framework for own research was mainly the A. Beck’s concept of autonomy and sociotropy. The aim of the study was to answer the research question whether a person suffering from an eating disorder is characterized by ...

  3. Understanding critical care nurses' autonomy in Jordan.

    Science.gov (United States)

    Maharmeh, Mahmoud

    2017-10-02

    Purpose The aim of this study was to describe Jordanian critical care nurses' experiences of autonomy in their clinical practice. Design/methodology/approach A descriptive correlational design was applied using a self-reported cross-sectional survey. A total of 110 registered nurses who met the eligibility criteria participated in this study. The data were collected by a structured questionnaire. Findings A majority of critical care nurses were autonomous in their decision-making and participation in decisions to take action in their clinical settings. Also, they were independent to develop their own knowledge. The study identified that their autonomy in action and acquired knowledge were influenced by a number of factors such as gender and area of practice. Practical implications Nurse's autonomy could be increased if nurses are made aware of the current level of autonomy and explore new ways to increase empowerment. This could be offered through classroom lectures that concentrate on the concept of autonomy and its implication in practice. Nurses should demonstrate autonomous nursing care at the same time in the clinical practice. This could be done through collaboration between educators and clinical practice to help merge theory to practice. Originality/value Critical care nurses were more autonomous in action and knowledge base. This may negatively affect the quality of patient care and nurses' job satisfaction. Therefore, improving nurses' clinical decision-making autonomy could be done by the support of both hospital administrators and nurses themselves.

  4. Autonomy and informed consent: a mistaken association?

    Science.gov (United States)

    Kristinsson, Sigurdur

    2007-09-01

    For decades, the greater part of efforts to improve regulatory frameworks for research ethics has focused on informed consent procedures; their design, codification and regulation. Why is informed consent thought to be so important? Since the publication of the Belmont Report in 1979, the standard response has been that obtaining informed consent is a way of treating individuals as autonomous agents. Despite its political success, the philosophical validity of this Belmont view cannot be taken for granted. If the Belmont view is to be based on a conception of autonomy that generates moral justification, it will either have to be reinterpreted along Kantian lines or coupled with a something like Mill's conception of individuality. The Kantian interpretation would be a radical reinterpretation of the Belmont view, while the Millian justification is incompatible with the liberal requirement that justification for public policy should be neutral between controversial conceptions of the good. This consequence might be avoided by replacing Mill's conception of individuality with a procedural conception of autonomy, but I argue that the resulting view would in fact fail to support a non-Kantian, autonomy-based justification of informed consent. These difficulties suggest that insofar as informed consent is justified by respect for persons and considerations of autonomy, as the Belmont report maintained, the justification should be along the lines of Kantian autonomy and not individual autonomy.

  5. Perceived autonomy in the first semester of mathematics studies

    OpenAIRE

    Liebendörfer, Michael; Hochmuth, Reinhard

    2015-01-01

    International audience; We focus on the perceived autonomy of mathematics students in their first semester at university. According to self-determination theory by Deci and Ryan (1985), students have to satisfy their need for autonomy in order to develop intrinsic motivation. Using two facets of autonomy, we analyse interview data to explore which situations foster or hinder the students' perceived autonomy. The main factors affecting students' autonomy are briefly discussed.

  6. Factor structure of the autonomy preference index in people with severe mental illness.

    Science.gov (United States)

    Bonfils, Kelsey A; Adams, Erin L; Mueser, Kim T; Wright-Berryman, Jennifer L; Salyers, Michelle P

    2015-08-30

    People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  7. Let it go: Relationship autonomy predicts pro-relationship responses to partner transgressions.

    Science.gov (United States)

    Hadden, Benjamin W; Baker, Zachary G; Knee, C Raymond

    2017-11-24

    The purpose of the present research is to better understand how relationship autonomy-having more self-determined reasons for being committed to a relationship-contributes to pro-relationship responses to transgressions in romantic relationships (e.g., forgiveness and accommodation). Study 1 employed a cross-sectional design (N = 350) and Study 2 used a weekly diary (N = 121) to test associations between relationship autonomy and pro-relationship responses to transgressions. Studies 3 and 4 utilized dyadic designs (Study 3: N = 200 couples, 400 individuals; Study 4: N = 275 couples, 550 individuals) to determine how both partners' relationship autonomy is associated with pro-relationship responses. Results revealed that relationship autonomy is robustly associated with pro-relationship responses to transgressions, both as general tendencies and as responses to idiosyncratic transgressions. Results of actor-partner interdependence model (APIM) analyses in Studies 3 and 4 provide evidence that one's partner's relationship autonomy is important for promoting pro-relationship responses as well. Study 4 also found that people perceive that partners respond better to transgressions if their partner is high in relationship autonomy. This research provides consistent and compelling evidence that the degree of self-determination underlying commitment is important for understanding how people respond to transgressions in their relationships, beyond their current levels of commitment. © 2017 Wiley Periodicals, Inc.

  8. The Discriminant Analysis: an Exploratory Study Concerning the Degree of Financial Autonomy of Companies in the Context of the Romanian Business Environment

    Directory of Open Access Journals (Sweden)

    Marinela Mironiuc

    2010-12-01

    Full Text Available This study aims at analyzing the evolution of financial autonomy on a sample of 80 companies quoted in the Bucharest Stock Exchange, between 2006-2008. Classically, financial autonomy is measured using the global and day-to-day rates of financial autonomy. However, this study has tested the dependency between the global rate of financial autonomy (Own Capital/ Total debts and a series of economic and financial indicators, with the purpose of obtaining both a score function that would help making a classification of the companies subject to our analysis, in performance groups (companies with a high financial autonomy, companies with a medium financial autonomy, companies with a low financial autonomy, and companies with no financial autonomy, and quantifying the influence of the relative variations of these economic and financial indicators on the relative variation of financial autonomy. In order to calculate the results, the statistic instrument SPSS 15.0 was used, and the work method was the discriminant analysis and the regression and multiple correlation analysis.

  9. Mothers' autonomy and childhood stunting: evidence from semi-urban communities in Lao PDR.

    Science.gov (United States)

    Kamiya, Yusuke; Nomura, Marika; Ogino, Hina; Yoshikawa, Kanako; Siengsounthone, Latsamy; Xangsayarath, Phonepadith

    2018-05-22

    Childhood stunting (height-for-age z-scores below - 2), a form of chronic undernutrition, remains a global health burden. Although a growing literature has examined the association between mothers' autonomy and childhood stunting, these studies have been limited to countries in South Asia or Sub-Saharan Africa where women have relatively lower social status than do men. Little research has analyzed the effect of mothers' autonomy on childhood stunting in Lao PDR, where women's social status is relatively high compared to that in other countries. We conducted a cross-sectional questionnaire and body scale measurement targeting 100 mothers and their 115 children (autonomy, we measured self-esteem, self-efficacy, decision-making power, freedom of mobility, and control of money. We then analyzed how each dimension was associated with the likelihood of childhood stunting. The likelihood of childhood stunting was significantly lower if mothers had higher self-efficacy for health care (OR = 0.15, p = 0.007), self-esteem (OR = 0.11, p = 0.025), or control of money (OR = 0.11, p = 0.041). In contrast, mothers' decision-making power and freedom of mobility were not significantly associated with childhood stunting. We clarified which dimensions of women's autonomy were associated with childhood stunting in Lao PDR. A closer examination of mothers' autonomy will aid proper understanding of the determinants of childhood stunting.

  10. How important are autonomy and work setting to nurse practitioners' job satisfaction?

    Science.gov (United States)

    Athey, Erin K; Leslie, Mayri Sagady; Briggs, Linda A; Park, Jeongyoung; Falk, Nancy L; Pericak, Arlene; El-Banna, Majeda M; Greene, Jessica

    2016-06-01

    Nurse practitioners (NPs) have reported aspects of their jobs that they are more and less satisfied with. However, few studies have examined the factors that predict overall job satisfaction. This study uses a large national sample to examine the extent to which autonomy and work setting predict job satisfaction. The 2012 National Sample Survey of Nurse Practitioners (n = 8311) was used to examine bivariate and multivariate relationships between work setting and three autonomy variables (independent billing practices, having one's NP skills fully utilized, and relationship with physician), and job satisfaction. NPs working in primary care reported the highest levels of autonomy across all three autonomy measures, while those working in hospital surgical settings reported the lowest levels. Autonomy, specifically feeling one's NP skills were fully utilized, was the factor most predictive of satisfaction. In multivariate analyses, those who strongly agreed their skills were being fully utilized had satisfaction scores almost one point higher than those who strongly disagreed. Work setting was only marginally related to job satisfaction. In order to attract and retain NPs in the future, healthcare organizations should ensure that NPs' skills are being fully utilized. ©2015 American Association of Nurse Practitioners.

  11. The teacher benefits from giving autonomy support during physical education instruction.

    Science.gov (United States)

    Cheon, Sung Hyeon; Reeve, Johnmarshall; Yu, Tae Ho; Jang, Hue Ryen

    2014-08-01

    Recognizing that students benefit when they receive autonomy-supportive teaching, the current study tested the parallel hypothesis that teachers themselves would benefit from giving autonomy support. Twenty-seven elementary, middle, and high school physical education teachers (20 males, 7 females) were randomly assigned either to participate in an autonomy-supportive intervention program (experimental group) or to teach their physical education course with their existing style (control group) within a three-wave longitudinal research design. Manipulation checks showed that the intervention was successful, as students perceived and raters scored teachers in the experimental group as displaying a more autonomy-supportive and less controlling motivating style. In the main analyses, ANCOVA-based repeated-measures analyses showed large and consistent benefits for teachers in the experimental group, including greater teaching motivation (psychological need satisfaction, autonomous motivation, and intrinsic goals), teaching skill (teaching efficacy), and teaching well-being (vitality, job satisfaction, and lesser emotional and physical exhaustion). These findings show that giving autonomy support benefits teachers in much the same way that receiving it benefits their students.

  12. An investigation into the impact of reflective teaching on EFL learners autonomy and intrinsic motivation

    Directory of Open Access Journals (Sweden)

    Elahe Fallah

    2015-12-01

    Full Text Available This study has sought to explore the effect of reflective teaching on learner autonomy and the intrinsic motivation of Iranian upper-intermediate female learners. The subjects included 60 adult upper-intermediate EFL learners chosen out of ninety, based on the scores obtained through administration of the TOEFL exam. They were randomly assigned to two groups: a the experimental group - taught by a reflective teacher - and b the control group instructed by an unreflective teacher. The motivation questionnaire and the autonomy questionnaire were administered to both groups to make sure that the two groups were not significantly different in terms of the level of motivation and autonomy. The experimental group was then taught by the reflective teacher and the control group was taught by the unreflective teacher who adopted no tangible reflective actions. Finally, both groups sat for motivation and autonomy questionnaires. The results indicate that reflective teaching leads to the enhancement of both learners’ autonomy and the intrinsic motivation level.

  13. Controlled Autonomy: Novice Principals' Schema for District Control and School Autonomy

    Science.gov (United States)

    Weiner, Jennie M.; Woulfin, Sarah L.

    2017-01-01

    Purpose: The purpose of this paper is to gain insights into how a group of novice principals, all in schools that deployed principles of autonomy as mechanisms for improvement, conceptualized what the authors label "controlled autonomy"--a condition in which school leaders are expected to both make site-based decisions and be accountable…

  14. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes.

    Science.gov (United States)

    Mohn, J; Graue, M; Assmus, J; Zoffmann, V; B Thordarson, H; Peyrot, M; Rokne, B

    2015-11-01

    To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. This cross-sectional study comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43.2% reported elevated (≥40) Problem Areas in Diabetes scores. A significant negative association was found between autonomy support and Problem Areas in Diabetes score (B = -3.61, P = 0.001), indicating that lower autonomy support was associated with greater diabetes distress. When perceived competence was controlled, it mediated the association of autonomy support with diabetes distress, reducing it to non-significance. There was a significant negative association between perceived competence and Problem Areas in Diabetes score (B = -8.89, P perceived competence was associated with greater perceived distress. There was an indirect (fully mediated) relationship between autonomy support and diabetes distress; autonomy support was associated with increased perceived competence, which, in turn, was associated with reduced distress. Healthcare providers' communication styles enhancing perceived competence through autonomy support may contribute to effective treatment for people with Type 1 diabetes and suboptimum glycaemic control. © 2015 The Authors. Diabetic Medicine Published by John Wiley & Sons

  15. Quadratic prediction of factor scores

    NARCIS (Netherlands)

    Wansbeek, T

    1999-01-01

    Factor scores are naturally predicted by means of their conditional expectation given the indicators y. Under normality this expectation is linear in y but in general it is an unknown function of y. II is discussed that under nonnormality factor scores can be more precisely predicted by a quadratic

  16. Executive functions in adolescents with spina bifida: relations with autonomy development and parental intrusiveness.

    Science.gov (United States)

    Tuminello, Elizabeth R; Holmbeck, Grayson N; Olson, Rick

    2012-01-01

    The current study was part of a larger longitudinal investigation and examined the relation of parent-report and performance measures of executive functioning (EF) with measures of behavioral and emotional autonomy and parental intrusiveness in adolescents with and without spina bifida (SB; n=65 in a comparison sample and 61 in an SB sample; M age=14.55, SD=0.63). For both groups, higher levels of parent-reported EF problems predicted higher levels of observed child dependency and lower levels of teacher-reported intrinsic motivation. Higher scores on performance EF measures predicted lower levels of observed child dependency and observed maternal intrusiveness for both groups. In adolescents with SB only, higher performance EF scores predicted higher intrinsic motivation and emotional autonomy from both mother and father and predicted lower levels of observed paternal intrusiveness. While causal conclusions cannot be drawn, EFs appear to be closely related to autonomy development and parental intrusiveness, particularly for adolescents with SB. These results suggest that the inclusion of EF training in interventions targeting adolescents with SB may be beneficial for autonomy development.

  17. The development of autonomy in children's education.

    Directory of Open Access Journals (Sweden)

    Laura Cavana

    2011-12-01

    Full Text Available This work deals with the development of autonomy in the education of the child and focuses on the analysis of empirical data collected in some services for children in North and South of Italy (Trento, Bologna, Caltagirone, through the administration of semi-structured interviews with educators of the nursery and kindergarten teachers. The returned responses were read in the light of the phenomenological paradigm that permitted to highlight two major kinds of considerations: the one refers to as "parents support and encourage the development of the autonomy of their child more in words than deeds"; the other to as the educators and teachers interviewed showed an explicit difficulty to attribute a clear meaning to the concept of adult autonomy. The incoming in this set of considerations first of all emphasize the important role of adult education and its path of reflexivity and growth.

  18. The autonomy of grammar and semantic internalism

    Directory of Open Access Journals (Sweden)

    Dobler Tamara

    2014-01-01

    Full Text Available In his post-Tractatus work on natural language use, Wittgenstein defended the notion of what he dubbed the autonomy of grammar. According to this thought, grammar - or semantics, in a more recent idiom - is essentially autonomous from metaphysical considerations, and is not answerable to the nature of things. The argument has several related incarnations in Wittgenstein’s post-Tractatus writings, and has given rise to a number of important insights, both critical and constructive. In this paper I will argue for a potential connection between Wittgenstein’s autonomy argument and some more recent internalist arguments for the autonomy of semantics. My main motivation for establishing this connection comes from the fact that the later Wittgenstein’s comments on grammar and meaning stand in opposition to some of the core assumptions of semantic externalism.

  19. School nurses' perceptions of empowerment and autonomy.

    Science.gov (United States)

    DeSisto, Marie C; DeSisto, Thomas Patrick

    2004-08-01

    The purpose of this study was to explore Kanter's Theory of Structural Power in Organizations, using school nurses and to answer the research question of whether there is a relationship between empowerment and autonomy in school nurses. This study found a positive relationship between the nurses' perceptions of empowerment and autonomy. The school nurses surveyed perceived themselves to have a high degree of autonomy and a moderate degree of empowerment, and they reported that their access to informal power structures was higher than their access to formal power structures in their school systems. School nurses can benefit by understanding factors that can increase their empowerment in the workplace. They need to understand the organizational structure of their workplace to increase their effectiveness and job satisfaction.

  20. Privacy, autonomy, and public policy: French and North American perspectives.

    Science.gov (United States)

    Merchant, Jennifer

    2016-12-01

    This article raises the question of whether in both the United States and in France, an individual's autonomy and private decision-making right(s) in matters of health care and access to reproductive technologies can be conciliated with the general interest, and more specifically, the role of the State. Can a full-fledged right to privacy, the ability to exercise one's autonomy, exist alongside the general interest, and depend neither on financial resources like in the United States nor on centralised government decisions or the medical hierarchy like in France? The contrast between these two modern democracies justify the importance of comparing them. I will demonstrate that overlaps do exist: the free exercise of religion and opinion, freedom of expression, the inherent value of each individual. What differs, however, are the institutions and how they provide, protect, promote, or frame access to and expressions of these democratic principles. The impact of the global economy, the exposure of people around the world to each other via the internet, and the mirror effects of social media, blogs, and other such forums, have created new perspectives that countries project onto one another. For example, does France now seem to tout 'autonomy' as a new and important value because it appears to be an 'American success story'? Does the United States now seem to value human rights and a social-democratic approach because of the 'French model'? There seems to be some truth behind these assertions, but as this article will demonstrate, the portrayals of what the 'right to privacy' is in the United States and what 'socialised medicine' is in France are not necessarily fully accurate.

  1. [Prognostic scores for pulmonary embolism].

    Science.gov (United States)

    Junod, Alain

    2016-03-23

    Nine prognostic scores for pulmonary embolism (PE), based on retrospective and prospective studies, published between 2000 and 2014, have been analyzed and compared. Most of them aim at identifying PE cases with a low risk to validate their ambulatory care. Important differences in the considered outcomes: global mortality, PE-specific mortality, other complications, sizes of low risk groups, exist between these scores. The most popular score appears to be the PESI and its simplified version. Few good quality studies have tested the applicability of these scores to PE outpatient care, although this approach tends to already generalize in the medical practice.

  2. EVALUATION OF FINANCIAL AUTONOMY PROCESS OF BINH THUAN PROVINCE IN TRAINING PUBLIC HUMAN RESOURCES IN FOREIGN COUNTRIES

    OpenAIRE

    NGUYEN THANH, NHAN

    2012-01-01

    This paper will discuss the financial autonomy in training public human resources in foreign countries in Binh Thuan province. The process of financial autonomy helps Binh Thuan province be proactive in dealing with its performances in many aspects, especially in training public human resources. Although central government has built many training policies, the training focuses on the fields that meet the general requirements of the whole country. This leads to the situation that the trained m...

  3. Autonomy and the human element in space

    Science.gov (United States)

    1985-01-01

    NASA is contemplating the next logical step in the U.S. space program - the permanent presence of humans in space. As currently envisioned, the initial system, planned for the early 1990's, will consist of manned and unmanned platforms situated primarily in low Earth orbit. The manned component will most likely be inhabited by 6-8 crew members performing a variety of tasks such as materials processing, satellite servicing, and life science experiments. The station thus has utility in scientific and commercial enterprises, in national security, and in the development of advanced space technology. The technical foundations for this next step have been firmly established as a result of unmanned spacecraft missions to other planets, the Apollo program, and Skylab. With the shuttle, NASA inaugurates a new era of frequent flights and more routine space operations supporting a larger variety of missions. A permanently manned space system will enable NASA to expand the scope of its activities still further. Since NASA' s inception there has been an intense debate over the relative merits of manned and unmanned space systems. Despite the generally higher costs associated with manned components, astronauts have accomplished numerous essential, complex tasks in space. The unique human talent to evaluate and respond inventively to unanticipated events has been crucial in many missions, and the presence of crews has helped arouse and sustain public interest in the space program. On the other hand, the hostile orbital environment affects astronaut physiology and productivity, is dangerous, and mandates extensive support systems. Safety and cost factors require the entire station complex, both space and ground components, to be highly automated to free people from mundane operational chores. Recent advances in computer technology, artificial intelligence (AI), and robotics have the potential to greatly extend space station operations, offering lower costs and superior

  4. Using eHealth to Increase Autonomy Supportive Care

    DEFF Research Database (Denmark)

    Johnsen, Helle; Blom, Karina Fischer; Lee, Anne

    2018-01-01

    eHealth solutions are increasingly implemented in antenatal care to enhance women's involvement. The main aim of this study was to evaluate women's assessment of autonomy supportive care during the antenatal care visits among low-risk pregnant women. An intervention study was conducted including...... a control group attending standard antenatal care and an intervention group having access to an eHealth knowledge base, in addition to standard care. A total of 87 women were included in the control group and a total of 121 women in the intervention group. Data were collected using an online questionnaire 2...... weeks after participants had given birth. Data were analyzed using χ tests and Wilcoxon rank sums. Use of an eHealth knowledge base was associated with statistically significant higher scores for women's overall assessment of antenatal care visits, the organization of antenatal care visits, confidence...

  5. Changing Professional autonomy in the Context of Institutional Change

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh; Houlberg Salomonsen, Heidi

    The Changing autonomy of doctors and civil servants  in Denmark in different institutional contexts......The Changing autonomy of doctors and civil servants  in Denmark in different institutional contexts...

  6. The importance of autonomy support and the mediating role of work motivation for well-being: testing self-determination theory in a Chinese work organisation.

    Science.gov (United States)

    Nie, Youyan; Chua, Bee Leng; Yeung, Alexander Seeshing; Ryan, Richard M; Chan, Wai Yen

    2015-08-01

    We examine relations between perceived organisational autonomy support and different types of work motivation and well-being outcomes in 266 teachers from two government schools in China. We hypothesised that greater autonomy support would be associated with more autonomous forms of employee motivation, and that teacher motivation would in turn mediate the effects of autonomy support on indicators of work well-being (i.e., job satisfaction, work stress and physical ill symptoms). Results generally supported the hypothesised relations between perceived autonomy support and SDT's five types of motivations. Findings also showed that perceived autonomy support predicted job satisfaction directly and indirectly through the mediating roles of intrinsic motivation, identified regulation, introjected regulation and external regulation. Perceived autonomy support predicted work stress directly and indirectly through the mediating roles of external regulation and amotivation. Autonomy support also predicted illness symptoms via the mediating roles of intrinsic motivation, introjected regulation and amotivation. The current findings highlight how perceived organisational support for autonomy relates to motivational differences in a Chinese work context, and the potential relevance of autonomy support for employee well-being. © 2014 International Union of Psychological Science.

  7. Marked differences in core beliefs about self and others, between sociotropy and autonomy: personality vulnerabilities in the cognitive model of depression.

    Science.gov (United States)

    Otani, Koichi; Suzuki, Akihito; Matsumoto, Yoshihiko; Shirata, Toshinori

    2018-01-01

    The cognitive model of depression posits two distinctive personality vulnerabilities termed sociotropy and autonomy, each of which is composed of a cluster of maladaptive self-schemas. It is postulated that negative core beliefs about self underlie maladaptive self-schemas as a whole, whereas those about others may be implicated in the autonomous self-schemas. Therefore, the present study examined the relations of sociotropy and autonomy with core beliefs about self and others. The sample of this study consisted of 321 healthy Japanese volunteers. Sociotropy and autonomy were evaluated by the corresponding subscales of the Sociotropy-Autonomy Scale. Core beliefs about self and others were assessed by the negative-self, positive-self, negative-other and positive-other subscales of the Brief Core Schema Scales. In the forced multiple regression analysis, sociotropy scores were correlated with negative-self scores ( β = 0.389, P vulnerabilities to depression.

  8. Dependent Autonomy : Towards a Contestualised and Dialogic Aim for Moral Education

    NARCIS (Netherlands)

    Altena, Patrick; Hermans, Chris A.M.; Scheepers, Peer L.H.

