WorldWideScience

Sample records for making life easier

  1. Making Healthy Choices Easier

    DEFF Research Database (Denmark)

    Guldborg Hansen, Pelle; Skov, Laurits Rohden; Lund Skov, Katrine

    2016-01-01

    . However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier is being threatened by inadequate understandings of its scientific character, relationship with regulation and its ethical implications. This article reviews...... working with or incorporating the nudge approach into programs or policies aimed at making healthy choices easier...

  2. Making Healthy Choices Easier: Regulation versus Nudging.

    Science.gov (United States)

    Hansen, Pelle Guldborg; Skov, Laurits Rohden; Skov, Katrine Lund

    2016-01-01

    In recent years, the nudge approach to behavior change has emerged from the behavioral sciences to challenge the traditional use of regulation in public health strategies to address modifiable individual-level behaviors related to the rise of noncommunicable diseases and their treatment. However, integration and testing of the nudge approach as part of more comprehensive public health strategies aimed at making healthy choices easier are being threatened by inadequate understandings of its scientific character, its relationship with regulation, and its ethical implications. This article reviews this character and its ethical implication with a special emphasis on the compatibility of nudging with traditional regulation, special domains of experience, and the need for a more nuanced approach to the ethical debate. The aim is to advance readers' understanding and give guidance to those who have considered working with or incorporating the nudge approach into programs or policies aimed at making healthful choices easier.

  3. Counter traction makes endoscopic submucosal dissection easier.

    Science.gov (United States)

    Oyama, Tsuneo

    2012-11-01

    Poor counter traction and poor field of vision make endoscopic submucosal dissection (ESD) difficult. Good counter traction allows dissections to be performed more quickly and safely. Position change, which utilizes gravity, is the simplest method to create a clear field of vision. It is useful especially for esophageal and colon ESD. The second easiest method is clip with line method. Counter traction made by clip with line accomplishes the creation of a clear field of vision and suitable counter traction thereby making ESD more efficient and safe. The author published this method in 2002. The name ESD was not established in those days; the name cutting endoscopic mucosal resection (EMR) or EMR with hook knife was used. The other traction methods such as external grasping forceps, internal traction, double channel scope, and double scopes method are introduced in this paper. A good strategy for creating counter traction makes ESD easier.

  4. Managing Daily Life

    Science.gov (United States)

    ... Duchenne / Managing Daily Life Print Email Managing Daily Life Environmental accessibility As the person with Duchenne starts ... such as wider doorways and ramps, can make life easier once the person with Duchenne cannot climb ...

  5. Making Health Easier: Healthy Schools in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-07

    A middle school student is making healthy changes in his life, like eating less junk food, thanks to healthy changes at his school.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  6. Go4Life

    Medline Plus

    Full Text Available ... This item has been hidden Go4Life Exercises — Building Strength Play all Try some of these Go4Life exercises to improve your strength! Stronger muscles can make it easier to do ...

  7. Go4Life

    Medline Plus

    Full Text Available ... all Try some of these Go4Life exercises to improve your flexibility! 2:48 Play next Play now ... all Try some of these Go4Life exercises to improve your strength! Stronger muscles can make it easier ...

  8. Go4Life

    Medline Plus

    Full Text Available ... Go4Life exercises to improve your strength! Stronger muscles can make it easier to do everyday things like ... 513 views Trainer Sandy shows Irene that you can do Go4Life exercises anywhere, even the kitchen! CC ...

  9. How to Make Evaluation Time Stress-Free!

    Science.gov (United States)

    Peterson, Kristy

    2010-01-01

    When it's annual review time, are you frustrated or overwhelmed by the task of remembering an employee's performance throughout the year? Do you ever feel that if you took notes on each task set within the year, it would be easier for you to summarize the evaluation? There is a way to make everyone's life a little easier when giving or receiving…

  10. Should divorce be easier or harder?

    OpenAIRE

    Gonzalez, Libertad

    2014-01-01

    Many countries have enacted legislation over the past few decades making divorce easier. Some countries have legalized divorce where it had previously been banned, and many have eased the conditions required for a divorce, such as allowing unilateral divorce (both spouses do not have to agree on the divorce). Divorce laws can regulate the grounds for divorce, division of property, child custody, and child support or maintenance payments. Reforms can have a range of social effects beyond incre...

  11. Go4Life

    Medline Plus

    Full Text Available ... strength! Stronger muscles can make it easier to do everyday things like get up from a chair, ... 797 views Trainer Sandy shows Linda how to do lower body exercises in her office with Go4Life's ...

  12. JMARS - Planetary Remote Sensing Analysis Made Even Easier

    Science.gov (United States)

    Dickenshied, S.; Christensen, P. R.; Noss, D.; Anwar, S.; Carter, S.; Smith, M. E.

    2012-12-01

    Planetary remote sensing data has been collected and made public over the years from a variety of missions, but accessing this data and performing analysis on it has often been a time consuming and problematic task. JMARS (Java Mission-planning and Analysis for Remote Sensing) is a free geospatial application developed by the Mars Space Flight Facility at Arizona State University. Originally written as a misson planning tool for the THEMIS instrument on board the MARS Odyssey Spacecraft, it was released as an analysis tool to the general public in 2003. Since then it has expanded to be used for mission planning and scientific data analysis by additional NASA missions to Mars, the Moon, and Vesta and it has come to be used by scientists, researchers and students of all ages from more than 40 countries around the world. JMARS tries to save a user from the nuances of working with planetary data by providing a quick and consistent method of accessing data from various missions which can then be analyzed and compared with each other. A user can easily access hundreds of maps and millions of individual images collected by the Viking, MOC, MOLA, TES, THEMIS, HiRISE, CTX, and CRISM instruments. Users can also import their own data and work with it in an identical fashion, then optionally share that data with other users. Recent effort has been put into making JMARS easier and more consistent to use. A new toolbar makes panning and zooming easier and more intuitive, especially for systems without three button mice. Additionally, the toolbar also exposes measuring and data investigation tools that used to only be accessible in specific layers and obscure keyboard commands. The Layer Manager, which has long allowed users to reorder layers, adjust transparency, and access layer specific options, can now be optionally docked into the main view window, making it easier to work on laptops or overhead projectors. The Layer Manager can still be torn off into it's own independent

  13. Easier living?

    DEFF Research Database (Denmark)

    Høholt, Stine

    2005-01-01

    I ph.d.-projektet: "Easier Living? Streamline design og den æstetiserede livsverden" analyseres 1930'ernes Streamline-bevægelse, som tilhører den amerikanske modernisme inden for industrielt produktdesign. Bevægelsens glatte, strømlinede produkter bliver med deres enorme udbredelse det historiske...

  14. Is Making Divorce Easier Bad for Children? The Long-Run Implications of Unilateral Divorce

    OpenAIRE

    Jonathan Gruber

    2004-01-01

    Most states in the U.S. allow for unilateral divorce, which increases the ease of divorce by not requiring the explicit consent of both partners. Such regulations have come under fire for their perceived negative consequences for marital stability and resulting child outcomes, but there is no evidence to date to support the contention that easier divorce regulations are actually bad for children. I assess the long run implications for children of growing up in a unilateral divorce environment...

  15. Toward an easier indigocarmine chromoendoscopy.

    Science.gov (United States)

    Barret, Maximilien; Camus, Marine; Leblanc, Sarah; Coriat, Romain; Prat, Frédéric; Chaussade, Stanislas

    2015-07-10

    Indigocarmine chromoendoscopy has been proven to improve the detection of colonic lesions during screening colonoscopy, and is associated with increased adenoma detection rates. Furthermore, it is commonly used to help in the delineation and characterization of colorectal neoplasms. However, it usually requires the use of a spraying catheter that decreases the suction capacity of the endoscope, and is time- consuming. Herein, we report on the feasibility of indigo carmine chromoendoscopy during colonoscopy without using a spraying catheter, with the dye being administered through the air/water channel of the endoscope. Since the suction channel remains free, the air can be exsufflated and the staining then applies uniformly onto the colonic walls with the excess indigocarmine dye being immediately eliminated. In our experience with various types of colonoscopes and cap-assisted colonoscopy, this procedure makes indigocarmine chromoendoscopy much easier and quicker to perform, and might save the use of a spray catheter.

  16. Technology makes life better

    Institute of Scientific and Technical Information of China (English)

    李红

    2015-01-01

    There are many theories about the relationship between technology and society.With the development of world economy,technology has made great progress.However,many changes were taken place in our daily life,especially the appearance of computer.Sending emails,chatting with others online,search for information which is what we need to learn and many other demands in people’s daily life,computers make all of it into possibility.

  17. Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass |

    Science.gov (United States)

    News | NREL Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass Breakdown Breakthrough: NREL Finds Easier Ways to Deconstruct Biomass May 22, 2018 Roman Brunecky (left), Yannick Bomble soften biomass. Photo by Dennis Schroeder, NREL If there's an easier, more efficient method, science will

  18. Counter Traction Makes Endoscopic Submucosal Dissection Easier

    OpenAIRE

    Oyama, Tsuneo

    2012-01-01

    Poor counter traction and poor field of vision make endoscopic submucosal dissection (ESD) difficult. Good counter traction allows dissections to be performed more quickly and safely. Position change, which utilizes gravity, is the simplest method to create a clear field of vision. It is useful especially for esophageal and colon ESD. The second easiest method is clip with line method. Counter traction made by clip with line accomplishes the creation of a clear field of vision and suitable co...

  19. Ei Compendex: A new database makes life easier for engineers

    CERN Multimedia

    2001-01-01

    The Library is expanding its range of databases. The latest arrival, called Ei Compendex, is the world's most comprehensive engineering database, which indexes engineering literature published throughout the world. It also offers bibliographic entries for articles published in scientific journals and for conference proceedings and covers an extensive range of subjects from mechanical engineering to the environment, materials science, solid state physics and superconductivity. Moreover, it is the most relevant quality control and engineering management database. Ei Compendex contains over 4.6 million references from over 2600 journals, conference proceedings and technical reports dating from 1966 to the present. Every year, 220,000 new abstracts are added to the database which is also updated on a weekly basis. In the case of articles published in recent years, it provides an electronic link to the full texts of all major publishers. The database also contains the full texts of Elsevier periodicals (over 250...

  20. Competence and Quality in Real-Life Decision Making.

    Science.gov (United States)

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria.

  1. Competence and Quality in Real-Life Decision Making

    Science.gov (United States)

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definition of decision-making competence could be beneficially expanded by adding aspects of competence in terms of social skills and time-approach. The predictive power for each of these three aspects of decision-making competence was explored for different indicators of real-life decision-making success. Overall, our results suggest that research on decision-making competence would benefit by expanding the definition of competence, by including decision-related abilities in terms of social skills and time-approach. Finally, the results also indicate that individual differences in real-life decision-making success profitably can be approached and measured by different criteria. PMID:26545239

  2. Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

    OpenAIRE

    Langhoff, J; Mayer, J; Faber, L; Kästner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

    2008-01-01

    Objectives: Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. Material and methods...

  3. Life Support Baseline Values and Assumptions Document

    Science.gov (United States)

    Anderson, Molly S.; Ewert, Michael K.; Keener, John F.

    2018-01-01

    The Baseline Values and Assumptions Document (BVAD) provides analysts, modelers, and other life support researchers with a common set of values and assumptions which can be used as a baseline in their studies. This baseline, in turn, provides a common point of origin from which many studies in the community may depart, making research results easier to compare and providing researchers with reasonable values to assume for areas outside their experience. This document identifies many specific physical quantities that define life support systems, serving as a general reference for spacecraft life support system technology developers.

  4. Soundoff: Mathematics Is Getting Easier.

    Science.gov (United States)

    Usiskin, Zalman

    1984-01-01

    Teaching mathematics in hard ways, rather than using easier methods or technology, is described. Employing the most efficient means possible to solve a problem is the essence of good mathematics, rather than wasting time in practicing obsolete skills. (MNS)

  5. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.

  6. Luxuries are Easier to Postpone

    DEFF Research Database (Denmark)

    Browning, Martin; Crossley, Thomas

    2000-01-01

    We show that (Marshallian) income elasticities are proportional to (Frisch) own price elasticities if all goods are additively separable. This implies that luxuries are likely to be easier to postpone. It also implies that preferences over "consumption" are unlikely to display a constant elasticity...

  7. Making Health Easier: Active Living in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-07

    Making communities bike-friendly can help reduce traffic congestion and increase the physical activity of residents. Learn how one Philadelphia resident worked with his community to make Philadelphia a more bike-friendly city.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  8. Issues surrounding end-of-life decision-making

    Directory of Open Access Journals (Sweden)

    Tejwani V

    2013-08-01

    Full Text Available Vickram Tejwani,1,* YiFan Wu,1,* Sabrina Serrano,2 Luis Segura,2 Michael Bannon,3 Qi Qian1 1Department of Medicine, Division of Nephrology and Hypertension, 2Mayo Graduate School, 3Department of Trauma, Critical Care, and General Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA *These authors contributed equally to this work Abstract: End-of-life decision-making is a complex process that can be extremely challenging. We describe a 42-year-old woman in an irreversible coma without an advance directive. The case serves to illustrate the complications that can occur in end-of-life decision-making and challenges in resolving difficult futility disputes. We review the role of advance directives in planning end-of-life care, the responsibility and historical performance of patient surrogates, the genesis of futility disputes, and approaches to resolving disputes. Keywords: end-of-life care, advance directive, surrogate, futility dispute, conflict resolution

  9. The enactment stage of end-of-life decision-making for children.

    Science.gov (United States)

    Sullivan, Jane Elizabeth; Gillam, Lynn Heather; Monagle, Paul Terence

    2018-01-11

    Typically pediatric end-of-life decision-making studies have examined the decision-making process, factors, and doctors' and parents' roles. Less attention has focussed on what happens after an end-of-life decision is made; that is, decision enactment and its outcome. This study explored the views and experiences of bereaved parents in end-of-life decision-making for their child. Findings reported relate to parents' experiences of acting on their decision. It is argued that this is one significant stage of the decision-making process. A qualitative methodology was used. Semi-structured interviews were conducted with bereaved parents, who had discussed end-of-life decisions for their child who had a life-limiting condition and who had died. Data were thematically analysed. Twenty-five bereaved parents participated. Findings indicate that, despite differences in context, including the child's condition and age, end-of-life decision-making did not end when an end-of-life decision was made. Enacting the decision was the next stage in a process. Time intervals between stages and enactment pathways varied, but the enactment was always distinguishable as a separate stage. Decision enactment involved making further decisions - parents needed to discern the appropriate time to implement their decision to withdraw or withhold life-sustaining medical treatment. Unexpected events, including other people's actions, impacted on parents enacting their decision in the way they had planned. Several parents had to re-implement decisions when their child recovered from serious health issues without medical intervention. Significance of results A novel, critical finding was that parents experienced end-of-life decision-making as a sequence of interconnected stages, the final stage being enactment. The enactment stage involved further decision-making. End-of-life decision-making is better understood as a process rather than a discrete once-off event. The enactment stage has particular

  10. Managing Small Spacecraft Projects: Less is Not Easier

    Science.gov (United States)

    Barley, Bryan; Newhouse, Marilyn

    2012-01-01

    Managing small, low cost missions (class C or D) is not necessarily easier than managing a full flagship mission. Yet, small missions are typically considered easier to manage and used as a training ground for developing the next generation of project managers. While limited resources can be a problem for small missions, in reality most of the issues inherent in managing small projects are not the direct result of limited resources. Instead, problems encountered by managers of small spacecraft missions often derive from 1) the perception that managing small projects is easier if something is easier it needs less rigor and formality in execution, 2) the perception that limited resources necessitate or validate omitting standard management practices, 3) less stringent or unclear guidelines or policies for small projects, and 4) stakeholder expectations that are not consistent with the size and nature of the project. For example, the size of a project is sometimes used to justify not building a full, detailed integrated master schedule. However, while a small schedule slip may not be a problem for a large mission, it can indicate a serious problem for a small mission with a short development phase, highlighting the importance of the schedule for early identification of potential issues. Likewise, stakeholders may accept a higher risk posture early in the definition of a low-cost mission, but as launch approaches this acceptance may change. This presentation discusses these common misconceptions about managing small, low cost missions, the problems that can result, and possible solutions.

  11. Making Sense Bringing Everyday Life at Work

    DEFF Research Database (Denmark)

    Egmose, Jonas; Gleerup, Janne; Nielsen, Birger Steen

    Inspired by contemporary work life studies on making sense at work this paper elaborates on using Critical Utopian Action Research as methodology for enabling shared learning spaces in which citizens and professionals can conjoin around discussions of deeper human aspirations enabled through...... synergies between civil engagement and organisational capabilities. The paper reports on experiences with enabling free spaces in the contexts of everyday life, where broader human concerns and aspirations can be addressed, as in the context of work life, where organisational responses on these orientations...

  12. End-of-life decision making in the ICU.

    Science.gov (United States)

    Siegel, Mark D

    2009-03-01

    A large proportion of deaths, particularly in the developed world, follows admission to an ICU. Therefore, end-of life decision making is an essential facet of critical care practice. For intensivists, managing death in the critically ill has become a key professional skill. They must be thoroughly familiar with the ethical framework that guides end-of-life decision making. Decisions should generally be made collaboratively by clinicians partnering with patients' families. Treatment choices should be crafted to meet specific, achievable goals. A rational, empathic approach to working with families should encourage appropriate, mutually satisfactory outcomes.

  13. Making Health Easier: Active Living in Austin, TX PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-07

    A local Austin, Texas, woman started a walking group to make physical activity fun for herself and community.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  14. Making Health Easier: Healthy Snacking in Philadelphia, PA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-07

    Instead of candy bars and chips, see how one employee is making healthier snack choices with the help of new vending machines.  Created: 6/7/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/7/2013.

  15. Making Health Easier: Worksite Wellness in Pima, AZ PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    To ease its rising healthcare costs, one company decided to make healthy changes in the workplace, like offering healthy food in vending machines and creating a walking path. As a result of the company’s efforts, health claims dropped by 70 percent and employees lost 440 pounds as a group.

  16. Nurse involvement in end-of-life decision making: the ETHICUS Study

    DEFF Research Database (Denmark)

    Benbenishty, Julie; Ganz, Freda DeKeyser; Lippert, Anne

    2006-01-01

    The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making.......The purpose was to investigate physicians' perceptions of the role of European intensive care nurses in end-of-life decision making....

  17. Decision-making heuristics and biases across the life span

    Science.gov (United States)

    Strough, JoNell; Karns, Tara E.; Schlosnagle, Leo

    2013-01-01

    We outline a contextual and motivational model of judgment and decision-making (JDM) biases across the life span. Our model focuses on abilities and skills that correspond to deliberative, experiential, and affective decision-making processes. We review research that addresses links between JDM biases and these processes as represented by individual differences in specific abilities and skills (e.g., fluid and crystallized intelligence, executive functioning, emotion regulation, personality traits). We focus on two JDM biases—the sunk-cost fallacy (SCF) and the framing effect. We trace the developmental trajectory of each bias from preschool through middle childhood, adolescence, early adulthood, and later adulthood. We conclude that life-span developmental trajectories differ depending on the bias investigated. Existing research suggests relative stability in the framing effect across the life span and decreases in the SCF with age, including in later life. We highlight directions for future research on JDM biases across the life span, emphasizing the need for process-oriented research and research that increases our understanding of JDM biases in people’s everyday lives. PMID:22023568

  18. Decision-making heuristics and biases across the life span.

    Science.gov (United States)

    Strough, Jonell; Karns, Tara E; Schlosnagle, Leo

    2011-10-01

    We outline a contextual and motivational model of judgment and decision-making (JDM) biases across the life span. Our model focuses on abilities and skills that correspond to deliberative, experiential, and affective decision-making processes. We review research that addresses links between JDM biases and these processes as represented by individual differences in specific abilities and skills (e.g., fluid and crystallized intelligence, executive functioning, emotion regulation, personality traits). We focus on two JDM biases-the sunk-cost fallacy (SCF) and the framing effect. We trace the developmental trajectory of each bias from preschool through middle childhood, adolescence, early adulthood, and later adulthood. We conclude that life-span developmental trajectories differ depending on the bias investigated. Existing research suggests relative stability in the framing effect across the life span and decreases in the SCF with age, including in later life. We highlight directions for future research on JDM biases across the life span, emphasizing the need for process-oriented research and research that increases our understanding of JDM biases in people's everyday lives. © 2011 New York Academy of Sciences.

  19. Making Health Easier: Worksite Wellness in Pima, AZ PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-05

    To ease its rising healthcare costs, one company decided to make healthy changes in the workplace, like offering healthy food in vending machines and creating a walking path. As a result of the company’s efforts, health claims dropped by 70 percent and employees lost 440 pounds as a group.  Created: 6/5/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/5/2013.