    2004-01-01

    This article presents two approaches to moral education: the autonomy approach and the heteronomy approach. Generally the two approaches are considered to be mutually exclusive. The study described here, conducted among Dutch teachers at Catholic primary schools, reflects a positive relation between

  9. Adolescent Autonomy-Relatedness and the Family in Cultural Context: What Is Optimal?

    Science.gov (United States)

    Kagitcibasi, Cigdem

    2013-01-01

    This review examines self-family-culture links from a cultural and global perspective utilizing Kagitcibasi's Family Change Theory and Self Theory as general frameworks. These theories have the "autonomous-related self" at their point of intersection. Autonomy and relatedness dynamics is the key to understanding the self, and family…

  10. School autonomy – a cross-national perspective. Can we compare the opinion of school principals?

    NARCIS (Netherlands)

    Węziak-Białowolska, Dorota; Isac, Maria Magdalena

    2014-01-01

    Perception of school autonomy was measured by the International Civic and Citizenship Education Study (ICCS) 2009, allowing potential cross-national comparison. The possibility of a common, general scale for all countries participating in the study was investigated. Using multi-group confirmatory

  11. Cognitive Personality Characteristics Impact the Course of Depression: A Prospective Test of Sociotropy, Autonomy and Domain-Specific Life Events.

    Science.gov (United States)

    Iacoviello, Brian M; Grant, David A; Alloy, Lauren B; Abramson, Lyn Y

    2009-01-01

    Prospective tests of the impact of sociotropy and autonomy on the course of depression are lacking. In a sample of 97 cognitive high-risk and 62 cognitive low-risk undergraduates who experienced at least one prospective depressive episode, the interactions of sociotropy and interpersonal life events and autonomy and achievement-related life events were examined as predictors of four indicators of the course of depression. Initial analyses failed to support the hypothesis that global scores for sociotropy and autonomy interact with domain-congruent life events to predict the course indicators. The autonomy-achievement events interaction predicted less severe episodes, contrary to hypothesis. Then, factors hypothesized to underlie Sociotropy (Fear of Criticism and Rejection; Preference for Affiliation) and Autonomy were also analyzed. The puzzling autonomy-achievement life event interaction was explained by the underlying Independent Goal Attainment factor. Interactions between Fear of Criticism and Rejection and achievement events, and between Sensitivity to Others' Control and interpersonal events, significantly predicted chronicity, number and severity of episodes. The findings are discussed in terms of the event-congruency hypothesis.

  12. Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

    OpenAIRE

    Rostbøll, Christian F.

    2009-01-01

    Udgivelsesdato: 2009 Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disre...

  13. The autonomy: A challenge in shared spaces

    Directory of Open Access Journals (Sweden)

    María Elena NITRI

    2009-11-01

    Full Text Available This paper has as a goal, to study a few up- dated alternatives on the field of Teaching Coaching toe the focus of reflection. From the concept to autonomy we built and implement teaching strategies focussing on the development of autonomous working projects and tutorial systems, whose aim is placed in the creation of shared spaces which allow decision-taking.

  14. A Dynamic Coordination Mechanism Using Adjustable Autonomy

    NARCIS (Netherlands)

    Neef, R.M.; Vecht, B. van der; Dignum, F.; Meyer, J.J.C.

    2008-01-01

    Agents in an organization need to coordinate their actions in order to reach the organizational goals. This research describes the relation between types of coordination and the autonomy of actors. In an experimental setting we show that there is not one best way to coordinate in all situations. The

  15. A Dynamic Coordination Mechanism Using Adjustable Autonomy

    NARCIS (Netherlands)

    Vecht, B. van der; Dignum, F.; Meyer, J.J.C.; Neef, R.M.

    2007-01-01

    Agents in an organization need to coordinate their actions in order to reach the organizational goals. This research describes the relation between types of coordination and the autonomy of actors. In an experimental setting we show that there is not one best way to coordinate in all situations. The

  16. The Development of Personal Autonomy throughout Cultures

    Science.gov (United States)

    Helwig, Charles C.

    2006-01-01

    It is argued here that autonomy entails universal psychological needs pertaining to agency and identity formation, expressed in different ways over different developmental periods. As children develop skills and abilities related to psychological needs for self-expression and competence, they will claim areas related to the exercise of these…

  17. Identity, Motivation and Autonomy in Language Learning

    Science.gov (United States)

    Lamb, Terry; Murray, Garold; Gao, Xuesong

    2011-01-01

    In this volume researchers from Asia, Europe, the Middle East and North and South America employ a variety of theoretical perspectives and methodological approaches in their exploration of the links between identity, motivation, and autonomy in language learning. On a conceptual level the authors explore issues related to agency, metacognition,…

  18. The Charter School Experience: Autonomy in Practice

    Science.gov (United States)

    McDonald, Tonya Senne

    2013-01-01

    While traditional public school and charter school systems continue to undergo dramatic reforms in response to the educational crisis, charter schools are praised as possessing the distinguishing characteristic of maintaining autonomy in exchange for increased accountability (Buckley & Schneider, 2009). The expectations for charter schools are…

  19. Autonomy in the case of enthyreotic goiter

    International Nuclear Information System (INIS)

    Mahlstedt, J.

    1981-01-01

    To identify, quantify, and exclude thyroidal autonomy, under enthyreotic conditions (positive TRH-test), the in-vivo diagnosing with radionuclides is the only method available to assess the thyroidal trap in connection with the suppression test. Its application is urgently necessary for any goiter patient in the iodine lacking region, the methodical proceeding depends on the individual circumstances. (orig.) [de

  20. On autonomy and participation in rehabilitation.

    NARCIS (Netherlands)

    Cardol, M.; Jong, B.A. de; Ward, C.D.

    2002-01-01

    To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and

  1. How Sex Selection Undermines Reproductive Autonomy.

    Science.gov (United States)

    Browne, Tamara Kayali

    2017-06-01

    Non-medical sex selection is premised on the notion that the sexes are not interchangeable. Studies of individuals who undergo sex selection for non-medical reasons, or who have a preference for a son or daughter, show that they assume their child will conform to the stereotypical roles and norms associated with their sex. However, the evidence currently available has not succeeded in showing that the gender traits and inclinations sought are caused by a "male brain" or a "female brain". Therefore, as far as we know, there is no biological reason why parents cannot have the kind of parenting experience they seek with a child of any sex. Yet gender essentialism, a set of unfounded assumptions about the sexes which pervade society and underpin sexism, prevents parents from realising this freedom. In other words, unfounded assumptions about gender constrain not only a child's autonomy, but also the parent's. To date, reproductive autonomy in relation to sex selection has predominantly been regarded merely as the freedom to choose the sex of one's child. This paper points to at least two interpretations of reproductive autonomy and argues that sex selection, by being premised on gender essentialism and/or the social pressure on parents to ensure their children conform to gender norms, undermines reproductive autonomy on both accounts.

  2. Critical Thinking, Autonomy and Practical Reason

    Science.gov (United States)

    Cuypers, Stefaan E.

    2004-01-01

    This article points out an internal tension, or even conflict, in the conceptual foundations of Harvey Siegel's conception of critical thinking. Siegel justifies critical thinking, or critically rational autonomy, as an educational ideal first and foremost by an appeal to the Kantian principle of respect for persons. It is made explicit that this…

  3. Codes of Ethics and Teachers' Professional Autonomy

    Science.gov (United States)

    Schwimmer, Marina; Maxwell, Bruce

    2017-01-01

    This article considers the value of adopting a code of professional ethics for teachers. After having underlined how a code of ethics stands to benefits a community of educators--namely, by providing a mechanism for regulating autonomy and promoting a shared professional ethic--the article examines the principal arguments against codes of ethics.…

  4. Agility and adaptive autonomy in networked organizations

    NARCIS (Netherlands)

    Neef, R.M.; Vecht, B. van der

    2010-01-01

    In any multi-actor environment, there is an inevitable trade-off between achieving global coordination of activities and respecting the autonomy of the actors involved. Agile and resilient behavior demands dynamic coordination capabilities, but task and resource allocation quickly becomes

  5. Adjustable Autonomy: Controling Influences on Decision Making

    NARCIS (Netherlands)

    Vecht, B. van der

    2009-01-01

    Due to technological developments we foresee future systems where groups of actors coordinate their actions in a dynamic manner to reach their goals. Our aim is to develop a reasoning model for artificial actors in such systems. Starting point is the relation between autonomy of individuals and

  6. Autonomy and the Working-Class Freelance

    Science.gov (United States)

    Medway, Peter

    2015-01-01

    In taking into account the realities of the writing process in the ways teachers organize their classrooms, they inescapably find themselves involved with the notion of student autonomy. Some guidelines for supporting independent-minded adolescents in the classroom suggest themselves, and this article provides other suggestions for planning…

  7. Autonomy Level Specification for Intelligent Autonomous Vehicles

    Science.gov (United States)

    2003-09-01

    Autonomy Level Specification for Intelligent Autonomous Vehicles : Interim Progress Report Hui-Min Huang, Elena Messina, James Albus...Level Specification for Intelligent Autonomous Vehicles : Interim Progress Report 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6

  8. Autonomy under threat: a revised Frankfurtian account

    NARCIS (Netherlands)

    Nys, T.

    2009-01-01

    In the early 1970s Harry Frankfurt argued that so-called ‘coercive threats’ cause a violation of their victim's autonomy, thereby excluding him from moral responsibility. A person is therefore not responsible for doing what he is forced to do. Although this seems correct on an intuitive level, I

  9. University Autonomy: Two Fault-Lines

    Science.gov (United States)

    Evans, G. R.

    2010-01-01

    The doctrine of university autonomy in the UK contains a least two major "fault-lines" where the structure is inherently weak and there is danger of functional breakdown. The first occurs at the junction between the institution and the state, the second within the institution, where the unity in policy-making between academic and…

  10. Patient autonomy: a view from the kitchen.

    Science.gov (United States)

    Struhkamp, Rita M

    2005-01-01

    In contemporary liberal ethics patient autonomy is often interpreted as the right to self-determination: when it comes to treatment decisions, the patient is given the right to give or withhold informed consent. This paper joins in the philosophical and ethical criticism of the liberal interpretation as it does not regard patient autonomy as a right, rule or principle, but rather as a practice. Patient autonomy, or so I will argue, is realised in the concrete activities of day-to-day health care, in the material and technological context of care, in arrangements of health care institutions, in the physical training of people with disabilities, as well as in the concrete activities of care-giving. This move from conversations in the consultation room to other sites and situations in the practice of care takes seriously the empirical reality of medical care and intends to show that patient autonomy is practically realised in a much richer and more creative way than most ethical theory seems to assume.

  11. Supporting Student Autonomy in Physical Education

    Science.gov (United States)

    Perlman, Dana; Webster, Collin A.

    2011-01-01

    The lack of motivation among students is a common challenge in physical education. Studies drawing on the self-determination theory consistently show that perceived autonomy facilitates adaptive motivation in students, which can lead to a wide range of desired educational outcomes. However, instructional strategies designed to support student…

  12. Autonomi og informeret samtykke i sygeplejepraksis

    DEFF Research Database (Denmark)

    Mathar, Helle; Morville, Annette

    2006-01-01

    is described as freedom from compulsion and other forms of regulatory influence. In relation to autonomy and informed consent, information is a defined nursing responsibility in connection with self-managed nursing duties, nursing research and duties where nurses have had been entrusted with responsibility...

  13. Construction of a Personal Autonomy Inventory.

    Science.gov (United States)

    Strumpfer, D. J. W.

    The inventory contains three factural scales: independence of judgement, moral relativism, and adventurousness. The item pool was based upon descriptions of the need for autonomy (positive) and for independence (negative). The preliminary English form included the Crowne-Marlowe Social Desirability Scale, and was completed by 233 English-speaking…

  14. School leadership for equity and learning and the question of school autonomy

    Directory of Open Access Journals (Sweden)

    Pavlos Hatzopoulos

    2015-03-01

    Full Text Available The article draws from the work conducted in the context of the European Policy Network on School Leadership (EPNoSL. In particular, it is based on an in-depth review of school leadership policies in 21 European countries and the discourse that is taking place in EPNoSL’s webinars, national workshops and peer learning activities organised in several EU countries with the participation of a variety of school leadership stakeholders (including policy makers at European, national, and local levels, school leaders, teachers and other professionals, academics, researchers, parents and students. EPNoSL is a network of 42 European institutions that aims at improving policy on, and practice in, school leadership in Europe. The article discusses the question of school autonomy in the context of school leadership policy development in Europe. School autonomy is considered as a critical precondition for the development of comprehensive school leadership policies. Based on the comprehensive framework of school leadership policy development that has been developed in the context of this project, the article undertakes two main tasks. Firstly, it attempts to show that instead of searching for universal solutions on the question of school autonomy, it is important to reflect on context-specific policies on autonomy that aim at the attainment of concrete learning and equity goals. Secondly, it specifies seven general directions for policies on school autonomy that are adaptive to the divergent experiences of European education systems.

  15. Contextualizing the Physician Charter on Professionalism in Qatar: From Patient Autonomy to Family Autonomy.

    Science.gov (United States)

    Ho, Ming-Jung; Alkhal, Abdullatif; Tekian, Ara; Shih, Julie; Shaw, Kevin; Wang, Chung-Hsiang; Alyafei, Khalid; Konopasek, Lyuba

    2016-12-01

    The Physician Charter on medical professionalism has been endorsed by professional organizations worldwide, yet it is unclear if this Western framework of professionalism is applicable in non-Western countries. This study examines how physicians practicing in a Middle Eastern context perceive the terms, principles, and commitments outlined in the charter. In May 2013, the authors conducted 6 focus groups with 43 clinician-educators practicing at Hamad Medical Corporation in Doha, Qatar, to discuss the applicability of the Physician Charter in a local context. The research team coded and analyzed transcripts to identify sociocultural influences on professionalism. Participants generally expressed agreement with the applicability of the charter's principles to physician professionalism in Qatar. However, 3 contextual factors (religious beliefs and practices, family-centered decision making, and multinationality) complicated the application of the core principles of patient autonomy and social justice. Islamic beliefs reinforced the importance of professional values such as altruism, but presented a barrier to the principle of self-determination for female patients. The family-centered culture in Qatar called for enlarging the scope of patient-centered decision making to include the patient's family. Qatar's multinational population prompted debate over equal treatment and how to conceptualize and implement the principle of social justice. Several sociocultural contexts influence the conceptualization of the principles of medical professionalism in Qatar. The findings suggest that contextual factors should be considered when developing or adopting a professionalism framework in an international setting and context.

  16. Autonomy and Complexity at Sandia Executive Summary of Academic Alliance Workshop on Autonomy and Complex Systems.

    Energy Technology Data Exchange (ETDEWEB)

    Hayden, Nancy Kay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kleban, Stephen D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-05-01

    Sandia has identified autonomy as a strategic initiative and an important area for providing national leadership. A key question is, “How might autonomy change how we think about the national security challenges we address and the kinds of solutions we deliver?” Three workshops at Sandia early in 2017 brought together internal stakeholders and potential academic partners in autonomy to address this question. The first focused on programmatic applications and needs. The second explored existing internal capabilities and research and development needs. This report summarizes the outcome of the third workshop, held March 3, 2017 in Albuquerque, NM, which engaged Academic Alliance partners in autonomy efforts at Sandia by discussing research needs and synergistic areas of interest within the complex systems and system modeling domains, and identifying opportunities for partnering on laboratory directed and other joint research opportunities.

  17. The relationship between autonomous motivation and autonomy support in medical students' academic achievement.

    Science.gov (United States)

    Feri, Rose; Soemantri, Diantha; Jusuf, Anwar

    2016-12-29

    This study applied self-determination theory (SDT) to investigate the relationship between students' autonomous motivation and tutors' autonomy support in medical students' academic achievement. This was a cross-sectional study. Out of 204 students in a fundamental medical science course, 199 participated in the study. Data was collected using two questionnaires: the Learning Self-Regulation and Learning Climate Questionnaires. The score of the course assessment was the measure of academic achievement. Data was analyzed and reported with descriptive and inferential statistics (mean, standard deviation and multiple regression analysis). Mean score (±standard deviation) of the autonomous motivation, tutors' autonomy support, and academic achievement were 5.48±0.89, 5.22±0.92, and 5.22±0.92. Multiple regression results reported students' autonomous motivation was associated with improvement of students' academic achievement (β=15.2, p=0.004). However, augmentation of tutors' autonomy support was not reflected in the improvement of students' academic achievement (β = -12.6, p = 0.019). Both students' autonomous motivation and tutors' autonomy support had a contribution of about 4.2% students' academic achievement (F = 4.343, p = 0.014, R 2 = 0.042). Due to the unique characteristic of our medical students' educational background, our study shows that tutors' autonomy support is inconsistent with students' academic achievement. However, both autonomous motivation and support are essential to students' academic achievement. Further study is needed to explore students' educational background and self-regulated learning competence to improve students' academic achievement.

  18. The relationship between autonomous motivation and autonomy support in medical students’ academic achievement

    Science.gov (United States)

    Soemantri, Diantha; Jusuf, Anwar

    2016-01-01

    Objectives This study applied self-determination theory (SDT) to investigate the relationship between students’ autonomous motivation and tutors’ autonomy support in medical students’ academic achievement. Methods This was a cross-sectional study. Out of 204 students in a fundamental medical science course, 199 participated in the study. Data was collected using two questionnaires: the Learning Self-Regulation and Learning Climate Questionnaires. The score of the course assessment was the measure of academic achievement. Data was analyzed and reported with descriptive and inferential statistics (mean, standard deviation and multiple regression analysis).  Results Mean score (±standard deviation) of the autonomous motivation, tutors’ autonomy support, and academic achievement were 5.48±0.89, 5.22±0.92, and 5.22±0.92. Multiple regression results reported students’ autonomous motivation was associated with improvement of students’ academic achievement (β=15.2, p=0.004). However, augmentation of tutors’ autonomy support was not reflected in the improvement of students’ academic achievement (β = -12.6, p = 0.019). Both students’ autonomous motivation and tutors’ autonomy support had a contribution of about 4.2% students’ academic achievement (F = 4.343, p = 0.014, R2 = 0.042). Conclusions Due to the unique characteristic of our medical students’ educational background, our study shows that tutors’ autonomy support is inconsistent with students’ academic achievement. However, both autonomous motivation and support are essential to students’ academic achievement. Further study is needed to explore students’ educational background and self-regulated learning competence to improve students’ academic achievement.               PMID:28035054

  19. A Multi-Informant Examination of Maternal Symptoms and Autonomy Granting in Youth Anxiety.

    Science.gov (United States)

    Wei, Chiaying; Swan, Anna J; Makover, Heather B; Kendall, Philip C

    2017-12-01

    Evidence suggests the important role of (a) parenting behaviors and (b) parental psychopathology in the development and maintenance of youth anxiety. Using a multi-informant approach, the current study examined the association of maternal autonomy granting and maternal symptoms (i.e., anxiety and depression) with youth anxiety among mothers and 88 youth (ages of 6-17) diagnosed with a principal anxiety disorder. Results from the generalized estimating equations (GEE) analyses indicated that mothers reported higher youth anxiety symptoms compared to youth self-reports. Youth-perceived maternal autonomy granting was inversely associated with youth anxiety, and maternal self-reported anxiety and depressive symptoms significantly moderated this relationship: As mothers reported higher anxiety and depressive symptoms, the inverse association between parental autonomy granting and youth anxiety weakened. The interaction between parenting behavior and parental psychopathology significantly influenced youth anxiety symptoms, which presents important clinical implications to integrate into parenting work in the treatment of youth anxiety disorders.

  20. Autonomy and Interests: The Social Life of a Curriculum.

    Science.gov (United States)

    Reddiford, Gordon

    1993-01-01

    Examines the arguments that students should determine their own curriculum. Reviews the case for student autonomy based on philosophical anarchism and Immanuel Kant's views on autonomy. Argues that curriculum should be a result of the shared autonomy of students and teachers. (CFR)

  1. Fathers' Autonomy Support and Social Competence of Sons and Daughters

    Science.gov (United States)

    Corwyn, Robert F.; Bradley, Robert H.

    2016-01-01

    Relations between paternal autonomy support and four aspects of adolescent social competence and responsibility at age 16 were examined using data from the NICHD Study of Early Child Care and Youth Development. With controls on maternal autonomy support, significant relations were observed between paternal autonomy support and three of the four…

  2. "It's My Life": Autonomy and People with Intellectual Disabilities

    Science.gov (United States)

    Björnsdóttir, Kristín; Stefánsdóttir, Guðrún V; Stefánsdóttir, Ástríður

    2015-01-01

    This article discusses autonomy in the lives of adults with intellectual disabilities. The article draws on inclusive research in Iceland with 25 women and 16 men and employs ideas of relational autonomy from the perspectives of the Nordic relational approach to disability. In this article, we examine autonomy in relation to private life, that is,…

  3. Lessons for Hospital Autonomy : Implementation in Vietnam from International Experience

    OpenAIRE

    Vietnam Ministry of Health; Health Strategy and Policy Institute; World Bank; World Health Organization

    2011-01-01

    The Government of Vietnam sees hospital autonomy policy as important and consistent with current development trends in Vietnam. It is based on government policies as laid out in government Decree on financial autonomy of revenue-generating public service entities; and to 2006, it is replaced by decree on professional, organizational, human resource management and financial autonomy of reve...

  4. Advancing Learner Autonomy in TEFL via Collaborative Learning

    Science.gov (United States)

    Jacobs, George M.; Shan, Tan Hui

    2015-01-01

    The present paper begins by situating learner autonomy and collaborative learning as part of a larger paradigm shift towards student-centred learning. Next are brief discussions of learner autonomy and how learner autonomy links with collaborative learning. In the main part of the paper, four central principles of collaborative learning are…

  5. Charter School Autonomy: The Mismatch between Theory and Practice

    Science.gov (United States)

    Finnigan, Kara S.

    2007-01-01

    In theory, the charter school concept is based on a trade-off or exchange: greater autonomy for increased accountability. Although charter schools have been operating for more than 10 years, little is known about charter school autonomy in practice. This mixed-methods study used survey and case study data to examine the degree of autonomy of…

  6. [Autonomy and dementia Part II: autonomy and representation: a possible combination?].

    Science.gov (United States)

    Rigaux, Natalie

    2011-06-01

    This paper, based on a critical review of the medico-social literature, questions the representation of patients with dementia in relation to the autonomy perspectives presented in a previous article. In the canonical perspective of autonomy (defined as a rational decision-making by a stand alone self), the surrogate is the spokeperson of the subject's wills when he was competent because he knows these wills through advance directives or assuming them via substituted judgment. Best patient's interest is then depreciated because it is focused on the present incompetent self. In the relational perspective, where autonomy is constructed through a dialogue with others, the surrogate is the present interlocutor, making the decisions with the patient and care-givers in a way varying with the disease process. He represents the subject with dementia as he was before the disease but also as he has become. Therefore, there is a continuum between autonomy and representation. Autonomy and well being are both the surrogate aims. The relational perspective allows care continuity of patients with dementia even when considered as incompetent. It offers a more balanced perspective on the patient autonomy since it is embedded in all others, and opens a richer view on what good life is, untill the end of dementia.

  7. School Autonomy and District Support: How Principals Respond to a Tiered Autonomy Initiative in Philadelphia Public Schools

    Science.gov (United States)

    Steinberg, Matthew P.; Cox, Amanda Barrett

    2017-01-01

    A tiered autonomy policy was recently implemented in Philadelphia, where select principals were granted autonomy to manage school operations while others were promised greater district support to improve school functioning. This article provides evidence on how principals used their autonomy and the extent of district support for non-autonomous…

  8. [Cataract surgery and its impact on balance and autonomy in elderly].