  20. New technical design of food packaging makes the opening process easier for patients with hand disorders.

    Science.gov (United States)

    Hensler, Stefanie; Herren, Daniel B; Marks, Miriam

    2015-09-01

    Opening packaged food is a complex daily activity carried out worldwide. Peelable packaging, as used for cheese or meat, causes real problems for many consumers, especially elderly people and those with hand disorders. Our aim was to investigate the possibility of producing meat packaging that is easier for patients with hand disorders to open. One hundred patients with hand osteoarthritis were asked to open a meat package currently available in supermarkets (Type A) and a modified, newly designed version (Type B), and rate their experiences with a consumer satisfaction index (CSI). The mean CSI of the Type B packs was 68.9%, compared with 41.9% for Type A (p food packages that afford greater consumer satisfaction. Such future packaging would benefit not only people with hand disorders but also the population as a whole. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

  1. Life course approach in social epidemiology: an overview, application and future implications.

    Science.gov (United States)

    Cable, Noriko

    2014-01-01

    The application of the life course approach to social epidemiology has helped epidemiologists theoretically examine social gradients in population health. Longitudinal data with rich contextual information collected repeatedly and advanced statistical approaches have made this challenging task easier. This review paper provides an overview of the life course approach in epidemiology, its research application, and future challenges. In summary, a systematic approach to methods, including theoretically guided measurement of socioeconomic position, would assist researchers in gathering evidence for reducing social gradients in health, and collaboration across individual disciplines will make this task achievable.

  2. Influence of physicians' life stances on attitudes to end-of-life decisions and actual end-of-life decision-making in six countries

    DEFF Research Database (Denmark)

    Cohen, J; van Delden, J; Mortier, F

    2008-01-01

    AIM: To examine how physicians' life stances affect their attitudes to end-of-life decisions and their actual end-of-life decision-making. METHODS: Practising physicians from various specialties involved in the care of dying patients in Belgium, Denmark, The Netherlands, Sweden, Switzerland......) and Protestants (up to 20.4% in The Netherlands) reported ever having made such a decision. DISCUSSION: The results suggest that religious teachings influence to some extent end-of-life decision-making, but are certainly not blankly accepted by physicians, especially when dealing with real patients...... large life-stance groups in each country. RESULTS: Only small differences in life stance were found in all countries in general attitudes and intended and actual behaviour with regard to various end-of-life decisions. However, with regard to the administration of drugs explicitly intended to hasten...

  3. Competence and Quality in Real-Life Decision Making

    OpenAIRE

    Geisler, Martin; Allwood, Carl Martin

    2015-01-01

    What distinguishes a competent decision maker and how should the issue of decision quality be approached in a real-life context? These questions were explored in three studies. In Study 1, using a web-based questionnaire and targeting a community sample, we investigated the relationships between objective and subjective indicators of real-life decision-making success. In Study 2 and 3, targeting two different samples of professionals, we explored if the prevalent cognitively oriented definiti...

  4. What is a “good” treatment decision?: Decisional control, knowledge, treatment decision-making, and quality of life in men with clinically localized prostate cancer

    Science.gov (United States)

    Orom, Heather; Biddle, Caitlin; Underwood, Willie; Nelson, Christian J.; Homish, D. Lynn

    2016-01-01

    Objective We explored whether active patient involvement in decision making and greater patient knowledge are associated with better treatment decision making experiences and better quality of life (QOL) among men with clinically localized prostate cancer. Localized prostate cancer treatment decision-making is an advantageous model for studying patient treatment decision-making dynamics as there are multiple treatment options and a lack of empirical evidence to recommend one over the other; consequently, it is recommended that patients be fully involved in making the decision. Methods Men with newly diagnosed clinically localized prostate cancer (N=1529) completed measures of decisional control, prostate cancer knowledge, and their decision-making experience (decisional conflict, and decision-making satisfaction and difficulty) shortly after they made their treatment decision. Prostate cancer-specific QOL was assessed 6-months after treatment. Results More active involvement in decision making and greater knowledge were associated with lower decisional conflict and higher decision-making satisfaction, but greater decision-making difficulty. An interaction between decisional control and knowledge revealed that greater knowledge was only associated with greater difficulty for men actively involved in making the decision (67% of sample). Greater knowledge, but not decisional control predicted better QOL 6-months post-treatment. Conclusion Although men who are actively involved in decision making and more knowledgeable may make more informed decisions, they could benefit from decisional support (e.g., decision-making aids, emotional support from providers, strategies for reducing emotional distress) to make the process easier. Men who were more knowledgeable about prostate cancer and treatment side effects at the time they made their treatment decision may have appraised their QOL as higher because they had realistic expectations about side effects. PMID:26957566

  5. Absolute symbolic addressing, a structure making time-sharing easier

    International Nuclear Information System (INIS)

    Debraine, P.

    1968-08-01

    Time-sharing of computers asks for a certain number of conditions, particularly, an efficient dynamic loading of programs and data. This paper indicates a paging method making linkages with a minimum of table-looking operations. The principle is to use associative memory registers for calling blocks of physical memory, the block address being given by the concatenation of a file number (located in a base register) and a page number (located in the instruction proper). The position within the block is given by a displacement located in the instruction. A second associated base register contains the local part (page number + displacement) of the base address. This extended base register system allows executing programs in a very large programming complex without loss of time. The addresses are fixed at assembly time and the blocks can be loaded anywhere without modification for execution. The various problems associated with the execution of complex programs are presented in this context and shown to be easily solved by the proposed system, the realization of which would be very easy starting from the computer structures existing now. (author) [fr

  6. Data Access Services that Make Remote Sensing Data Easier to Use

    Science.gov (United States)

    Lynnes, Christopher

    2010-01-01

    This slide presentation reviews some of the processes that NASA uses to make the remote sensing data easy to use over the World Wide Web. This work involves much research into data formats, geolocation structures and quality indicators, often to be followed by coding a preprocessing program. Only then are the data usable within the analysis tool of choice. The Goddard Earth Sciences Data and Information Services Center is deploying a variety of data access services that are designed to dramatically shorten the time consumed in the data preparation step. On-the-fly conversion to the standard network Common Data Form (netCDF) format with Climate-Forecast (CF) conventions imposes a standard coordinate system framework that makes data instantly readable through several tools, such as the Integrated Data Viewer, Gridded Analysis and Display System, Panoply and Ferret. A similar benefit is achieved by serving data through the Open Source Project for a Network Data Access Protocol (OPeNDAP), which also provides subsetting. The Data Quality Screening Service goes a step further in filtering out data points based on quality control flags, based on science team recommendations or user-specified criteria. Further still is the Giovanni online analysis system which goes beyond handling formatting and quality to provide visualization and basic statistics of the data. This general approach of automating the preparation steps has the important added benefit of enabling use of the data by non-human users (i.e., computer programs), which often make sub-optimal use of the available data due to the need to hard-code data preparation on the client side.

  7. Making perfect life : bio-engineering (in) the 21st century : interim study

    NARCIS (Netherlands)

    Est, van R.; Keulen, van I.; Geesink, I.; Schuiff, M.

    2010-01-01

    Reportnumber: PE 438.829; This document is the result of the preparatory phase of the STOA-project "Making perfect life", that defined the project focus. This resulted in the study document Making Perfect Life: Bio-engineering (in) the 21st century. A project plan for the next two phases was

  8. Ethical decision-making near the end of life.

    Science.gov (United States)

    Finucane, T E; Harper, M

    1996-05-01

    For ethical decision-making near the end of life, autonomy is the moral North Star. At the same time, for some treatments, the burdens so clearly outweigh benefits that physicians may make a judgment not to offer the treatment. This is often clearer in surgery. A person with colon cancer and metastases may not insist on resection of the metastases. For some reason, some treatments have escaped these logical constraints. Attempted resuscitation of a dying patient is a good example. The circumstances in which a physician may make choices on behalf of a competent, terminally-ill patient without consent, and even without notification, are hotly debated, but data suggest that physicians do so frequently. Patients who lack capacity present even more difficult challenges. Advance directives, when available, can be extremely helpful, but even with them difficult problems can remain. If advance directives have not been established, family and close friends are an obvious source of guidance. Their legal role varies in different jurisdictions; in practice, they are crucial in bedside decision-making. Guardianship and alternatives to it remain a poor last resort. Euthanasia is a very difficult problem. We believe it is semantically misleading to lump under the term "passive euthanasia" those circumstances where potentially life-sustaining treatment is withheld or withdrawn. The tension between patient autonomy and medical common sense remains unresolved within the "futility" controversy. The authors believe it serves no purpose to discuss carefully with dying patients propositions that are nonsense. At the same time, physicians must not confuse decisions about quality of life with judgements about treatment effectiveness. We believe that what many, although not all, dying patients want are physicians with intelligent compassion who can take care of them through the dying process.

  9. Team Leadership and Cancer End-of-Life Decision Making.

    Science.gov (United States)

    Waldfogel, Julie M; Battle, Dena J; Rosen, Michael; Knight, Louise; Saiki, Catherine B; Nesbit, Suzanne A; Cooper, Rhonda S; Browner, Ilene S; Hoofring, Laura H; Billing, Lynn S; Dy, Sydney M

    2016-11-01

    End-of-life decision making in cancer can be a complicated process. Patients and families encounter multiple providers throughout their cancer care. When the efforts of these providers are not well coordinated in teams, opportunities for high-quality, longitudinal goals of care discussions can be missed. This article reviews the case of a 55-year-old man with lung cancer, illustrating the barriers and missed opportunities for end-of-life decision making in his care through the lens of team leadership, a key principle in the science of teams. The challenges demonstrated in this case reflect the importance of the four functions of team leadership: information search and structuring, information use in problem solving, managing personnel resources, and managing material resources. Engaging in shared leadership of these four functions can help care providers improve their interactions with patients and families concerning end-of-life care decision making. This shared leadership can also produce a cohesive care plan that benefits from the expertise of the range of available providers while reflecting patient needs and preferences. Clinicians and researchers should consider the roles of team leadership functions and shared leadership in improving patient care when developing and studying models of cancer care delivery.

  10. Medical futility in children's nursing: making end-of-life decisions.

    Science.gov (United States)

    Brien, Irene O; Duffy, Anita; Shea, Ellen O

    Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of 'parental autonomy' and 'the child's best interests' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children's nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children's nursing.

  11. Medical futility in children's nursing: making end-of-life decisions.

    LENUS (Irish Health Repository)

    Brien, Irene O

    2012-02-01

    Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. However, for some parents, emotions and guilt often are unbearable and, understandably, parents can be reluctant to make a decision. Despite the recognition of parental autonomy, if parents disagree with a decision made by medical staff, the case will be referred to and solved by the courts. The courts\\' decisions are often based on the best interest of the child. In this article, the authors discuss the concepts of \\'parental autonomy\\' and \\'the child\\'s best interests\\' when determining medical futility for infants or neonates. The role of the nurse when caring for the dying child and their family is multifaceted. While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents\\' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children\\'s nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children\\'s nursing.

  12. Application of structural reliability and risk assessment to life prediction and life extension decision making

    International Nuclear Information System (INIS)

    Meyer, T.A.; Balkey, K.R.; Bishop, B.A.

    1987-01-01

    There can be numerous uncertainties involved in performing component life assessments. In addition, sufficient data may be unavailable to make a useful life prediction. Structural Reliability and Risk Assessment (SRRA) is primarily an analytical methodology or tool that quantifies the impact of uncertainties on the structural life of plant components and can address the lack of data in component life prediction. As a prelude to discussing the technical aspects of SRRA, a brief review of general component life prediction methods is first made so as to better develop an understanding of the role of SRRA in such evaluations. SRRA is then presented as it is applied in component life evaluations with example applications being discussed for both nuclear and non-nuclear components

  13. Process integrated modelling for steelmaking Life Cycle Inventory analysis

    International Nuclear Information System (INIS)

    Iosif, Ana-Maria; Hanrot, Francois; Ablitzer, Denis

    2008-01-01

    During recent years, strict environmental regulations have been implemented by governments for the steelmaking industry in order to reduce their environmental impact. In the frame of the ULCOS project, we have developed a new methodological framework which combines the process integrated modelling approach with Life Cycle Assessment (LCA) method in order to carry out the Life Cycle Inventory of steelmaking. In the current paper, this new concept has been applied to the sinter plant which is the most polluting steelmaking process. It has been shown that this approach is a powerful tool to make the collection of data easier, to save time and to provide reliable information concerning the environmental diagnostic of the steelmaking processes

  14. Are Models Easier to Understand than Code? An Empirical Study on Comprehension of Entity-Relationship (ER) Models vs. Structured Query Language (SQL) Code

    Science.gov (United States)

    Sanchez, Pablo; Zorrilla, Marta; Duque, Rafael; Nieto-Reyes, Alicia

    2011-01-01

    Models in Software Engineering are considered as abstract representations of software systems. Models highlight relevant details for a certain purpose, whereas irrelevant ones are hidden. Models are supposed to make system comprehension easier by reducing complexity. Therefore, models should play a key role in education, since they would ease the…

  15. The Effect of Providing Life Support on Nurses' Decision Making Regarding Life Support for Themselves and Family Members in Japan.

    Science.gov (United States)

    Shaku, Fumio; Tsutsumi, Madoka

    2016-12-01

    Decision making in terminal illness has recently received increased attention. In Japan, patients and their families typically make decisions without understanding either the severity of illness or the efficacy of life-supporting treatments at the end of life. Japanese culture traditionally directs the family to make decisions for the patient. This descriptive study examined the influence of the experiences of 391 Japanese nurses caring for dying patients and family members and how that experience changed their decision making for themselves and their family members. The results were mixed but generally supported the idea that the more experience nurses have in caring for the dying, the less likely they would choose to institute lifesupport measures for themselves and family members. The results have implications for discussions on end-of-life care. © The Author(s) 2016.

  16. Does surface anodisation of titanium implants change osseointegration and make their extraction from bone any easier?

    Science.gov (United States)

    Langhoff, J D; Mayer, J; Faber, L; Kaestner, S B; Guibert, G; Zlinszky, K; Auer, J A; von Rechenberg, B

    2008-01-01

    Titanium implants have a tendency for high bone-implant bonding, and, in comparison to stainless steel implants are more difficult to remove. The current study was carried out to evaluate, i) the release strength of three selected anodized titanium surfaces with increased nanohardness and low roughness, and ii) bone-implant bonding in vivo. These modified surfaces were intended to give improved anchorage while facilitating easier removal of temporary implants. The new surfaces were referenced to a stainless steel implant and a standard titanium implant surface (TiMAX). In a sheep limb model, healing period was 3 months. Bone-implant bonding was evaluated either biomechanically or histologically. The new surface anodized screws demonstrated similar or slightly higher bone-implant-contact (BIC) and torque release forces than the titanium reference. The BIC of the stainless steel implants was significant lower than two of the anodized surfaces (p = 0.04), but differences between stainless steel and all titanium implants in torque release forces were not significant (p = 0.06). The new anodized titanium surfaces showed good bone-implant bonding despite a smooth surface and increased nanohardness. However, they failed to facilitate implant removal at 3 months.

  17. How do trees and the small life forms under the ground talk to each other and other outside things: Can they make our world hot (or cool) again?

    Science.gov (United States)

    Sihi, D.

    2017-12-01

    Trees use water and a bad stuff in air as food with the help of sun light and store the bad stuff in it's body parts (both the parts above the ground and under the ground). However, trees (both above and under ground parts) also return part of the same bad stuff stored in their food to air as it grows. After death, these trees become part of the dead things under the ground and a large part of the bad stuff can be locked under the ground for quite a long time. But, small life forms living under the ground, eat these dead things and return part of the bad stuff locked in these dead things under the ground to the air. The small life forms living under the ground can also make two other stuff (which are even more bad) while eating these dead things under the ground and return them to the air. All of these bad stuffs returned to the air make the air hot. Different things (like sun light, rain, water in the air and under the ground) could make it easier or harder in either storing or returning each of these bad stuffs by the trees or life forms living under the ground in different ways. We study how trees and the small life forms living under the ground talk to each other and to other things mentioned above, and decide how much of those bad stuffs to store and return. But, we do not know well how each of these things can change one another and how trees and small life forms living under the ground will respond to these changes. So, we are yet to understand how much the air will be hotter (if more bad stuff are returned to the air than stored in trees and under the ground) or cooler (if less bad stuffs are returned to the air than stored in trees and under the ground) in tomorrow's world.

  18. Are networks with more edges easier to synchronize, or not?

    International Nuclear Information System (INIS)

    Zhi-Sheng, Duan; Chao, Liu; Guan-Rong, Chen; Wen-Xu, Wang

    2009-01-01

    In this paper, the relationship between network synchronizability and the edge-addition of its associated graph is investigated. First, it is shown that adding one edge to a cycle definitely decreases the network synchronizability. Then, since sometimes the synchronizability can be enhanced by changing the network structure, the question of whether the networks with more edges are easier to synchronize is addressed. Based on a subgraph and complementary graph method, it is shown by examples that the answer is negative even if the network structure is arbitrarily optimized. This reveals that generally there are redundant edges in a network, which not only make no contributions to synchronization but actually may reduce the synchronizability. Moreover, a simple example shows that the node betweenness centrality is not always a good indicator for the network synchronizability. Finally, some more examples are presented to illustrate how the network synchronizability varies following the addition of edges, where all the examples show that the network synchronizability globally increases but locally fluctuates as the number of added edges increases. (general)

  19. Preferences for autonomy in end-of-life decision making in modern Korean society.

    Science.gov (United States)

    Kim, Su Hyun

    2015-03-01

    The demand for autonomy in medical decision making is increasing among Korean people, but it is not well known why some people prefer autonomy in decision making but others do not. The aim of this study was to determine the extent to which Korean adults wished to exercise autonomy in the process of decision making regarding end-of-life treatment and to determine whether economic issues and family functioning, in particular, were associated with preferences for participation in decision making in Korean people. This study was a cross-sectional correlational study using a survey. Data were collected using structured questionnaires from 354 patients or their families who visited ambulatory departments at two general hospitals in South Korea, recruited by the proportionate quota sampling method. Data analysis was performed using multinomial logistic regression analyses. The study was approved by the hospitals' directors and the ethics committee of Kyungpook National University Hospital. Written informed consent was given by all participants. A majority of Korean people wanted to make autonomous decisions regarding treatment at the end of life. Preferences for autonomous decision making regarding end-of-life treatment, rather than relying on family, showed a significant increase in association with poor family functioning and low income. Results of this study suggested the necessity for development of alternatives to a dominant traditional "family-centered" approach in Korean people, in order to enhance end-of-life decision making for people who wish to take an active role in the decision-making process. Healthcare providers need to examine not only patients' preferred decision-making style but also any reasons for their choice, in particular, family conflict and financial burden. © The Author(s) 2014.

  20. Dwelling in Possibilities: Our Students' Spectacular Hunger for Life Makes Them Radically Vulnerable

    Science.gov (United States)

    Edmundson, Mark

    2009-01-01

    In this article, the author discusses how today's student generation has a spectacular hunger for life and more life. They want to study, travel, make friends, make more friends, read everything (superfast), take in all the movies, listen to every hot band, keep up with everyone they've ever known. They live to multiply possibilities. The author…

  1. [The influence of meaning making following stressful life experiences on change of self-concept].

    Science.gov (United States)

    Horita, Ryo; Sugie, Masashi

    2013-10-01

    As interest in meaning making following stressful life experiences continues to grow, it is important to clarify the features and functions of the meaning- making process. We examined the influence of meaning making following stressful life experiences on change of self-concept. In two studies, university students selected their most stressful life experience and completed the Assimilation and Accommodation of Meaning Making Scale. In Study 1, 235 university students also completed questionnaires regarding post-traumatic growth and positive change of the sense of identity following their stressful life experience. The results of covariance structure analysis indicated that accommodation promoted a positive change of self-concept. In Study 2, 199 university students completed questionnaires regarding change of self-concept and emotion as a positive or negative change following stressful life experiences. The results of covariance structure analysis indicated that accommodation promoted a positive change, similar to the results of Study 1. In addition, accommodation also promoted negative change. However, assimilation did not promote positive change but did restrain negative change.