    Science.gov (United States)

    Raynal, M; Aupy, B; Jahidi, A; Ettien, D; Le Page, P; Briche, T; Kossowski, M; Pailllaud, E

    2009-01-01

    Cataract is a major cause of visual impairment among elderly. Cataract surgery improves visual afferencies and can have an impact on balance. The present study assessed the impact of cataract surgery upon balance and autonomy in elderly. We realized clinical examinations and objective tests the day before surgery and 2-months later. The initial cohort consisted of 66 patients that had to undergo a cataract surgery. Their mean age was 79 +/- 0.5. For logistic reasons, only 33 patients have been completely evaluated before and after surgery. Each patient underwent a history and examination that have assessed autonomy, walking, visual and then cochleo-vestibular functions including bone vibratory test and dynamic computerized posturography (Equitest). After 2 months, cataract surgery had no incidence on balance. The fear of falling has stayed the same whereas the number of falls has been noticeably reduced by surgery. The overall score of Equitest has shown an increase in visual dependence after surgery. Although cataract surgery has no incidence on autonomy, it may improve the quality of life among older people by leisure activities recovery. An early physical rehabilitation facilitated by visual improvement after surgery can also prevent visual dependence and autonomy loss. We recommend vestibular rehabilitation in elderly with major visual dependence.

  9. A balanced intervention ladder: promoting autonomy through public health action.

    Science.gov (United States)

    Griffiths, P E; West, C

    2015-08-01

    The widely cited Nuffield Council on Bioethics 'Intervention Ladder' structurally embodies the assumption that personal autonomy is maximized by non-intervention. Consequently, the Intervention Ladder encourages an extreme 'negative liberty' view of autonomy. Yet there are several alternative accounts of autonomy that are both arguably superior as accounts of autonomy and better suited to the issues facing public health ethics. We propose to replace the one-sided ladder, which has any intervention coming at a cost to autonomy, with a two-sided 'Balanced Intervention Ladder,' where intervention can either enhance or diminish autonomy. We show that not only the alternative, richer accounts of autonomy but even Mill's classic version of negative liberty puts some interventions on the positive side of the ladder. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

  10. Teacher Autonomy Perceptions of Iranian and Turkish EFL Teachers

    Directory of Open Access Journals (Sweden)

    Ebrahim KHEZERLOU

    2013-07-01

    Full Text Available The study aimed at examining Iranian (N= 218 and Turkish (N=142 high school EFL teachers’ opinions about teacher autonomy over (a the choice of appropriate teaching methods, strategies and techniques and implementation of the established curriculum (b teacher involvement in decision making processes and (c teachers’ use of personal initiative in solving their work problems. An 11-item questionnaire (α= .758 was used to measure autonomy perceptions of the participants. The results revealed that Turkish teachers’ autonomy perceptions were greater than that of Iranian teachers in the three teacher autonomy dimensions. Moreover, it was observed that male and master- holder teachers perceive less autonomy than female and bachelor-holder ones; whereas, no significant relationship were observed for the age and marital status variables with any teacher autonomy dimensions. Lastly, decision making dimension was the strongest predictor of teacher autonomy among both Iranian and Turkish teachers.

  11. Impact of anxiety, apathy and reduced functional autonomy on perceived quality of life in Parkinson's disease.

    Science.gov (United States)

    D'Iorio, Alfonsina; Vitale, Carmine; Piscopo, Fausta; Baiano, Chiara; Falanga, Anna Paola; Longo, Katia; Amboni, Marianna; Barone, Paolo; Santangelo, Gabriella

    2017-10-01

    Parkinson's disease (PD) is characterized by a wide spectrum of non-motor symptoms that may impact negatively on the activities of the patient's daily life and reduce Health-related quality of life (HRQoL). The present study explored the impact of specific non-motor symptoms on the HRQoL in PD. Eighty-four outpatients underwent the Montreal Cognitive Assessment (MoCA) assessing global functioning and several questionnaires to assess depression, apathy, impulse control disorders (ICD), anxiety, anhedonia and functional impact of cognitive impairment. The perceived QoL was assessed by Parkinson's Disease Questionnaire (PDQ-8). The PD sample was divided into patients with high and low HRQoL around the median of PDQ-8 and compared on clinical features, cognitive and neuropsychiatric variables. A linear regression analysis, in which the global functioning, apathy, depression, anxiety, anhedonia, ICD and the functional autonomy scores were entered as independent variables and PDQ-8 score as dependent variable, was applied. Patients with lower HRQoL were more depressed, apathetic, anxious and showed more severe reduction of functional autonomy and global functioning than patients with high HRQoL. The regression analysis revealed that higher level of anxiety, executive apathy and more reduced functional autonomy were significantly associated with higher score on PDQ-8. The finding indicated that anxiety, apathy associated with impaired planning, attention and organization (i.e., executive apathy evaluated by the Dimensional Apathy Scale) and reduced functional autonomy contribute significantly to reduce the HRQoL in PD. Therefore, early identification and management of these neuropsychiatric symptoms should be relevant to preserve HRQoL in PD. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. Allegheny County Walk Scores

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

  13. Autonomy, Competence and Non-interference.

    Science.gov (United States)

    Roberts, Joseph T F

    2017-12-30

    In light of the variety of uses of the term autonomy in recent bioethics literature, in this paper, I suggest that competence, not being as contested, is better placed to play the anti-paternalistic role currently assigned to autonomy. The demonstration of competence, I will argue, can provide individuals with robust spheres of non-interference in which they can pursue their lives in accordance with their own values. This protection from paternalism is achieved by granting individuals rights to non-interference upon demonstration of competence. In this paper, I present a risk-sensitive account of competence as a means of grounding rights to non-interference. On a risk-sensitive account of competence individuals demonstrate their competence by exercising three capacities to the extent necessary to meet a threshold determined by the riskiness of the decision. These three capacities are the capacity to (i) acquire knowledge, (ii) use instrumental rationality, and (iii) form and revise a life plan.

  14. Focus on energy autonomy in overseas districts

    International Nuclear Information System (INIS)

    Billerey, Jerome

    2016-01-01

    As French overseas territories have also had a role of leader in the development of renewable energies, and as the French law on energy transition states that energy autonomy is an objective by 2030 for these territories, with 50 per cent of renewable energies by 2020, this publication proposes an overview of the situation in these territories which still strongly depend on imported energies, notably for transports. The publication outlines the specificities of these islands with respect to the metropolitan territory in terms of electric power system: small territories, high production costs, strong consumption increase. It describes how the new energy policy plans evolutions to reach this autonomy: development of renewable energies and of smart grids, development of vehicles fuelled with electricity, biofuels or hydrogen, management of energy consumption in housing and through the use of renewable energies

  15. [Euthanasia and the paradoxes of autonomy].

    Science.gov (United States)

    Siqueira-Batista, Rodrigo; Schramm, Fermin Roland

    2008-01-01

    The principle of respect for autonomy has proved very useful for bioethical arguments in favor of euthanasia. However unquestionable its theoretical efficacy, countless aporiae can be raised when conducting a detailed analysis of this concept, probably checkmating it. Based on such considerations, this paper investigates the principle of autonomy, starting with its origins in Greek and Christian traditions, and then charting some of its developments in Western cultures through to its modern formulation, a legacy of Immanuel Kant. The main paradoxes of this concept are then presented in the fields of philosophy, biology, psychoanalysis and politics, expounding several of the theoretical difficulties to be faced in order to make its applicability possible within the scope of decisions relating to the termination of life.

  16. Autonomy, rationality and the wish to die.

    Science.gov (United States)

    Clarke, D M

    1999-12-01

    Although suicide has traditionally carried a negative sanction in Western societies, this is now being challenged, and while there remains substantial public concern surrounding youth and elder suicide, there is a paradoxical push to relax the prohibition under certain circumstances. Central to the arguments behind this are the principles of respect for autonomy and the importance of rationality. It is argued here that the concepts of rationality and autonomy, while valuable, are not strong enough to substantiate a categorical "right to suicide" and that the concepts of "understandability" and "respect" are more useful and able to provide the foundation for responding to a person expressing a wish to die. Roman suicide, sometimes held as an example of "rational suicide", illustrates the effects of culture, tradition and values on the attitudes to, and the practice of, suicide.

  17. Building up Autonomy Through Reading Strategies

    Directory of Open Access Journals (Sweden)

    Alexander Izquierdo Castillo

    2014-10-01

    Full Text Available This article reports on an action research project conducted with six ninth grade students in a rural public school in Colombia. The purpose of the study was to determine how the implementation of three reading strategies (skimming, scanning, and making predictions, when reading topics selected by learners, helps them to improve their reading comprehension and promotes their autonomy in the learning process. The results show that these learners developed some autonomous features such as making decisions for learning and doing assigned homework, increasing reading awareness and motivation. Additionally, the training on reading strategies allowed them to succeed in their reading comprehension. We conclude that these reading strategies are tools that take learners along the path of autonomy.

  18. [School nutrition and autonomy - challenges and opportunities].

    Science.gov (United States)

    Barbosa, Najla Veloso Sampaio; Machado, Neila Maria Viçosa; Soares, Maria Cláudia Veiga; Pinto, Anelise Regina Royer

    2013-04-01

    This study seeks to emphasize school food as an important policy to promote student autonomy by means of food and nutrition education included in the curriculum, integrated with different actors and based on the standpoint of citizenship. It seeks to return to fundamental concepts in the context of school food reflecting on them through theoretical assumptions to identify possible strategies to promote citizenship and autonomy in school. The strategies involved food and nutrition education with the daily presence of quality and suitability in school meals, discussions on the various dimensions of food in the curriculum and integrating food in the pedagogical project extended to various areas of the education system. School food fosters the need for integration of actions, actors and the various social spaces interested in the food issue, such as ministries, education systems, departments and schools, so that they may tackle the demands of contemporary reality in an integrated, systematic, consistent and efficient manner.

  19. Autonomy-Supportive Parenting and Autonomy-Supportive Sibling Interactions: The Role of Mothers' and Siblings' Psychological Need Satisfaction.

    Science.gov (United States)

    van der Kaap-Deeder, Jolene; Vansteenkiste, Maarten; Soenens, Bart; Loeys, Tom; Mabbe, Elien; Gargurevich, Rafael

    2015-11-01

    Autonomy-supportive parenting yields manifold benefits. To gain more insight into the family-level dynamics involved in autonomy-supportive parenting, the present study addressed three issues. First, on the basis of self-determination theory, we examined whether mothers' satisfaction of the psychological needs for autonomy, competence, and relatedness related to autonomy-supportive parenting. Second, we investigated maternal autonomy support as an intervening variable in the mother-child similarity in psychological need satisfaction. Third, we examined associations between autonomy-supportive parenting and autonomy-supportive sibling interactions. Participants were 154 mothers (M age = 39.45, SD = 3.96) and their two elementary school-age children (M age = 8.54, SD = 0.89 and M age = 10.38, SD = 0.87). Although mothers' psychological need satisfaction related only to maternal autonomy support in the younger siblings, autonomy-supportive parenting related to psychological need satisfaction in both siblings and to an autonomy-supportive interaction style between siblings. We discuss the importance of maternal autonomy support for family-level dynamics. © 2015 by the Society for Personality and Social Psychology, Inc.

  20. The role of social support in dialysis patients' feelings of autonomy and self-esteem: is support more beneficial for patients with specific illness perceptions?

    Science.gov (United States)

    Jansen, Daphne L; Rijken, Mieke; Kaptein, Ad A; Boeschoten, Elisabeth W; Dekker, Friedo W; Groenewegen, Peter P

    2014-09-01

    The purpose of this study was to investigate whether effects of various types of support on dialysis patients' perceived autonomy and self-esteem depend on patients' perceived concerns and personal control regarding their illness. One hundred sixty-six patients completed written questionnaires. Main and interaction effects of support, concern, and personal control on autonomy and self-esteem were examined using linear regression analyses. General emotional support was positively related to autonomy in highly concerned patients (p autonomy (p emotional support (p autonomy appears to depend on patients' illness perceptions, whereas the role of support in patients' self-esteem does not. These findings suggest that dialysis patients' personal views about their illness can provide insight into whether patients could benefit from support, and that the provision of support should be tailored to patients' individual needs.

  1. Assessing Residents' Readiness for OR Autonomy: A Qualitative Descriptive Study of Expert Surgical Teachers' Best Practices.

    Science.gov (United States)

    Chen, Xiaodong Phoenix; Sullivan, Amy M; Alseidi, Adnan; Kwakye, Gifty; Smink, Douglas S

    Providing resident autonomy in the operating room (OR) is one of the major challenges for surgical educators today. The purpose of this study was to explore what approaches expert surgical teachers use to assess residents' readiness for autonomy in the OR. We particularly focused on the assessments that experts make prior to conducting the surgical time-out. We conducted semistructured in-depth interviews with expert surgical teachers from March 2016 to September 2016. Purposeful sampling and snowball sampling were applied to identify and recruit expert surgical teachers from general surgery residency programs across the United States to represent a range of clinical subspecialties. All interviews were audio-recorded, deidentified, and transcribed. We applied the Framework Method of content analysis, discussed and reached final consensus on the themes. We interviewed 15 expert teachers from 9 institutions. The majority (13/15) were Program or Associate Program Directors; 47% (7/15) primarily performed complex surgical operations (e.g., endocrine surgery). Five themes regarding how expert surgical teachers determine residents' readiness for OR autonomy before the surgical time-out emerged. These included 3 domains of evidence elicited about the resident (resident characteristics, medical knowledge, and beyond the current OR case), 1 variable relating to attending characteristics, and 1 variable composed of contextual factors. Experts obtained one or more examples of evidence, and adjusted residents' initial autonomy using factors from the attending variable and the context variable. Expert surgical teachers' assessments of residents' readiness for OR autonomy included 5 key components. Better understanding these inputs can contribute to both faculty and resident development, enabling increased resident autonomy and preparation for independent practice. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  2. Demonstration of Human-Autonomy Teaming Principles

    Science.gov (United States)

    Shively, Robert Jay

    2016-01-01

    Known problems with automation include lack of mode awareness, automation brittleness, and risk of miscalibrated trust. Human-Autonomy Teaming (HAT) is essential for improving these problems. We have identified some critical components of HAT and ran a part-task study to introduce these components to a ground station that supports flight following of multiple aircraft. Our goal was to demonstrate, evaluate, and refine HAT principles. This presentation provides a brief summary of the study and initial findings.

  3. On autonomy and participation in rehabilitation.

    OpenAIRE

    Cardol, M.; Jong, B.A. de; Ward, C.D.

    2002-01-01

    To explore the concept of autonomy as a basis for social participation, with particular reference to rehabilitation. Method: A study of relevant literature from the field of rehabilitation, building on theory developed in other fields (ethics, social sciences), and deriving important concepts and strategies for rehabilitation practice. Results: The focus of rehabilitation for people with a chronic disabling condition is shifting from a biomedical to a client-centred perspective. Conceptions o...

  4. [Carers and the policy for autonomy].

    Science.gov (United States)

    Naiditch, Michel

    2016-03-01

    Long-time invisible, the role of informal carers in providing assistance to elderly patients losing their autonomy is gaining recognition. A policy in favour of carers coordinated with that aimed at the people being cared for is necessary, but it is struggling to establish itself in France. Some progress can however be seen with the French bill on adapting society to the ageing of the population. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Autonomy-How much is too much

    Science.gov (United States)

    2007-06-22

    Autonomous Robots Automatically Operated Car (1977) The first demonstration of a driverless car occurred in 1977 in Tsukuba, Japan[19][20] The car ...is autonomy? Brief history of autonomous robots Current field use of robots Current state-of-the-art for autonomous robots Barriers to the use of... autonomous robots Considering the human factor Outlook for the future 19 June 2007 Systems & Software Technology

  6. Autonomy and purity in Kant's moral theory

    OpenAIRE

    Benson, Carolyn Jane

    2010-01-01

    Kant believed that the moral law is a law that the rational will legislates. This thesis examines this claim and its broader implications for Kant’s moral theory. Many are drawn to Kantian ethics because of its emphasis on the dignity and legislative authority of the rational being. The attractiveness of this emphasis on the special standing and capacities of the self grounds a recent tendency to interpret Kantian autonomy as a doctrine according to which individual agents create binding ...

  7. [From dependency to autonomy, a geriatric pathway].

    Science.gov (United States)

    Iglesias, Antoine; Da Costa Ribeiro, Florence; Pedra, Maryse; Chassaigne, Marie-Christine; Berbon, Caroline

    Preventing dependency is essential in our ageing society. One of its components is the avoidable dependency which develops during a period of hospitalisation. Caregivers play an important role in helping the elderly person regain their autonomy. Various actions have been undertaken on this theme within the gerontology unit of Toulouse university hospital, including the creation of a multi-disciplinary group of experts among the caregivers working in the unit. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  8. Maximing Learning Strategies to Promote Learner Autonomy

    Directory of Open Access Journals (Sweden)

    Junaidi Mistar

    2001-01-01

    Full Text Available Learning a new language is ultimately to be able to communicate with it. Encouraging a sense of responsibility on the part of the learners is crucial for training them to be proficient communicators. As such, understanding the strategies that they employ in acquiring the language skill is important to come to ideas of how to promote learner autonomy. Research recently conducted with three different groups of learners of English at the tertiary education level in Malang indicated that they used metacognitive and social startegies at a high frequency, while memory, cognitive, conpensation, and affective strategies were exercised at a medium frewuency. This finding implies that the learners have acquired some degrees of autonomy because metacognive strategies requires them to independently make plans for their learning activities as well as evaluate the progress, and social strategies requires them to independently enhance communicative interactions with other people. Further actions are then to be taken increase their learning autonomy, that is by intensifying the practice of use of the other four strategy categories, which are not yet applied intensively.

  9. Multiculturalism and legal autonomy for cultural minorities

    Directory of Open Access Journals (Sweden)

    Morten Ebbe Juul Nielsen

    2013-11-01

    Full Text Available Does multiculturalism imply that certain cultural minorities – nomos groups, whose cultural conceptions extend in important ways into views about the law – should have forms of legal autonomy that go beyond normal multicultural accommodations such as exemptions and special protection? In other words: should we allow «minority jurisdictions» for multicultural reasons and give certain minorities powers of legislation and adjudication on certain issues? The paper sketches how one might arrive at such a conclusion given some standard multicultural reasoning, and then proceeds by examining eight key rejoinders to such a proposal. None of these rejoinders provide by themselves knockdown arguments against extending multicultural rights to forms of legal autonomy, but together they do provide a basis for some skepticism about the cogency and desirability of at least more ambitious forms of legal autonomy for cultural minorities within a liberal framework.http://dx.doi.org/10.5324/eip.v7i2.1798

  10. Perceived autonomy and self-esteem in Dutch dialysis patients: the importance of illness and treatment perceptions.

    Science.gov (United States)

    Jansen, Daphne L; Rijken, Mieke; Heijmans, Monique; Boeschoten, Elisabeth W

    2010-07-01

    Compared to healthy people, end-stage renal disease (ESRD) patients participate less in paid jobs and social activities. This study explored the perceived autonomy, state self-esteem and labour participation in ESRD patients on dialysis, and the role illness and treatment perceptions play in these concepts. Patients completed questionnaires at home or in the dialysis centre (N = 166). Data were analysed using bivariate and multivariate analyses. Labour participation among dialysis patients was low, the average autonomy levels were only moderate, and the average self-esteem level was rather high. On the whole, positive illness and treatment perceptions were associated with higher autonomy and self-esteem, but not with labour participation. Multiple regression analyses demonstrated that illness and treatment perceptions explained 18 to 27% of the variance in autonomy and self-esteem. Perceptions of personal control, less impact of the illness and treatment, and less concern were important predictors. Our results indicate that dialysis patients' beliefs about their illness and treatment play an important role in their perceived autonomy and self-esteem. Stimulating positive (realistic) beliefs and altering maladaptive beliefs might contribute to a greater sense of autonomy and self-esteem, and to social participation in general. Interventions focusing on these beliefs may assist patients to adjust to ESRD.

  11. Promoting Learner Autonomy Through Teacher-Student Partnership Assessment in an American High School: A Cycle of Action Research

    Directory of Open Access Journals (Sweden)

    Edgar Picón Jácome

    2012-07-01

    Full Text Available In this article I present some findings of an action research study intended to find out to what extent a teacher-student partnership in writing assessment could promote high school students’ autonomy. The study was conducted in a U.S. school. Two main action strategies in the assessment process were the use of symbols as the form of feedback and the design of a rubric containing criteria negotiated with the students as the scoring method. Results showed that the students developed some autonomy reflected in three dimensions: ownership of their learning process, metacognition, and critical thinking, which positively influenced an enhancement of their writing skills in both English and Spanish. Likewise, the role of the teacher was found to be paramount to set appropriate conditions for the students’ development of autonomy.

  12. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers.

    Science.gov (United States)

    Havermans, Bo M; Boot, Cécile R L; Houtman, Irene L D; Brouwers, Evelien P M; Anema, Johannes R; van der Beek, Allard J

    2017-06-08

    Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the relation between psychosocial safety climate and stress in health care workers can be explained by autonomy and social support. In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277). Linear mixed models analyses were performed to assess to what extent social support and autonomy explained the relation between psychosocial safety climate and stress. A lower psychosocial safety climate score was associated with significantly higher stress (B = -0.21, 95% CI = -0.27 - -0.14). Neither co-worker support, supervisor support, nor autonomy explained the relation between psychosocial safety climate and stress. Taken together, autonomy and both social support measures diminished the relation between psychosocial safety climate and stress by 12% (full model: B = -0.18, 95% CI = -0.25 - -0.11). Autonomy and social support together seemed to bring about a small decrease in the relation between psychosocial safety climate and stress in health care workers. Future research should discern whether other psychosocial work factors explain a larger portion of this relation. This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

  13. The role of autonomy and social support in the relation between psychosocial safety climate and stress in health care workers

    Directory of Open Access Journals (Sweden)

    Bo M. Havermans

    2017-06-01

    Full Text Available Abstract Background Health care workers are exposed to psychosocial work factors. Autonomy and social support are psychosocial work factors that are related to stress, and are argued to largely result from the psychosocial safety climate within organisations. This study aimed to assess to what extent the relation between psychosocial safety climate and stress in health care workers can be explained by autonomy and social support. Methods In a cross-sectional study, psychosocial safety climate, stress, autonomy, co-worker support, and supervisor support were assessed using questionnaires, in a sample of health care workers (N = 277. Linear mixed models analyses were performed to assess to what extent social support and autonomy explained the relation between psychosocial safety climate and stress. Results A lower psychosocial safety climate score was associated with significantly higher stress (B = −0.21, 95% CI = −0.27 – -0.14. Neither co-worker support, supervisor support, nor autonomy explained the relation between psychosocial safety climate and stress. Taken together, autonomy and both social support measures diminished the relation between psychosocial safety climate and stress by 12% (full model: B = −0.18, 95% CI = −0.25 – -0.11. Conclusions Autonomy and social support together seemed to bring about a small decrease in the relation between psychosocial safety climate and stress in health care workers. Future research should discern whether other psychosocial work factors explain a larger portion of this relation. Trial registration This study was registered in the Netherlands National Trial Register, trial code: NTR5527 .

  14. Unregulated Autonomy: Uncredentialed Educational Interpreters in Rural Schools.

    Science.gov (United States)

    Fitzmaurice, Stephen

    2017-01-01

    Although many rural Deaf and Hard of Hearing students attend public schools most of the day and use the services of educational interpreters to gain access to the school environment, little information exists on what interpreters are doing in rural school systems in the absence of credentialing requirements. The researcher used ethnographic interviews and field observations of three educational interpreters with no certification or professional assessment to explore how uncredentialed interpreters were enacting their role in a rural high school. The findings indicate that uncredentialed interpreters in rural settings perform four major functions during their school day: preparing the environment, staff, and materials; interpreting a variety of content; interacting with numerous stakeholders; and directly instructing Deaf and Hard of Hearing students. Generally, educational interpreters in rural districts operate with unregulated autonomy, a situation that warrants further research and a national standard for all educational interpreters.