  2. Theories of Health Care Decision Making at the End of Life: A Meta-Ethnography.

    Science.gov (United States)

    Kim, Kyounghae; Heinze, Katherine; Xu, Jiayun; Kurtz, Melissa; Park, Hyunjeong; Foradori, Megan; Nolan, Marie T

    2017-08-01

    The aim of this meta-ethnography is to appraise the types and uses of theories relative to end-of-life decision making and to develop a conceptual framework to describe end-of-life decision making among patients with advanced cancers, heart failure, and amyotrophic lateral sclerosis (ALS) and their caregivers or providers. We used PubMed, Embase, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) databases to extract English-language articles published between January 2002 and April 2015. Forty-three articles were included. The most common theories included decision-making models ( n = 14) followed by family-centered ( n = 11) and behavioral change models ( n = 7). A conceptual framework was developed using themes including context of decision making, communication and negotiation of decision making, characteristics of decision makers, goals of decision making, options and alternatives, and outcomes. Future research should enhance and apply these theories to guide research to develop patient-centered decision-making programs that facilitate informed and shared decision making at the end of life among patients with advanced illness and their caregivers.

  3. Broad themes of difference between French and Americans in attitudes to food and other life domains: Personal versus communal values, quantity versus quality, and comforts versus joys

    Directory of Open Access Journals (Sweden)

    Paul eRozin

    2011-07-01

    Full Text Available Analysis of previous literature on the role of food in life in France and the United States suggests some fundamental differences in attitudes which may generalize outside of the food domain. Questionnaire results from French and American adults suggest that, compared to the French, Americans emphasize quantity rather than quality in making choices, Americans have a higher preference for variety, and Americans usually prefer comforts (things that make life easier over joys (unique things that make life interesting. The American preference for quantity over quality is discussed in terms of the American focus on abundance as opposed to the French preference for moderation. The American preference for variety is reflective of Americans’ more personal as opposed to communal food and other values.

  4. Broad Themes of Difference between French and Americans in Attitudes to Food and Other Life Domains: Personal Versus Communal Values, Quantity Versus Quality, and Comforts Versus Joys.

    Science.gov (United States)

    Rozin, Paul; Remick, Abigail K; Fischler, Claude

    2011-01-01

    Analysis of previous literature on the role of food in life in France and the United States suggests some fundamental differences in attitudes which may generalize outside of the food domain. Questionnaire results from French and American adults suggest that, compared to the French, Americans emphasize quantity rather than quality in making choices, Americans have a higher preference for variety, and Americans usually prefer comforts (things that make life easier) over joys (unique things that make life interesting). The American preference for quantity over quality is discussed in terms of the American focus on abundance as opposed to the French preference for moderation. The American preference for variety is reflective of Americans' more personal as opposed to communal food and other values.

  5. The quality of life of single mothers making the transition from welfare to work.

    Science.gov (United States)

    Cook, Kay; Davis, Elise; Smyth, Paul; McKenzie, Hayley

    2009-09-01

    This study examined the quality of life of single mothers making the mandatory transition from welfare to work. The Australian government purported that the benefits of making this transition would include higher incomes, better social participation, and improved wellbeing. It is currently unknown, however, how single mothers currently engaged in welfare to work programs evaluate their quality of life. Quality of life scores for 334 single mothers engaged in welfare to work in Australia were compared with normative data. Participants reported significantly lower quality of life scores than the general population for all quality of life domains, highlighting the need to carefully examine welfare to work policies to ensure they promote participants' quality of life.

  6. Advance Directive in End of Life Decision-Making among the Yoruba of South-Western Nigeria.

    Science.gov (United States)

    Jegede, Ayodele Samuel; Adegoke, Olufunke Olufunsho

    2016-11-01

    End-of-life decision making is value-laden within the context of culture and bioethics. Also, ethics committee role is difficult to understand on this, thus need for ethnomethodological perspective in an expanding bioethical age. Anthropological approach was utilized to document Yoruba definition and perspective of death, cultural beliefs about end-of-life decision making, factors influencing it and ethics committee role. Interviews were conducted among selected Yoruba resident in Akinyele LGA, Oyo State, Nigeria. Content analytical approach was used for data analysis. Yoruba culture, death is socially constructed having spiritual, physical and social significance. Relationship between the dying and significant others influences decision making. Hierarchy of authority informs implementing traditional advance directive. Socialization, gender, patriarchy, religious belief and tradition are major considerations in end-of-life decision making. Awareness, resource allocation and advocacy are important ethics committees' roles. Further research into cultural diversity of end-of-life decision making will strengthen ethical practice in health care delivery.

  7. Communication and Decision-Making About End-of-Life Care in the Intensive Care Unit.

    Science.gov (United States)

    Brooks, Laura Anne; Manias, Elizabeth; Nicholson, Patricia

    2017-07-01

    Clinicians in the intensive care unit commonly face decisions involving withholding or withdrawing life-sustaining therapy, which present many clinical and ethical challenges. Communication and shared decision-making are key aspects relating to the transition from active treatment to end-of-life care. To explore the experiences and perspectives of nurses and physicians when initiating end-of-life care in the intensive care unit. The study was conducted in a 24-bed intensive care unit in Melbourne, Australia. An interpretative, qualitative inquiry was used, with focus groups as the data collection method. Intensive care nurses and physicians were recruited to participate in a discipline-specific focus group. Focus group discussions were audio-recorded, transcribed, and subjected to thematic data analysis. Five focus groups were conducted; 17 nurses and 11 physicians participated. The key aspects discussed included communication and shared decision-making. Themes related to communication included the timing of end-of-life care discussions and conducting difficult conversations. Implementation and multidisciplinary acceptance of end-of-life care plans and collaborative decisions involving patients and families were themes related to shared decision-making. Effective communication and decision-making practices regarding initiating end-of-life care in the intensive care unit are important. Multidisciplinary implementation and acceptance of end-of-life care plans in the intensive care unit need improvement. Clear organizational processes that support the introduction of nurse and physician end-of-life care leaders are essential to optimize outcomes for patients, family members, and clinicians. ©2017 American Association of Critical-Care Nurses.

  8. RELATION BETWEEN QUALITY OF LIFE, CHOICE MAKING, AND FUTURE EXPECTATIONS IN ADULTS WITH INTELLECTUAL DISABILITY

    Directory of Open Access Journals (Sweden)

    Vesna KOSTIKJ-IVANOVIKJ

    2016-09-01

    Full Text Available Introduction: Quality of life of individuals depends significantly on the ability to have control over everyday life, realized through the freedom to make choices from available options and self-determination. Objective: To determine the correlation between possibilities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities according self-assessment and assessment by others. Methods: Descriptive, method of correlation and comparative analysis ware applied. From techniques, analysis of documents, surveys with the Quality of life questionnaire by Schalock and Keith and Questionnaire for expectations for the future by Speck, and scaling with the Scale for assessment of the opportunities for making choices by Kishi et al. Sample consisted of 130 intellectually disabled adults and 130 proxies. For establishing connection between the examined phenomena Pearson correlation coefficient (r was used, at p<0,01. Results: There is a strong correlation between the results obtained from the questionnaires about quality of life and opportunities for making choices, self-assessment r(130=0,497, p<0,01, assessment by others r(130=0,482, p<0,01. There is a correlation between the results obtained from the questionnaires about quality of life and expectations for the future, but not very strong, self-assessment r(130=0,233, p=0,008<0,01, assessment by others r(130=0,305, p<0,01. Conclusion: There is a correlation between opportunities for making choices and expectations for the future with the quality of life in adults with intellectual disabilities. To improve the quality of life in these individuals, it is necessary to design programs that will develop self-concept, abilities for self-determination and making personal choices.

  9. Perceived risks around choice and decision making at end-of-life: a literature review.

    Science.gov (United States)

    Wilson, F; Gott, M; Ingleton, C

    2013-01-01

    the World Health Organization identifies meeting patient choice for care as central to effective palliative care delivery. Little is known about how choice, which implies an objective balancing of options and risks, is understood and enacted through decision making at end-of-life. to explore how perceptions of 'risk' may inform decision-making processes at end-of-life. an integrative literature review was conducted between January and February 2010. Papers were reviewed using Hawker et al.'s criteria and evaluated according to clarity of methods, analysis and evidence of ethical consideration. All literature was retained as background data, but given the significant international heterogeneity the final analysis specifically focused on the UK context. the databases Medline, PsycINFO, Assia, British Nursing Index, High Wire Press and CINAHL were explored using the search terms decision*, risk, anxiety, hospice and palliative care, end-of-life care and publication date of 1998-2010. thematic analysis of 25 papers suggests that decision making at end-of-life is multifactorial, involving a balancing of risks related to caregiver support; service provider resources; health inequalities and access; challenges to information giving; and perceptions of self-identity. Overall there is a dissonance in understandings of choice and decision making between service providers and service users. the concept of risk acknowledges the factors that shape and constrain end-of-life choices. Recognition of perceived risks as a central factor in decision making would be of value in acknowledging and supporting meaningful decision making processes for patients with palliative care needs and their families.

  10. End-of-life decision-making for children with severe developmental disabilities: The parental perspective.

    Science.gov (United States)

    Zaal-Schuller, I H; de Vos, M A; Ewals, F V P M; van Goudoever, J B; Willems, D L

    2016-01-01

    The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and PsycINFO. The search was limited to articles in English or Dutch published between January 2004 and August 2014. We included qualitative and quantitative original studies that directly investigated the experiences of parents of children aged 0-18 years with severe developmental disorders for whom an end-of-life decision had been considered or made. We identified nine studies that met all inclusion criteria. Reportedly, parental involvement in end-of-life decision-making varied widely, ranging from having no involvement to being the sole decision-maker. Most parents preferred to actively share in the decision-making process regardless of their child's specific diagnosis or comorbidity. The main factors that influenced parents in their decision-making were: their strong urge to advocate for their child's best interests and to make the best (possible) decision. In addition, parents felt influenced by their child's visible suffering, remaining quality of life and the will they perceived in their child to survive. Most parents of children with severe developmental disorders wish to actively share in the end-of-life decision-making process. An important emerging factor in this process is the parents' feeling that they have to stand up for their child's interests in conversations with the medical team. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. End-of-life decision making is more than rational.

    Science.gov (United States)

    Eliott, Jaklin A; Olver, Ian N

    2005-01-01

    Most medical models of end-of-life decision making by patients assume a rational autonomous adult obtaining and deliberating over information to arrive at some conclusion. If the patient is deemed incapable of this, family members are often nominated as substitutes, with assumptions that the family are united and rational. These are problematic assumptions. We interviewed 23 outpatients with cancer about the decision not to resuscitate a patient following cardiopulmonary arrest and examined their accounts of decision making using discourse analytical techniques. Our analysis suggests that participants access two different interpretative repertoires regarding the construct of persons, invoking a 'modernist' repertoire to assert the appropriateness of someone, a patient or family, making a decision, and a 'romanticist' repertoire when identifying either a patient or family as ineligible to make the decision. In determining the appropriateness of an individual to make decisions, participants informally apply 'Sanity' and 'Stability' tests, assessing both an inherent ability to reason (modernist repertoire) and the presence of emotion (romanticist repertoire) which might impact on the decision making process. Failure to pass the tests respectively excludes or excuses individuals from decision making. The absence of the romanticist repertoire in dominant models of patient decision making has ethical implications for policy makers and medical practitioners dealing with dying patients and their families.

  12. What parents want from doctors in end-of-life decision-making for children.

    Science.gov (United States)

    Sullivan, J; Monagle, P; Gillam, L

    2014-03-01

    End-of-life decision-making is difficult for everyone involved, as many studies have shown. Within this complexity, there has been little information on how parents see the role of doctors in end-of-life decision-making for children. This study aimed to examine parents' views and experiences of end-of-life decision-making. A qualitative method with a semistructured interview design was used. Parent participants were living in the community. Twenty-five bereaved parents. Parents reported varying roles taken by doctors: being the provider of information without opinion; giving information and advice as to the decision that should be taken; and seemingly being the decision maker for the child. The majority of parents found their child's doctor enabled them to be the ultimate decision maker for their child, which was what they very clearly wanted to be, and consequently enabled them to exercise their parental autonomy. Parents found it problematic when doctors took over decision-making. A less frequently reported, yet significant role for doctors was to affirm decisions after they had been made by parents. Other important aspects of the doctor's role were to provide follow-up support and referral. Understanding the role that doctors take in end-of-life decisions, and the subsequent impact of that role from the perspective of parents can form the basis of better informed clinical practice.

  13. Family communication and decision making at the end of life: a literature review.

    Science.gov (United States)

    Wallace, Cara L

    2015-06-01

    Patients and families coping with a terminal illness are faced with a number of decisions over the course of their disease. The role that family communication plays in the process of decision making is an important one. The objectives for this review are to examine the current state of empirical literature on the relationship between family communication and decision making about end-of-life care, to identify gaps, and to discuss implications for policy, practice, and future research. Articles were identified using systematic keyword searches within the following relevant databases: Academic Search Complete, CINAHL Plus, Communications and Mass Media Complete, ERIC, PsychINFO, MEDLINE, SocINDEX, and ProQuest. The three bodies of relevant literature that emerged during this review include: (1) the importance of family communication at the end of life (EoL); (2) family decision making at the EoL; and (3) the interrelationship of communication (both within the family and with healthcare professionals) and decision making at the EoL. While the literature highlights the role of communication between medical professionals and the patient or family members, there is very little focus on the process of how family communication among the family members themselves contributes to decision making at the end of life. Barriers to end-of-life care are important considerations for helping patients to access timely and appropriate services. Understanding the pertinent role of family communication as it relates to the decision for EoL care is the first step in working to provide another avenue for overcoming these barriers.

  14. Family members' informal roles in end-of-life decision making in adult intensive care units.

    Science.gov (United States)

    Quinn, Jill R; Schmitt, Madeline; Baggs, Judith Gedney; Norton, Sally A; Dombeck, Mary T; Sellers, Craig R

    2012-01-01

    To support the process of effective family decision making, it is important to recognize and understand informal roles that various family members may play in the end-of-life decision-making process. To describe some informal roles consistently enacted by family members involved in the process of end-of-life decision making in intensive care units. Ethnographic study. Data were collected via participant observation with field notes and semistructured interviews on 4 intensive care units in an academic health center in the mid-Atlantic United States from 2001 to 2004. The units studied were a medical, a surgical, a burn and trauma, and a cardiovascular intensive care unit. Health care clinicians, patients, and family members. Informal roles for family members consistently observed were primary caregiver, primary decision maker, family spokesperson, out-of-towner, patient's wishes expert, protector, vulnerable member, and health care expert. The identified informal roles were part of families' decision-making processes, and each role was part of a potentially complicated family dynamic for end-of-life decision making within the family system and between the family and health care domains. These informal roles reflect the diverse responses to demands for family decision making in what is usually a novel and stressful situation. Identification and description of these informal roles of family members can help clinicians recognize and understand the functions of these roles in families' decision making at the end of life and guide development of strategies to support and facilitate increased effectiveness of family discussions and decision-making processes.

  15. End-of-life decision-making and terminal sedation among very old patients.

    Science.gov (United States)

    De Gendt, Cindy; Bilsen, Johan; Mortier, Freddy; Vander Stichele, Robert; Deliens, Luc

    2009-01-01

    About half of the persons who die in developed countries are very old (aged 80 years or older) and this proportion is still rising. In general, there is little information available concerning the circumstances and quality of the end of life of this group. This study aims (1) to describe the incidence and characteristics of medical end-of-life decisions with a possible or certain life-shortening effect (ELDs) and terminal sedation among very old patients who died nonsuddenly, (2) to describe the characteristics of the preceding decision-making process, and (3) to compare this with the deaths of younger patients. A sample of 5,005 death certificates was selected from all deaths in Flanders (Belgium) in the second half of 2001 (before euthanasia was legalized). Questionnaires were mailed to the certifying physicians. Response rate was 58.9%. An ELD was made for 53.6% very old (aged 80+) patients who died nonsuddenly (vs. 63.3% for the younger patients). Use of life-ending drugs occurred among 1.1% (six times less frequently than in younger patients), with no euthanasia cases, pain and symptom alleviation with a possible life-shortening effect among 27.3% (two times less frequently), and withholding or withdrawing life-prolonging treatments among 25.2% (slightly more frequently). Terminal sedation occurred among 6.9% of the cases, two times less frequently than for the younger patients. ELDs were not often discussed with very old patients. Among competent patients this was less than compared with younger patients. ELDs are less common for very old than for younger patients. Physicians seem to have a more reluctant attitude towards the use of lethal drugs, terminal sedation and participation in decision-making when dealing with very old patients. Advance care planning should increase the involvement of very old competent and noncompetent patients in end-of-life decision-making. (c) 2008 S. Karger AG, Basel.

  16. Factors That Impact End-of-Life Decision Making in African Americans With Advanced Cancer

    Science.gov (United States)

    Campbell, Cathy L.; Williams, Ishan C.; Orr, Tamara

    2013-01-01

    Significance African Americans with cancer are less likely to use hospice services and more likely to die in the hospital than white patients with the same diagnosis. However, there is much that is not understood about the factors that lead African Americans to choose options for end-of-life care. Design A qualitative, descriptive design was used in this pilot study. Methods Interviews were conducted with two groups of African Americans with advanced-stage cancer (people enrolled in hospice and those who were not under hospice care). Findings End-of-life decisions were primarily guided by clinical factors, the patient-related physical, emotional, and cognitive symptoms that are sequelae of the underlying disease or medical treatments. The physician was the healthcare provider most likely to be involved in decision making with patients, family members, and caregivers. Individual factors, such as personal beliefs, influenced end-of-life decision making. Religion and spirituality were a topic in many interviews, but they did not consistently influence decision making. Discussion Future studies should include interviews with family members, caregivers, and healthcare professionals so that factors that impact end-of-life decision making can be fully described. Strategies to facilitate recruitment will need to be added to future protocols. PMID:23645999

  17. Making healthy choices easy choices: the role of empowerment

    NARCIS (Netherlands)

    Koelen, M.A.; Lindström, B.

    2005-01-01

    An important goal of health promotion is to make it easier for people to make healthy choices. However, this may be difficult if people do not feel control over their environment and their personal circumstances. An important concept in relation to this is empowerment. Health professionals are

  18. The Forms and Functions of Real-Life Moral Decision-Making.

    Science.gov (United States)

    Krebs, Dennis L.; Denton, Kathy; Wark, Gillian

    1997-01-01

    Observes that the Kohlbergian model of morality does not give a good account of the ways in which people make moral decisions in their everyday lives. Argues that a functional model of moral judgment and moral behavior derived from evolutionary theory may supply a better account of real-life morality. (DSK)

  19. Planning cultural heritage protection is easier than managing an actual disaster

    Directory of Open Access Journals (Sweden)

    Zdena Rosická

    2011-01-01

    Full Text Available Efficient preparedness is easier to carry out comparing to dealing with consequences of disasters, anthropogenic incidents and other emergencies. Most disasters are water related, i.e. the result of flooding due to high water, water used to extinguish the fire, etc. Cultural heritage as a whole is exposed to attack from natural weathering processes, pollutants as well as water-origin disasters, fires, arson, theft, landslides or extreme weather events. In case of a disaster or any other emergency, unfortunately, no one can afford to wait for all the data and information to be entirely completed in order to make conclusions and survive a disastrous attack. When a disaster occurs and a historical object is affected, decisions must me made fast about rescue priorities, which items to save and which to sacrifice; there must be available priority lists, working guides for salvage teams as well as a disaster plan, updated lists of human resources, suppliers and service providers, lists of types and number of vehicles including passable roads available in case the movable cultural heritage evacuation becomes urgent. Emergency-response officials must be trained in measures to ensure relevant handling, conservation and care.

  20. The rational choice model in family decision making at the end of life.

    Science.gov (United States)

    Karasz, Alison; Sacajiu, Galit; Kogan, Misha; Watkins, Liza

    2010-01-01

    Most end-of-life decisions are made by family members. Current ethical guidelines for family decision making are based on a hierarchical model that emphasizes the patient's wishes over his or her best interests. Evidence suggests that the model poorly reflects the strategies and priorities of many families. Researchers observed and recorded 26 decision-making meetings between hospital staff and family members. Semi-structured follow-up interviews were conducted. Transcriptions were analyzed using qualitative techniques. For both staff and families, consideration of a patient's best interests generally took priority over the patient's wishes. Staff generally introduced discussion of the patient's wishes for rhetorical purposes, such as persuasion. Competing moral frameworks, which de-emphasized the salience of patients' autonomy and "right to choose," played a role in family decision making. The priority given to the patients' wishes in the hierarchical model does not reflect the priorities of staff and families in making decisions about end-of-life care.

  1. Is patient autonomy a critical determinant of quality of life in Korea? End-of-life decision making from the perspective of the patient.