  15. Autonomy and self-esteem of women who donate to an oocyte cryopreservation bank in the Netherlands.

    Science.gov (United States)

    Bakker, Marjolein R; Maas, Joyce; Bekker, Marrie H; Bredenoord, Annelien L; Fauser, Bart C; Bos, Annelies M

    2017-08-01

    Worldwide, oocyte donors donate voluntarily or receive varying amounts of money for donation. This raises ethical questions regarding the appropriateness of financial compensation, and the possibility of undue inducement and exploitation of oocyte donors. Are these donors capable of making an independent, well-considered decision? Regarding this matter, it is important to examine aspects such as autonomy-connectedness and self-esteem. In this cross-sectional study, demographic characteristics and donation motivations were assessed in 92 women who attended the University Medical Center (UMC) Utrecht as potential oocyte donors between June 2012 and July 2016. Demographic characteristics were assessed. Motivations were recorded in semi-structured interviews (response rate 59%). The Rosenberg Self-Esteem Scale was used to assess level of self-esteem. The Autonomy-Connectedness Scale was used to measure the level of autonomy-connectedness. The typical oocyte donor at the UMC Utrecht is a well-educated, employed, 31-year-old woman living with her partner in a completed family with two children, and donating on altruistic grounds. The donors showed higher autonomy-connectedness scores than the average female Dutch population and do not lack self-esteem (questionnaire response rate 66%). Concerns regarding exploitation and attraction of women with lower socioeconomic status, with shortcomings in autonomy-connectedness and self-esteem, could not be confirmed in this group. Copyright © 2017 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  16. Euthyroid goitre with and without functional autonomy: A comparison

    International Nuclear Information System (INIS)

    Hillenhinrichs, H.; Emrich, D.

    1998-01-01

    Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global 99m Tc thyroid uptake of ≥3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [de

  17. Autonomy and Housing Accessibility Among Powered Mobility Device Users

    Science.gov (United States)

    Brandt, Åse; Lexell, Eva Månsson; Iwarsson, Susanne

    2015-01-01

    OBJECTIVE. To describe environmental barriers, accessibility problems, and powered mobility device (PMD) users’ autonomy indoors and outdoors; to determine the home environmental barriers that generated the most housing accessibility problems indoors, at entrances, and in the close exterior surroundings; and to examine personal factors and environmental components and their association with indoor and outdoor autonomy. METHOD. This cross-sectional study was based on data collected from a sample of 48 PMD users with a spinal cord injury (SCI) using the Impact of Participation and Autonomy and the Housing Enabler instruments. Descriptive statistics and logistic regression were used. RESULTS. More years living with SCI predicted less restriction in autonomy indoors, whereas more functional limitations and accessibility problems related to entrance doors predicted more restriction in autonomy outdoors. CONCLUSION. To enable optimized PMD use, practitioners must pay attention to the relationship between client autonomy and housing accessibility problems. PMID:26356666

  18. Autonomy and job satisfaction for a sample of Greek teachers.

    Science.gov (United States)

    Koustelios, Athanasios D; Karabatzaki, Despina; Kousteliou, Ioanna

    2004-12-01

    Analysing the relation between Job Satisfaction and Autonomy in a sample of 300 Greek teachers (114 men and 186 women, 28 to 59 years old) from primary and secondary schools, showed statistically significant positive correlations between Job Satisfaction and Autonomy. Particularly, Autonomy was correlated with Job Itself (.21), Supervision (.22), and the Organizational as a Whole (.27), aspects of Job Satisfaction. Findings are in line with previous studies conducted in different cultural contexts. Percent common variance accounted for is small.

  19. Autonomy support for autonomous motivation in medical education.

    Science.gov (United States)

    Kusurkar, Rashmi A; Croiset, Gerda

    2015-01-01

    Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT) classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

  20. Autonomy support for autonomous motivation in medical education

    Directory of Open Access Journals (Sweden)

    Rashmi A. Kusurkar

    2015-05-01

    Full Text Available Background: Medical students often study only to fare well in their examinations or pursue a specific specialty, or study only those topics that they perceive to be useful in medical practice. The motivation for study in these cases comes from external or internal pressures or from the desire to obtain rewards. Self-determination theory (SDT classifies this type of motivation as controlled motivation and the type of motivation that comes from genuine interest or personal value as autonomous motivation. Autonomous motivation, in comparison with controlled motivation, has been associated with better learning, academic success, and less exhaustion. SDT endorses autonomous motivation and suggests that autonomy support is important for autonomous motivation. The meaning of autonomy is misinterpreted by many. This article tries to focus on how to be autonomy-supportive in medical education. Discussion: Autonomy support refers to the perception of choice in learning. Some of the ways of supporting autonomy in medical education are small group teaching, problem-based learning, and gradual increase in responsibility of patients. Autonomy-supportive teaching behavior is not a trait and can be learned. Autonomy support in medical education is not limited to bringing in changes in the medical curriculum for students; it is about an overall change in the way of thinking and working in medical schools that foster autonomy among those involved in education. Research into autonomy in medical education is limited. Some topics that need to be investigated are the ideas and perceptions of students and teachers about autonomy in learning. Conclusion: Autonomy support in medical education can enhance autonomous motivation of students for medical study and practice and make them autonomy-supportive in their future medical practice and teaching.

  1. Learner Autonomy in Language Education : A Cross-Cultural Perspective

    OpenAIRE

    Kojima, Hideo

    2006-01-01

    In recent years, the importance of developing learner autonomy in language education hasbeen one of its more prominent themes in Japan as well as in the West. In spite of agreementconcerning its importance, there remains a good deal of uncertainty about its meaning inteaching and learning English as a foreign language (EFL). This paper aims to consider theconcept of learner autonomy amongst different cultures. Autonomy has a social as well as anindividual dimension. The promotion of learner a...

  2. Learner Autonomy in Foreign Language Education and in Cultural Context

    OpenAIRE

    Ivanovska, Biljana

    2015-01-01

    The present paper is a brief review of the theoretical concepts about learner autonomy focusing on highlighting the main themes on learner autonomy in foreign language education and in cultural context as a globalized construct. These themes are based on the concepts of learner responsibility and independence, the importance of the autonomy in foreign language education in both the Western and Eastern style and the role of the culture in the concept of learner independence. The present study ...

  3. Psychological autonomy and hierarchical relatedness as organizers of developmental pathways

    OpenAIRE

    Keller, Heidi

    2016-01-01

    The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize d...

  4. School staff autonomy and educational performance: within school type evidence

    OpenAIRE

    VERSCHELDE, Marijn; HINDRIKS, Jean; RAYP, Glenn; SCHOORS, Koen

    2012-01-01

    This paper shows the effect of school staff autonomy on educational performance. The distinctive feature with existing literature is that we employ variation in autonomy within the same country and within the same school type to reduce the omitted variables problems. To fully capture the informational advantage of local actors, we define autonomy as the operational empowerment of the school’s direction and teachers. The Flemish secondary school system in Belgium is analyzed as it displays uni...

  5. The persistence of depression score

    NARCIS (Netherlands)

    Spijker, J.; de Graaf, R.; Ormel, J.; Nolen, W. A.; Grobbee, D. E.; Burger, H.

    2006-01-01

    Objective: To construct a score that allows prediction of major depressive episode (MDE) persistence in individuals with MDE using determinants of persistence identified in previous research. Method: Data were derived from 250 subjects from the general population with new MDE according to DSM-III-R.

  6. Autonomy and intimacy in the family as risk factors for sexual abuse

    Directory of Open Access Journals (Sweden)

    Tanja Repič

    2006-08-01

    Full Text Available The study examined the level of two risk factors (autonomy and intimacy for healthy functional family among sexually abused and sexually non-abused individuals. Autonomy and intimacy were measured with Family-of-Origin Scale (FOS; Hovestadt, Anderson, Piercy, Cochran, & Fine, 1985. 261 participants (194 girls and 67 boys completed the FOS, average age was 25 years (SD = 7. Among all participants 18% were sexually abused (N = 46, approximately every fifth (5.7 girl and every seventh (6.7 boy. There were 78% girls and 22% boys among sexually abused participants. Families of sexually abused participants in comparison with the families of sexually non-abused showed many statistically significant differences in elements of autonomy (clarity of expressing emotions, responsibility, respect for others, openness to others, and acceptance of separation and loss and intimacy (encouraging expression of a range of feelings, creating a warm atmosphere in the home, dealing with conflict resolution without undue stress, promoting empathy among family members, trust and developing trust. In general the sexually abused group had a statistically significantly lower level of autonomy and intimacy in comparison with sexually non-abused group.

  7. The Goldilocks contract: The synergistic benefits of combining structure and autonomy for persistence, creativity, and cooperation.

    Science.gov (United States)

    Chou, Eileen Y; Halevy, Nir; Galinsky, Adam D; Murnighan, J Keith

    2017-09-01

    Contracts are commonly used to regulate a wide range of interactions and relationships. Yet relying on contracts as a mechanism of control often comes at a cost to motivation. Integrating theoretical perspectives from psychology, economics, and organizational theory, we explore this control-motivation dilemma inherent in contracts and present the Contract-Autonomy-Motivation-Performance-Structure (CAMPS) model, which highlights the synergistic benefits of combining structure and autonomy. The model proposes that subtle reductions in the specificity of a contract's language can boost autonomy, which increases intrinsic motivation and improves a range of desirable behaviors. Nine field and laboratory experiments found that less specific contracts increased task persistence, creativity, and cooperation, both immediately and longitudinally, because they boosted autonomy and intrinsic motivation. These positive effects, however, only occurred when contracts provided sufficient structure. Furthermore, the effects were limited to control-oriented clauses (i.e., legal clauses), and did not extend to coordination-oriented clauses (i.e., technical clauses). That is, there were synergistic benefits when a contract served as a scaffold that combined structure with general clauses. Overall, the current model and experiments identify a low-cost solution to the common problem of regulating social relationships: finding the right amount of contract specificity promotes desirable outcomes, including behaviors that are notoriously difficult to contract. The CAMPS model and the current set of empirical findings explain why, when, and how contracts can be used as an effective motivational tool. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Adolescent autonomy revisited: clinicians need clearer guidance.

    Science.gov (United States)

    Brierley, Joe; Larcher, Victor

    2016-08-01

    In 1996, Brazier and Bridge raised the question 'is adolescent autonomy truly dead and buried' following judicial decisions which had seemed to reverse the Gillick-inspired trend for greater child autonomy in healthcare. Subsequent decisions by the courts have reinforced the view that those below 18 years in England and Wales remain children with limited rights to refuse treatment compared with adults. This is at variance with the daily experience of those working with young people who increasingly seek to actively involve them in making freely informed decisions about their healthcare, in accordance with the principles enunciated in the UN Convention of the Rights of the Child and the UK Children Acts. We review the derivation of the law in England and Wales in this area, in the light of another recent family court judgement enforcing treatment on a 'competent' child without his or her consent and ask: 'How can the Common Law and the ethical practice of those caring for young people have diverged so far?' Either young people can decide whether to have a recommended treatment, or they cannot. Given Ian McEwan's book, the Children Act, has stimulated wider social debate in this area might this be an opportune moment to seek public policy resolution with regards to healthcare decision making by young people? We argue that events since the Gillick case have underlined the need for a comprehensive review of legal policy and practice in this area. While absolute autonomy and freedom of choice are arguably inconsistent with the protection rights that society has agreed are owed to children, healthcare practitioners need clarity over the circumstances in which society expects that autonomous choices of adolescents can be overridden. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  9. Autonomy and reason: treatment choice in breast cancer.

    Science.gov (United States)

    Twomey, Mary

    2012-10-01

    The practice of offering choice to those women with breast cancer for whom either breast conserving surgery or mastectomy would be equally beneficial has come to be seen as an important aspect of medical care. As well as improving satisfaction with treatment, this is seen as satisfying the ethical principle of respect for autonomy. A number of studies, however, show that women are not always comfortable with such choice, preferring to leave treatment decisions to their surgeons. A question then arises as to the extent that these women can be seen as autonomous or as exercising autonomy. This paper argues, however, that the understanding of autonomy which is applied in current approaches to breast cancer care does not adequately support the exercise of autonomy, and that the clinical context of care means that women are not able to engage in the kind of reasoning that might promote the exercise of autonomy. Where respect for autonomy is limited to informed consent and choice, there is a danger that women's interests are overlooked in those aspects of their care where choice is not appropriate, with very real, long-term consequences for some women. Promoting the exercise of autonomy, it is argued, needs to go beyond the conception of autonomy as rational individuals making their own decisions, and clinicians need to work with an understanding of autonomy as relational in order to better involve women in their care. © 2012 Blackwell Publishing Ltd.

  10. [Autonomy: to what extent is the concept relevant in psychiatry?].

    Science.gov (United States)

    de Wit, F A

    2012-01-01

    Autonomy is an important concept in psychiatry, but because it is a somewhat abstract and ambiguous notion, it is not applicable in its entirety in a psychiatric context. This becomes obvious in situations where patients are receiving long term care and treatment. To modify the concept of autonomy in such a way that it acquires an extra dimension that renders it applicable to daily psychiatric practice. The literature was reviewed in order to find articles that reveal the tensions that arise between autonomy and dependence in psychiatry and that reflect the human characteristics that are concealed behind the modern concepts of autonomy, freedom and respect for autonomy. Concepts such as person, identity, acknowledgement, dialogical ethics and life histories are used as an addition to the concepts of autonomy of Kant and Mill. A phenomenological and a context sensitive conception of autonomy is needed within the perspective of dialogical ethics. A dialogical perspective requires from psychiatric professionals a susceptibility for what the patient as a human being really has to say. On the basis of a dialogue where there is space and attention for life histories, backgrounds and the potentials of patients, a new perspective can be developed that is shared by the persons involved. In psychiatry, statements about real autonomy and genuine respect for autonomy are only truly meaningful within the context of doctors, nurses and patients. A hermeneutic approach to patients which involves dialogue creates new opportunities in the field of staff-patient relations.

  11. Concept analysis: patient autonomy in a caring context.

    Science.gov (United States)

    Lindberg, Catharina; Fagerström, Cecilia; Sivberg, Bengt; Willman, Ania

    2014-10-01

    This paper is a report of an analysis of the concept of patient autonomy Many problems regarding patient autonomy in healthcare contexts derive from the patient's dependent condition as well as the traditional authoritarian position of healthcare professionals. Existing knowledge and experience reveal a lack of consensus among nurses regarding the meaning of this ethical concept. Concept analysis. Medline, CINAHL, The Cochrane Library and PsycINFO were searched (2005-June 2013) using the search blocks 'autonomy', 'patient' and 'nursing/caring'. A total of 41 articles were retrieved. The Evolutionary Method of Concept Analysis by Rodgers was used to identify and construct the meaning of the concept of patient autonomy in a caring context. Five attributes were identified, thus creating the following descriptive definition: 'Patient autonomy is a gradual, time-changing process of (re-)constructing autonomy through the interplay of to be seen as a person, the capacity to act and the obligation to take responsibility for one's actions'. Patient vulnerability was shown to be the antecedent of patient autonomy and arises due to an impairment of a person's physical and/or mental state. The consequences of patient autonomy were discussed in relation to preserving control and freedom. Patient autonomy in a caring context does not need to be the same before, during and after a care episode. A tentative model has been constructed, thus extending the understanding of this ethical concept in a caring context. © 2014 John Wiley & Sons Ltd.

  12. Autonomie du groupe restreint et performance

    Directory of Open Access Journals (Sweden)

    Elke Nissen

    2005-09-01

    Full Text Available Un groupe est autonome lorsqu'il prend lui-même en charge sa gestion (Abric, 1996 et lorsque celle-ci fonctionne bien. L'autonomie du groupe restreint est une caractéristique revendiquée dans le cadre actuel de l'expansion de dispositifs collaboratifs à distance entre apprenants. La question qui se pose alors est de savoir si un groupe restreint autonome est plus performant qu'un groupe moins autonome. L'autonomie d'un groupe d'apprentissage en ligne est-elle en relation avec la qualité de la réalisation de la tâche ? Est-elle en relation avec les progrès réalisés par les membres du groupe ? Dans le cadre de notre étude expérimentale, menée dans deux dispositifs pédagogiques différents (l'environnement d'apprentissage Babbelnet et une formation sur la plate-forme Acolad, des étudiants ont réalisé en groupes restreints, avec l'accompagnement d'un tuteur, une tâche de type actionnel – en l'occurrence une rédaction en langue étrangère (allemand ou anglais. Pour ce faire, ils disposaient d'aides méthodologiques et linguistiques dans l'environnement pédagogique en ligne. Ils ont interagi par le biais d'Internet au moyen de différents outils de communication. Une analyse de l'interaction qui a eu lieu dans chaque groupe, l'évaluation des rédactions réalisées conjointement, deux tests réalisés respectivement avant et après la phase de travail en groupe ainsi qu'un formulaire auto-administré nous permettent de mettre en lien l'autonomie des groupes, d'une part, et leur performance, voire leur apprentissage, d'autre part. Au vu de cette étude, il apparaît que l'autonomie du groupe n'a pas d'influence directe sur l'apprentissage des groupes restreints. En revanche, un rapport est visible entre l'appréciation du fonctionnement du groupe par ses membres et l'évolution de la performance des groupes.

  13. Learner autonomy, self regulation and metacognition

    Directory of Open Access Journals (Sweden)

    Feryal Çubukcu

    2009-10-01

    Full Text Available Different theories try to explain why some students are more successful than the others. Phenomenologists (Mc Combs, 1989 study self concepts of the students and find such students prone to achieve more. Attributional Theorists (Dweck, 1986; Weiner, 2005 focus on personal outcome such as effort or ability. Metacognitive theorists (Pressley, 2000; Schunk, Pintrich & Meece, 2007 examine students’ self regulated learning strategies whereas Constructivists (Maxim, 2009; Paris & Byrnes, 1989 believe supportive environments are important to be successful. In this study, the metacognitive theory will be given more importance and the purpose of the article is to find the correlation between self regulation, metacognition and autonomy.

  14. Reproductive cloning, genetic engineering and the autonomy of the child: the moral agent and the open future.

    Science.gov (United States)

    Mameli, M

    2007-02-01

    Some authors have argued that the human use of reproductive cloning and genetic engineering should be prohibited because these biotechnologies would undermine the autonomy of the resulting child. In this paper, two versions of this view are discussed. According to the first version, the autonomy of cloned and genetically engineered people would be undermined because knowledge of the method by which these people have been conceived would make them unable to assume full responsibility for their actions. According to the second version, these biotechnologies would undermine autonomy by violating these people's right to an open future. There is no evidence to show that people conceived through cloning and genetic engineering would inevitably or even in general be unable to assume responsibility for their actions; there is also no evidence for the claim that cloning and genetic engineering would inevitably or even in general rob the child of the possibility to choose from a sufficiently large array of life plans.

  15. Human dignity and autonomy in the care for patients with dementia: differences among formal caretakers from various cultural backgrounds.

    Science.gov (United States)

    Bentwich, Miriam Ethel; Dickman, Nomy; Oberman, Amitai

    2018-02-01

    To explore whether gaps exist between caretakers from different ethno-cultural groups (Israeli-born Jews [Sabras], Israeli Arabs [Arabs], and migrants from Russia [Russians]) regarding their perceptions of autonomy and human dignity of patients with dementia. A mixed-methods research scheme was used, comprised of qualitative and quantitative methods, utilizing semi-structured interviews and self-reported questionnaires. Twenty formal caretakers participated in the qualitative portion, and approximately 200 caretakers were included in the quantitative portion. All participants were recruited from three nursing homes and one hospital in the Galilee region (Israel). The qualitative portion of the study yielded eight themes encapsulated in the concept of autonomy and ten themes entailed within human dignity, in the context of care for patients with dementia. By utilizing these themes in the quantitative portion, substantial differences in nursing homes were found in the attitudes to autonomy and dignity of patients with dementia between Russian and Arab as well as Sabra caretakers (index score for autonomy: 2.97, 4.07, and 4, respectively; index score for dignity: 3.17, 4.1, and 4.07). A multi-variable regression, focusing on caretakers from nursing homes, showed the most significant influencing variables on the indexes of autonomy and dignity were ethno-culture Arab/Russian (0.84, 0.62) and the patient's family (0.29, 0.30). Regarding the autonomy index, being a female caretaker also had a significant influence (0.24). In the hospital, no influence emerged for the ethno-culture variables, and neither type of institution showed any influence of religion or religiousness as well as societal or community norms. Contrary to past research, in nursing homes, significant differences were found between certain ethno-cultural groups (Arabs and Russians) regarding their stance toward the dignity and autonomy of patients with dementia. Arab caretakers' fostering of more

  16. Resident Autonomy in the Operating Room: Expectations Versus Reality.

    Science.gov (United States)

    Meyerson, Shari L; Sternbach, Joel M; Zwischenberger, Joseph B; Bender, Edward M

    2017-09-01

    There is concern about graduating thoracic trainees' independent operative skills due to limited autonomy in training. This study compared faculty and trainee expected levels of autonomy with intraoperative measurements of autonomy for common cardiothoracic operations. Participants underwent frame-of-reference training on the 4-point Zwisch scale of operative autonomy (show and tell → active help → passive help → supervision only) and evaluated autonomy in actual cases using the Zwisch Me!! mobile application. A separate "expected autonomy" survey elicited faculty and resident perceptions of how much autonomy a resident should have for six common operations: decortication, wedge resection, thoracoscopic lobectomy, coronary artery bypass grafting, aortic valve replacement, and mitral valve repair. Thirty-three trainees from 7 institutions submitted evaluations of 596 cases over 18 months (March 2015 to September 2016). Thirty attendings subsequently provided their evaluation of 476 of those cases (79.9% response rate). Expected autonomy surveys were completed by 21 attendings and 19 trainees from 5 institutions. The six operations included in the survey constituted 47% (226 of 476) of the cases evaluated. Trainee and attending expectations did not differ significantly for senior trainees. Both groups expected significantly higher levels of autonomy than observed in the operating room for all six types of cases. Although faculty and trainees both expect similar levels of autonomy in the operating room, real-time measurements of autonomy show a gap between expectations and reality. Decreasing this gap will require a concerted effort by both faculty and residents to focus on the development of independent operative skills. Copyright © 2017 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  17. Bankruptcy Prediction Based on the Autonomy Ratio

    Directory of Open Access Journals (Sweden)

    Daniel Brîndescu Olariu

    2016-11-01

    Full Text Available The theory and practice of the financial ratio analysis suggest the existence of a negative correlation between the autonomy ratio and the bankruptcy risk. Previous studies conducted on a sample of companies from Timis County (largest county in Romania confirm this hypothesis and recommend the autonomy ratio as a useful tool for measuring the bankruptcy risk two years in advance. The objective of the current research was to develop a methodology for measuring the bankruptcy risk that would be applicable for the companies from the Timis County (specific methodologies are considered necessary for each region. The target population consisted of all the companies from Timis County with annual sales of over 10,000 lei (aprox. 2,200 Euros. The research was performed over all the target population. The study has thus included 53,252 yearly financial statements from the period 2007 – 2010. The results of the study allow for the setting of benchmarks, as well as the configuration of a methodology of analysis. The proposed methodology cannot predict with perfect accuracy the state of the company, but it allows for a valuation of the risk level to which the company is subjected.