    Science.gov (United States)

    Mo, Ha Na; Shin, Dong Wook; Woo, Jae Ha; Choi, Jin Young; Kang, Jina; Baik, Young Ji; Huh, Yu Rae; Won, Joo Hee; Park, Myung Hee; Cho, Sang Hee

    2012-04-01

    We aimed to investigate the current practice of the involvement in decision making from the perspectives of terminal cancer patients, and to explore its possible associations with quality of life and quality of death in Korea. A multi-center, cross-sectional survey was performed on 93 terminal cancer patients. The questionnaire solicited their opinions regarding participation in treatment decision making, as well as quality of life (European Organization for Research and Treatment of Cancer Quality-of-Life Questionnaire for Palliative Care) and quality of death (Good Death Inventory-Patient Version). A total of 78.5% of the patients had awareness of their terminal status, while 21.5% did not; 42.4% stated that they knew their condition and shared the decision-making responsibility with the medical staff and their family, while 21.7% made decisions on their own, and 35.9% left the decision-making responsibility to others. Patients who were aware of their illness and who actively participated in the decision making did not score higher than others on outcome measures of quality of life and quality of death. Moreover, the former even showed lower scores in some domains, including the 'physical and psychological comfort' (4.99 versus 5.61, p = 0.03), 'environmental comfort' (5.51 versus 6.04, p = 0.08), and 'emotional functioning' (55.70 versus 71.01, p = 0.06). in Korea, patient autonomy is not a universally accepted value from the perspectives of terminal cancer patients, nor is patient involvement in decision making always conducive to high quality of life or quality of death. The level of information and the pace at which it is provided should be tailored to each individual's ability, preference, need, and culture.

  2. Making the Earth to Life Connection Using Climate Change

    Science.gov (United States)

    Haine, D. B.; Berbeco, M.

    2016-12-01

    From ocean acidification to changes in air quality to shifts in the range of disease vectors, there are many opportunities for educators to make the earth science to life science connection by incorporating the impacts of climate change on organisms and entire ecosystems and by describing how living organisms impact climate. NCSE's study in Science found that 86% of life science teachers are teaching climate, but few admit they have any formal climate science training. This session will introduce activities we developed that utilize the 2014 National Climate Assessment, data visualizations, technology tools and models to allow students to explore the evidence that climate change is impacting life. Translating the NCA into classroom activities is an approach that becomes more pertinent with the advent of the Next Generation Science Standards (NGSS). Using the NCA and the NGSS we demonstrate strategies for weaving the concept of climate change into an already packed life science curriculum by enhancing rather than displacing content and ultimately promoting integration of science and engineering practices into instruction. Since the fall of 2014 we have engaged approximately 200 K-12 educators at local, state, regional and national teacher professional development events. Here we will summarize what we have learned from science teachers about how they address life science impacts of climate change and we will summarize evaluation data to inform future efforts to engage life science educators in light of the recent USGCRP Climate and Health Assessment and the upcoming 4th National Climate Assessment.

  3. LCA-ship. Design tool for energy efficient ships. A Life Cycle Analysis Program for Ships. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Jiven, Karl; Sjoebris, Anders [MariTerm AB, Goeteborg (Sweden); Nilsson, Maria [Lund Univ. (Sweden). Stiftelsen TEM; Ellis, Joanne; Traegaardh, Peter; Nordstroem, Malin [SSPA Sweden AB, Goeteborg (Sweden)

    2004-05-01

    In order to make it easier to include aspects during ship design that will improve environmental performance, general methods for life cycle calculations and a prototype tool for LCA calculations of ships and marine transportation have been developed. The base of the life cycle analyses is a comprehensive set of life cycle data that was collected for the materials and consumables used in ship construction and vessel operations. The computer tool developed makes it possible to quickly and simply specify (and calculate) the use of consumables over the vessel's life time cycle. Special effort has been made to allow the tool to be used for different types of vessels and sea transport. The main result from the project is the computer tool LCA ship, which incorporates collected and developed life cycle data for some of the most important materials and consumables used in ships and their operation. The computer application also contains a module for propulsion power calculations and a module for defining and optimising the energy system onboard the vessel. The tool itself is described in more detail in the Computer application manual. The input to the application should, as much as possible, be the kind of information that is normally found in a shipping company concerning vessel data and vessel movements. It all starts with defining the ship to be analysed and continues with defining how the ship is used over the lifetime. The tool contains compiled and processed background information about specific materials and processes (LCA data) connected to shipping operations. The LCA data is included in the tool in a processed form. LCA data for steel will for example include the environmental load from the steel production, the process to build the steel structure of the ship, the scrapping and the recycling phase. To be able to calculate the environmental load from the use of steel the total amount of steel used over the life cycle of the ship is also needed. The

  4. Negotiating end-of-life decision making: a comparison of Japanese and U.S. residents' approaches.

    Science.gov (United States)

    Gabbay, Baback B; Matsumura, Shinji; Etzioni, Shiri; Asch, Steven M; Rosenfeld, Kenneth E; Shiojiri, Toshiaki; Balingit, Peter P; Lorenz, Karl A

    2005-07-01

    To compare Japanese and U.S. resident physicians' attitudes, clinical experiences, and emotional responses regarding making disclosures to patients facing incurable illnesses. From September 2003 to June 2004, the authors used a ten-item self-administered anonymous questionnaire in a cross-sectional survey of 103 internal medicine residents at two U.S. sites in Los Angeles, California, and 244 general medical practice residents at five Japanese sites in Central Honshu, Kyushu, Okinawa, Japan. The Japanese residents were more likely to favor including the family in disclosing diagnosis (95% versus 45%, pguilt about these behaviors. The residents' approaches to end-of-life decision making reflect known cultural preferences related to the role of patients and their families. Although Japanese trainees were more likely to endorse the role of the family, they expressed greater uncertainty about their approach. Difficulty and uncertainty in end-of-life decision making were common among both the Japanese and U.S. residents. Both groups would benefit from ethical training to negotiate diverse, changing norms regarding end-of-life decision making.

  5. Spiritual Growth or Decline and Meaning-Making as Mediators of Anxiety and Satisfaction with Life During Religious Struggle.

    Science.gov (United States)

    Zarzycka, Beata; Zietek, Pawel

    2018-03-14

    A number of studies have demonstrated links between spiritual struggles and health problems. As yet, however, only a few studies have investigated what makes religious struggle a source of mental problems or a source of well-being. We determined whether spiritual growth, spiritual decline, and meaning-making mediated the relationship between religious struggle and anxiety and satisfaction with life. Of the 180 respondents, 92 were women, and mean (SD) age was 24 (8.2) years. Each respondent completed the Religious and Spiritual Struggles Scale, the Meaning-Making Scale, the Spiritual Transformation Scale, the State-Trait Anxiety Inventory, and the Satisfaction with Life Scale. Religious struggle correlated positively with anxiety and negatively with satisfaction with life. Spiritual growth mediated the relationship between moral and demonic struggle with satisfaction with life, and spiritual decline mediated the relationship between demonic, moral, and interpersonal struggle with anxiety. Finally, meaning-making mediated the relationship between religious doubt and satisfaction with life.

  6. Supporting End of Life Decision Making: Case Studies of Relational Closeness in Supported Decision Making for People with Severe or Profound Intellectual Disability

    Science.gov (United States)

    Watson, Joanne; Wilson, Erin; Hagiliassis, Nick

    2017-01-01

    Background: The United Nations Convention on the Rights of Persons with Disabilities (UNCRPD) promotes the use of supported decision making in lieu of substitute decision making. To date, there has been a lack of focus on supported decision making for people with severe or profound intellectual disability, including for end of life decisions.…

  7. Make the most of your doctor visit

    Science.gov (United States)

    ... the notes in your phone or in an email to your provider. Writing things down makes it easier to remember details ... Duplication for commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site ... to RSS Follow us Disclaimers Copyright ...

  8. Excel 2016 for biological and life sciences statistics a guide to solving practical problems

    CERN Document Server

    Quirk, Thomas J; Horton, Howard F

    2016-01-01

    This book is a step-by-step exercise-driven guide for students and practitioners who need to master Excel to solve practical biological and life science problems. If understanding statistics isn’t your strongest suit, you are not especially mathematically-inclined, or if you are wary of computers, this is the right book for you. Excel is an effective learning tool for quantitative analyses in biological and life sciences courses. Its powerful computational ability and graphical functions make learning statistics much easier than in years past. However, Excel 2016 for Biological and Life Sciences Statistics: A Guide to Solving Practical Problems is the first book to capitalize on these improvements by teaching students and managers how to apply Excel 2016 to statistical techniques necessary in their courses and work. Each chapter explains statistical formulas and directs the reader to use Excel commands to solve specific, easy-to-understand biological and life science problems. Practice problems are provided...

  9. Maintaining families’ well-being in everyday life

    Directory of Open Access Journals (Sweden)

    Kristina Ziegert

    2011-05-01

    Full Text Available The aim of this paper is to discuss how everyday life changes for the family in the event of chronic illness or disability. It changes physically due to loss of body function and socially due to time and other constraints related to treatment or lack of mobility. Equally important, there is a psychological impact due to the uncertainty of the future. The article will explore how family participation can help to maintain well-being in everyday life. The family should therefore focus on their own needs as much as on the needs of the family members who are ill. In order to maintain well-being in everyday life, it is crucial for the family to create routines and spend time doing things that they enjoy. By doing this, the family will create a rhythm of well-being regardless of the critical family situation. Family members and professional caregivers also need to come together at the beginning and during the illness or disability event to discuss changes that could be made day-to-day for all those involved, thereby making for an easier transition into care giving.

  10. 76 FR 68047 - Making It Easier for America's Small Businesses and America's Exporters to Access Government...

    Science.gov (United States)

    2011-11-02

    ... Government should be individualized and efficient. If the private sector can allow consumers to customize... local government services as well as those of private sector partners. (3) Agencies shall make... competitiveness, innovation, and job growth. If we are to thrive in the global economy, and make America the best...

  11. STRATEGIC DECISION MAKING, ENTREPRENEURIAL ORIENTATION AND PERFORMANCE: AN ORGANIZATIONAL LIFE CYCLE APPROACH

    Directory of Open Access Journals (Sweden)

    Héctor Montiel Campos

    2015-06-01

    Full Text Available EntrepreneurialOrientation (EO and Strategic Decision Making (SDM have been studied in awide variety of settings. However, there is not enough research available thatcombines both topics and studies the ways in which entrepreneurs make strategicdecisions in early stages of organizational life cycle. The purpose of thisresearch was therefore to examine the effects of the factors associated withthe decision maker influencing EO and performance for two categories of firms.The results were achieved by using empirical data from two independent samplesof firms in different stages of organizational life cycle: start-up stage (n=133 and growth stage (n=173. The results show that SDM andcontrol variables have different effects in the two samples; however, for bothsamples there is significant relation between EO and performance. The paperconcludes with a discussion about the results and suggestions for futureresearch.

  12. Decision Making Among Older Adults at the End of Life: A Theoretical Perspective.

    Science.gov (United States)

    Romo, Rafael D; Dawson-Rose, Carol S; Mayo, Ann M; Wallhagen, Margaret I

    Understanding changes in decision making among older adults across time is important for health care providers. We examined how older adults with a limited prognosis used their perception of prognosis and health in their decision-making processes and related these findings to prospect theory. The theme of decision making in the context of ambiguity emerged, reflecting how participants used both prognosis and health to value choices, a behavior not fully captured by prospect theory. We propose an extension of the theory that can be used to better visualize decision making at this unique time of life among older adults.

  13. Making SPC easier with zone control charts

    International Nuclear Information System (INIS)

    Lanning, B.

    1995-01-01

    The zone control chart is a simple, easy to learn statistical process control (SPC) tool that can be applied to any process where the data are normally distributed. Several Shewhart runs rules are incorporated into a simple scoring system, with a single rule to determine when a process is out of control. Zone charts have average run lengths (ARLs) for detecting shifts in the process mean which, for most cases, are uniformly better than the standard control charts. This paper presents the simplified methodology behind the zone control chart

  14. Better science does not make decisions easier

    NARCIS (Netherlands)

    Ale, B.J.M.

    2013-01-01

    Forty years of development in the science and technology of estimating and quantifying risk, of understanding of human behaviour and human rationale has made decision makers more informed. We are in a much better position now, than forty years ago in estimating probabilities, consequences, and

  15. Make man-machine communication easier: fuzzy programming

    Energy Technology Data Exchange (ETDEWEB)

    Farreny, H; Prade, H

    1982-06-01

    Procedures and data used by the human brain are not always accurately specified; fuzzy programming may help in the realisation of languages for the manipulation of such fuzzy entities. After having considered fuzzy instruction and its requirements, arguments, functions, predicates and designations, the authors present the outlines of a fuzzy filtering system. Two applications are given as examples; these are the accessing of a database and an expert system which may be used to solve problems in robotics.

  16. Creating Healthy Habits: Make Better Choices Easier

    Science.gov (United States)

    ... O'Donnell S, Oluyomi DT, Epstein LH. Consciousness and Cognition. 2017 May;51:10-16. doi: 10.1016/ ... Editor: Tianna Hicklin, Ph.D. Illustrator: Alan Defibaugh Attention Editors: Reprint our articles and illustrations in your ...

  17. Like cognitive function, decision making across the life span shows profound age-related changes.

    Science.gov (United States)

    Tymula, Agnieszka; Rosenberg Belmaker, Lior A; Ruderman, Lital; Glimcher, Paul W; Levy, Ifat

    2013-10-15

    It has long been known that human cognitive function improves through young adulthood and then declines across the later life span. Here we examined how decision-making function changes across the life span by measuring risk and ambiguity attitudes in the gain and loss domains, as well as choice consistency, in an urban cohort ranging in age from 12 to 90 y. We identified several important age-related patterns in decision making under uncertainty: First, we found that healthy elders between the ages of 65 and 90 were strikingly inconsistent in their choices compared with younger subjects. Just as elders show profound declines in cognitive function, they also show profound declines in choice rationality compared with their younger peers. Second, we found that the widely documented phenomenon of ambiguity aversion is specific to the gain domain and does not occur in the loss domain, except for a slight effect in older adults. Finally, extending an earlier report by our group, we found that risk attitudes across the life span show an inverted U-shaped function; both elders and adolescents are more risk-averse than their midlife counterparts. Taken together, these characterizations of decision-making function across the life span in this urban cohort strengthen the conclusions of previous reports suggesting a profound impact of aging on cognitive function in this domain.

  18. Much Lower Launch Costs Make Resupply Cheaper than Recycling for Space Life Support

    Science.gov (United States)

    Jones, Harry W.

    2017-01-01

    The development of commercial launch vehicles by SpaceX has greatly reduced the cost of launching mass to Low Earth Orbit (LEO). Reusable launch vehicles may further reduce the launch cost per kilogram. The new low launch cost makes open loop life support much cheaper than before. Open loop systems resupply water and oxygen in tanks for crew use and provide disposable lithium hydroxide (LiOH) in canisters to remove carbon dioxide. Short human space missions such as Apollo and shuttle have used open loop life support, but the long duration International Space Station (ISS) recycles water and oxygen and removes carbon dioxide with a regenerative molecular sieve. These ISS regenerative and recycling life support systems have significantly reduced the total launch mass needed for life support. But, since the development cost of recycling systems is much higher than the cost of tanks and canisters, the relative cost savings have been much less than the launch mass savings. The Life Cycle Cost (LCC) includes development, launch, and operations. If another space station was built in LEO, resupply life support would be much cheaper than the current recycling systems. The mission most favorable to recycling would be a long term lunar base, since the resupply mass would be large, the proximity to Earth would reduce the need for recycling reliability and spares, and the launch cost would be much higher than for LEO due to the need for lunar transit and descent propulsion systems. For a ten-year lunar base, the new low launch costs make resupply cheaper than recycling systems similar to ISS life support.

  19. End-of-life decision-making in Canada: the report by the Royal Society of Canada expert panel on end-of-life decision-making.

    Science.gov (United States)

    Schüklenk, Udo; van Delden, Johannes J M; Downie, Jocelyn; McLean, Sheila A M; Upshur, Ross; Weinstock, Daniel

    2011-11-01

    This report on end-of-life decision-making in Canada was produced by an international expert panel and commissioned by the Royal Society of Canada. It consists of five chapters. Chapter 1 reviews what is known about end-of-life care and opinions about assisted dying in Canada. Chapter 2 reviews the legal status quo in Canada with regard to various forms of assisted death. Chapter 3 reviews ethical issues pertaining to assisted death. The analysis is grounded in core values central to Canada's constitutional order. Chapter 4 reviews the experiences had in a number of jurisdictions that have decriminalized or recently reviewed assisted dying in some shape or form. Chapter 5 provides recommendations with regard to the provision of palliative care in Canada, as well as recommendations for reform with respect to the various forms of assisted death covered in this document. © 2011 Blackwell Publishing Ltd.

  20. Making decisions at the end of life when caring for a person with dementia: a literature review to explore the potential use of heuristics in difficult decision-making.

    Science.gov (United States)

    Mathew, R; Davies, N; Manthorpe, J; Iliffe, S

    2016-07-19

    Decision-making, when providing care and treatment for a person with dementia at the end of life, can be complex and challenging. There is a lack of guidance available to support practitioners and family carers, and even those experienced in end of life dementia care report a lack of confidence in decision-making. It is thought that the use of heuristics (rules of thumb) may aid decision-making. The aim of this study is to identify whether heuristics are used in end of life dementia care, and if so, to identify the context in which they are being used. A narrative literature review was conducted taking a systematic approach to the search strategy, using the Centre for Reviews and Dissemination guidelines. Rapid appraisal methodology was used in order to source specific and relevant literature regarding the use of heuristics in end of life dementia care. A search using terms related to dementia, palliative care and decision-making was conducted across 4 English language electronic databases (MEDLINE, EMBASE, PsycINFO and CINAHL) in 2015. The search identified 12 papers that contained an algorithm, guideline, decision tool or set of principles that we considered compatible with heuristic decision-making. The papers addressed swallowing and feeding difficulties, the treatment of pneumonia, management of pain and agitation, rationalising medication, ending life-sustaining treatment, and ensuring a good death. The use of heuristics in palliative or end of life dementia care is not described in the research literature. However, this review identified important decision-making principles, which are largely a reflection of expert opinion. These principles may have the potential to be developed into simple heuristics that could be used in practice. 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/

  1. End of life care and decision making: Opinions and experiences of the general public, bereaved relatives, and professionals

    NARCIS (Netherlands)

    N.J.H. Raijmakers (Natasja)

    2013-01-01

    textabstractEnd-of-life care aims to improve quality of life of patients and their relatives facing problems associated with life-threatening illness in the last days of life. End-of-life decision-making is an important aspect of end-of-life care that can have a significant impact on the process of

  2. An expandable software model for collaborative decision making during the whole building life cycle

    International Nuclear Information System (INIS)

    Papamichael, K.; Pal, V.; Bourassa, N.; Loffeld, J.; Capeluto, G.

    2000-01-01

    Decisions throughout the life cycle of a building, from design through construction and commissioning to operation and demolition, require the involvement of multiple interested parties (e.g., architects, engineers, owners, occupants and facility managers). The performance of alternative designs and courses of action must be assessed with respect to multiple performance criteria, such as comfort, aesthetics, energy, cost and environmental impact. Several stand-alone computer tools are currently available that address specific performance issues during various stages of a building's life cycle. Some of these tools support collaboration by providing means for synchronous and asynchronous communications, performance simulations, and monitoring of a variety of performance parameters involved in decisions about a building during building operation. However, these tools are not linked in any way, so significant work is required to maintain and distribute information to all parties. In this paper we describe a software model that provides the data management and process control required for collaborative decision making throughout a building's life cycle. The requirements for the model are delineated addressing data and process needs for decision making at different stages of a building's life cycle. The software model meets these requirements and allows addition of any number of processes and support databases over time. What makes the model infinitely expandable is that it is a very generic conceptualization (or abstraction) of processes as relations among data. The software model supports multiple concurrent users, and facilitates discussion and debate leading to decision making. The software allows users to define rules and functions for automating tasks and alerting all participants to issues that need attention. It supports management of simulated as well as real data and continuously generates information useful for improving performance prediction and

  3. Subject Relative Clauses Are Not Universally Easier to Process: Evidence from Basque

    Science.gov (United States)

    Carreiras, Manuel; Dunabeitia, Jon Andoni; Vergara, Marta; de la Cruz-Pavia, Irene; Laka, Itziar

    2010-01-01

    Studies from many languages consistently report that subject relative clauses (SR) are easier to process than object relatives (OR). However, Hsiao and Gibson (2003) report an OR preference for Chinese, a finding that has been contested. Here we report faster OR versus SR processing in Basque, an ergative, head-final language with pre-nominal…

  4. Lifehacker The Guide to Working Smarter, Faster, and Better

    CERN Document Server

    Pash, Adam

    2011-01-01

    A new edition, packed with even more clever tricks and methods that make everyday life easier Lifehackers redefine personal productivity with creative and clever methods for making life easier and more enjoyable. This new edition of a perennial bestseller boasts new and exciting tips, tricks, and methods that strike a perfect balance between current technology and common sense solutions for getting things done. Exploring the many ways technology has changed since the previous edition, this new edition has been updated to reflect the latest and greatest in technological and personal productivit

  5. Hardships of end-of-life care with court-appointed guardians.

    Science.gov (United States)

    Hastings, Kylie B

    2014-02-01

    In the United States, the court-appointed guardians do not have the ability to make decisions regarding end-of-life (EOL) care for their clients. Additionally, the process of initiating EOL care measures can be slow and cumbersome, despite an existing process of getting approval for such care. This process has the potential to prolong suffering and delay imperative decisions. This article reviews the hardships that patients, court-appointed guardians, and health care staff endure while moving through the oppressive process of obtaining EOL care orders through the court. This article also proposes ways of tuning up the laws, regulations, and communications to make it easier and faster to obtain orders regarding EOL care to preserve the dignity of our patients and loved ones. "A guardianship is a legal relationship created when a person or institution named in a will or assigned by the court to take care of minor children or incompetent adults."