  18. Mount Athos: Between autonomy and statehood

    Directory of Open Access Journals (Sweden)

    Avramović Dragutin

    2013-01-01

    Full Text Available Legal status of the Mount Athos is characterized by many special features that make it internationally unique legal regime. The author analyzes peculiarities of Mount Athos territorial status, legal position of residents and visitors, as well as organization of Mount Athos authorities. The author concludes that the Mount Athos is characterized by a kind of para-sovereignty. Its autonomy involves not only the internal organization, autonomous governance and religious autonomy, but it also includes many elements of secular life of their visitors. Mount Athos has its own, separate legislative, administrative and judicial powers, while the Statute of the Mount Athos has greater legal force than all the other laws of the Greek state, because the state can not unilaterally change its provisions. Having in mind that the wide self-government is vested in church authorities and that the monks have very specific way of living, the author takes a position that the Mount Athos represent 'monastic state', but without statehood. The author also states that the Mount Athos will be faced with many challenges in the context of spreading of an assimilating, universal conception of human rights.

  19. [Respecting minors' autonomy in child custody cases].

    Science.gov (United States)

    Santa Rosa, Bárbara; Corte-Real, Francisco; Vieira, Duarte Nuno

    2013-01-01

    Child custody decisions are among the most difficult for judges to make. The possibility of child abuse allegations or parents' deviant/ psychopathologic behaviours within this context, make the decision further complicated. Based on jurisprudence the listening of children opinion is a way to protect their best interest. In fact children have the right to express an opinion in all matters affecting their life. It should be given proper consideration to children opinion according with his/her age and maturity. Nonetheless custody disputes are emotionally draining issues. Asking the child to express an opinion during a public hearing, most likely in the presence of both parents, its not recommended because this is a potential stressful experience. Child interviews should take place in a proper environment and be set to their age. Medicine and Psychology have an important role in assessing children cognitive, emotional and volitional abilities, which is essential to properly account their opinions according to autonomy degree. This essay analyses the contribution of medico-legal and/or psychological exams to respect the autonomy of the child in cases of regulation of parental responsibilities. The conclusion is the need to establish a symbiotic relationship between the medical and legal perspectives of the (open) concept of child's best interests.

  20. The Zhongshan Score

    Science.gov (United States)

    Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

    2015-01-01

    Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

  1. Safeguarding donors' personal rights and biobank autonomy in biobank networks: the CRIP privacy regime.

    Science.gov (United States)

    Schröder, Christina; Heidtke, Karsten R; Zacherl, Nikolaus; Zatloukal, Kurt; Taupitz, Jochen

    2011-08-01

    Governance, underlying general ICT (Information and Communication Technology) architecture, and workflow of the Central Research Infrastructure for molecular Pathology (CRIP) are discussed as a model enabling biobank networks to form operational "meta biobanks" whilst respecting the donors' privacy, biobank autonomy and confidentiality, and the researchers' needs for appropriate biospecimens and information, as well as confidentiality. Tailored to these needs, CRIP efficiently accelerates and facilitates research with human biospecimens and data.

  2. Lower bounds to the reliabilities of factor score estimators

    NARCIS (Netherlands)

    Hessen, D.J.

    2017-01-01

    Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone’s factor score estimators, Bartlett’s factor score

  3. Women’s autonomy and maternal healthcare service utilization in Ethiopia

    Directory of Open Access Journals (Sweden)

    Fentanesh Nibret Tiruneh

    2017-11-01

    Full Text Available Abstract Background Most previous studies on healthcare service utilization in low-income countries have not used a multilevel study design to address the importance of community-level women’s autonomy. We assessed whether women’s autonomy, measured at both individual and community levels, is associated with maternal healthcare service utilization in Ethiopia. Methods We analyzed data from the 2005 and 2011 Ethiopia Demographic and Health Surveys (N = 6058 and 7043, respectively for measuring women’s decision-making power and permissive gender norms associated with wife beating. We used Spearman’s correlation and the chi-squared test for bivariate analyses and constructed generalized estimating equation logistic regression models to analyze the associations between women’s autonomy indicators and maternal healthcare service utilization with control for other socioeconomic characteristics. Results Our multivariate analysis showed that women living in communities with a higher percentage of opposing attitudes toward wife beating were more likely to use all three types of maternal healthcare services in 2011 (adjusted odds ratios = 1.21, 1.23, and 1.18 for four or more antenatal care visits, health facility delivery, and postnatal care visits, respectively. In 2005, the adjusted odds ratios were 1.16 and 1.17 for four or more antenatal care visits and health facility delivery, respectively. In 2011, the percentage of women in the community with high decision-making power was positively associated with the likelihood of four or more antenatal care visits (adjusted odds ratio = 1.14. The association of individual-level autonomy on maternal healthcare service utilization was less profound after we controlled for other individual-level and community-level characteristics. Conclusions Our study shows that women’s autonomy was positively associated with maternal healthcare service utilization in Ethiopia. We suggest addressing woman

  4. The gender gap in student engagement: The role of teachers' autonomy support, structure, and involvement.

    Science.gov (United States)

    Lietaert, Sofie; Roorda, Debora; Laevers, Ferre; Verschueren, Karine; De Fraine, Bieke

    2015-12-01

    The gender gap in education in favour of girls is a widely known phenomenon. Boys generally have higher dropout rates, obtain lower grades, and show lower engagement. Insight into factors related to these academic outcomes could help to address the gender gap. This study investigated, for Dutch language classes, (1) how boys and girls differ in behavioural engagement, (2) which teacher support dimensions (autonomy support, structure, involvement) may explain gender differences in engagement (mediation hypothesis), and (3) whether and which of these teacher support dimensions matter more for boys' as opposed to girls' engagement (moderation or differential effects hypothesis). A total of 385 Grade 7 students and their 15 language teachers participated in this study. Teacher support was assessed through student reports. Student engagement was measured using student, teacher, and observer reports. By means of structural equation modelling, the mediating role of the teacher support dimensions for gender differences in behavioural engagement was tested. The potential differential role of the teacher support dimensions for boys' and girls' engagement was investigated through multigroup analysis. Boys were less engaged than girls and reported lower support from their teacher. Autonomy support and involvement partially mediated the relationship between gender and behavioural engagement. Autonomy support was demonstrated to be a protective factor for boys' engagement but not for girls'. Structure and involvement contributed equally to engagement for both sexes. Although involvement and autonomy support partly explained the gender gap in engagement (mediation hypothesis), more support was found for differential effects of autonomy support on boys' versus girls' engagement (differential effects hypothesis). © 2015 The British Psychological Society.

  5. Relations Between Student Procrastination and Teaching Styles: Autonomy-Supportive and Controlling.

    Science.gov (United States)

    Codina, Nuria; Valenzuela, Rafael; Pestana, Jose V; Gonzalez-Conde, Joan

    2018-01-01

    Procrastination is a complex problem that can be defined as delaying an intended course of action (despite anticipating adverse consequences). Even when some students have equivalent motivation and skill levels, they tend to procrastinate more frequently than others. Approaches that analyze whether contextual influences may prevent or promote dysregulation processes associated with procrastination are scarce. According to Self-Determination Theory, contextual influences can facilitate self-regulated motivation (e.g., autonomous pursuit of interests or personal goals), if teaching style is autonomy-supportive and guarantees the satisfaction of students' basic psychological needs for perceived competence, autonomy, and relatedness. Contrariwise, school context can also impede the development of autonomous motivation if teachers frustrate the satisfaction of their students' psychological needs by recurring to controlling teaching behaviors, such as controlling use of rewards, negative conditional regard, excessive personal control, or intimidation. The goal of the present study was to assess the relations between controlling and autonomy-supportive teaching behaviors, psychological needs satisfaction (of the needs for competence, autonomy, and relatedness), and four distinct measures of procrastination: general procrastination, decisional procrastination, procrastination linked to task avoidance, and pure procrastination. Data based on public university undergraduate students ( N = 672) shows that controlling teaching behaviors are associated negatively with psychological needs satisfaction and positively with procrastination. Contrariwise, autonomy-supportive teaching behaviors are positively associated with psychological needs satisfaction and negatively with procrastination. The data obtained is useful for suggesting new lines of research to study the link between contextual influences and the prevention of academic procrastination in view of Self

  6. Relations Between Student Procrastination and Teaching Styles: Autonomy-Supportive and Controlling

    Directory of Open Access Journals (Sweden)

    Nuria Codina

    2018-05-01

    Full Text Available Procrastination is a complex problem that can be defined as delaying an intended course of action (despite anticipating adverse consequences. Even when some students have equivalent motivation and skill levels, they tend to procrastinate more frequently than others. Approaches that analyze whether contextual influences may prevent or promote dysregulation processes associated with procrastination are scarce. According to Self-Determination Theory, contextual influences can facilitate self-regulated motivation (e.g., autonomous pursuit of interests or personal goals, if teaching style is autonomy-supportive and guarantees the satisfaction of students’ basic psychological needs for perceived competence, autonomy, and relatedness. Contrariwise, school context can also impede the development of autonomous motivation if teachers frustrate the satisfaction of their students’ psychological needs by recurring to controlling teaching behaviors, such as controlling use of rewards, negative conditional regard, excessive personal control, or intimidation. The goal of the present study was to assess the relations between controlling and autonomy-supportive teaching behaviors, psychological needs satisfaction (of the needs for competence, autonomy, and relatedness, and four distinct measures of procrastination: general procrastination, decisional procrastination, procrastination linked to task avoidance, and pure procrastination. Data based on public university undergraduate students (N = 672 shows that controlling teaching behaviors are associated negatively with psychological needs satisfaction and positively with procrastination. Contrariwise, autonomy-supportive teaching behaviors are positively associated with psychological needs satisfaction and negatively with procrastination. The data obtained is useful for suggesting new lines of research to study the link between contextual influences and the prevention of academic procrastination in view of

  7. Relational trustworthiness: how status affects intra-organizational inequality in job autonomy.

    Science.gov (United States)

    Campos-Castillo, Celeste; Ewoodzie, Kwesi

    2014-03-01

    Recent accounts of trustworthiness have moved away from treating it as a stable, individual-level attribute toward viewing it as a variable situated in a relational context, but have not been formalized or supported empirically. We extend status characteristics theory (SCT) to develop formal propositions about relational trustworthiness. We posit that members of task- and collectively oriented groups (non-consciously) infer three qualities from their relative status that are commonly used to determine an individual's trustworthiness: ability, benevolence, and integrity. We apply our formalization to clarify ambiguities regarding intra-organizational job autonomy inequality, thereby linking SCT to broader disparities rooted in job autonomy. We analyze data from a vignette experiment and the General Social Survey to test incrementally how well our propositions generalize across different settings and populations. Results generally support our proposed links between status and intra-organizational job autonomy. We discuss implications for SCT in understanding broader patterns of inequalities. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Experienced job autonomy among maternity care professionals in The Netherlands

    NARCIS (Netherlands)

    Perdok, H.; Cronie, D.; Speld, C. van der; Dillen, J. van; Jonge, A . de; Rijnders, M.; Graaf, I. de; Schellevis, F.G.; Verhoeven, C.J.

    2017-01-01

    OBJECTIVE: High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care

  9. Experienced job autonomy among maternity care professionals in The Netherlands

    NARCIS (Netherlands)

    Perdok, Hilde; Cronie, Doug; van der Speld, Cecile; van Dillen, Jeroen; de Jonge, Ank; Rijnders, Marlies; de Graaf, Irene; Schellevis, François G.; Verhoeven, Corine J.

    2017-01-01

    Objective: High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care

  10. Experienced job autonomy among maternity care professionals in The Netherlands

    NARCIS (Netherlands)

    Perdok, H.; Cronie, D.; Speld, C. van der; Dillen, J. van; Jonge, A. de; Rijnders, M.; Graaf, I. de; Schellevis, F.G.; Verhoeven, G.

    2017-01-01

    Objective High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care

  11. Experienced job autonomy among maternity care professionals in The Netherlands.

    NARCIS (Netherlands)

    Perdok, H.; Cronie, D.; Speld, C. van der; Dillen, J. van; Jonge, A. de; Rijnders, M.; Graaf, J. de; Schellevis, F.; Verhoeven, C.

    2017-01-01

    Objective: High levels of experienced job autonomy are found to be beneficial for healthcare professionals and for the relationship with their patients. The aim of this study was to assess how maternity care professionals in the Netherlands perceive their job autonomy in the Dutch maternity care

  12. 40 CFR 73.86 - State regulatory autonomy.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 16 2010-07-01 2010-07-01 false State regulatory autonomy. 73.86 Section 73.86 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS... regulatory autonomy. Nothing in this subpart shall preclude a State or State regulatory authority from...

  13. Attachment, Autonomy, and Emotional Reliance: A Multilevel Model

    Science.gov (United States)

    Lynch, Martin F.

    2013-01-01

    This article reports a test of a multilevel model investigating how attachment security and autonomy contribute to emotional reliance, or the willingness to seek interpersonal support. Participants ("N" = 247) completed online measures of attachment, autonomy, emotional reliance, and vitality with respect to several everyday…

  14. The Need for Authenticity-Based Autonomy in Medical Ethics.

    Science.gov (United States)

    White, Lucie

    2017-08-11

    The notion of respect for autonomy dominates bioethical discussion, though what qualifies precisely as autonomous action is notoriously elusive. In recent decades, the notion of autonomy in medical contexts has often been defined in opposition to the notion of autonomy favoured by theoretical philosophers. Where many contemporary theoretical accounts of autonomy place emphasis on a condition of "authenticity", the special relation a desire must have to the self, bioethicists often regard such a focus as irrelevant to the concerns of medical ethics, and too stringent for use in practical contexts. I argue, however, that the very condition of authenticity that forms a focus in theoretical philosophy is also essential to autonomy and competence in medical ethics. After tracing the contours of contemporary authenticity-based theories of autonomy, I consider and respond to objections against the incorporation of a notion of authenticity into accounts of autonomy designed for use in medical contexts. By looking at the typical problems that arise when making judgments concerning autonomy or competence in a medical setting, I reveal the need for a condition of authenticity-as a means of protecting choices, particularly high-stakes choices, from being restricted or overridden on the basis of intersubjective disagreement. I then turn to the treatment of false and contestable beliefs, arguing that it is only through reference to authenticity that we can make important distinctions in this domain. Finally, I consider a potential problem with my proposed approach; its ability to deal with anorexic and depressive desires.

  15. Dutch dilemmas: Decentralization, school autonomy and professionalization of teachers

    NARCIS (Netherlands)

    Sleegers, P.; Wesselingh, A.

    1995-01-01

    The policy of decentralisation of the Dutch Ministry of Education, Culture and Science is aimed at increasing the autonomy of schools. This policy is also considered an appropriate strategy for the revitalisation of the teaching profession. Decentralisation, school autonomy and professionalisation

  16. A Study of Autonomy English Learning on the Internet

    Science.gov (United States)

    Zhong, Yunsheng

    2008-01-01

    With the variety of environment and method of English learning, Autonomy English learning on the Internet is playing a more and more important role in modern English learning. It challenges the traditional learning approach, and also is forwardness. This paper points out that autonomy English learning on the Internet facilitates the improvement of…

  17. School Autonomy: A Comparison between China and the United States

    Science.gov (United States)

    Xia, Jiangang; Gao, Xingyuan; Shen, Jianping

    2017-01-01

    This study examined and compared school autonomy in China and the United States. Based on the international PISA 2012 school data, the authors examined three aspects of school autonomy. We found that in comparison with the United States, (1) principals from China were less likely to have responsibility over eleven school decisions (hiring…

  18. On the relations between parents' ideals and children's autonomy

    NARCIS (Netherlands)

    de Ruyter, D.J.; Schinkel, A.

    2013-01-01

    In this article Doret J. de Ruyter and Anders Schinkel argue that parents' ideals can enhance children's autonomy, but that they may also have a detrimental effect on the development of children's autonomy. After describing the concept of ideals and elucidating a systems theoretical conception of

  19. Relations among Autonomy, Attribution Style, and Happiness in College Students

    Science.gov (United States)

    O'Donnell, Susan L.; Chang, Kelly B.; Miller, Kristen S.

    2013-01-01

    Research suggests that a personal sense of autonomy supports individuals' success in a variety of domains, but information regarding these processes remains unclear. This paper attempts to establish a link between personal autonomy and cognitive processes, in the form of attributions for success and failure, in establishing a sense of subjective…

  20. "The Pleasure Is All Mine": Music and Female Sexual Autonomy

    OpenAIRE

    Strube, Miriam

    2004-01-01

    To analyze sexual autonomy this paper concentrates on the recent concept of relational autonomy, which is different from the classic tradition in its multilevel perspective on persons as embodied, desiring, creative as well as rational creatures. I then apply this concept to music asking in which way women performers are both relational and (sexually) autonomous.

  1. Measuring local autonomy: A decision-making approach

    NARCIS (Netherlands)

    Fleurke, F.; Willemse, R.

    2006-01-01

    In studies on central-local relations it is common to assess local autonomy in a deductive way. The extent of local autonomy is determined by measuring the central legal and financial competence, after which the remaining room for local decision-making is determined. The outcome of this indirect

  2. Review of "Charter School Autonomy: A Half-Broken Promise"

    Science.gov (United States)

    Gulosino, Charisse

    2010-01-01

    This report concludes that autonomy is a prerequisite for innovative and effective charter schools to emerge. Especially important is freedom from external bureaucratic control. Yet there is nothing in this report that addresses levels of autonomy in relationship to financial performance, resource allocation practices, academic results, and other…

  3. Documenting Different Domains of Promotion of Autonomy in Families

    Science.gov (United States)

    Manzi, Claudia; Regalia, Camillo; Pelucchi, Sara; Fincham, Frank D.

    2012-01-01

    Parental promotion of autonomy for offspring well-being has been widely recognized in developmental psychology. Recent studies, however, show that this association varies across cultures. Such variation may reflect inappropriate measurement of this dimension of parenting. Therefore, three existing measures of promotion of autonomy were used to…

  4. Issues of promoting learner autonomy in EFL context

    Directory of Open Access Journals (Sweden)

    Pichugova Inna L.

    2016-01-01

    Full Text Available The paper is focuded on investigating the phenomenon of learner autonomy, which has mostly been explored in Europe and the USA and is now attracting attention of researchers and academics in many other countries including Russia. Learner autonomy through a focus on learner reflection and taking responsibility for one’s own learning processes has become a central concern in the recent history of language teaching. However, many language teachers, who are committed to concepts of learnercentredness and autonomy, struggle with the ways to foster learner autonomy or at least to encourage the idea of learner autonomy in language classroom. The study aims at investigating what the most important issues which have a great impact on developing learner autonomy are. Having given special attention to conditions which can insure development of learner autonomy, a model covering seven issues relating to the subject matter has been designed. The authors state that such aspects as choice, goals and needs, support, emotional climate, learning strategies, learner attitude and motivation, and self-esteem should be considered as the goal to promote learner autonomy in EFL context.

  5. the doctrine of party autonomy in international commercial arbitration

    African Journals Online (AJOL)

    RAYAN_

    provoke discussions in many fora on the applicability of party autonomy in international ... questions, this article analyses the principle of party autonomy. The ultimate aim of .... 12 Odoe, (n 1) 48; English Arbitration Act 1996 s 6. 13 Odoe ibid ...

  6. Workload Measurement in Human Autonomy Teaming: How and Why?

    Science.gov (United States)

    Shively, Jay

    2016-01-01

    This is an invited talk on autonomy and workload for an AFRL Blue Sky workshop sponsored by the Florida Institute for Human Machine Studies. The presentation reviews various metrics of workload and how to move forward with measuring workload in a human-autonomy teaming environment.

  7. School Autonomy, Leadership and Student Achievement: Reflections from Finland

    Science.gov (United States)

    Saarivirta, Toni; Kumpulainen, Kristiina

    2016-01-01

    Purpose: The purpose of this paper is to provide national information on school autonomy, leadership and student achievements in Finland. Design/methodology/approach: The paper is a literature review on Finnish studies focusing on school autonomy, leadership and student achievement. The studies have been reviewed on the basis of a content…

  8. Italian Adaptation of the "Autonomy and Relatedness Coding System"

    Directory of Open Access Journals (Sweden)

    Sonia Ingoglia

    2013-08-01

    Full Text Available The study examined the applicability of the observational technique developed by Allen and colleagues (Allen, Hauser, Bell, & O’Connor, 1994; Allen, Hauser, et al., 2003 to investigate the issues of autonomy and relatedness in parent-adolescent relationship in the Italian context. Thirty-five mother-adolescent dyads participated to a task in which they discussed a family issue about which they disagree. Adolescents were also administered a self-report measure assessing their relationship with mothers. Mothers reported significantly higher levels of promoting and inhibiting autonomy, and promoting relatedness behaviors than their children. Results also suggested a partial behavioral reciprocity within the dyads, regarding promoting and inhibiting relatedness, and inhibiting autonomy. Finally, mothers’ inhibiting autonomy behaviors positively correlated to teens’ perception of their relationship as conflicting; adolescents’ inhibiting and promoting autonomy and inhibiting relatedness behaviors positively correlated to open confrontation, rejection and coolness, while promoting relatedness behaviors negatively correlated to open confrontation, rejection and coolness. The results suggest that, for Italian mothers, behaviors linked to autonomy seem to be associated with being involved in a more negative relationship with their children, even if not characterized by open hostility, while for Italian adolescents, behaviors linked to autonomy seem to be associated with threatening the closeness of the relationship. Globally, the findings suggest that the application of this observational procedure may help our understanding of youth autonomy and relatedness development in Italy, but they leave unanswered questions regarding its appropriate adaptation and the role played by cultural differences.

  9. Feeling angry and acting angry: different effects of autonomy-connectedness in boys and girls.

    Science.gov (United States)

    Karreman, Annemiek; Bekker, Marrie H J

    2012-04-01

    This study examined effects of the autonomy-connectedness components sensitivity to others, self-awareness and capacity for managing new situations on anger experience versus anger expression in adolescent boys and girls. One hundred thirty-one high school students were randomly assigned to an anger-inducing or neutral condition using the Dictator Game. Whereas after anger induction boys experienced and expressed anger independent of autonomy-connectedness, girls' anger experience depended on the level of sensitivity to others: girls experienced increased anger only when they scored high on sensitivity to others. However, girls' expression of anger did not depend on the level of sensitivity to others. Effects of self-awareness and capacity for managing new situations were found when anger was not induced. This study contributed to emotion regulation research by showing differences in anger experience and anger expression as a function of autonomy-connectedness in boys and girls. Copyright © 2011 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  10. International migration of partner, autonomy and depressive symptoms among women from a mexican rural area.

    Science.gov (United States)

    Bojorquez, Ietza; Salgado de Snyder, Nelly; Casique, Irene

    2009-07-01

    The emigration of Mexicans to the USA has increased in the last decades, and little is known about the effect of this on the mental health of those who stay behind. To evaluate the association of emigration of husband and depressive symptoms (DS) among women who stay in Mexico. We also tested the hypothesis that the husband's migration would increase the woman's autonomy, which in turn would decrease DS. A survey was conducted in a rural area in Mexico. Participants (n = 418) were selected through probabilistic sampling in three stages: localities, households and individuals. DS were evaluated using the Centre for Epidemiological Studies-Depression (CES-D) scale. Having a partner in the USA was associated with higher odds of scoring above the cut-off point in CES-D (OR 3.77, 95% CI 1.92-7.43). Economic autonomy was also associated with DS (OR 1.45, 95% CI 1.04-2.02). Migration of husband was associated with DS among women. The construct of autonomy and its operational definition should be further explored.