  6. AAS Publishing News: Preparing Your Manuscript Just Got Easier

    Science.gov (United States)

    Kohler, Susanna

    2016-03-01

    Watermarking using the command watermark{DRAFT, v2}.Are you an astronomer considering submitting a paper to an AAS journal (i.e., AJ, ApJ, ApJ Letters, or ApJ Supplements)? If so, this post is for you! Read on to find out about the exciting new things you can do with the AASs newest LaTeX class file, available for download now.Why the Update?AAS publishing has maintained a consistent class file for LaTeX manuscript preparation for the past decade. But academic publishing is changing rapidly in todays era of electronic journals! Since its journals went fully electronic, the AAS has been continuously adding new publishing capabilities based on the recommendations of the Journals Task Force and the needs and requests of AAS authors. The AASs manuscript preparation tools are now being updated accordingly.Whats New in AASTex 6.0?There are many exciting new features and capabilities in AASTex 6.0. Here are just a few:Tracking options for author revisions include added{text}, deleted{text}, replaced{old}{new}, and explain{text}.Based on emulateapjDo you use the popular class file emulateapj to prepare your manuscripts? AASTex 6.0 is based on emulateapj, rather than on the older AASTex 5.2 (though 5.2 is still supported). This means that it is easy to produce a double-columned, single-spaced, and astro-ph-ready manuscript. Since two thirds of the AAS journals authors use emulateapj, this transition was designed to make manuscript preparation and sharing an easier and more seamless process.Tools for collaborationsDo you work in a large collaboration? AASTex now includes new tools to make preparing a manuscript within a collaboration easier. Drafts can now be watermarked to differentiate between versions. New markup for large author lists streamlines the display so that readers can access article information immediately, yet they can still access the full author list and affiliations at the end of the paper. And author revision markup allows members of a collaboration to

  7. Relationship of External Influence to Parental Distress in Decision Making Regarding Children with a Life-Threatening Illness

    Science.gov (United States)

    Luce, Mary Frances; Nelson, Robert M.

    2011-01-01

    Objective To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. Methods Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. Results More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high. Conclusions External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making. PMID:21693541

  8. Relationship of external influence to parental distress in decision making regarding children with a life-threatening illness.

    Science.gov (United States)

    Miller, Victoria A; Luce, Mary Frances; Nelson, Robert M

    2011-01-01

    To examine the relationship of external influence to parental distress when making a decision about research or treatment for a child with a life-threatening illness and to test potential moderators of this relationship. Parents (n = 219) who made a decision about research or treatment for a child completed measures of external influence, distress, decision-making preference, and coping. More external influence was associated with more hostility, uncertainty, and confusion. Decision-making preference and coping style moderated the relationship between external influence and distress: More external influence was associated with more distress when decision-making preference was low and task-focused coping was high. External influence appears to be related to distress in parents making research and treatment decisions for children with life-threatening illnesses. However, it is important to consider parent characteristics, such as decision-making preference and coping style, when examining the effects of contextual factors on distress during decision making.

  9. Patients' preferences for participation in treatment decision-making at the end of life: qualitative interviews with advanced cancer patients.

    Science.gov (United States)

    Brom, Linda; Pasman, H Roeline W; Widdershoven, Guy A M; van der Vorst, Maurice J D L; Reijneveld, Jaap C; Postma, Tjeerd J; Onwuteaka-Philipsen, Bregje D

    2014-01-01

    Patients are often encouraged to participate in treatment decision-making. Most studies on this subject focus on choosing between different curative treatment types. In the last phase of life treatment decisions differ as they often put more emphasis on weighing quantity against quality of life, such as whether or not to start treatment aimed at life prolongation but with the possibility of side effects. This study aimed to obtain insight into cancer patients' preferences and the reasons for patients' preferred role in treatment decision-making at the end of life. 28 advanced cancer patients were included at the start of their first line treatment. In-depth interviews were held prior to upcoming treatment decisions whether or not to start a life prolonging treatment. The Control Preference Scale was used to start discussing the extent and type of influence patients wanted to have concerning upcoming treatment decision-making. Interviews were audio taped and transcribed. All patients wanted their physician to participate in the treatment decision-making process. The extent to which patients themselves preferred to participate seemed to depend on how patients saw their own role or assessed their own capabilities for participating in treatment decision-making. Patients foresaw a shift in the preferred level of participation to a more active role depending in the later phase of illness when life prolongation would become more limited and quality of life would become more important. Patients vary in how much involvement they would like to have in upcoming treatment decision-making. Individual patients' preferences may change in the course of the illness, with a shift to more active participation in the later phases. Communication about patients' expectations, wishes and preferences for participation in upcoming treatment decisions is of great importance. An approach in which these topics are openly discussed would be beneficial.

  10. Speech-language pathology students' self-reports on voice training: easier to understand or to do?

    Science.gov (United States)

    Lindhe, Christina; Hartelius, Lena

    2009-01-01

    The aim of the study was to describe the subjective ratings of the course 'Training of the student's own voice and speech', from a student-centred perspective. A questionnaire was completed after each of the six individual sessions. Six speech and language pathology (SLP) students rated how they perceived the practical exercises in terms of doing and understanding. The results showed that five of the six participants rated the exercises as significantly easier to understand than to do. The exercises were also rated as easier to do over time. Results are interpreted within in a theoretical framework of approaches to learning. The findings support the importance of both the physical and reflective aspects of the voice training process.

  11. Environmental performance of straw-based pulp making: A life cycle perspective.

    Science.gov (United States)

    Sun, Mingxing; Wang, Yutao; Shi, Lei

    2018-03-01

    Agricultural straw-based pulp making plays a vital role in pulp and paper industry, especially in forest deficient countries such as China. However, the environmental performance of straw-based pulp has scarcely been studied. A life cycle assessment on wheat straw-based pulp making in China was conducted to fill of the gaps in comprehensive environmental assessments of agricultural straw-based pulp making. On average, the global warming potential (GWP), GWP excluding biogenic carbon, acidification potential and eutrophication potential of wheat straw based pulp making are 2299kg CO 2 -eq, 4550kg CO 2 -eq, 16.43kg SO 2 -eq and 2.56kg Phosphate-eq respectively. The dominant factors contributing to environmental impacts are coal consumption, electricity consumption, and chemical (NaOH, ClO 2 ) input. Chemical input decrease and energy recovery increase reduce the total environmental impacts dramatically. Compared with wood-based and recycled pulp making, wheat straw-based pulp making has higher environmental impacts, which are mainly due to higher energy and chemical requirements. However, the environmental impacts of wheat straw-based pulp making are lower than hemp and flax based pulp making from previous studies. It is also noteworthy that biogenic carbon emission is significant in bio industries. If carbon sequestration is taken into account in pulp making industry, wheat straw-based pulp making is a net emitter rather than a net absorber of carbon dioxide. Since wheat straw-based pulp making provides an alternative for agricultural residue management, its evaluation framework should be expanded to further reveal its environmental benefits. Copyright © 2017 Elsevier B.V. All rights reserved.

  12. Actions speak louder: a look at congressional votes on human life issues.

    Science.gov (United States)

    Shannon, D; Mazpule, D

    1991-01-01

    The decision to bring a new life into the world is the most important decision a caring person can make. Many fundamental factors must be considered like: housing, income, food, clothing, etc. The terms pro-choice and pro-life are used to describe both sides of the abortion debate, a debate that is of critical importance when making that decision about new life. While most members of Congress who are pro-choice also support social programs that make raising children easier; most members who are pro-life do not support such social justice programs. It seems paradoxical that someone claiming to be pro-life would then be anti-social justice. To be truly pro-life, a person must not only support a woman's right to choose, but must also support programs and policies that help parents to raise healthy, happy, and productive children. Yet it is the very people who claim to be pro-life that fight equally as hard against choice and against social justice. They fight legal abortion, but they also fight legislation that would make abortion less necessary. This article includes charts of the voting records of all members of the 101st Congress on legislation supported by 7 pro-choice or pro-child organizations. Planned Parenthood Federation of America (PPFA), the Children's Defense Fund (CDF), the Leadership Conference on Civil Rights (LCCR), the National Women's Political Caucus (NWPC), the American Public Health Association (APHA) and the League of Conservation Voters (LCV). The CDF, LCCR, and LCV do not have positions on abortion rights. The voting record of the JustLife Educational Fund are also given. In comparing the voting records, those that supported PPFA at least 75% of the time were labeled pro-choice, those that supported PPFA less than 25% of the time were called anti-choice, and those that supported it 26-74% of the time were called mixed. Once this determination is made, a comparison of their voting records for the other organizations clearly confirm that those

  13. Effects of Healthy Aging and Mild Cognitive Impairment on a Real-Life Decision-Making Task.

    Science.gov (United States)

    Pertl, Marie-Theres; Benke, Thomas; Zamarian, Laura; Delazer, Margarete

    2017-01-01

    In this study, we investigated the effects of age and of mild cognitive impairment (MCI) on decision making under risk by adopting a task representing real-life health-related situations and involving complex numerical information. Moreover, we assessed the relationship of real-life decision making to other cognitive functions such as number processing, executive functions, language, memory, and attention. For this reason, we compared the performance of 19 healthy, relatively younger adults with that of 18 healthy older adults and the performance of the 18 healthy older adults with that of 17 patients with MCI. Results indicated difficulties in real-life decision making for the healthy older adults compared with the healthy, relatively younger adults. Difficulties of patients with MCI relative to the healthy older adults arose in particular in difficult items requiring processing of frequencies and fractions. Significant effects of age and of MCI in processing frequencies were also evident in a ratio number comparison task. Decision-making performance of healthy participants and of the patient group correlated significantly with number processing. There was a further significant correlation with executive functions for the healthy participants and with reading comprehension for the patients. Our results suggest that healthy older individuals and patients with MCI make less advantageous decisions when the information is complex and high demands are put on executive functions and numerical abilities. Moreover, we show that executive functions and numerical abilities are not only essential in laboratory gambling tasks but also in more realistic and ecological decision situations within the health context.

  14. Application of preference selection index method for decision making over the design stage of production system life cycle

    Directory of Open Access Journals (Sweden)

    Rajesh Attri

    2015-07-01

    Full Text Available The life cycle of production system shows the progress of production system from the inception to the termination of the system. During each stage, mainly in the design stage, certain strategic decisions have to be taken. These decisions are more complex as the decision makers have to assess a wide range of alternatives based on a set of conflicting criteria. As the decision making process is found to be unstructured, characterized by domain dependent knowledge, there is a need to apply an efficient multi-criteria decision making (MCDM tool to help the decision makers in making correct decisions. This paper explores the application of a novel MCDM method i.e. Preference selection index (PSI method to solve various decision-making problems that are generally encountered in the design stage of production system life cycle. To prove the potentiality, applicability and accuracy of PSI method in solving decision making problem during the design stage of production system life cycle, five examples are cited from the literature and are compared with the results obtained by the past researchers.

  15. [Quality of life or life expectancy? Criteria and sources of information in the decision-making of patients undergoing aortic valve surgery].

    Science.gov (United States)

    Schmied, Wolfram; Barnick, Saskia; Heimann, Dierk; Schäfers, Hans-Joachim; Köllner, Volker

    2015-01-01

    Physicians are expected to involve patients adequately in the decision-making process prior to surgery. To this end, it is essential to have knowledge about the potential reasons for such a decision. In this study we investigated which information sources and decision criteria are important to patients prior to aortic valve surgery. A consecutive sample of 468 patients (70.1%m, aged 66.9±14.2 years) was examined 2 years after aortic valve replacement or reconstruction with a self-developed questionnaire. Preoperative discussion with a cardiologist or a cardiac surgeon was the information source patients used most frequently and felt to be the most helpful. The most important decision criterion was quality of life, followed by life expectancy and likelihood of reoperation. Two years postoperatively, 97.3% of the patients were satisfied with their decision. Preoperative counseling by a physician plays an essential role in the decision-making process prior to cardiac surgery. Patients want to be involved in decision-making, though they do not want to bear the full responsibility.

  16. Decision-Making of Patients With Implantable Cardioverter-Defibrillators at End of Life: Family Members' Experiences.

    Science.gov (United States)

    Lee, Mei Ching; Sulmasy, Daniel P; Gallo, Joseph; Kub, Joan; Hughes, Mark T; Russell, Stuart; Kellogg, Anela; Owens, Sharon G; Terry, Peter; Nolan, Marie T

    2017-07-01

    Many patients with advanced heart failure (HF) experience the life-extending benefits of implantable cardioverter-defibrillators (ICD), but at the end stage of HF, patients may experience shocks with increasing frequency and change the plan for end-of-life (EOL) care including the deactivation of the ICD. This report describes family members' experiences of patients with ICD making decisions at EOL. Understanding the decision-making of patients with ICD at EOL can promote informed decision-making and improve the quality of EOL care. This pilot study used a mixed methods approach to test the effects of a nurse-guided discussion in decision-making about ICD deactivation (turning off the defibrillation function) at the EOL. Interviews were conducted, audiotaped, and transcribed in 2012 to 2013 with 6 family members of patients with advanced HF and ICDs. Three researchers coded the data and identified themes in 2014. Three main themes described family members' experiences related to patients having HF with ICDs making health-care decision at EOL: decision-making preferences, patients' perception on ICD deactivation, and communication methods. Health-care providers need to have knowledge of patients' decision-making preferences. Preferences for decision-making include the allowing of appropriate people to involve and encourages direct conversation with family members even when advance directives is completed. Information of ICD function and the option of deactivation need to be clearly delivered to patients and family members. Education and guidelines will facilitate the communication of the preferences of EOL care.

  17. Health Care Decisions at the End of Life: Theological and Ethical Foundations for Decision Making.

    Science.gov (United States)

    Allegretti, Joseph G.

    This paper provides a framework for making sense of perplexing problems surrounding issues of death and dying by exploring the theological and ethical background to health care decision making at the end of life. The paper first examines several of the basic principles that theologians and secular ethicists employ when analyzing such questions.…

  18. Mental competence and surrogate decision-making towards the end of life.

    Science.gov (United States)

    Strätling, M; Scharf, V E; Schmucker, P

    2004-01-01

    German legislation demands that decisions about the treatment of mentally incompetent patients require an 'informed consent'. If this was not given by the patient him-/herself before he/she became incompetent, it has to be sought by the physician from a guardian, who has to be formally legitimized before. Additionally this surrogate has to seek the permission of a Court of Guardianship (Vormundschaftsgericht), if he/she intends to consent to interventions, which pose significant risks to the health or the life of the person under his/her care. This includes 'end-of-life decisions'. Deviations from this procedure are only allowed in acute emergencies or cases of 'medical futility'. On the basis of epidemiological and demographical data it can be shown that the vast majority of surrogate decisions on incompetent patients in Germany is not covered by legally valid consent. Moreover, the data suggests that if consent were to be requested according to the legal regulations, both the legal and medical system could realistically never cope with the practical consequences of this. Additionally, empiric research has revealed serious deficits concerning medical 'end of life-decisions' and practical performance in palliative care. As a consequence a multidisciplinary discussion has developed in Germany about the reform of present legislation with respect to key-issues like the assessment of mental competence, the options for exercising patient self-determination via advance directives and durable powers of attorney, the improvement of palliative care facilities, the clarification of formal procedures for surrogate decision-making in health care and towards the end of life and the possibilities and their limitations of controlling these decision-making processes 'externally' (e.g., by Guardianship Courts or committees). The authors discuss those proposals, which clearly dominate the present debate: They all aim to comply with the scientific basis of German law, jurisdiction

  19. "What makes life good?" Developing a culturally grounded quality of life measure for Alaska Native college students.

    Science.gov (United States)

    Sharma, Dinghy Kristine B; Lopez, Ellen D S; Mekiana, Deborah; Ctibor, Alaina; Church, Charlene

    2013-01-01

    Alaska Native (AN) college students experience higher attrition rates than their non-Native peers. Understanding the factors that contribute to quality of life ("what makes life good") for AN students will help inform supportive programs that are congruent with their culture and college life experiences. Co-develop a conceptual model and a measure of quality of life (QOL) that reflects the experiences of AN college students. Six focus groups were conducted with 26 AN college students. Within a community-academic partnership, interactive data collection activities, co-analysis workgroup sessions and an interactive findings forum ensured a participant-driven research process. Students identified and operationally defined eight QOL domains (values, culture and traditions, spirituality, relationships, basic needs, health, learning and leisure). The metaphor of a tree visually illustrates how the domains values, culture and traditions and spirituality form the roots to the other domains that appear to branch out as students navigate the dual worldviews of Native and Western ways of living. The eight QOL domains and their items identified during focus groups were integrated into a visual model and an objective QOL measure. The hope is to provide a useful tool for developing and evaluating university-based programs and services aimed toward promoting a positive QOL and academic success for AN students.

  20. Parental explicit heuristics in decision-making for children with life-threatening illnesses.

    Science.gov (United States)

    Renjilian, Chris B; Womer, James W; Carroll, Karen W; Kang, Tammy I; Feudtner, Chris

    2013-02-01

    To identify and illustrate common explicit heuristics (decision-making aids or shortcuts expressed verbally as terse rules of thumb, aphorisms, maxims, or mantras and intended to convey a compelling truth or guiding principle) used by parents of children with life-threatening illnesses when confronting and making medical decisions. Prospective cross-sectional observational study of 69 parents of 46 children who participated in the Decision-making in Pediatric Palliative Care Study between 2006 and 2008 at the Children's Hospital of Philadelphia. Parents were guided individually through a semistructured in-depth interview about their experiences and thoughts regarding making medical decisions on behalf of their ill children, and the transcribed interviews were qualitatively analyzed. All parents in our study employed explicit heuristics in interviews about decision-making for their children, with the number of identified explicit heuristics used by an individual parent ranging from tens to hundreds. The heuristics served 5 general functions: (1) to depict or facilitate understanding of a complex situation; (2) to clarify, organize, and focus pertinent information and values; (3) to serve as a decision-making compass; (4) to communicate with others about a complex topic; and (5) to justify a choice. Explicit heuristics played an important role in decision-making and communication about decision-making in our population of parents. Recognizing explicit heuristics in parent interactions and understanding their content and functions can aid clinicians in their efforts to partner with parents in the decision-making process.

  1. LIFE SKILLS OF YOUNG PEOPLE WITH DISABILITIES AND YOUTH WITHOUT DISABILITIES

    Directory of Open Access Journals (Sweden)

    Izeta Husić-Đuzić

    2017-09-01

    Full Text Available The aim of this paper is to determine the differences in life skills of young people with and without disability in chronological age from 18-35 year-old in Tuzla Canton. The respondents sample consists of two sub-samples. First sub-sample contains 50 young people with disability, chronological age from 18-35 of both genders. Second sub-sample contained 50 young people without disability, chronological age from 18- 35 of both genders. Research data were analysed using method of parametric and non-parametric statistics. Frequencies, percentages and measures of central tendency have been calculated (arithmetic mean and standard deviation. P-values have been used for examining the difference between variables and variance analysis has been used for examining the importance of differences. The results show that there is a significant statistical difference between young people with and without disabilities in the of life skills assessed: job retention skills, skills to cope in danger. Based on the results obtained, it is recommended to start the program and training in early age which will make life easier to disabled persons and their families.

  2. Contributions of the life course perspective to research on food decision making.

    Science.gov (United States)

    Wethington, Elaine; Johnson-Askew, Wendy L

    2009-12-01

    The life course perspective (LCP) has emerged as a powerful organizing framework for the study of health, illness, and mortality. LCP represents a "whole life" analysis perspective which originated in the field of sociology. Its concepts are increasingly applied to understanding the development of chronic disease over long periods of time in the human life span. A missing link, however, in the adaptation of the LCP to health research, is the insight the LCP may offer into understanding the societal, social network, and family contexts that frame stability and change in dietary behavior. This paper reviews key concepts that comprise the LCP but primarily focuses on applications that have relevance to food decision making in social context. A case study of chronic work-family stress and perceived time scarcity as barriers to dietary improvement is included. Illustrative findings are presented on dietary behavior in a diverse sample of lower-income working parents. This paper also offers ideas on increasing the contributions of the LCP to nutritional research.

  3. Approaches to end-of-life decision-making in the NICU: insights from Dostoevsky's The Grand Inquisitor.

    Science.gov (United States)

    Paris, J J; Graham, N; Schreiber, M D; Goodwin, M

    2006-07-01

    For many parents stopping life-sustaining medical treatment on their dying infant is psychologically impossible. Dostoevsky's insights into human behavior, particularly the fact that individuals do not want the anxiety and guilt associated with responsibility for making difficult decisions, might change the way physicians approach parents for permission to withdraw life-prolonging medical interventions on dying infants.

  4. Making Health Easier: Healthy Changes Start in Preschool

    Centers for Disease Control (CDC) Podcasts

    This podcast highlights the efforts of one educational organization, Los Angeles Universal Preschool (LAUP), to keep kids healthy at an early age. Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. LAUP teaches kids healthy habits and is incorporating small, healthy changes that can be made in any classroom—like teaching fun dances and providing nutritious snacks.

  5. Making Health Easier: Healthy Changes Start in Preschool

    Centers for Disease Control (CDC) Podcasts

    2012-09-19

    This podcast highlights the efforts of one educational organization, Los Angeles Universal Preschool (LAUP), to keep kids healthy at an early age. Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. LAUP teaches kids healthy habits and is incorporating small, healthy changes that can be made in any classroom—like teaching fun dances and providing nutritious snacks.  Created: 9/19/2012 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 10/1/2012.

  6. Managing Diabetes: New Technologies Can Make It Easier

    Science.gov (United States)

    ... Epub ahead of print]. PMID: 28855239. 12-Week 24/7 Ambulatory Artificial Pancreas With Weekly Adaptation of Insulin ... nih.gov/wellnesstoolkits . Footer Subscribe Find us on Facebook RSS Home Past Issues About Us Privacy Accessibility ...

  7. Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values

    Directory of Open Access Journals (Sweden)

    Jonathan D. Santoro

    2018-04-01

    Full Text Available Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.

  8. Ethics of End of Life Decisions in Pediatrics: A Narrative Review of the Roles of Caregivers, Shared Decision-Making, and Patient Centered Values.

    Science.gov (United States)

    Santoro, Jonathan D; Bennett, Mariko

    2018-04-26

    Background: This manuscript reviews unique aspects of end of life decision-making in pediatrics. Methods: A narrative literature review of pediatric end of life issues was performed in the English language. Results: While a paternalistic approach is typically applied to children with life-limiting medical prognoses, the cognitive, language, and physical variability in this patient population is wide and worthy of review. In end of life discussions in pediatrics, the consideration of a child’s input is often not reviewed in depth, although a shared decision-making model is ideal for use, even for children with presumed limitations due to age. This narrative review of end of life decision-making in pediatric care explores nomenclature, the introduction of the concept of death, relevant historical studies, limitations to the shared decision-making model, the current state of end of life autonomy in pediatrics, and future directions and needs. Although progress is being made toward a more uniform and standardized approach to care, few non-institutional protocols exist. Complicating factors in the lack of guidelines include the unique facets of pediatric end of life care, including physical age, paternalism, the cognitive and language capacity of patients, subconscious influencers of parents, and normative values of death in pediatrics. Conclusions: Although there have been strides in end of life decision-making in pediatrics, further investigation and research is needed in this field.

  9. End-of-life decision-making for children with severe developmental disabilities: The parental perspective

    NARCIS (Netherlands)

    Zaal-Schuller, I. H.; de Vos, M. A.; Ewals, F. V. P. M.; van Goudoever, J. B.; Willems, D. L.

    2016-01-01

    The objectives of this integrative review were to understand how parents of children with severe developmental disorders experience their involvement in end-of-life decision-making, how they prefer to be involved and what factors influence their decisions. We searched MEDLINE, EMBASE, CINAHL and

  10. Real-life decision making in college students. II: Do individual differences show reliable effects?

    Science.gov (United States)

    Galotti, Kathleen M; Tandler, Jane M; Wiener, Hillary J D

    2014-01-01

    First-year undergraduates participated in a short-term longitudinal study of real-life decision making over their first 14 months of college. They were surveyed about 7 different decisions: choosing courses for upcoming terms (on 3 different occasions), choosing an academic major (twice), planning for the upcoming summer, and planning for sophomore-year housing. They also completed a survey of self-reported decision-making styles and the Need for Cognition survey (Cacioppo & Petty, 1982) to assess their focus on rationality and enjoyment of analytic thinking. Results showed few statistically significant correlations between stylistic measures and behavioral measures of decision making, in either the amount of information considered or the way in which the information integration tracked predictions of linear models of decision making applied to each participant's data. However, there were consistent correlations, across the 7 decisions, between stylistic measures and affective reactions to, or retrospective descriptions of, episodes of decision making. We suggest that decision-making styles instruments may better reflect the construction of narratives of self as a decision maker more than they do actual behavior during decision making.

  11. Information Technology for Agriculture: Using it tools to aid decision-making process in small properties

    Directory of Open Access Journals (Sweden)

    Caroline de Oliveira Ferraz

    2017-07-01

    Full Text Available With the current scenario of agricultural competitiveness, the use of Information and Communication Technology (ICT tools has become increasingly common in the rural community, making life easier for farmers. The information obtained through Agroinformatics (Information Technology applied to agribusiness, serves as a basis for both decision-making, planning, and application of the best techniques and production processes. In Brazil, companies such as EMPRAPA (The Brazilian Agricultural Research Corporation work in the research and development of new technological tools, which seek to boost the agricultural production of small rural producers, reducing their costs and improving their results. But for this, it is necessary that the producers understand the concept of the importance in carrying out information collection in a correct way, because the information will be processed according to what is inserted in the systems. In this sense, this article aims to demonstrate through an explanatory research of qualitative nature and bibliographical character the importance of the use of ICT to support decision-making in the Brazilian rural sector. Also highlighting the benefits originated by the use of ICT in all stages of agricultural production and its accounting management, through examples of tools.

  12. Potential of life cycle assessment to support environmental decision making at commercial dairy farms

    NARCIS (Netherlands)

    Meul, M.; Middelaar, van C.E.; Boer, de I.J.M.; Passel, van S.; Fremaut, D.; Haesaert, G.

    2014-01-01

    In this paper, we evaluate the potential of life cycle assessment (LCA) to support environmental decision making at commercial dairy farms. To achieve this, we follow a four-step method that allows converting environmental assessment results using LCA into case-specific advice for farmers. This is

  13. Voices of African American, Caucasian, and Hispanic surrogates on the burdens of end-of-life decision making.

    Science.gov (United States)

    Braun, Ursula K; Beyth, Rebecca J; Ford, Marvella E; McCullough, Laurence B

    2008-03-01

    End-of-life decisions are frequently made by patients' surrogates. Race and ethnicity may affect such decision making. Few studies have described how different racial/ethnic groups experience end-of-life surrogate decision making. To describe the self-reported experience the self-reported experience of African-American, Caucasian, and Hispanic surrogate decision makers of seriously ill patients and to examine the relationship of race, ethnicity, and culture to that experience. Purposive sample to include racial/ethnic minorities in a qualitative study using focus group interviews. The participants of the study were 44 experienced, mostly female, surrogate decision makers for older veterans. Transcripts were qualitatively analyzed to identify major themes, with particular attention to themes that might be unique to each of the three groups. The experience of burden of end-of-life decision making was similar in all three groups. This burden in its medical, personal, and familial dimensions is compounded by uncertainty about prognosis and the patient's preferences. Racial/ethnic variations of responses to this burden concerned the physician-family relationship, religion and faith, and past experiences with race/ethnicity concordant versus non-concordant physicians. Regardless of race/ethnicity, surrogates for seriously ill patients appeared to experience increased significant, multidimensional burdens of decision making under conditions of uncertainty about a patient's preferences. This aspect of the burden of surrogate decision making may not be fully appreciated by physicians. Physicians should identify and be especially attentive to strategies used by surrogates, which may vary by race/ethnicity, to reduce the uncertainty about a patient's preferences and thus the burden of surrogate decision making to assist them in this difficult process.

  14. End-of-Life Decision Making in Palliative Care and Recommendations of the Council of Europe: Qualitative Secondary Analysis of Interviews and Observation Field Notes.

    Science.gov (United States)

    Martins Pereira, Sandra; Fradique, Emília; Hernández-Marrero, Pablo

    2018-05-01

    End-of-life decisions (ELDs) are embedded in clinical, sociocultural, political, economic, and ethical concerns. In 2014, the Council of Europe (CoE) through its Committee on Bioethics launched the "Guide on the decision-making process regarding medical treatment in end-of-life situations," aiming at improving decision-making processes and empowering professionals in making ELDs. To analyze if end-of-life decision making in palliative care (PC) is consistent with this Guide and to identify if disputed/controversial issues are part of current ELDs. Qualitative secondary analysis. Four qualitative datasets, including 44 interviews and 9 team observation field notes from previous studies with PC teams/professionals in Portugal. An analysis grid based on the abovementioned guide was created considering three dimensions: ethical and legal frameworks, decision-making process, and disputed/controversial issues. The majority of the professionals considered the ethical principle of autonomy paramount in end-of-life decision making. Justice and beneficence/nonmaleficence were also valued. Although not mentioned in the Guide, the professionals also considered other ethical principles when making ELDs, namely, responsibility, integrity, and dignity. Most of the interviewees and field notes referred to the collective interprofessional dimension of the decision-making process. Palliative sedation and the wish to hasten death were the most mentioned disputed/controversial issues. The nature, limitations, and benefits of qualitative secondary analysis are discussed. End-of-life decision-making processes made by Portuguese PC teams seem to be consistent with the guidelines of the CoE. Further research is needed about disputed/controversial issues and the actual use, effectiveness, and impact of ethical guidelines for end-of-life decision making on professionals' empowerment and for all parties involved.

  15. How Accumulated Real Life Stress Experience and Cognitive Speed Interact on Decision-Making Processes

    Directory of Open Access Journals (Sweden)

    Eva Friedel

    2017-06-01

    Full Text Available Rationale: Advances in neurocomputational modeling suggest that valuation systems for goal-directed (deliberative on one side, and habitual (automatic decision-making on the other side may rely on distinct computational strategies for reinforcement learning, namely model-free vs. model-based learning. As a key theoretical difference, the model-based system strongly demands cognitive functions to plan actions prospectively based on an internal cognitive model of the environment, whereas valuation in the model-free system relies on rather simple learning rules from operant conditioning to retrospectively associate actions with their outcomes and is thus cognitively less demanding. Acute stress reactivity is known to impair model-based but not model-free choice behavior, with higher working memory capacity protecting the model-based system from acute stress. However, it is not clear which impact accumulated real life stress has on model-free and model-based decision systems and how this influence interacts with cognitive abilities.Methods: We used a sequential decision-making task distinguishing relative contributions of both learning strategies to choice behavior, the Social Readjustment Rating Scale questionnaire to assess accumulated real life stress, and the Digit Symbol Substitution Test to test cognitive speed in 95 healthy subjects.Results: Individuals reporting high stress exposure who had low cognitive speed showed reduced model-based but increased model-free behavioral control. In contrast, subjects exposed to accumulated real life stress with high cognitive speed displayed increased model-based performance but reduced model-free control.Conclusion: These findings suggest that accumulated real life stress exposure can enhance reliance on cognitive speed for model-based computations, which may ultimately protect the model-based system from the detrimental influences of accumulated real life stress. The combination of accumulated real life

  16. How Accumulated Real Life Stress Experience and Cognitive Speed Interact on Decision-Making Processes.

    Science.gov (United States)

    Friedel, Eva; Sebold, Miriam; Kuitunen-Paul, Sören; Nebe, Stephan; Veer, Ilya M; Zimmermann, Ulrich S; Schlagenhauf, Florian; Smolka, Michael N; Rapp, Michael; Walter, Henrik; Heinz, Andreas

    2017-01-01

    Rationale: Advances in neurocomputational modeling suggest that valuation systems for goal-directed (deliberative) on one side, and habitual (automatic) decision-making on the other side may rely on distinct computational strategies for reinforcement learning, namely model-free vs. model-based learning. As a key theoretical difference, the model-based system strongly demands cognitive functions to plan actions prospectively based on an internal cognitive model of the environment, whereas valuation in the model-free system relies on rather simple learning rules from operant conditioning to retrospectively associate actions with their outcomes and is thus cognitively less demanding. Acute stress reactivity is known to impair model-based but not model-free choice behavior, with higher working memory capacity protecting the model-based system from acute stress. However, it is not clear which impact accumulated real life stress has on model-free and model-based decision systems and how this influence interacts with cognitive abilities. Methods: We used a sequential decision-making task distinguishing relative contributions of both learning strategies to choice behavior, the Social Readjustment Rating Scale questionnaire to assess accumulated real life stress, and the Digit Symbol Substitution Test to test cognitive speed in 95 healthy subjects. Results: Individuals reporting high stress exposure who had low cognitive speed showed reduced model-based but increased model-free behavioral control. In contrast, subjects exposed to accumulated real life stress with high cognitive speed displayed increased model-based performance but reduced model-free control. Conclusion: These findings suggest that accumulated real life stress exposure can enhance reliance on cognitive speed for model-based computations, which may ultimately protect the model-based system from the detrimental influences of accumulated real life stress. The combination of accumulated real life stress exposure

  17. Remodelling the Life Course: Making the Most of Life with Multiple Sclerosis

    Directory of Open Access Journals (Sweden)

    Milka Satinovic

    2017-06-01

    Full Text Available The aim of the study was to develop a substantive grounded theory on how to live a life as good as possible with multiple sclerosis (MS. The question of how to improve the quality of life is of key importance when speaking of a chronic illness like MS. We still have little knowledge of this important question from the patients’ perspective. Classic grounded theory was used to explore patients’ experiences of living with MS. The aim was to identify their main concern and how they process this concern at different phases in their life course. Twenty-one interviews were conducted with 17 participants diagnosed with multiple sclerosis. Participant observation at five courses for people with a multiple sclerosis diagnosis generated field notes. The participants’ main concern was how to live a life as good as possible in spite of their deteriorating health. The participants met this challenge through a process of remodelling the life course, in four phases: postponing (keeping up a normal life, adjusting (moving on to a changed life, restructuring (doing the best of it in a changed life, and transforming (preventing illness from controlling life. The remodelling process is influenced by the individual context, like the current health situation, biography, relations, and structural conditions. The process of remodelling helps us understand what facilitates and what hinders patients with MS from living a good life.

  18. Life support decision making in critical care: Identifying and appraising the qualitative research evidence.

    Science.gov (United States)

    Giacomini, Mita; Cook, Deborah; DeJean, Deirdre

    2009-04-01

    The objective of this study is to identify and appraise qualitative research evidence on the experience of making life-support decisions in critical care. In six databases and supplementary sources, we sought original research published from January 1990 through June 2008 reporting qualitative empirical studies of the experience of life-support decision making in critical care settings. Fifty-three journal articles and monographs were included. Of these, 25 reported prospective studies and 28 reported retrospective studies. We abstracted methodologic characteristics relevant to the basic critical appraisal of qualitative research (prospective data collection, ethics approval, purposive sampling, iterative data collection and analysis, and any method to corroborate findings). Qualitative research traditions represented include grounded theory (n = 15, 28%), ethnography or naturalistic methods (n = 15, 28%), phenomenology (n = 9, 17%), and other or unspecified approaches (n = 14, 26%). All 53 documents describe the research setting; 97% indicate purposive sampling of participants. Studies vary in their capture of multidisciplinary clinician and family perspectives. Thirty-one (58%) report research ethics board review. Only 49% report iterative data collection and analysis, and eight documents (15%) describe an analytically driven stopping point for data collection. Thirty-two documents (60%) indicated a method for corroborating findings. Qualitative evidence often appears outside of clinical journals, with most research from the United States. Prospective, observation-based studies follow life-support decision making directly. These involve a variety of participants and yield important insights into interactions, communication, and dynamics. Retrospective, interview-based studies lack this direct engagement, but focus on the recollections of fewer types of participants (particularly patients and physicians), and typically address specific issues (communication and

  19. Towards the bibliography of life

    Directory of Open Access Journals (Sweden)

    David King

    2011-11-01

    Full Text Available This paper discusses how we intend to take forward the vision of a Bibliography of Life in the ViBRANT project. The underlying principle of the Bibliography is to provide taxonomists and others with a freely accessible bibliography covering the whole of life. Such a bibliography has been achieved for specific study areas within taxonomy, but not for “life” as a whole.The creation of such a comprehensive tool has been hindered by various social and technical issues. The social concerns focus on the willingness of users to contribute to the Bibliography. The technical concerns relate to the architecture required to deliver the Bibliography. These issues are discussed in the paper and approaches to addressing them within the ViBRANT project are described, to demonstrate how we can now seriously consider building a Bibliography of Life. We are particularly interested in the potential of the resulting tool to improve the quality of bibliographic references. Through analysing the large number of references in the Bibliography we will be able to add metadata by resolving known issues such as geographical name variations. This should result in a tool that will assist taxonomists in two ways. Firstly, it will be easier for them to discover relevant literature, especially pre-digital literature; and secondly, it will be easier for them to identify the canonical form for a citation.The paper also covers related issues relevant to building the tool in ViBRANT, including implementation and copyright, with suggestions as to how we could address them.

  20. Life and Death Decision Making, by Baruch A. Brody.

    Science.gov (United States)

    Veatch, Robert M

    1989-04-01

    Veatch considers the pluralistic casuistry theory advocated by Baruch Brody in his 1988 book, Life and Death Decision Making, to be an important contribution to the secular medical ethics literature. The casuistic and pluralistic elements of Brody's new model are described as intriguing but controversial because Brody both excludes several ethical appeals (i.e., classical Hippocratic ethics, virtue theory) and/or limits other questionable appeals (i.e., consequences for families and others in society, the virtue of integrity) without accounting for these decisions. Veatch also questions Brody's use of intuitional judgment to determine what ought to be done after examination of various appeals and their significance because Brody's approach raises serious problems about how various appeals are counted. Veatch does affirm the rich assessment of medical ethical problems made possible by Brody's pluralistic approach but notes the difficulties it raises.

  1. A model for emergency department end-of-life communications after acute devastating events--part I: decision-making capacity, surrogates, and advance directives.

    Science.gov (United States)

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-09-01

    Making decisions for a patient affected by sudden devastating illness or injury traumatizes a patient's family and loved ones. Even in the absence of an emergency, surrogates making end-of-life treatment decisions may experience negative emotional effects. Helping surrogates with these end-of-life decisions under emergent conditions requires the emergency physician (EP) to be clear, making medical recommendations with sensitivity. This model for emergency department (ED) end-of-life communications after acute devastating events comprises the following steps: 1) determine the patient's decision-making capacity; 2) identify the legal surrogate; 3) elicit patient values as expressed in completed advance directives; 4) determine patient/surrogate understanding of the life-limiting event and expectant treatment goals; 5) convey physician understanding of the event, including prognosis, treatment options, and recommendation; 6) share decisions regarding withdrawing or withholding of resuscitative efforts, using available resources and considering options for organ donation; and 7) revise treatment goals as needed. Emergency physicians should break bad news compassionately, yet sufficiently, so that surrogate and family understand both the gravity of the situation and the lack of long-term benefit of continued life-sustaining interventions. EPs should also help the surrogate and family understand that palliative care addresses comfort needs of the patient including adequate treatment for pain, dyspnea, or anxiety. Part I of this communications model reviews determination of decision-making capacity, surrogacy laws, and advance directives, including legal definitions and application of these steps; Part II (which will appear in a future issue of AEM) covers communication moving from resuscitative to end-of-life and palliative treatment. EPs should recognize acute devastating illness or injuries, when appropriate, as opportunities to initiate end-of-life discussions and to

  2. Meaning making and psychological adjustment following cancer: the mediating roles of growth, life meaning, and restored just-world beliefs.