  11. Autonomy and interdependence: beliefs of Brazilian mothers from state capitals and small towns.

    Science.gov (United States)

    Vieira, Mauro Luis; Seidl-de-Moura, Maria Lucia; Macarini, Samira Mafioletti; Martins, Gabriela Dal Forno; Lordelo, Eulina da Rocha; Tokumaru, Rosana Suemi; Oliva, Angela Donate

    2010-11-01

    This study aimed to investigate characteristics of Brazilian mothers' beliefs system, in the dimensions of autonomy and interdependence. A group of 600 women, half from state capitals and half from small towns, participated in the study. They were individually interviewed with Scales of Allocentrism, Beliefs about Parental Practices and Socialization Goals. Paired and Independent samples t tests and Multivariate GLM were performed. The results indicate that although mothers from both contexts value autonomy, mothers inhabiting small towns considered the relational dimension as the most important; whereas mothers inhabiting capitals valued equally both dimensions, either in their beliefs about practices or in the socialization goals for their children. Mothers from small towns have a higher mean score for allocentrism than mothers living in capitals. Thus, place of residence proved to be a relevant variable in the modulation of maternal beliefs. Educational level was not a significant factor in the variables considered and with this group of mothers. The study results are discussed in terms of their contribution to the understanding of the complex relationship between dimensions of autonomy and interdependence in mothers' beliefs system.

  12. Autonomy of nurse practitioners in primary care: An integrative review.

    Science.gov (United States)

    Choi, Min; De Gagne, Jennie C

    2016-03-01

    This integrative review of the existing literature was conducted to identify dimensions related to nurse practitioner (NP) autonomy and to recommend future areas of research related to the important topic of NP autonomy in this era of cost-conscious healthcare reform. Articles were identified from the following databases: CINAHL, MEDLINE, PubMed, Ovid, Scopus, Google Scholar, and EBSCO. Over 24 articles were found; 12 peer-reviewed articles met the inclusion criteria of research conducted with NPs, physicians, and patients. The results revealed three categories of association with regard to NP autonomy: job satisfaction, patient satisfaction, and physician-NP collaboration. This review was undertaken to advance understanding of autonomy among NPs and the dynamics involved in their delivery of care. Further research into the associations between NP autonomy and its dimensions are necessary to indicate a future direction to the NP role. ©2015 American Association of Nurse Practitioners.

  13. Autonomy, Respect, and Arrogance in the Danish Cartoon Controversy

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2009-01-01

    is understood as something we should presume everyone possesses, it provides a strong basis for equal respect among people from diverse cultures. A Kantian conception of autonomy can justify the right to freedom of expression while it at the same time requires that we in the exercise of freedom of expression......Autonomy is increasingly rejected as a fundamental principle by liberal political theorists, because it is regarded as incompatible with respect for diversity. This article seeks, via an analysis of the Danish cartoon controversy, to show that the relationship between autonomy and diversity is more...... complex than often posited. Particularly, it asks whether the autonomy defense of freedom of expression encourages disrespect for religious feelings. Autonomy leads to disrespect for diversity only when it is understood as a character ideal that must be promoted as an end in itself. If it by contrast...

  14. Patient autonomy and informed consent in critically lll

    Directory of Open Access Journals (Sweden)

    Todorović Zoran M.

    2017-01-01

    Full Text Available Patient autonomy has been a cornerstone of contemporary clinical ethics since the Nuremberg trial, especially in American school of bioethics. Topic: Patient autonomy has been defined in the Nuremberg Code, and re-defined in the Declaration of Helsinki, Belmont Report and Barcelona Declaration. Founders and followers of the rights-oriented bioethics (for example, Hellegers, Beauchamp and Childers have established and promoted the patient autonomy as the main principle of bio(medical ethics since 1970s. However, there is a lot of controversy surrounding such a principle, especially in vulnerable patients. We aimed at evaluating the real meaning and value of patient autonomy in critical care settings regarding the communication between health workers and their patients and families. Conclusion: Protection of patients autonomy in critically ill is a complex issue. Careful benefit-risk assessment is needed in order to find the most appropriate way of obtaining the informed consent, proxy consent or to omit or delay it.

  15. [Psychiatric advance directives and the role of autonomy].

    Science.gov (United States)

    Ambrosini, Daniel L; Crocker, Anne G

    2009-01-01

    Although psychiatric advance directives (PADs) are grounded in the ethics of autonomy, the relationship between the two is unclear. PADs are legal documents that allow individuals with mental illness to record their treatment preferences should they become incompetent in the future. The relationship between autonomy and PADs has been discussed in ethical, legal, and philosophical terms, but has not been clearly operationalized for clinical purposes. Autonomy is a fundamental ethical value that includes having the independence from outside controlling influences and the mental capacity to direct one's personal actions. Individuals with mental illness sometimes require assistance to understand their ethical and legal rights with respect to autonomous choice, and professional stakeholders need education regarding the importance of autonomy for clinical practice. Competency to consent to treatment is the mental prerequisite that ensures individuals with mental illness are able to complete PADs with insight, whereas autonomy is the value that empowers individuals to work towards their recovery.

  16. Intelligent autonomy for unmanned naval systems

    Science.gov (United States)

    Steinberg, Marc

    2006-05-01

    This paper provides an overview of the development and demonstration of intelligent autonomy technologies for control of heterogeneous unmanned naval air and sea vehicles and describes some of the current limitations of such technologies. The focus is on modular technologies that support highly automated retasking and fully autonomous dynamic replanning for up to ten heterogeneous unmanned systems based on high-level mission objectives, priorities, constraints, and Rules-of-Engagement. A key aspect of the demonstrations is incorporating frequent naval operator evaluations in order to gain better understanding of the integrated man/machine system and its tactical utility. These evaluations help ensure that the automation can provide information to the user in a meaningful way and that the user has a sufficient level of control and situation awareness to task the system as needed to complete complex mission tasks. Another important aspect of the program is examination of the interactions of higher-level autonomy algorithms with other relevant components that would be needed within the decision-making and control loops. Examples of these are vision and other sensor processing algorithms, sensor fusion, obstacle avoidance, and other lower level vehicle autonomous navigation, guidance, and control functions. Initial experiments have been completed using medium and high-fidelity vehicle simulations in a virtual warfare environment and inexpensive surrogate vehicles in flight and in-water demonstrations. Simulation experiments included integration of multi-vehicle task allocation, dynamic replanning under constraints, lower level autonomous vehicle control, automatic assessment of the impact of contingencies on plans, management of situation awareness data, operator alert management, and a mixed-initiative operator interface. In-water demonstrations of a maritime situation awareness capability were completed in both a river and a harbor environment using unmanned surface

  17. Linkage between company scores and stock returns

    Directory of Open Access Journals (Sweden)

    Saban Celik

    2017-12-01

    Full Text Available Previous studies on company scores conducted at firm-level, generally concluded that there exists a positive relation between company scores and stock returns. Motivated by these studies, this study examines the relationship between company scores (Corporate Governance Score, Economic Score, Environmental Score, and Social Score and stock returns, both at portfolio-level analysis and firm-level cross-sectional regressions. In portfolio-level analysis, stocks are sorted based on each company scores and quintile portfolio are formed with different levels of company scores. Then, existence and significance of raw returns and risk-adjusted returns difference between portfolios with the extreme company scores (portfolio 10 and portfolio 1 is tested. In addition, firm-level cross-sectional regression is performed to examine the significance of company scores effects with control variables. While portfolio-level analysis results indicate that there is no significant relation between company scores and stock returns; firm-level analysis indicates that economic, environmental, and social scores have effect on stock returns, however, significance and direction of these effects change, depending on the included control variables in the cross-sectional regression.

  18. Why job autonomy matters for young companies' performance: company maturity as a moderator between job autonomy and company performance

    NARCIS (Netherlands)

    Preenen, P.T.Y.; Howaldt, J.; Oeij, P.R.A.; Dhondt, S.; Kraan, K.O.; Jansen, E.

    2016-01-01

    Although the positive impact of job autonomy has been widely shown for individual-level employee outcomes, research on job autonomy and company-level outcomes has been surprisingly scarce. Therefore, among 3,311 companies in the Netherlands, we investigate the relationship between employees' job

  19. Do Children's Executive Functions Account for Associations Between Early Autonomy-Supportive Parenting and Achievement Through High School?

    Science.gov (United States)

    Bindman, Samantha W; Pomerantz, Eva M; Roisman, Glenn I

    2015-08-01

    This study evaluated whether the positive association between early autonomy-supportive parenting and children's subsequent achievement is mediated by children's executive functions. Using observations of mothers' parenting from the NICHD Study of Early Child Care and Youth Development ( N = 1,306), analyses revealed that mothers' autonomy support over the first 3 years of life predicted enhanced executive functions (i.e., inhibition, delay of gratification, and sustained attention) during the year prior to kindergarten and academic achievement in elementary and high school even when mothers' warmth and cognitive stimulation, as well as other factors (e.g., children's early general cognitive skills and mothers' educational attainment) were covaried. Mediation analyses demonstrated that over and above other attributes (e.g., temperament), children's executive functions partially accounted for the association between early autonomy-supportive parenting and children's subsequent achievement.

  20. Euthanasia--he illusion of autonomy.

    Science.gov (United States)

    Hartling, O J

    2006-03-01

    The paper deals with some of the more common arguments used for the legalisation of voluntary euthanasia. It looks at these arguments from an ethical and philosophical point of view. First, the argument that to offer a person the possibility of euthanasia is to respect that person's autonomy is questionable. Can a person's decision on euthanasia be really autonomous? If euthanasia were legal everybody would be conscious of this option: the patient, the doctor, the family and the nursing staff. Thus, there could be indirect pressure on the patient to make a decision. The choice is meant to be free but the patient is not free not to make the choice. Secondly, a choice that seeks to alleviate suffering and thus improve life by annihilating it is irrational. Thirdly, autonomy as to one's own death is hardly exercised freely. Even an otherwise competent person may not be competent in deciding on his own death on account of despair, hopelessness, fear or maybe a feeling of being weak, superfluous and unwanted. This is a very uncertain base for decision-making, especially in the irrevocable decision of euthanasia. Finally, a competent person usually makes any choice in a responsible way and after due consideration; a 'good' decision should consider and respect the wishes and feelings of others. This will be no less the case in making a decision on the so-called free choice of euthanasia. Thus 'normal' behaviour in decision making will only add to the tendency of the already depressed person to feel a burden on his family, the staff and even on society.

  1. Model Based Autonomy for Robust Mars Operations

    Science.gov (United States)

    Kurien, James A.; Nayak, P. Pandurang; Williams, Brian C.; Lau, Sonie (Technical Monitor)

    1998-01-01

    Space missions have historically relied upon a large ground staff, numbering in the hundreds for complex missions, to maintain routine operations. When an anomaly occurs, this small army of engineers attempts to identify and work around the problem. A piloted Mars mission, with its multiyear duration, cost pressures, half-hour communication delays and two-week blackouts cannot be closely controlled by a battalion of engineers on Earth. Flight crew involvement in routine system operations must also be minimized to maximize science return. It also may be unrealistic to require the crew have the expertise in each mission subsystem needed to diagnose a system failure and effect a timely repair, as engineers did for Apollo 13. Enter model-based autonomy, which allows complex systems to autonomously maintain operation despite failures or anomalous conditions, contributing to safe, robust, and minimally supervised operation of spacecraft, life support, In Situ Resource Utilization (ISRU) and power systems. Autonomous reasoning is central to the approach. A reasoning algorithm uses a logical or mathematical model of a system to infer how to operate the system, diagnose failures and generate appropriate behavior to repair or reconfigure the system in response. The 'plug and play' nature of the models enables low cost development of autonomy for multiple platforms. Declarative, reusable models capture relevant aspects of the behavior of simple devices (e.g. valves or thrusters). Reasoning algorithms combine device models to create a model of the system-wide interactions and behavior of a complex, unique artifact such as a spacecraft. Rather than requiring engineers to all possible interactions and failures at design time or perform analysis during the mission, the reasoning engine generates the appropriate response to the current situation, taking into account its system-wide knowledge, the current state, and even sensor failures or unexpected behavior.

  2. Work-related health complaints in surgical residents and the influence of social support and job-related autonomy.

    Science.gov (United States)

    Boerjan, Martine; Bluyssen, Simone J M; Bleichrodt, Robert P; van Weel-Baumgarten, Evelyn M; van Goor, Harry

    2010-08-01

    The aim of this cross-sectional study was to investigate the influence of job-related autonomy and social support provided by consultants and colleagues on the stress-related health complaints of surgical residents in the Netherlands. All (n = 400) Dutch residents in training in general surgery were sent validated self-report questionnaires. Odds ratios were calculated predicting health and exposure to long-term stress for gender, number of working hours, type of hospital, level of social support, job-related autonomy and training phase. The interactions between job-related autonomy and level of social support provided by consultants and colleagues, and all variables, were analysed. A total of 254 of 400 (64%) residents returned questionnaires that were eligible for analysis. Residents experienced more health complaints than the average member of the Dutch working population (4.0 versus 2.5; p = 0.000). Male and senior residents were significantly 'healthier' than female and junior residents, respectively. Social support by consultants was a strong predictor of health and social support by colleagues showed a significant interaction with gender. Women and residents in university hospitals experienced less social support by consultants than men and residents in general teaching hospitals. Residents working in university hospitals experienced lower levels of job-related autonomy and less support from colleagues in comparison with those working in general teaching hospitals. A working week of > 60 hours adversely affected health and job-related autonomy. Social support provided by consultants and colleagues, and job control, are important factors that interact with the work-associated, stress-related health of residents in training in general surgery. Residents report a greater number of health complaints than the average member of the working population, especially female and junior residents. General teaching hospitals seem to provide better support at work than

  3. Cultural differences in the relationships among autonomy support, psychological need satisfaction, subjective vitality, and effort in British and Chinese physical education.

    Science.gov (United States)

    Taylor, Ian M; Lonsdale, Chris

    2010-10-01

    Using basic psychological needs theory (BPNT; Ryan & Deci, 2000) as our guiding framework, we explored cultural differences in the relationships among physical education students' perceptions of teacher autonomy support, psychological need satisfaction, subjective vitality and effort in class. Seven hundred and fifteen students (age range from 13 to 15 years) from the U.K. and Hong Kong, China, completed a multisection inventory during a timetabled physical education class. Multilevel analyses revealed that the relationships among autonomy support, subjective vitality and effort were mediated by students' perceptions of psychological need satisfaction. The relationship between autonomy support and perceptions of competence was stronger in the Chinese sample, compared with the U.K. sample. In addition, the relationship between perceptions of relatedness and effort was not significant in the Chinese students. The findings generally support the pan-cultural utility of BPNT and imply that a teacher-created autonomy supportive environment may promote positive student experiences in both cultures.

  4. Are there limits to respect for autonomy in bioethics?

    Science.gov (United States)

    de Roubaix, Malcolm

    2008-06-01

    I discuss the significance of respect for personal autonomy in bioethics with reference to its practical expression: rational informed patient choice. The question is whether, given the apparent practical limitations to this notion, bioethical autonomy should be seen as an absolute. After a historical review of informed consent and its development, I discuss the requirements for informed consent. Some inherent tensions are evaluated, as is the applicability of the notion that in order to be legitimate, autonomy should do some ethical work. Limits to the notion of informed consent are explored with reference to six examples: the right of women to reproductive autonomy; the autonomy of legally minor Jehovah's Witnesses; autonomy in cosmetic surgery; inappropriate treatment; autonomy and human medical research, and euthanasia and other end-of-life options. The discussion is within a South African framework with reference to other jurisdictions and decisions where appropriate. I conclude that whilst some unusual instances of limitation of bioethical informed consent might be ethically justifiable, the arguments presented point to the opposite: the unfounded limitation of informed consent.

  5. Relational autonomy: moving beyond the limits of isolated individualism.

    Science.gov (United States)

    Walter, Jennifer K; Ross, Lainie Friedman

    2014-02-01

    Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.

  6. Feminist ethics and menopause: autonomy and decision-making in primary medical care.

    Science.gov (United States)

    Murtagh, Madeleine J; Hepworth, Julie

    2003-04-01

    The construction of menopause as a long-term risk to health and the adoption of discourses of prevention has made necessary a decision by women about medical treatment; specifically regarding the use of hormone replacement therapy. In a study of general practitioners' accounts of menopause and treatment in Australia, women's 'choice', 'informed decision-making' and 'empowerment' were key themes through which primary medical care for women at menopause was presented. These accounts create a position for women defined by the concept of individual choice and an ethic of autonomy. These data are a basis for theorising more generally in this paper. We critically examine the construct of 'informed decision-making' in relation to several approaches to ethics including bioethics and a range of feminist ethics. We identify the intensification of power relations produced by an ethic of autonomy and discuss the ways these considerations inform a feminist ethics of decision-making by women. We argue that an 'ethic of autonomy' and an 'offer of choice' in relation to health care for women at menopause, far from being emancipatory, serves to intensify power relations. The dichotomy of choice, to take or not to take hormone replacement therapy, is required to be a choice and is embedded in relations of power and bioethical discourse that construct meanings about what constitutes decision-making at menopause. The deployment of the principle of autonomy in medical practice limits decision-making by women precisely because it is detached from the construction of meaning and the self and makes invisible the relations of power of which it is a part.

  7. How to score questionnaires

    NARCIS (Netherlands)

    Hofstee, W.K.B.; Ten Berge, J.M.F.; Hendriks, A.A.J.

    The standard practice in scoring questionnaires consists of adding item scores and standardizing these sums. We present a set of alternative procedures, consisting of (a) correcting for the acquiescence variance that disturbs the structure of the questionnaire; (b) establishing item weights through

  8. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  9. Clinical guidelines and the fate of medical autonomy in Ontario.

    Science.gov (United States)

    Rappolt, S G

    1997-04-01

    Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.

  10. More Issues in Observed-Score Equating

    Science.gov (United States)

    van der Linden, Wim J.

    2013-01-01

    This article is a response to the commentaries on the position paper on observed-score equating by van der Linden (this issue). The response focuses on the more general issues in these commentaries, such as the nature of the observed scores that are equated, the importance of test-theory assumptions in equating, the necessity to use multiple…

  11. [Physician and autonomy: on time perception and job satisfaction].

    Science.gov (United States)

    Huisman, Frank G

    2015-01-01

    Is it true that haste is sneaking into medicine? In this article, it is argued that it mainly concerns the perception of being rushed, which is caused by a loss of autonomy of the modern physician. In the fifties, physicians were busy as well, but because they enjoyed a greater degree of autonomy compared to their contemporary colleagues, they did not experience this in a negative way. Due to increased bureaucracy and the introduction of market dynamics, the medical profession has lost autonomy, which in turn led to a loss of job satisfaction.

  12. Does Country Context Distance Determine Subsidiary Decision-Making Autonomy?

    DEFF Research Database (Denmark)

    de Jong, Gjalt; Van Vo, Dut; Marek, Philipp

    2015-01-01

    enterprises, highlighting the importance of such intra-firm collaboration. The division of decision-making autonomy is a core issue in the management of headquarters–subsidiary relationships. The main contribution of our paper is that we confront two valid theoretical frameworks – business network theory......We studied an underrepresented area in the international business (IB) literature: the effect of country context distance on the distribution of decision-making autonomy across headquarters and foreign affiliates. Foreign affiliates directly contribute to the competitive advantages of multinational...... approach to the study of subsidiary decision-making autonomy...

  13. Evaluation of Existing Situation of University Institutional Autonomy in Moldova

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Bugaian, Larisa; Gulieva, Valeria

    2014-01-01

    This chapter introduces four studies in which the current status of university institutional autonomy in Moldova is evaluated. At the same time it discusses the methodology employed in the study, provide a brief introduction to the higher education sector in Moldova and summaries key findings fro...... the evaluation of organizational, financial, HR and academic autonomy in Moldova.......This chapter introduces four studies in which the current status of university institutional autonomy in Moldova is evaluated. At the same time it discusses the methodology employed in the study, provide a brief introduction to the higher education sector in Moldova and summaries key findings from...

  14. The Bandim tuberculosis score

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina

    2013-01-01

    Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  15. Don’t Always Prefer My Chosen Objects: Low Level of Trait Autonomy and Autonomy Deprivation Decreases Mere Choice Effect

    Science.gov (United States)

    Shang, Zhe; Tao, Tuoxin; Wang, Lei

    2016-01-01

    Choice effect is a robust phenomenon in which even “mere choice” that does not include actual choosing actions could result in more preference for the self-chosen objects over other-chosen objects. In the current research, we proposed that autonomy would impact the mere choice effect. We conducted two studies to examine the hypothesis. The results showed that the mere choice effect measured by Implicit Association Test (IAT) significantly decreased for participants with lower levels of trait autonomy (Study 1) and when participants were primed to experience autonomy deprivation (Study 2). The theoretical and practical implications are discussed. PMID:27148132

  16. Threats to Autonomy in Consumer Societies and Their Implications for Education

    Science.gov (United States)

    Schinkel, Anders; de Ruyter, Doret; Steutel, Jan

    2010-01-01

    The development of autonomy in children is a central concern of liberal philosophers of education. We endorse the liberal intuition that autonomy matters and that it is an appropriate aim of education. However, we divert from autonomy liberals, who defend a rather limited and demanding conception of autonomy that is closely connected with skills…

  17. the search for local government autonomy in nigeria

    African Journals Online (AJOL)

    RAYAN_

    autonomous. Keywords: Search, local government, autonomy, pathways and realization .... time. 6 There were, for instance, the Native Authority Ordinance, the Native Revenue .... Construction and maintenance of primary schools; and e.

  18. Emotional autonomy and problem behavior among Chinese adolescents.

    Science.gov (United States)

    Chou, Kee-Lee

    2003-12-01

    The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.

  19. Radioiodine therapy of benign thyroid disorders: functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.

    2005-01-01

    In the last 15 years, several concepts have been developed to further improve the outcome of radioiodine therapy in functional thyroid autonomy. Results of radioiodine therapy in functional autonomy are considerably better than in Graves' disease. All of the currently-applied concepts offer healing rates of 75-100%, but they differ considerably in the hypothyreosis rates attained. The target volume can be precisely determined by sonography only in unifocal autonomy. In the case of multifocal and disseminated autonomy, the entire thyroid is taken as the target volume and the focal dose is reduced ('dosimetric compromise'). TcTUs-based dose concepts calculate the functionally autonomous volume from the TcTUs and replace the target volume by sonography, in the TcTUs-adapted dose concepts, sonographic target volume is left and the focal dose varied in dependence of the suppression uptake. The objective is to attain a high rate of success with a low rate of hypothyreosis. (orig.)

  20. Innovations in Computer Generated Autonomy at the MOVES Institute

    National Research Council Canada - National Science Library

    Hiles, John

    2001-01-01

    The M6VES Institute's Computer-Generated Autonomy Group has focused on a research goal of modeling intensely complex and adaptive behavior while at the same time making the behavior far easier to create and control...

  1. the Effect of Egyptian Married Women's Decision-Making Autonomy

    African Journals Online (AJOL)

    AJRH Managing Editor

    women's autonomy influences their use of modern contraception methods and to determine the mediating effect of education .... attention should be given to other social ..... possibly due to their greater exposure to media, ... prohibited in Islam.

  2. Autonomy-connectedness mediates sex differences in symptoms of psychopathology

    NARCIS (Netherlands)

    Bekker, Marrie H.J.; Van Assen, Marcel A.L.M.

    2017-01-01

    Objectives: This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder). Method: Participants

  3. Autonomy-connectedness mediates sex differences in symptoms of psychopathology

    NARCIS (Netherlands)

    Bekker, M.H.J.; van Assen, M.A.L.M.

    2017-01-01

    Objectives This study aimed to examine if autonomy-connectedness, capacity for self-governance under the condition of connectedness, would mediate sex differences in symptoms of various mental disorders (depression, anxiety, eating disorders, antisocial personality disorder). Method Participants (N

  4. Developing child autonomy in pediatric healthcare: towards an ethical model.

    Science.gov (United States)

    Martakis, Kyriakos; Brand, Helmut; Schröder-Bäck, Peter

    2018-06-01

    The changes initiated by the new National Civil and Commercial Code in Argentina underline the pediatric task to empower children's and adolescents' developing autonomy. In this paper, we have framed a model describing autonomy in child healthcare. We carried out a literature review focusing on i) the concept of autonomy referring to the absolute value of the autonomous individual, and ii) the age-driven process of competent decisionmaking development. We summarized our findings developing a conceptual model that includes the child, the pediatrician and the parents. The pediatricianchild relationship is based on different forms of guidance and cooperation, resulting in varying levels of activity and passivity. Parental authority influences the extent of autonomy, based on the level of respect of the child's moral equality. Contextual, existential, conceptual, and socialethical conditions shall be considered when applying the model to facilitate dialogue between pediatricians, children, parents and other actors. Sociedad Argentina de Pediatría.