    Science.gov (United States)

    Park, Crystal L; Edmondson, Donald; Fenster, Juliane R; Blank, Thomas O

    2008-10-01

    Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making processes and meanings made as determinants of adjustment has shown inconsistent effects, partly because of the lack of clearly articulated theoretical frameworks and problematic research strategies. In a 1-year longitudinal study, the authors distinguished the meaning making process from the outcomes of that process (meanings made), employing specific measures of both. The authors tested pathways through which meaning making efforts led to 3 different meanings made (growth, life meaning, and restored just-world belief) in a sample of 172 young to middle-age adult cancer survivors, and they explored whether those meanings made mediated the effect of meaning making efforts on psychological adjustment. Cross-sectional and longitudinal path models of the meaning making process indicate that meaning making efforts are related to better adjustment through the successful creation of adaptive meanings made from the cancer experience. The authors conclude with clinical implications and suggestions for future research. (c) 2008 APA, all rights reserved.

  3. Towards a life cycle sustainability assessment: making informed choices on products

    Energy Technology Data Exchange (ETDEWEB)

    Ciroth, Andreas [GreenDeltaTC, Berlin (Germany); Finkbeiner, Matthias; Traverso, Marzia [TU Berlin (Germany); Hildenbrand, Jutta [Chalmers University (United States); Kloepffer, Walter [Editor-in-Chief of the International Journal of Life Cycle Assessment (Germany); Mazijn, Bernard [Ghent University (Belgium); Prakash, Siddharth [Oeko-Institut (Germany); Sonnemann, Guido; Valdivia, Sonia [UNEP (France); Ugaya, Cassia Maria Lie [Technological Federal University of Parana, ACV (Brazil); Vickery-Niederman, Gina [University of Arkansas (United States)

    2011-07-01

    In this introduction to the concept of life cycle sustainability assessment (LCSA), we acknowledge the foundations laid by previous works and initiatives. One such initiative has been the ISO 14040 series (Environmental management -- Life cycle assessment -- Principles and framework), which in addition to the ISO 26000: Social Responsibility Guidance Standard, and the contribution of a number of international initiatives (Appendix A) have been essential for the development of this publication. The life cycle of a product involves flows of material, energy and money. Nonetheless, the picture is not complete unless we look also at the production and consumption impacts on all actors along the 'value chain' -- workers, local communities, consumers and society itself. Different life cycle assessment techniques allow individuals and enterprises to assess the impact of their purchasing decisions and production methods along different aspects of this value chain. An (Environmental) life cycle assessment (LCA) looks at potential impacts to the environment as a result of the extraction of resources, transportation, production, use, recycling and discarding of products; life cycle costing (LCC) is used to assess the cost implications of this life cycle; and social life cycle assessment (S-LCA) examines the social consequences. However, in order to get the 'whole picture', it is vital to extend current life cycle thinking to encompass all three pillars of sustainability: (i) environmental, (ii) economic and (iii) social. This means carrying out an assessment based on environmental, economic and social issues -- by conducting an overarching life cycle sustainability assessment (LCSA). This publication shows how all three techniques -- which all share similar methodological frameworks and aims -- can be combined to make the move towards an overarching LCSA possible. Because it is holistic, systemic and rigorous, (environmental) LCA is the preferred technique

  4. Towards a life cycle sustainability assessment: making informed choices on products

    Energy Technology Data Exchange (ETDEWEB)

    Ciroth, Andreas [GreenDeltaTC, Berlin (Germany); Finkbeiner, Matthias; Traverso, Marzia [TU Berlin (Germany); Hildenbrand, Jutta [Chalmers University (United States); Kloepffer, Walter [Editor-in-Chief of the International Journal of Life Cycle Assessment (Germany); Mazijn, Bernard [Ghent University (Belgium); Prakash, Siddharth [Oeko-Institut (Germany); Sonnemann, Guido; Valdivia, Sonia [UNEP (France); Ugaya, Cassia Maria Lie [Technological Federal University of Parana, ACV (Brazil); Vickery-Niederman, Gina [University of Arkansas (United States)

    2011-07-01

    In this introduction to the concept of life cycle sustainability assessment (LCSA), we acknowledge the foundations laid by previous works and initiatives. One such initiative has been the ISO 14040 series (Environmental management -- Life cycle assessment -- Principles and framework), which in addition to the ISO 26000: Social Responsibility Guidance Standard, and the contribution of a number of international initiatives (Appendix A) have been essential for the development of this publication. The life cycle of a product involves flows of material, energy and money. Nonetheless, the picture is not complete unless we look also at the production and consumption impacts on all actors along the 'value chain' -- workers, local communities, consumers and society itself. Different life cycle assessment techniques allow individuals and enterprises to assess the impact of their purchasing decisions and production methods along different aspects of this value chain. An (Environmental) life cycle assessment (LCA) looks at potential impacts to the environment as a result of the extraction of resources, transportation, production, use, recycling and discarding of products; life cycle costing (LCC) is used to assess the cost implications of this life cycle; and social life cycle assessment (S-LCA) examines the social consequences. However, in order to get the 'whole picture', it is vital to extend current life cycle thinking to encompass all three pillars of sustainability: (i) environmental, (ii) economic and (iii) social. This means carrying out an assessment based on environmental, economic and social issues -- by conducting an overarching life cycle sustainability assessment (LCSA). This publication shows how all three techniques -- which all share similar methodological frameworks and aims -- can be combined to make the move towards an overarching LCSA possible. Because it is holistic, systemic and rigorous, (environmental) LCA is the preferred technique when it comes to

  5. East meets West: cross-cultural perspective in end-of-life decision making from Indian and German viewpoints.

    Science.gov (United States)

    Chattopadhyay, Subrata; Simon, Alfred

    2008-06-01

    Culture creates the context within which individuals experience life and comprehend moral meaning of illness, suffering and death. The ways the patient, family and the physician communicate and make decisions in the end-of-life care are profoundly influenced by culture. What is considered as right or wrong in the healthcare setting may depend on the socio-cultural context. The present article is intended to delve into the cross-cultural perspectives in ethical decision making in the end-of-life scenario. We attempt to address the dynamics of the roles of patient, family and physician therein across two countries from East and West, namely, India and Germany. In India, where illness is more a shared family affair than an individual incident, a physician is likely to respect the family's wishes and may withhold the [Symbol: see text]naked truth' about the diagnosis of a fatal disease to the patient. In Germany, a physician is legally required to inform the patient about the disease. In India, advance directive being virtually non-existent, the family acts as the locus of the decision-making process, taking into account the economic cost of available medical care. In Germany, advance directive is regarded as mandatory and healthcare is covered by insurance. Family and the physician appear to play larger roles in ethical decision making for patients in India than for those in Germany, who place greater emphasis on autonomy of the individual patient. Our study explicates how culture matters in ethical decision-making and why the bioethical discourse is necessary in the concrete realities of the socio-cultural context. To explore the possibility of finding a common ground of morality across different cultures while acknowledging and respecting cultural diversity, thus remains a formidable challenge for the bioethicists.

  6. Struggling to find meaning in life among spouses of people with ALS.

    Science.gov (United States)

    Ozanne, Anneli O; Graneheim, Ulla H; Strang, Susann

    2015-08-01

    The aim of this study was to illuminate experiences of finding meaning in life among spouses of people with amyotrophic lateral sclerosis. Thirteen interviews were analyzed with qualitative content analysis. The spouses were struggling for meaning at the end of a dark tunnel. They felt limited and isolated in their proximity to death. They lived imprisoned lives, felt lonely, considered life to be unfair and incomplete, and mourned the loss of their future. However, they found meaning despite the proximity of death through cherishing their own lives, fellowship, accepting the present, and believing in meaning after the partner's death. Meaning in life strengthened spouses' well-being and ability to find pleasure in a difficult situation. It also strengthened their will to live after the partner's death. Limitations and isolations were strong predictors of what could impair their well-being and the possibility of finding meaning after the partner's death. Spouses need individual support throughout the disease process and after the partner's death, to give them the strength to find meaning in life and prioritize what is important for them. Paying attention to what might prevent them from finding meaning could make it easier to help them in their situation. Providing joint support to the patient and spouse might also help them to see each other's situation, come together, and help each other.

  7. Economic modeling for life extension decision making

    International Nuclear Information System (INIS)

    Farber, M.A.; Harrison, D.L.; Carlson, D.D.

    1986-01-01

    This paper presents a methodology for the economic and financial analysis of nuclear plant life extension under uncertainty and demonstrates its use in a case analysis. While the economic and financial evaluation of life extension does not require new analytical tools, such studies should be based on the following three premises. First, the methodology should examine effects at the level of the company or utility system, because the most important economic implications of life extension relate to the altered generation system expansion plan. Second, it should focus on the implications of uncertainty in order to understand the factors that most affect life extension benefits and identify risk management efforts. Third, the methodology should address multiple objectives, at a minimum, both economic and financial objectives

  8. Negotiated reorienting: a grounded theory of nurses' end-of-life decision-making in the intensive care unit.

    Science.gov (United States)

    Gallagher, Ann; Bousso, Regina Szylit; McCarthy, Joan; Kohlen, Helen; Andrews, Tom; Paganini, Maria Cristina; Abu-El-Noor, Nasser Ibrahim; Cox, Anna; Haas, Margit; Arber, Anne; Abu-El-Noor, Mysoon Khalil; Baliza, Michelle Freire; Padilha, Katia Grillo

    2015-04-01

    Intensive care units (ICUs) focus on treatment for those who are critically ill and interventions to prolong life. Ethical issues arise when decisions have to be made regarding the withdrawal and withholding of life-sustaining treatment and the shift to comfort and palliative care. These issues are particularly challenging for nurses when there are varying degrees of uncertainty regarding prognosis. Little is known about nurses' end-of-life (EoL) decision-making practice across cultures. To understand nurses' EoL decision-making practices in ICUs in different cultural contexts. We collected and analysed qualitative data using Grounded Theory. Interviews were conducted with experienced ICU nurses in university or hospital premises in five countries: Brazil, England, Germany, Ireland and Palestine. Semi-structured interviews were conducted with 51 nurses (10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine). They were purposefully and theoretically selected to include nurses having a variety of characteristics and experiences concerning end-of-life (EoL) decision-making. The study used grounded theory to inform data collection and analysis. Interviews were facilitated by using key questions. The comparative analysis of the data within and across data generated by the different research teams enabled researchers to develop a deeper understanding of EoL decision-making practices in the ICU. Ethical approval was granted in each of the participating countries and voluntary informed consent obtained from each participant. The core category that emerged was 'negotiated reorienting'. Whilst nurses do not make the 'ultimate' EoL decisions, they engage in two core practices: consensus seeking (involving coaxing, information cuing and voice enabling); and emotional holding (creating time-space and comfort giving). There was consensus regarding the core concept and core practices employed by nurses in the ICUs in the five countries. However

  9. Individual variations in maternal care early in life correlate with later life decision-making and c-fos expression in prefrontal subregions of rats.

    Directory of Open Access Journals (Sweden)

    Felisa N van Hasselt

    Full Text Available Early life adversity affects hypothalamus-pituitary-adrenal axis activity, alters cognitive functioning and in humans is thought to increase the vulnerability to psychopathology--e.g. depression, anxiety and schizophrenia--later in life. Here we investigated whether subtle natural variations among individual rat pups in the amount of maternal care received, i.e. differences in the amount of licking and grooming (LG, correlate with anxiety and prefrontal cortex-dependent behavior in young adulthood. Therefore, we examined the correlation between LG received during the first postnatal week and later behavior in the elevated plus maze and in decision-making processes using a rodent version of the Iowa Gambling Task (rIGT. In our cohort of male and female animals a high degree of LG correlated with less anxiety in the elevated plus maze and more advantageous choices during the last 10 trials of the rIGT. In tissue collected 2 hrs after completion of the task, the correlation between LG and c-fos expression (a marker of neuronal activity was established in structures important for IGT performance. Negative correlations existed between rIGT performance and c-fos expression in the lateral orbitofrontal cortex, prelimbic cortex, infralimbic cortex and insular cortex. The insular cortex correlations between c-fos expression and decision-making performance depended on LG background; this was also true for the lateral orbitofrontal cortex in female rats. Dendritic complexity of insular or infralimbic pyramidal neurons did not or weakly correlate with LG background. We conclude that natural variations in maternal care received by pups may significantly contribute to later-life decision-making and activity of underlying brain structures.

  10. Real-life decision making in college students. I: Consistency across specific decisions.

    Science.gov (United States)

    Galotti, Kathleen M; Wiener, Hillary J D; Tandler, Jane M

    2014-01-01

    First-year undergraduates participated in a short-term longitudinal study of real-life decision making over their first 14 months of college. They were surveyed about 7 different decisions: choosing courses for an upcoming term (3 different terms), choosing an academic major (twice), planning for the upcoming summer, and planning for sophomore-year housing. Participants showed moderate levels of consistency in the options they considered and in the criteria they used to decide between options, with about half of the options or criteria being used at 2 different points on the decision repeatedly studied. Participants varied somewhat in structural consistency, the tendency to consider the same number of options or criteria across decisions. They also varied in the way they integrated information across decision-making tasks. We suggest that people attempt to keep the information demands of the task within workable limits, sometimes sacrificing consistency as a result.

  11. Economic modelling for life extension decision making

    International Nuclear Information System (INIS)

    Farber, M.A.; Harrison, D.L.; Carlson, D.D.

    1987-01-01

    This paper presents a methodology for the economic and financial analysis of nuclear plant life extension under uncertainty and demonstrates its use in a case analysis. While the economic and financial evaluation of life extension does not require new analytical tools, such studies should be based on the following three premises. First, the methodology should examine effects at the level of the company or utility system, because the most important economic implications of life extension relate to the altered generation system expansion plan. Second, it should focus on the implications of uncertainty in order to understand the factors that most affect life extension benefits and identify risk management efforts. Third, the methodology should address multiple objectives, at a minimum, both economic and financial objectives. An analysis of the role of life extension for Virginia Power's generating system was performed using the MIDAS model, developed by the Electric Power Research Institute. MIDAS is particularly well suited to this type of study because of its decision analysis framework. The model incorporates modules for load analysis, capacity expansion, production costing, financial analysis, and rates. The decision tree structure facilitates the multiple-scenario analysis of uncertainty. The model's output includes many economic and financial measures, including capital expenditures, fuel and purchases power costs, revenue requirements, average rates, external financing requirements, and coverage ratio. Based on findings for Virginia Power's Surry 1 plant, nuclear plant life extension has economic benefits for a utility's customers and financial benefits for the utility's investors. These benefits depend on a number of economic, technical and regulatory factors. The economic analysis presented in this paper identifies many of the key factors and issues relevant to life extension planning

  12. Are advance directives helpful for good end of life decision making: a cross sectional survey of health professionals.

    Science.gov (United States)

    Peicius, Eimantas; Blazeviciene, Aurelija; Kaminskas, Raimondas

    2017-06-05

    This paper joins the debate over changes in the role of health professionals when applying advance directives to manage the decision-making process at the end of life care. Issues in relation to advance directives occur in clinical units in Lithuania; however, it remains one of the few countries in the European Union (EU) where the discussion on advance directives is not included in the health-care policy-making agenda. To encourage the discussion of advance directives, a study was designed to examine health professionals' understanding and preferences related to advance directives. In addition, the study sought to explore the views of health care professionals of the application of Advance Directives (AD) in clinical practice in Lithuania. A cross-sectional survey was conducted by interviewing 478 health professionals based at major health care centers in Kaunas district, Lithuania. The design of the study included the use of a questionnaire developed for this study and validated by a pilot study. The collected data were analyzed using standard descriptive statistical methods. The analysis of knowledge about AD revealed some statistically significant differences when comparing the respondents' profession and gender. The analysis also indicated key emerging themes among respondents including tranquility of mind, the longest possible life expectancy and freedom of choice. Further, the study findings revealed that more than half of the study participants preferred to express their will while alive by using advance directives. The study findings revealed a low level of knowledge on advance directives among health professionals. Most health professionals agreed that AD's improved end-of-life decision making while the majority of physicians appreciated AD as the best tool for sharing responsibilities in clinical practice in Lithuania. More physicians than nurses preferred the presence of advance directives to support their decision making in end-of-life situations.

  13. Key role of social work in effective communication and conflict resolution process: Medical Orders for Life-Sustaining Treatment (MOLST) Program in New York and shared medical decision making at the end of life.

    Science.gov (United States)

    Bomba, Patricia A; Morrissey, Mary Beth; Leven, David C

    2011-01-01

    In this article, the authors review the development of the Medical Orders for Life-Sustaining Treatment (MOLST) Program and recent landmark legislation in New York State in the context of advance care planning and shared medical decision making at the end of life. Social workers are central health care professionals in working with patients, families, practitioners, health care agents, and surrogates in the health systems and in the communication and conflict resolution process that is integral to health care decision making. The critical importance of ethics and end-of-life training and education for social workers is also addressed. Data from a pilot study evaluating interdisciplinary ethics training on legal and ethical content in communication and conflict resolution skills in health care decision making are reported. Recommendations are made for research on education and training of social workers, and investigation of the role and influence of systems in shaping social work involvement in end-of-life and palliative care.

  14. Meaning Making and Psychological Adjustment following Cancer: The Mediating Roles of Growth, Life Meaning, and Restored Just-World Beliefs

    Science.gov (United States)

    Park, Crystal L.; Edmondson, Donald; Fenster, Juliane R.; Blank, Thomas O.

    2008-01-01

    Cancer survivors' efforts at meaning making may influence the extent to which they successfully make meaning from their experience (i.e., experience posttraumatic growth, find life meaningful, and restore beliefs in a just world), which may, in turn, influence their psychological adjustment. Previous research regarding both meaning making…

  15. The Effect of Decision-Making Skill Training Programs on Self-Esteem and Decision-Making Styles

    Science.gov (United States)

    Colakkadioglu, Oguzhan; Celik, D. Billur

    2016-01-01

    Problem Statement: Decision making is a critical cognitive process in every area of human life. In this process, the individuals play an active role and obtain outputs with their functional use of decision-making skills. Therefore, the decision-making process can affect the course of life, life satisfaction, and the social relations of an…

  16. Making Health Easier: Active Living in Los Angeles, CA

    Centers for Disease Control (CDC) Podcasts

    Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. This podcast highlights one preschool teacher who teaches kids about active living and is incorporating small, healthy changes that can be made in any classroom—like teaching fun dances and yoga classes.

  17. Making Health Easier: Healthy Eating in Los Angeles, CA

    Centers for Disease Control (CDC) Podcasts

    Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. This podcast highlights one preschool teacher who teaches kids about healthy eating and is incorporating small, healthy changes that can be made in any classroom—like planting a classroom garden and eating healthy snacks.

  18. Making Health Easier: Healthy Schools in Minnesota PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    To bring healthier meals to students at the Dover-Eyota elementary school in Minnesota, school officials and parents started a partnership with local farmers. The farm-to-school program has brought better food, like watermelon and corn on the cob, to the children while building ties within the community.

  19. Making Interoperability Easier with the NASA Metadata Management Tool

    Science.gov (United States)

    Shum, D.; Reese, M.; Pilone, D.; Mitchell, A. E.

    2016-12-01

    ISO 19115 has enabled interoperability amongst tools, yet many users find it hard to build ISO metadata for their collections because it can be large and overly flexible for their needs. The Metadata Management Tool (MMT), part of NASA's Earth Observing System Data and Information System (EOSDIS), offers users a modern, easy to use browser based tool to develop ISO compliant metadata. Through a simplified UI experience, metadata curators can create and edit collections without any understanding of the complex ISO-19115 format, while still generating compliant metadata. The MMT is also able to assess the completeness of collection level metadata by evaluating it against a variety of metadata standards. The tool provides users with clear guidance as to how to change their metadata in order to improve their quality and compliance. It is based on NASA's Unified Metadata Model for Collections (UMM-C) which is a simpler metadata model which can be cleanly mapped to ISO 19115. This allows metadata authors and curators to meet ISO compliance requirements faster and more accurately. The MMT and UMM-C have been developed in an agile fashion, with recurring end user tests and reviews to continually refine the tool, the model and the ISO mappings. This process is allowing for continual improvement and evolution to meet the community's needs.

  20. Making Health Easier: Worksite Wellness in Minnesota PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    When firefighters in Minnesota discovered that over 50 percent of firefighter deaths were cardiovascular-related, they decided to implement healthy changes in the workplace. The firefighters now manage a garden near the fire station and eat fresh broccoli, squash, and tomatoes between shifts.

  1. Making Health Easier: Healthy Schools in Minnesota PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-05

    To bring healthier meals to students at the Dover-Eyota elementary school in Minnesota, school officials and parents started a partnership with local farmers. The farm-to-school program has brought better food, like watermelon and corn on the cob, to the children while building ties within the community.  Created: 6/5/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/5/2013.

  2. Making Health Easier: Worksite Wellness in Minnesota PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-06-04

    When firefighters in Minnesota discovered that over 50 percent of firefighter deaths were cardiovascular-related, they decided to implement healthy changes in the workplace. The firefighters now manage a garden near the fire station and eat fresh broccoli, squash, and tomatoes between shifts.  Created: 6/4/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/4/2013.