  5. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  6. Contingency Management with Human Autonomy Teaming

    Science.gov (United States)

    Shively, Robert J.; Lachter, Joel B.

    2018-01-01

    Automation is playing an increasingly important role in many operations. It is often cheaper faster and more precise than human operators. However, automation is not perfect. There are many situations in which a human operator must step in. We refer to these instances as contingencies and the act of stepping in contingency management. Here we propose coupling Human Autonomy Teaming (HAT) with contingency management. We describe two aspects to HAT, bi-directional communication, and working agreements (or plays). Bi-directional communication like Crew Resource Management in traditional aviation, allows all parties to contribute to a decision. Working agreements specify roles and responsibilities. Importantly working agreements allow for the possibility of roles and responsibilities changing depending on environmental factors (e.g., situations the automation was not designed for, workload, risk, or trust). This allows for the automation to "automatically" become more autonomous as it becomes more trusted and/or it is updated to deal with a more complete set of possible situations. We present a concrete example using a prototype contingency management station one might find in a future airline operations center. Automation proposes reroutes for aircraft that encounter bad weather or are forced to divert for environmental or systems reasons. If specific conditions are met, these recommendations may be autonomously datalinked to the affected aircraft.

  7. Coercive treatment and autonomy in psychiatry.

    Science.gov (United States)

    Sjöstrand, Manne; Helgesson, Gert

    2008-02-01

    There are three lines of argument in defence of coercive treatment of patients with mental disorders: arguments regarding (1) societal interests to protect others, (2) the patients' own health interests, and (3) patient autonomy. In this paper, we analyse these arguments in relation to an idealized case, where a person with a mental disorder claims not to want medical treatment for religious reasons. We also discuss who should decide what in situations where patients with mental disorders deny treatment on seemingly rational grounds. We conclude that, in principle, coercive treatment cannot be defended for the sake of protecting others. While coercive actions can be acceptable in order to protect close family and others, medical treatment is not justified for such reasons but should be given only in the interest of patients. Coercive treatment may be required in order to promote the patient's health interests, but health interests have to waive if they go against the autonomous interests of the patient. We argue that non-autonomous patients can have reasons, rooted in their deeply-set values, to renounce compulsory institutional treatment, and that such reasons should be respected unless it can be assumed that their new predicaments have caused them to change their views.

  8. Reconfigurable Autonomy for Future Planetary Rovers

    Science.gov (United States)

    Burroughes, Guy

    Extra-terrestrial Planetary rover systems are uniquely remote, placing constraints in regard to communication, environmental uncertainty, and limited physical resources, and requiring a high level of fault tolerance and resistance to hardware degradation. This thesis presents a novel self-reconfiguring autonomous software architecture designed to meet the needs of extraterrestrial planetary environments. At runtime it can safely reconfigure low-level control systems, high-level decisional autonomy systems, and managed software architecture. The architecture can perform automatic Verification and Validation of self-reconfiguration at run-time, and enables a system to be self-optimising, self-protecting, and self-healing. A novel self-monitoring system, which is non-invasive, efficient, tunable, and autonomously deploying, is also presented. The architecture was validated through the use-case of a highly autonomous extra-terrestrial planetary exploration rover. Three major forms of reconfiguration were demonstrated and tested: first, high level adjustment of system internal architecture and goal; second, software module modification; and third, low level alteration of hardware control in response to degradation of hardware and environmental change. The architecture was demonstrated to be robust and effective in a Mars sample return mission use-case testing the operational aspects of a novel, reconfigurable guidance, navigation, and control system for a planetary rover, all operating in concert through a scenario that required reconfiguration of all elements of the system.

  9. [Adult learning, professional autonomy and individual commitment].

    Science.gov (United States)

    Pardell-Alentá, H

    The concept of 'andragogy' is the basis of the adult education which is different from pedagogy in several aspects, particularly in the autonomy of the adult learner in choosing the educational programmes and the methodologies and sites in where learning occurs. This happens very often in the worksite. The professionals have to learn permanently during their active lives in order to maintain their competence updated. In this sense, continuing education correlates with continuing professional development, which is an attempt to enlarge the traditional domains of continuing education. Continuing education must be clearly differentiated from formal education, which is a requirement for granting professional degrees or titles. Very often it arises from the changing health needs and for this reason is necessary to avoid the institutionalization of continuing education programmes. Professional associations should be actively involved in providing and accrediting continuing education-continuing professional development programmes, because this involvement is an essential component of the professionals' self-regulation in the context of the current medical professionalism ideology.

  10. Marketing human organs: the autonomy paradox.

    Science.gov (United States)

    Marshall, P A; Thomasma, D C; Daar, A S

    1996-03-01

    The severe shortage of organs for transplantation and the continual reluctance of the public to voluntarily donate has prompted consideration of alternative strategies for organ procurement. This paper explores the development of market approaches for procuring human organs for transplantation and considers the social and moral implications of organ donation as both a "gift of life" and a "commodity exchange." The problematic and paradoxical articulation of individual autonomy in relation to property rights and marketing human body parts is addressed. We argue that beliefs about proprietorship over human body parts and the capacity to provide consent for organ donation are culturally constructed. We contend that the political and economic framework of biomedicine, in western and non-western nations, influences access to transplantation technology and shapes the form and development of specific market approaches. Finally, we suggest that marketing approaches for organ procurement are and will be negotiated within cultural parameters constrained by several factors: beliefs about the physical body and personhood, religious traditions, economic conditions, and the availability of technological resources.

  11. Learner autonomy development through digital gameplay

    Directory of Open Access Journals (Sweden)

    Alice Chik

    2011-04-01

    Full Text Available Playing digital games is undeniably a popular leisure activity, and digital gaming is also gaining academic attention and recognition for enhancing digital literacies and learning motivation. One tricky issue when exploring digital gaming in Asian contexts is the popularity of English and Japanese games. Though Chinese and Korean online games are readily available, many of the more popular commercial off-the-shelf (COTS digital games are in English and Japanese. Students in Hong Kong are required to take English as a foreign language, which resulted in a huge range of proficiency, but Japanese is not offered at public schools. So, most Hong Kong gamers are playing foreign language games. Yet language barriers do not diminish the market demand for foreign language digital games. This paper explores the phenomenon of digital gaming in foreign languages. Based on findings from an on-going research project with ten undergraduate video gamers (F=4, M=6, this paper argues that gamers exercise learner autonomy by managing their gaming both as leisure and learning experiences.

  12. The Chains on All My People Are the Chains on Me: Restrictions to Collective Autonomy Undermine the Personal Autonomy and Psychological Well-Being of Group Members.

    Science.gov (United States)

    Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A

    2018-01-11

    Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  13. Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?

    Science.gov (United States)

    Ashcroft, Richard E

    2011-06-01

    This paper reviews the ethical controversy concerning the use of monetary incentives in health promotion, focussing specifically on the arguments relating to the impact on personal autonomy of such incentives. Offering people small amounts of money in the context of health promotion and medical care has been attempted in a number of settings in recent years. This use of personal financial incentives has attracted a degree of ethical controversy. One form of criticism is that such schemes interfere with the autonomy of the patient or citizen in an illegitimate way. This paper presents a thematic analysis of the main arguments concerning personal autonomy and the use of monetary incentives in behaviour change. The main moral objections to the uses of incentives are that they may be in general or in specific instances paternalistic, coercive, involve bribery, or undermine the agency of the person. While incentive schemes may engage these problems on occasion, there is no good reason to think that they do so inherently and of necessity. We need better behavioural science evidence to understand how incentives work, in order to evaluate their moral effects in practice. © 2011 Blackwell Publishing Ltd.

  14. Mothers’ and Fathers’ Autonomy-Relevant Parenting: Longitudinal Links with Adolescents’ Externalizing and Internalizing Behavior

    Science.gov (United States)

    Lansford, Jennifer E.; Laird, Robert D.; Pettit, Gregory S.; Bates, John E.; Dodge, Kenneth A.

    2014-01-01

    The goal of this study was to advance the understanding of separate and joint effects of mothers’ and fathers’ autonomy-relevant parenting during early and middle adolescence. In a sample of 518 families, adolescents (49% female; 83% European American, 16% African American, 1% other ethnic groups) reported on their mothers’ and fathers’ psychological control and knowledge about adolescents’ whereabouts, friends, and activities at ages 13 and 16. Mothers and adolescents reported on adolescents’ externalizing and internalizing behaviors at ages 12, 14, 15, and 17. Adolescents perceived their mothers as using more psychological control and having more knowledge than their fathers, but there was moderate concordance between adolescents’ perceptions of their mothers and fathers. More parental psychological control predicted increases in boys’ and girls’ internalizing problems and girls’ externalizing problems. More parental knowledge predicted decreases in boys’ externalizing and internalizing problems. The perceived levels of behavior of mothers and fathers did not interact with one another in predicting adolescent adjustment. The results generalize across early and late adolescence and across mothers’ and adolescents’ reports of behavior problems. Autonomy-relevant mothering and fathering predict changes in behavior problems during early and late adolescence, but only autonomy-relevant fathering accounts for unique variance in adolescent behavior problems. PMID:24337705

  15. Mothers' and fathers' autonomy-relevant parenting: longitudinal links with adolescents' externalizing and internalizing behavior.

    Science.gov (United States)

    Lansford, Jennifer E; Laird, Robert D; Pettit, Gregory S; Bates, John E; Dodge, Kenneth A

    2014-11-01

    The goal of this study was to advance the understanding of separate and joint effects of mothers' and fathers' autonomy-relevant parenting during early and middle adolescence. In a sample of 518 families, adolescents (49 % female; 83 % European American, 16 % African American, 1 % other ethnic groups) reported on their mothers' and fathers' psychological control and knowledge about adolescents' whereabouts, friends, and activities at ages 13 and 16. Mothers and adolescents reported on adolescents' externalizing and internalizing behaviors at ages 12, 14, 15, and 17. Adolescents perceived their mothers as using more psychological control and having more knowledge than their fathers, but there was moderate concordance between adolescents' perceptions of their mothers and fathers. More parental psychological control predicted increases in boys' and girls' internalizing problems and girls' externalizing problems. More parental knowledge predicted decreases in boys' externalizing and internalizing problems. The perceived levels of behavior of mothers and fathers did not interact with one another in predicting adolescent adjustment. The results generalize across early and late adolescence and across mothers' and adolescents' reports of behavior problems. Autonomy-relevant mothering and fathering predict changes in behavior problems during early and late adolescence, but only autonomy-relevant fathering accounts for unique variance in adolescent behavior problems.

  16. Pharmacy ownership in Canada: implications for the authority and autonomy of community pharmacy managers.

    Science.gov (United States)

    Dobson, Roy Thomas; Perepelkin, Jason

    2011-12-01

    In recent years, the number of independently owned pharmacies has declined even as the total number of pharmacies in Canada has increased. With increasing corporate ownership, there is concern that this trend will adversely affect the profession's ability to influence pharmacy practice and practice change. To examine the relationship between ownership type and community pharmacy managers in terms of professional and employer authority, managerial autonomy, decision making, and amount of control. This study consisted of a cross-sectional survey of community pharmacy managers in Canada by means of a self-administered postal questionnaire sent to a stratified sample of community pharmacies. Statistical analysis consisted of exploratory factor analysis with reliability testing on identified constructs. Frequencies, 1-way analyses of variance, Scheffe post hoc tests, and general linear modeling were used to determine significant differences among groups based on ownership type. In total, 646 of 1961 questionnaires from pharmacy managers were completed and returned (response rate 32.9%). Respondents rated their authority similarly across ownership types. Autonomy, decision-making capabilities, and control needed to carry out the professional role appear most limited among corporate respondents and, to a lesser extent, franchise managers. Pharmacy managers currently perceive a high level of authority; but with limited autonomy among corporate managers, it is unclear whether this authority is sufficient to prevent the subordination of both patient and professional interests to financial interests. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Exploring the relationship between university internationalization and university autonomy

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Gullieva, Valeria

    This paper explores a research gap at the intersection of university internationalization and university autonomy. A process model of university internationalization is put forward whereby the process of university internationalization is mediated by university internationalization capacity...... and moderated by target country institutional autonomy and globalization; and entry modes, timing and pace, as well as product mix of internationalization define university’s internationalization pattern. A systematic review is conducted to identify empirical studies at this intersection. One of the questions...

  18. Direct-to-consumer genomics on the scales of autonomy

    Science.gov (United States)

    Vayena, Effy

    2015-01-01

    Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of such services, and even their prohibition, on the grounds of the harm they pose to consumers. Their advocates, by contrast, defend them as a means of enhancing the autonomy of those same consumers. Autonomy emerges as a key battle-field in this debate, because many of the ‘harm’ arguments can be interpreted as identifying threats to autonomy. This paper assesses whether DTC genomic services are a threat to, or instead, an enhancement of, personal autonomy. It deploys Joseph Raz's account of personal autonomy, with its emphasis on choice from a range of valuable options. It then seeks to counter claims that DTC genomics threatens autonomy because it involves manipulation in contravention of consumers’ independence or because it does not generate valuable options which can be meaningfully engaged with by consumers. It is stressed that the value of the options generated by DTC genomics should not be judged exclusively from the perspective of medical actionability, but should take into consideration plural utilities. Finally, the paper ends by broaching policy recommendations, suggesting that there is a strong autonomy-based argument for permitting DTC genomic services, and that the key question is the nature of the regulatory conditions under which they should be permitted. The discussion of autonomy in this paper helps illuminate some of these conditions. PMID:24797610

  19. Teacher autonomy in the era of New Public Management

    OpenAIRE

    Lundström, Ulf

    2015-01-01

    This article examines how upper secondary school teachers perceive and respond to the consequences for their professional autonomy of recent school reforms and restructurings. Based on empirical material from interviews of 119 teachers in three studies conducted between 2002 and 2014, the findings indicate that teacher autonomy has been reduced by school reforms and restructurings since the late 1980s. Regardless of their individual aims, these reforms have collectively created a power struct...

  20. Managing the accountability-autonomy tensions in university research commercialisation

    OpenAIRE

    Narayan, Anil K.; Northcott, Deryl; Parker, Lee D.

    2017-01-01

    This article investigates organisational responses to emerging concerns about how accountability–autonomy tensions can be managed within the context of university research commercialisation. The findings suggest that changed expectations of university research practices, which result from the introduction of a commercialisation logic, can be managed via the homogenisation of research goals and strategies. The successful management of accountability–autonomy tensions also depends on utilising ...

  1. Autonomy, religious values, and refusal of lifesaving medical treatment.

    OpenAIRE

    Wreen, M J

    1991-01-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assign...

  2. Factors Contributing to Learners’ Autonomy in EFL Reading

    OpenAIRE

    Sri Endah Tabiati

    2016-01-01

    Abstract: This study aims to discover factors that assist learners develop their autonomy in EFL reading. The approach employed is qualitative involving EFL learners in an English Department of the Faculty of Cultural Studies, Brawijaya University Malang. There are two stages in the study: the subject selection stage intended to gain potential subjects and the main study intended to find the answer of the research questions. The findings of the study show that the autonomy of EFL learners in ...

  3. Monetary Autonomy in Select Asian Economies : Role of International Reserves

    OpenAIRE

    Hiroyuki Taguchi; Geethanjali Nataraj; Pravakar Sahoo

    2010-01-01

    This paper examines the trends in monetary autonomy and its interaction with financial integration, currency regime and foreign reserves for the past two decades in select Asian countries viz., Thailand, Korea, Indonesia, Philippines, and India. Our main findings are as follows : First, Thailand, Korea and Indonesia, who experienced the change in currency regime towards a floating regime, have lowered the sensitivities of their interest rates (have raised monetary autonomy) after the regime c...

  4. Between Autonomy and Vulnerability : the Space of Movement

    OpenAIRE

    Kevin McDonald

    2011-01-01

    Analyses of the contemporary alterglobalization movement increasingly emphasize dimensions of autonomy, whose ultimate origins lie in theories of agency understood as sovereignty. This paper argues that critical dimensions of the alterglobalization movement involve practices of embodied action and forms of responsibility that point beyond autonomy, to a paradigm of relational vulnerability. Recognising this is central to understanding ethics, agency, and subjectivity and to understanding move...

  5. Between Autonomy and Vulnerability : the Space of Movement

    Directory of Open Access Journals (Sweden)

    Kevin McDonald

    2011-03-01

    Full Text Available Analyses of the contemporary alterglobalization movement increasingly emphasize dimensions of autonomy, whose ultimate origins lie in theories of agency understood as sovereignty. This paper argues that critical dimensions of the alterglobalization movement involve practices of embodied action and forms of responsibility that point beyond autonomy, to a paradigm of relational vulnerability. Recognising this is central to understanding ethics, agency, and subjectivity and to understanding movements as a space of experience.

  6. Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

    Science.gov (United States)

    Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

    2016-09-01

    Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

  7. Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

    Directory of Open Access Journals (Sweden)

    Yu-Kai Chang, Senlin Chen, Kun-Wei Tu, Li-Kang Chi

    2016-09-01

    Full Text Available Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61 or the control group (n = 65 for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation.

  8. AUDIT-C scores as a scaled marker of mean daily drinking, alcohol use disorder severity, and probability of alcohol dependence in a U.S. general population sample of drinkers.

    Science.gov (United States)

    Rubinsky, Anna D; Dawson, Deborah A; Williams, Emily C; Kivlahan, Daniel R; Bradley, Katharine A

    2013-08-01

    Brief alcohol screening questionnaires are increasingly used to identify alcohol misuse in routine care, but clinicians also need to assess the level of consumption and the severity of misuse so that appropriate intervention can be offered. Information provided by a patient's alcohol screening score might provide a practical tool for assessing the level of consumption and severity of misuse. This post hoc analysis of data from the 2001 to 2002 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) included 26,546 U.S. adults who reported drinking in the past year and answered additional questions about their consumption, including Alcohol Use Disorders Identification Test-Consumption questionnaire (AUDIT-C) alcohol screening. Linear or logistic regression models and postestimation methods were used to estimate mean daily drinking, the number of endorsed alcohol use disorder (AUD) criteria ("AUD severity"), and the probability of alcohol dependence associated with each individual AUDIT-C score (1 to 12), after testing for effect modification by gender and age. Among eligible past-year drinkers, mean daily drinking, AUD severity, and the probability of alcohol dependence increased exponentially across increasing AUDIT-C scores. Mean daily drinking ranged from alcohol dependence ranged from used to estimate patient-specific consumption and severity based on age, gender, and alcohol screening score. This information could be integrated into electronic decision support systems to help providers estimate and provide feedback about patient-specific risks and identify those patients most likely to benefit from further diagnostic assessment. Copyright © 2013 by the Research Society on Alcoholism.

  9. Basic autonomy as a fundamental step in the synthesis of life.

    Science.gov (United States)

    Ruiz-Mirazo, Kepa; Moreno, Alvaro

    2004-01-01

    In the search for the primary roots of autonomy (a pivotal concept in Varela's comprehensive understanding of living beings), the theory of autopoiesis provided an explicit criterion to define minimal life in universal terms, and was taken as a guideline in the research program for the artificial synthesis of biological systems. Acknowledging the invaluable contribution of the autopoietic school to present biological thinking, we offer an alternative way of conceiving the most basic forms of autonomy. We give a bottom-up account of the origins of "self-production" (or self-construction, as we propose to call it), pointing out which are the minimal material and energetic requirements for the constitution of basic autonomous systems. This account is, indeed, committed to the project of developing a general theory of biology, but well grounded in the universal laws of physics and chemistry. We consider that the autopoietic theory was formulated in highly abstract terms and, in order to advance in the implementation of minimal autonomous systems (and, at the same time, make major progress in exploring the origins of life), a more specific characterization of minimal autonomous systems is required. Such a characterization will not be drawn from a review of the autopoietic criteria and terminology (à la Fleischaker) but demands a whole reformulation of the question: a proper naturalization of the concept of autonomy. Finally, we also discuss why basic autonomy, according to our account, is necessary but not sufficient for life, in contrast with Varela's idea that autopoiesis was a necessary and sufficient condition for it.

  10. Volitional Trust, Autonomy Satisfaction, and Engagement at Work.

    Science.gov (United States)

    Heyns, Marita; Rothmann, Sebastiaan

    2018-02-01

    This study tested a structural model that identifies the nature of relationships between trust, autonomy satisfaction, and personal engagement at work. A cross-sectional survey design with a convenience sample ( n = 252) was used. The Behavioral Trust Inventory, Work-Related Basic Need Satisfaction Scale, and Work Engagement Scale were administered. While reliance-based trust did not have a significant influence on engagement, disclosure-based trust in a focal leader was found to predict satisfaction of autonomy needs and employee engagement. Mediation analyses revealed that satisfaction of the need for autonomy facilitates the influence of trust on work outcomes. More specifically, disclosure (a dimension of trust) impacted engagement via autonomy satisfaction. Overall, the model explained 44% of total variance in engagement, to which the variables proportionately contributed as follows: autonomy satisfaction = 79.58%, disclosure = 18.22%, and reliance = 2.20%. The findings provide possible directions for how leaders can leverage trust to facilitate autonomy support and higher levels of engagement.

  11. Radioiodine-treatment (RIT) of functional thyroidal autonomy

    International Nuclear Information System (INIS)

    Meller, J.; Sahlmann, C.O.; Becker, W.

    2002-01-01

    Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

  12. What does respect for the patient's autonomy require?

    Science.gov (United States)

    Cheng, Kam-Yuen

    2013-11-01

    Personal autonomy presupposes the notion of rationality. What is not so clear is whether, and how, a compromise of rationality to various degrees will diminish a person's autonomy. In bioethical literature, three major types of threat to the rationality of a patient's medical decision are identified: insufficient information, irrational beliefs/desires, and influence of different framing effects. To overcome the first problem, it is suggested that patients be provided with information about their diseases and treatment choices according to the objective standard. I shall explain how this should be finessed. Regarding the negative impact of irrational beliefs/desires, some philosophers have argued that holding irrational beliefs can still be an expression of autonomy. I reject this argument because the degree of autonomy of a decision depends on the degree of rationality of the beliefs or desires on which the decision is based. Hence, to promote patient autonomy, we need to eliminate irrational beliefs by the provision of evidence and good arguments. Finally, I argue that the way to smooth out the framing effects is to present the same information in different perspectives: it is too often assumed that medical information can always be given in a complete and unadorned manner. This article concludes with a cautionary note that the protection of patient autonomy requires much more time and effort than the current practice usually allows. © 2012 John Wiley & Sons Ltd.

  13. Psychological autonomy and hierarchical relatedness as organizers of developmental pathways.

    Science.gov (United States)

    Keller, Heidi

    2016-01-19

    The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective. © 2015 The Author(s).

  14. The Resident-Run Minor Surgery Clinic: A Pilot Study to Safely Increase Operative Autonomy.

    Science.gov (United States)

    Wojcik, Brandon M; Fong, Zhi Ven; Patel, Madhukar S; Chang, David C; Petrusa, Emil; Mullen, John T; Phitayakorn, Roy

    General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program. Single institution case-control pilot study of a resident-run minor surgery clinic from 9/2014 to 6/2015. Rotating third-year residents staffed the clinic once weekly. Residents performed operations independently in their own procedure room. A supervising attending surgeon staffed each case prior to residents performing the procedure and viewed the surgical site before wound closure. Postprocedure patient complications and admissions to the hospital because of a complication were analyzed and compared with an attending control cohort. Massachusetts General Hospital General in Boston, MA; an academic tertiary care general surgery residency program. Ten third-year general surgery residents. Overall, 341 patients underwent a total of 399 procedures (110 in the resident clinic vs. 289 in the attending clinic). Minor surgeries included soft tissue mass excision (n = 275), abscess incision and drainage (n = 66), skin lesion excision (n = 37), skin tag removal (n = 15), and lymph node excision (n = 6). There was no significant difference in the overall rate of patients developing a postprocedure complication within 30 days (3.6% resident vs. 2.8% attending; p = 0.65); which persisted on multivariate analysis. Similar findings were observed for the rate of hospital admission resulting from a complication. Resident evaluations overwhelmingly supported the rotation, citing

  15. Self-reported diabetes self-management competence and support from healthcare providers in achieving autonomy are negatively associated with diabetes distress in adults with Type 1 diabetes

    DEFF Research Database (Denmark)

    Mohn, J; Graue, M; Assmus, J

    2015-01-01

    comprised blood sampling and three self-report questionnaires, the Problem Areas in Diabetes scale, the Perceived Competence in Diabetes Scale and a measure of autonomy support by healthcare providers, the Health Care Climate Questionnaire. We fitted blockwise linear regression models to assess......AIM: To investigate the associations of self-perceived competence in diabetes management and autonomy support from healthcare providers with diabetes distress in adults with Type 1 diabetes mellitus that is not optimally controlled [HbA(1c) ≥ 64 mmol/mol (8.0%)]. METHODS: This cross-sectional study...... the associations between Problem Areas in Diabetes score and the variables of interest (autonomy support and perceived diabetes competence), controlling for clinical and sociodemographic variables. RESULTS: Of the study sample [n = 178; mean age 36.7 (±10.7) years], 31.5% had long-term complications and 43...

  16. Controlling the autonomy of a reconnaissance robot

    Science.gov (United States)

    Dalgalarrondo, Andre; Dufourd, Delphine; Filliat, David

    2004-09-01

    In this paper, we present our research on the control of a mobile robot for indoor reconnaissance missions. Based on previous work concerning our robot control architecture HARPIC, we have developed a man machine interface and software components that allow a human operator to control a robot at different levels of autonomy. This work aims at studying how a robot could be helpful in indoor reconnaissance and surveillance missions in hostile environment. In such missions, since a soldier faces many threats and must protect himself while looking around and holding his weapon, he cannot devote his attention to the teleoperation of the robot. Moreover, robots are not yet able to conduct complex missions in a fully autonomous mode. Thus, in a pragmatic way, we have built a software that allows dynamic swapping between control modes (manual, safeguarded and behavior-based) while automatically performing map building and localization of the robot. It also includes surveillance functions like movement detection and is designed for multirobot extensions. We first describe the design of our agent-based robot control architecture and discuss the various ways to control and interact with a robot. The main modules and functionalities implementing those ideas in our architecture are detailed. More precisely, we show how we combine manual controls, obstacle avoidance, wall and corridor following, way point and planned travelling. Some experiments on a Pioneer robot equipped with various sensors are presented. Finally, we suggest some promising directions for the development of robots and user interfaces for hostile environment and discuss our planned future improvements.

  17. Autonomy in robots and other agents.

    Science.gov (United States)

    Smithers, T

    1997-06-01

    The word "autonomous" has become widely used in artificial intelligence, robotics, and, more recently, artificial life and is typically used to qualify types of systems, agents, or robots: we see terms like "autonomous systems," "autonomous agents," and "autonomous robots." Its use in these fields is, however, both weak, with no distinctions being made that are not better and more precisely made with other existing terms, and varied, with no single underlying concept being involved. This ill-disciplined usage contrasts strongly with the use of the same term in other fields such as biology, philosophy, ethics, law, and human rights, for example. In all these quite different areas the concept of autonomy is essentially the same, though the language used and the aspects and issues of concern, of course, differ. In all these cases the underlying notion is one of self-law making and the closely related concept of self-identity. In this paper I argue that the loose and varied use of the term autonomous in artificial intelligence, robotics, and artificial life has effectively robbed these fields of an important concept. A concept essentially the same as we find it in biology, philosophy, ethics, and law, and one that is needed to distinguish a particular kind of agent or robot from those developed and built so far. I suggest that robots and other agents will have to be autonomous, i.e., self-law making, not just self-regulating, if they are to be able effectively to deal with the kinds of environments in which we live and work: environments which have significant large scale spatial and temporal invariant structure, but which also have large amounts of local spatial and temporal dynamic variation and unpredictability, and which lead to the frequent occurrence of previously unexperienced situations for the agents that interact with them.

  18. A locally adapted functional outcome measurement score for total ...

    African Journals Online (AJOL)

    ... in Europe or North America and seem not optimally suited for a general West ... We introduce a cross-cultural adaptation of the Lequesne index as a new score. ... Keywords: THR, Hip, Africa, Functional score, Hip replacement, Arthroscopy ...

  19. Women's autonomy and social support and their associations with infant and young child feeding and nutritional status: community-based survey in rural Nicaragua.

    Science.gov (United States)

    Ziaei, Shirin; Contreras, Mariela; Zelaya Blandón, Elmer; Persson, Lars-Åke; Hjern, Anders; Ekström, Eva-Charlotte

    2015-08-01

    To evaluate the associations of women's autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua. Cross-sectional study. Feeding practices and children's nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women's autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women's social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles. Los Cuatro Santos area, rural Nicaragua. A total of 1371 children 0-35 months of age. Children of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller. While lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.

  20. Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study.

    Science.gov (United States)

    McDonald, Ruth; Harrison, Stephen; Checkland, Kath; Campbell, Stephen M; Roland, Martin

    2007-06-30

    To explore the impact of financial incentives for quality of care on practice organisation, clinical autonomy, and internal motivation of doctors and nurses working in primary care. Ethnographic case study. Two English general practices. 12 general practitioners, nine nurses, four healthcare assistants, and four administrative staff. Observation of practices over a five month period after the introduction of financial incentives for quality of care introduced in the 2004 general practitioner contract. After the introduction of the quality and outcomes framework there was an increase in the use of templates to collect data on quality of care. New regimens of surveillance were adopted, with clinicians seen as "chasers" or the "chased," depending on their individual responsibility for delivering quality targets. Attitudes towards the contract were largely positive, although discontent was higher in the practice with a more intensive surveillance regimen. Nurses expressed more concern than doctors about changes to their clinical practice but also appreciated being given responsibility for delivering on targets in particular disease areas. Most doctors did not question the quality targets that existed at the time or the implications of the targets for their own clinical autonomy. Implementation of financial incentives for quality of care did not seem to have damaged the internal motivation of the general practitioners studied, although more concern was expressed by nurses.

  1. Instant MuseScore

    CERN Document Server

    Shinn, Maxwell

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.

  2. Patient autonomy in home care: Nurses' relational practices of responsibility.

    Science.gov (United States)

    Jacobs, Gaby

    2018-01-01

    Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

  3. A biochemistry laboratory course designed to enhance students autonomy

    Directory of Open Access Journals (Sweden)

    T. Silva

    2015-08-01

    Full Text Available INTRODUCTION: Laboratory sessions are responsible for promoting instrumentation skills desirable in biochemistry and biochemistry related careers. They are traditionally based on experimental protocols that lead to the expected results, and students usually have not autonomy to plan and execute their experiments. GOALS: This work aimed to enhance a traditional biochemistry lab course, applying pre-lab quizzes on protein biochemistry and lab techniques in order to have students better prepared to plan, execute and interpret experiments. This approach also aims to bring the laboratory sessions into an inquiry-based environment capable to improve students’ independent capabilities in 2 autonomy domains: learning and communication. MATERIAL AND METHODS: Online quizzes are delivered one week before each laboratory session, containing questions regarding the experimental techniques and theoretical basis related to them. Laboratory activities are presented in an inquiry-based approach where the first class of each activity is dedicated to plan experiments in order to answer the research questions presented by instructors. Activities are also organized in order to enhance students’ autonomy. The first activity is the simplest and more instructor-controlled and the last one is the most complex and less driven, transferring gradually to students the responsibility for their decisions in laboratory, supporting students’ autonomy. RESULTS: Online quizzes allowed instructors to identify students’ difficulties and to timely intervene. Scientific reports presented by students at the end of each activity showed that they performed better on less driven activities in which autonomy support were more complex than in the instructor controlled activities. CONCLUSIONS: Scientific reports analysis reveals students capabilities related to different scopes of autonomy, such as: discuss different strategies; find multiple solutions to solve problems; make their

  4. Evidence-Responsiveness and the Ongoing Autonomy of Treatment Preferences.

    Science.gov (United States)

    Weimer, Steven

    2017-06-14

    To be an autonomous agent is to determine one's own path in life. However, this cannot plausibly be seen as a one-off affair. An autonomous agent does not merely set herself on a particular course and then lock the steering wheel in place, so to speak, but must maintain some form of ongoing control over her direction in life-must keep her eyes on the road and her hands on the wheel. Circumstances often change in important and unexpected ways, after all, and it is reasonable to think that a crucial part of autonomy consists of the ability and disposition to recognize and properly respond to such changes. This implies, I contend, that a patient whose initial decision to undergo a given treatment satisfied plausible requirements of autonomy, but who is now unable to recognize that available evidence indicates the need to reconsider her medical situation and options has come to lack autonomy with respect to her desire to continue that treatment. However, and despite its importance with respect to both theoretical understandings of autonomy and applications of the concept to clinical ethics, this ongoing aspect of autonomy has received little attention. This paper aims to go some way toward remedying that. I first critically review two of the few theories of autonomy that do address "evidence-responsiveness" so as to identify and elaborate what I take to be the most promising way in which to account for this aspect of autonomy. After considering and responding to a possible objection to the evidence-responsiveness condition I propose, I conclude by discussing its clinical implications. That condition, I argue, is not merely theoretically sound, but can and should be applied to clinical practice.

  5. Instructors' Support of Student Autonomy in an Introductory Physics Course

    Science.gov (United States)

    Hall, Nicholas; Webb, David

    2014-12-01

    The role of autonomy in the student experience in a large-enrollment undergraduate introductory physics course was studied from a self-determination theory perspective. A correlational study investigated whether certain aspects of the student experience correlated with how autonomy supportive (versus controlling) students perceived their instructors to be. An autonomy-supportive instructor acknowledges students' perspectives and feelings and provides students with information and opportunities for choice while minimizing external pressures (e.g., incentives or deadlines). It was found that the degree to which students perceived their instructors as autonomy supportive was positively correlated with student interest and enjoyment in learning physics (β =0.31***) and negatively correlated with student anxiety about taking physics (β =-0.23**). It was also positively correlated with how autonomous (versus controlled) students' reasons for studying physics became over the duration of the course (i.e., studying physics more because they wanted to versus had to; β =0.24***). This change in autonomous reasons for studying physics was in turn positively correlated with student performance in the course (β =0.17*). Additionally, the degree to which students perceived their instructors as autonomy supportive was directly correlated with performance for those students entering the course with relatively autonomous reasons for studying physics (β =0.25**). In summary, students who perceived their instructors as more autonomy supportive tended to have a more favorable motivational, affective, and performance experience in the course. The findings of the present study are consistent with experimental studies in other contexts that argue for autonomy-supportive instructor behaviors as the cause of a more favorable student experience.

  6. Evaluation of a standard provision versus an autonomy promotive exercise referral programme: rationale and study design

    Directory of Open Access Journals (Sweden)

    Jolly Kate

    2009-06-01

    Full Text Available Abstract Background The National Institute of Clinical Excellence in the UK has recommended that the effectiveness of ongoing exercise referral schemes to promote physical activity should be examined in research trials. Recent empirical evidence in health care and physical activity promotion contexts provides a foundation for testing the utility of a Self Determination Theory (SDT-based exercise referral consultation. Methods/Design Design: An exploratory cluster randomised controlled trial comparing standard provision exercise on prescription with a Self Determination Theory-based (SDT exercise on prescription intervention. Participants: 347 people referred to the Birmingham Exercise on Prescription scheme between November 2007 and July 2008. The 13 exercise on prescription sites in Birmingham were randomised to current practice (n = 7 or to the SDT-based intervention (n = 6. Outcomes measured at 3 and 6-months: Minutes of moderate or vigorous physical activity per week assessed using the 7-day Physical Activity Recall; physical health: blood pressure and weight; health status measured using the Dartmouth CO-OP charts; anxiety and depression measured by the Hospital Anxiety and Depression Scale and vitality measured by the subjective vitality score; motivation and processes of change: perceptions of autonomy support from the advisor, satisfaction of the needs for competence, autonomy, and relatedness via physical activity, and motivational regulations for exercise. Discussion This trial will determine whether an exercise referral programme based on Self Determination Theory increases physical activity and other health outcomes compared to a standard programme and will test the underlying SDT-based process model (perceived autonomy support, need satisfaction, motivation regulations, outcomes via structural equation modelling. Trial registration The trial is registered as Current Controlled trials ISRCTN07682833.

  7. The lod score method.

    Science.gov (United States)

    Rice, J P; Saccone, N L; Corbett, J

    2001-01-01

    The lod score method originated in a seminal article by Newton Morton in 1955. The method is broadly concerned with issues of power and the posterior probability of linkage, ensuring that a reported linkage has a high probability of being a true linkage. In addition, the method is sequential, so that pedigrees or lod curves may be combined from published reports to pool data for analysis. This approach has been remarkably successful for 50 years in identifying disease genes for Mendelian disorders. After discussing these issues, we consider the situation for complex disorders, where the maximum lod score (MLS) statistic shares some of the advantages of the traditional lod score approach but is limited by unknown power and the lack of sharing of the primary data needed to optimally combine analytic results. We may still learn from the lod score method as we explore new methods in molecular biology and genetic analysis to utilize the complete human DNA sequence and the cataloging of all human genes.

  8. The Bayesian Score Statistic

    NARCIS (Netherlands)

    Kleibergen, F.R.; Kleijn, R.; Paap, R.

    2000-01-01

    We propose a novel Bayesian test under a (noninformative) Jeffreys'priorspecification. We check whether the fixed scalar value of the so-calledBayesian Score Statistic (BSS) under the null hypothesis is aplausiblerealization from its known and standardized distribution under thealternative. Unlike

  9. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently, SASS ... further investigation: spatial analyses of macroinvertebrate assemblages; and the use of structural and functional metrics. Keywords: .... conductivity levels was assessed using multiple linear regres- sion.

  10. Developing Scoring Algorithms

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  11. Regions’ Economic Autonomy in the New Reality

    Directory of Open Access Journals (Sweden)

    Vladimir Stepanovich Bochko

    2016-06-01

    Full Text Available The paper discloses the understanding of new reality (normality for Russia that consists in the strengthening of the role of a man-personality and in the expansion of the economic autonomy of the territories in their interaction with the federal center. The rationale is based on a hypothesis according to which in the conditions of new reality, the increase of the well-being of the population and the overcoming of economic inequality between the territories are provided by the expansion of their economic independence as it leads to the increase of their intellectual, engineering and manufacturing potential. In the research, the author used the basic concepts of the classical economic theory, the theory of behavioural economics, interdisciplinary approach and statistical grouping method. The dynamics of the economic independence of the territories, which is manifested in the decrease in a number of donor regions and the socio-economic dividing of the territories, is shown. The assumption is proved that the consequences of the territorial stratification are the restraining of the growth of their socio-economic development and possibility probable emergence of «regional peripheral economy» with the property of the dependence of the periphery on the center, the decrease in a local initiative, the inhibition of technological development. The need to use the social psychology of the population, the psychological sets of economic development, «the second invisible hand of the market» and soft power to overcome the «regional peripheral economy» is revealed. The result of the research is the proof that the expansion of the economic independence of the territories is not only the increase of the self-isolation of regions and municipalities, but also the need to save the considerable part of the income from the production of goods and services created by the local population under control of the regional and municipal authorities and direct it to the

  12. Measuring the e-Learning Autonomy of Distance Education Students

    Directory of Open Access Journals (Sweden)

    Mehmet Firat

    2016-08-01

    Full Text Available Previous studies have provided evidence that learner autonomy is an important factor in academic achievement. However, few studies have investigated the autonomy of distance education students in e-learning environments. The purpose of this study is to evaluate the e-learning autonomy of distance education students who are responsible for their own learning. For this purpose, as the first step of the study, an e-learning autonomy scale was developed. Analyses of the validity and reliability of the scale were carried out with the participation of 1,152 distance education students from Anadolu University, Open Education System. The scale has an internal consistency coefficient of α = 0.952 and a single factorial model that explains 66.58% of the total variance. The scale was implemented with 3,293 students from 42 different programs. According to the findings, student autonomy in e-learning environments is directly proportional to level of ICT use but not affected by program or gender.

  13. ARMD Strategic Thrust 6: Assured Autonomy for Aviation Transformation

    Science.gov (United States)

    Ballin, Mark; Holbrook, Jon; Sharma, Shivanjli

    2016-01-01

    In collaboration with the external community and other government agencies, NASA will develop enabling technologies, standards, and design guidelines to support cost-effective applications of automation and limited autonomy for individual components of aviation systems. NASA will also provide foundational knowledge and methods to support the next epoch. Research will address issues of verification and validation, operational evaluation, national policy, and societal cost-benefit. Two research and development approaches to aviation autonomy will advance in parallel. The Increasing Autonomy (IA) approach will seek to advance knowledge and technology through incremental increases in machine-based support of existing human-centered tasks, leading to long-term reallocation of functions between humans and machines. The Autonomy as a New Technology (ANT) approach seeks advances by developing technology to achieve goals that are not currently possible using human-centered concepts of operation. IA applications are mission-enhancing, and their selection will be based on benefits achievable relative to existing operations. ANT applications are mission-enabling, and their value will be assessed based on societal benefit resulting from a new capability. The expected demand for small autonomous unmanned aircraft systems (UAS) provides an opportunity for development of ANT applications. Supervisory autonomy may be implemented as an expansion of the number of functions or systems that may be controlled by an individual human operator. Convergent technology approaches, such as the use of electronic flight bags and existing network servers, will be leveraged to the maximum extent possible.

  14. Recentralization within decentralization: County hospital autonomy under devolution in Kenya

    Science.gov (United States)

    Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

    2017-01-01

    Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

  15. Patient autonomy in chronic care: solving a paradox

    Directory of Open Access Journals (Sweden)

    Reach G

    2013-12-01

    Full Text Available Gérard Reach Department of Endocrinology, Diabetes, and Metabolic Diseases, Avicenne Hospital AP-HP, and EA 3412, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bobigny, France Abstract: The application of the principle of autonomy, which is considered a cornerstone of contemporary bioethics, is sometimes in obvious contradiction with the principle of beneficence. Indeed, it may happen in chronic care that the preferences of the health care provider (HCP, who is largely focused on the prevention of long term complications of diseases, differ from those, more present oriented, preferences of the patient. The aims of this narrative review are as follows: 1 to show that the exercise of autonomy by the patient is not always possible; 2 where the latter is not possible, to examine how, in the context of the autonomy principle, someone (a HCP can decide what is good (a treatment for someone else (a patient without falling into paternalism. Actually this analysis leads to a paradox: not only is the principle of beneficence sometimes conflicting with the principle of autonomy, but physician's beneficence may enter into conflict with the mere respect of the patient; and 3 to propose a solution to this paradox by revisiting the very concepts of the autonomous person, patient education, and trust in the patient–physician relationship: this article provides an ethical definition of patient education. Keywords: preference, autonomy, person, reflexivity, empathy, sympathy, patient education, trust, respect, care

  16. The appearance of Kant's deontology in contemporary Kantianism: concepts of patient autonomy in bioethics.

    Science.gov (United States)

    Secker, B

    1999-02-01

    Kant's concept of autonomy and the Kantian notion of autonomy are often conflated in bioethics. However, the contemporary Kantian notion has very little at all to do with Kant's original. In order to further bioethics discourse on autonomy, I critically distinguish the contemporary Kantian notion from Kant's original concept of moral autonomy. I then evaluate the practical relevance of both concepts of autonomy for use in bioethics. I argue that it is not appropriate to appeal to either concept toward assessing which patients we ought to respect as autonomous. Finally, I sketch criteria for what I take to be a more promising concept of autonomy for patients.

  17. Moral distress, autonomy and nurse-physician collaboration among intensive care unit nurses in Italy.

    Science.gov (United States)

    Karanikola, Maria N K; Albarran, John W; Drigo, Elio; Giannakopoulou, Margarita; Kalafati, Maria; Mpouzika, Meropi; Tsiaousis, George Z; Papathanassoglou, Elizabeth D E

    2014-05-01

    To explore the level of moral distress and potential associations between moral distress indices and (1) nurse-physician collaboration, (2) autonomy, (3) professional satisfaction, (4) intention to resign, and (5) workload among Italian intensive care unit nurses. Poor nurse-physician collaboration and low autonomy may limit intensive care unit nurses' ability to act on their moral decisions. A cross-sectional correlational design with a sample of 566 Italian intensive care unit nurses. The intensity of moral distress was 57.9 ± 15.6 (mean, standard deviation) (scale range: 0-84) and the frequency of occurrence was 28.4 ± 12.3 (scale range: 0-84). The mean score of the severity of moral distress was 88.0 ± 44 (scale range: 0-336). The severity of moral distress was associated with (1) nurse-physician collaboration and dissatisfaction on care decisions (r = -0.215, P intention to resign (r = 0.244, P intention of nurses to resign (r = -0. 209, P intention to resign, whereas poor nurse-physician collaboration appears to be a pivotal factor accounting for nurses' moral distress. Enhancement of nurse-physician collaboration and nurses' participation in end-of-life decisions seems to be a managerial task that could lead to the alleviation of nurses' moral distress and their retention in the profession. © 2013 John Wiley & Sons Ltd.

  18. Credit scoring methods

    Czech Academy of Sciences Publication Activity Database

    Vojtek, Martin; Kočenda, Evžen

    2006-01-01

    Roč. 56, 3-4 (2006), s. 152-167 ISSN 0015-1920 R&D Projects: GA ČR GA402/05/0931 Institutional research plan: CEZ:AV0Z70850503 Keywords : banking sector * credit scoring * discrimination analysis Subject RIV: AH - Economics Impact factor: 0.190, year: 2006 http://journal.fsv.cuni.cz/storage/1050_s_152_167.pdf

  19. Focusing on relationships, not information, respects autonomy during antenatal consultations.

    Science.gov (United States)

    Gaucher, Nathalie; Payot, Antoine

    2017-01-01

    Policy statements regarding antenatal consultations for preterm labour are guided by physicians' concerns for upholding the legal doctrine of informed consent, through the provision of standardised homogeneous medical information. This approach, led by classical in-control conceptions of patient autonomy, conceives moral agents as rational, independent, self-sufficient decision-makers. Recent studies on these antenatal consultations have explored patients' perspectives, and these differ from guidelines' suggestions. Relational autonomy - which understands moral agents as rational, emotional, creative and interdependent - resonates impressively with these new data. A model for antenatal consultations is proposed. This approach encourages clinicians to explore individual patients' lived experiences and engage in trusting empowering relationships. Moreover, it calls on physicians to enhance patients' relational autonomy by becoming advocates for their patients within healthcare institutions and professional organisations, while calling for broadscale policy changes to encourage further funding and support in investigations of the patient's voice. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  20. Education and Reproductive Autonomy: The Case of Married Nigerian Women.

    Science.gov (United States)

    Princewill, Chitu Womehoma; De Clercq, Eva; Riecher-Rössler, Anita; Jegede, Ayodele Samuel; Wangmo, Tenzin; Elger, Bernice Simone

    2017-01-01

    In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.