  3. Making Health Easier: Active Living in Los Angeles, CA

    Centers for Disease Control (CDC) Podcasts

    2013-03-05

    Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. This podcast highlights one preschool teacher who teaches kids about active living and is incorporating small, healthy changes that can be made in any classroom—like teaching fun dances and yoga classes.  Created: 3/5/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/5/2013.

  4. Making Health Easier: Healthy Eating in Los Angeles, CA

    Centers for Disease Control (CDC) Podcasts

    2013-03-05

    Childhood obesity now affects about one in six kids and disproportionately affects low-income and minority populations. This podcast highlights one preschool teacher who teaches kids about healthy eating and is incorporating small, healthy changes that can be made in any classroom—like planting a classroom garden and eating healthy snacks.  Created: 3/5/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 3/5/2013.

  5. The impact of regional culture on intensive care end of life decision making: an Israeli perspective from the ETHICUS study.

    Science.gov (United States)

    Ganz, F D; Benbenishty, J; Hersch, M; Fischer, A; Gurman, G; Sprung, C L

    2006-04-01

    Decisions of patients, families, and health care providers about medical care at the end of life depend on many factors, including the societal culture. A pan-European study was conducted to determine the frequency and types of end of life practices in European intensive care units (ICUs), including those in Israel. Several results of the Israeli subsample were different to those of the overall sample. The objective of this article was to explore these differences and provide a possible explanation based on the impact of culture on end of life decision making. All adult patients admitted consecutively to three Israeli ICUs (n = 2778) who died or underwent any limitation of life saving interventions between 1 January 1999 and 30 June 2000 were studied prospectively (n = 363). These patients were compared with a similar sample taken from the larger study (ethics in European intensive care units: ETHICUS) carried out in 37 European ICUs. Patients were followed until discharge, death, or 2 months from the decision to limit therapy. End of life decisions were prospectively organised into one of five mutually exclusive categories: cardiopulmonary resuscitation (CPR), brain death, withholding treatment, withdrawing treatment, and active shortening of the dying process (SDP). The data also included patient characteristics (gender, age, ICU admission diagnosis, chronic disorders, date of hospital admission, date and time of decision to limit therapy, date of hospital discharge, date and time of death in hospital), specific therapies limited, and the method of SDP. The majority of patients (n = 252, 69%) had treatment withheld, none underwent SDP, 62 received CPR (17%), 31 had brain death (9%), and 18 underwent withdrawal of treatment (5%). The primary reason given for limiting treatment was that the patient was unresponsive to therapy (n = 187). End of life discussions were held with 132 families (36%), the vast majority of which revolved around withholding treatment (91

  6. Roman concept of mental capacity to make end-of-life decisions.

    Science.gov (United States)

    Mendelson, Danuta

    2007-01-01

    When assessing decisional competence of patients, psychiatrists have to balance the patients' right to personal autonomy, their condition and wishes against principles of medical ethics and professional discretion. This article explores the age-old legal and ethical dilemmas posed by refusal of vital medical treatment by patients and their mental capacity to make end-of-life decisions against the background of philosophical, legal and medical approaches to these issues in the time of the Younger Pliny (c62-c113 CE). Classical Roman discourse regarding mental competency and "voluntary death" formed an important theme of the vast corpus of Greco-Roman writings, which was moulded not only by legal permissibility of suicide but also by philosophical (in modern terms, moral or ethical) considerations. Indeed, the legal and ethical issues of evaluating the acceptability of end of life decisions discussed in the Letters are as pertinent today as they were 2000 years ago. We may gain valuable insights about our own methodologies and frames of reference in this area of the law and psychiatry by examining Classical Roman approaches to evaluating acceptability of death-choices as described in Pliny's Letters and the writings of some of his peers.

  7. Work-life Balance Decision-making of Norwegian Students: Implications for Human Resources Management

    Directory of Open Access Journals (Sweden)

    Remigiusz Gawlik

    2016-12-01

    Full Text Available Objective: The paper aims at identifying and assessing the significance of work-life balance determinants between the Youth of highly developed societies and its implications for human resources management on the example of Norway. Research Design & Methods: The research target group consists of 236 respondents recruited among Norwegian tertiary education students. It employed literature analysis, two-stage exploratory research: direct individual in-depth interviews, survey based on a self-administered, web-based questionnaire with single-answer, limited choice qualitative & quantitative, as well as explanatory research (informal moderated group discussions. Findings: The research on perceptions of determinants of quality of life and attractiveness of life strategies shows that in a country with relatively high socio-economic development level, such as Norway, differences in rankings do exist. They can be observed in relevance to both material and non-material QoL determinants. Implications & Recommendations: The study revealed a need for deeper research on individually driven early decision-making of future employees and entrepreneurs. This will result in closer modelling of socio-economic phenomena, including more accurate adaptation to trends on the labour market and creation of new business models. Contribution & Value Added: Research value added comes from the comparison of perceptions of quality of life determinants between countries at various stages of socio-economic development and its implications for human resource management.

  8. Seeking and Accepting: U.S. Clergy Theological and Moral Perspectives Informing Decision Making at the End of Life.

    Science.gov (United States)

    Sanders, Justin J; Chow, Vinca; Enzinger, Andrea C; Lam, Tai-Chung; Smith, Patrick T; Quiñones, Rebecca; Baccari, Andrew; Philbrick, Sarah; White-Hammond, Gloria; Peteet, John; Balboni, Tracy A; Balboni, Michael J

    2017-10-01

    People with serious illness frequently rely on religion/spirituality to cope with their diagnosis, with potentially positive and negative consequences. Clergy are uniquely positioned to help patients consider medical decisions at or near the end of life within a religious/spiritual framework. We aimed to examine clergy knowledge of end-of-life (EOL) care and beliefs about the role of faith in EOL decision making for patients with serious illness. Key informant interviews, focus groups, and survey. A purposive sample of 35 active clergy in five U.S. states as part of the National Clergy End-of-Life Project. We assessed participant knowledge of and desire for further education about EOL care. We transcribed interviews and focus groups for the purpose of qualitative analysis. Clergy had poor knowledge of EOL care; 75% desired more EOL training. Qualitative analysis revealed a theological framework for decision making in serious illness that balances seeking life and accepting death. Clergy viewed comfort-focused treatments as consistent with their faith traditions' views of a good death. They employed a moral framework to determine the appropriateness of EOL decisions, which weighs the impact of multiple factors and upholds the importance of God-given free will. They viewed EOL care choices to be the primary prerogative of patients and families. Clergy described ambivalence about and a passive approach to counseling congregants about decision making despite having defined beliefs regarding EOL care. Poor knowledge of EOL care may lead clergy to passively enable congregants with serious illness to pursue potentially nonbeneficial treatments that are associated with increased suffering.

  9. Como tornar os termos de consentimento mais fáceis de ler? How to make consent forms easier to read?

    Directory of Open Access Journals (Sweden)

    Diego Vinicius Pacheco de Araujo

    2010-01-01

    : Quantitative cross sectional study with 399 subjects. The sample was intentional, selected from different outpatient care units of HCFMUSP. Data collection used an instrument that contained a text with prose compatible for assessment of reading skills needed for comprehension of the consent form. Results. More than 46.6% of the interviewees were classified as functionally illiterate, of these, 12.7% were even unable to understand the proposed task in the text they read . Nevertheless , nearly 50% of the interviewees reported having at least started high school . CONCLUSION: The results and the orientations for the text writing centered on the reader allowed us to make recommendations to render the consent form easier to read . We recommend that the researcher modifies the text to a structural narrative, addressed to the reader, using terms that are familiar., In other words, with terms common to the subjects' and to the medical language. In addition to improving the relationship between the subject and researcher, it is believed that these recommendations may reduce the time taken for the proceeding of research projects, since problems in the wording of consent forms contribute significantly to project delays.

  10. The legal guardians' dilemma: Decision making associated with invasive non-life-saving procedures

    Science.gov (United States)

    2012-01-01

    Background ICU patients frequently undergo non-life-saving invasive procedures. When patient informed consent cannot be obtained, legal guardianship (LG), often from a close relative, may be required by law. The objective of this cohort study was to investigate the attitudes of LGs of ICU patients regarding the process of decision making for invasive non-life-saving procedures. Methods The study was conducted from May 2009 until June 2010 in general medical/surgical ICUs in two large Israeli medical centers. All 64 LGs who met the study criteria agreed to participate in the study. Three questionnaires were administered: a demographic data questionnaire, the Family Satisfaction with ICU 34 Questionnaire, and the Attitudes towards the LG Decision Making Process questionnaire, developed by the authors. Results The sample consisted of 64 LGs. Most participants were married (n = 56, 87.5%), male (n = 33, 51.6%), who had either a high school (n = 24, 37.5%) or college (n = 19, 29.7%) education, and were at a mean age of 49.2 (±11.22). Almost all of the procedures performed were tracheotomies (n = 63, 98.4%). About two-thirds of the LGs preferred decisions to be made by the medical staff after discussing options with them (n = 42, 65.6%) and about three-fifths stated that decisions could be made without the need for the appointment of an LG (n = 37, 57.8%). Attitudes towards ease of obtaining information and honesty of information were more positive compared to those of consistency and understanding of information. Conclusions The legal guardianship process requires better communication and more understandable information in order to assist LGs in making decisions for others in at times vague and stressful situations. PMID:23006738

  11. Influence of institutional culture and policies on do-not-resuscitate decision making at the end of life.

    Science.gov (United States)

    Dzeng, Elizabeth; Colaianni, Alessandra; Roland, Martin; Chander, Geetanjali; Smith, Thomas J; Kelly, Michael P; Barclay, Stephen; Levine, David

    2015-05-01

    Controversy exists regarding whether the decision to pursue a do-not-resuscitate (DNR) order should be grounded in an ethic of patient autonomy or in the obligation to act in the patient's best interest (beneficence). To explore how physicians' approaches to DNR decision making at the end of life are shaped by institutional cultures and policies surrounding patient autonomy. We performed semistructured in-depth qualitative interviews of 58 internal medicine physicians from 4 academic medical centers (3 in the United States and 1 in the United Kingdom) by years of experience and medical subspecialty from March 7, 2013, through January 8, 2014. Hospitals were selected based on expected differences in hospital culture and variations in hospital policies regarding prioritization of autonomy vs best interest. This study identified the key influences of institutional culture and policies on physicians' attitudes toward patient autonomy in DNR decision making at the end of life. A hospital's prioritization of autonomy vs best interest as reflected in institutional culture and policy appeared to influence the way that physician trainees conceptualized patient autonomy. This finding may have influenced the degree of choice and recommendations physician trainees were willing to offer regarding DNR decision making. Trainees at hospitals where policies and culture prioritized autonomy-focused approaches appeared to have an unreflective deference to autonomy and felt compelled to offer the choice of resuscitation neutrally in all situations regardless of whether they believed resuscitation to be clinically appropriate. In contrast, trainees at hospitals where policies and culture prioritized best-interest-focused approaches appeared to be more comfortable recommending against resuscitation in situations where survival was unlikely. Experienced physicians at all sites similarly did not exclusively allow their actions to be defined by policies and institutional culture and were

  12. Advance care planning and end-of-life decision making in dialysis: a randomized controlled trial targeting patients and their surrogates.

    Science.gov (United States)

    Song, Mi-Kyung; Ward, Sandra E; Fine, Jason P; Hanson, Laura C; Lin, Feng-Chang; Hladik, Gerald A; Hamilton, Jill B; Bridgman, Jessica C

    2015-11-01

    Few trials have examined long-term outcomes of advance care planning (ACP) interventions. We examined the efficacy of an ACP intervention on preparation for end-of-life decision making for dialysis patients and surrogates and for surrogates' bereavement outcomes. A randomized trial compared an ACP intervention (Sharing Patient's Illness Representations to Increase Trust [SPIRIT]) to usual care alone, with blinded outcome assessments. 420 participants (210 dyads of prevalent dialysis patients and their surrogates) from 20 dialysis centers. Every dyad received usual care. Those randomly assigned to SPIRIT had an in-depth ACP discussion at the center and a follow-up session at home 2 weeks later. preparation for end-of-life decision making, assessed for 12 months, included dyad congruence on goals of care at end of life, patient decisional conflict, surrogate decision-making confidence, and a composite of congruence and surrogate decision-making confidence. bereavement outcomes, assessed for 6 months, included anxiety, depression, and posttraumatic distress symptoms completed by surrogates after patient death. adjusting for time and baseline values, dyad congruence (OR, 1.89; 95% CI, 1.1-3.3), surrogate decision-making confidence (β=0.13; 95% CI, 0.01-0.24), and the composite (OR, 1.82; 95% CI, 1.0-3.2) were better in SPIRIT than controls, but patient decisional conflict did not differ between groups (β=-0.01; 95% CI, -0.12 to 0.10). 45 patients died during the study. Surrogates in SPIRIT had less anxiety (β=-1.13; 95% CI, -2.23 to -0.03), depression (β=-2.54; 95% CI, -4.34 to -0.74), and posttraumatic distress (β=-5.75; 95% CI, -10.9 to -0.64) than controls. Study was conducted in a single US region. SPIRIT was associated with improvements in dyad preparation for end-of-life decision making and surrogate bereavement outcomes. Copyright © 2015 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

  13. Contributions of the Life Course Perspective to Research on Food Decision Making

    Science.gov (United States)

    Johnson-Askew, Wendy L.

    2012-01-01

    Background The life course perspective (LCP) has emerged as a powerful organizing framework for the study of health, illness, and mortality. LCP represents a “whole life” analysis perspective which originated in the field of sociology. Methods Its concepts are increasingly applied to understanding the development of chronic disease over long periods of time in the human life span. A missing link, however, in the adaptation of the LCP to health research, is the insight the LCP may offer into understanding the societal, social network, and family contexts that frame stability and change in dietary behavior. Results This paper reviews key concepts that comprise the LCP but primarily focuses on applications that have relevance to food decision making in social context. A case study of chronic work–family stress and perceived time scarcity as barriers to dietary improvement is included. Conclusion Illustrative findings are presented on dietary behavior in a diverse sample of lower-income working parents. This paper also offers ideas on increasing the contributions of the LCP to nutritional research. PMID:19890684

  14. Encompassing the Work-Life Balance into Early Career Decision-Making of Future Employees Through the Analytic Hierarchy Process

    OpenAIRE

    Gawlik, Remigiusz

    2016-01-01

    The paper presents the results of ranking of the significance of quality of life determinants by University students that are starting professional activities. Research methodology: literature review; elaboration of an AHP decision-making model; two-stage expert selection; significance rankings by experts and a graphical and descriptive presentation of obtained results. Research sample: 14 experts out of almost 200 University students. Research outcome: a decision-making model that aims at ma...

  15. Understanding Exercise, Diet and Lung Disease

    Science.gov (United States)

    ... prepared foods or take-out meals from a restaurant can make your life easier. Remember, the sugar, ... dietitian (RD) A specialist in nutrition and food selection who is certified by the American Dietetic Association ( ...

  16. Informed decision making does not affect health-related quality of life in lung cancer screening (NELSON trial)

    NARCIS (Netherlands)

    van den Bergh, Karien A. M.; Essink-Bot, Marie-Louise; van Klaveren, Rob J.; de Koning, Harry J.

    2010-01-01

    Background: It is believed that making an informed decision about (screening) participation is associated with better health-related quality of life (HRQoL) outcomes. This is the first study in cancer screening to explore this association in subjects participating in a lung cancer computed

  17. [Decision-making processes in nursing and activities at the end of life in intensive care–An international comparative study].

    Science.gov (United States)

    Kohlen, Helen; McCarthy, Joan; Szylit Buosso, Regina; Gallagher, Ann; Andrews, Tom

    2015-12-01

    Intensive care units (ICUs) are traditionally settings that offer high technologically advanced treatment for those who are in critical situations due to an illness or accident. Questions regarding the withdrawal and withholding as well as the ending of life sustaining treatment are related to ethical dilemmas. Nurses’ decision-making processes and nursing activities in different countries are scarcely studied. Which end-of-life decision-making processes and activities that are performed by nurses can be identified and described? The objective is the identification of a nursing terrain regarding decision-making and activities in patient end-of-life care on the intensive care unit. Semi-structured interviews were conducted with 51 experienced nurses in university or hospital premises: 10 in Brazil, 9 in England, 10 in Germany, 10 in Ireland and 12 nurses in Palestine. The study used grounded theory to inform data collection and analysis. The finding of the study is the identification of a dynamic process in which activities with a focus on cure shift to activities with a focus on end-of-life care. The core category that emerged was ’negotiated reorienting’: The shift of activities implies negotiations between nurses and physicians, relatives as well as with oneself. Moreover the process is characterized by a constant re-orientation that is induced by changing patient data and the realisation of the whole situation. Nurses’ core practices are ’consensus seeking’ and ’emotional holding’ (sub-categories). In all countries a nursing terrain of activities in end-of-life care could be identified and described. However, it is unclear whether nursing activities connected to relatives of the patient are dominant in such a way that relations to dying patients and respect for their autonomy are put into the background. A field study could give answers to this question possible.

  18. eMovie: a storyboard-based tool for making molecular movies.

    Science.gov (United States)

    Hodis, Eran; Schreiber, Gideon; Rother, Kristian; Sussman, Joel L

    2007-05-01

    The 3D structures of macromolecules are difficult to grasp and also to communicate. By their nature, movies or animations are particularly useful for highlighting key features by offering a 'guided tour' of structures and conformation changes. However, high-quality movies are rarely seen because they are currently difficult and time consuming to make. By adopting the traditional movie 'storyboard' concept, which gives guidance and direction to filming, eMovie makes the creation of lengthy molecular animations much easier. This tool is a plug-in for the open-source molecular graphics program PyMOL, and enables experts and novices alike to produce informative and high-quality molecular animations.

  19. Situational and Age-Dependent Decision Making during Life Threatening Distress in Myotis macrodactylus.

    Directory of Open Access Journals (Sweden)

    Xiaobin Huang

    Full Text Available Echolocation and audiovocal communication have been studied extensively in bats. The manner in which these abilities are incorporated within escape behaviors during life-threatening distress is largely unknown. Here we tested the hypothesis that behavioral response profiles expressed during distress are relatively stereotypic given their evolutionary adaptations to avoid predators. We subjected juvenile and adult big-footed myotis (Myotis macrodactylus to a sequence of three types of life threatening distress: 1 trapping them in a mist-net (environmental threat, 2 approaching them when trapped (predator threat, and 3 partially restraining their freedom to move (arrest, and recorded their escape behavior in each of the three conditions. Response profiles differed across individuals and with the context in which they were expressed. During environmental and predator threat, bats displayed significantly more biting and wing-flapping behaviors and emitted more echolocation pulses than during arrest. Response profiles also varied with age. During arrest, juveniles were more likely than adults to emit distress calls and vice-versa for biting and wing flapping during environmental and predator threat. Overall, individualized response profiles were classified into ten clusters that were aligned along two divergent response trajectories when viewed within two-dimensional, multifactorial decision space. Juvenile behaviors tended to follow a predominantly "social-dependence" trajectory, whereas adult behaviors were mostly aligned along a "self-reliance" trajectory. We conclude that bats modify their vocal behavior and make age-appropriate and contextually adaptive decisions when distressed. This decision-making ability is consistent with observations in other social species, including humans.

  20. Patient involvement in the decision-making process improves satisfaction and quality of life in postmastectomy breast reconstruction.

    Science.gov (United States)

    Ashraf, Azra A; Colakoglu, Salih; Nguyen, John T; Anastasopulos, Alexandra J; Ibrahim, Ahmed M S; Yueh, Janet H; Lin, Samuel J; Tobias, Adam M; Lee, Bernard T

    2013-09-01

    The patient-physician relationship has evolved from the paternalistic, physician-dominant model to the shared-decision-making and informed-consumerist model. The level of patient involvement in this decision-making process can potentially influence patient satisfaction and quality of life. In this study, patient-physician decision models are evaluated in patients undergoing postmastectomy breast reconstruction. All women who underwent breast reconstruction at an academic hospital from 1999-2007 were identified. Patients meeting inclusion criteria were mailed questionnaires at a minimum of 1 y postoperatively with questions about decision making, satisfaction, and quality of life. There were 707 women eligible for our study and 465 completed surveys (68% response rate). Patients were divided into one of three groups: paternalistic (n = 18), informed-consumerist (n = 307), shared (n = 140). There were differences in overall general satisfaction (P = 0.034), specifically comparing the informed group to the paternalistic group (66.7% versus 38.9%, P = 0.020) and the shared to the paternalistic group (69.3% versus 38.9%, P = 0.016). There were no differences in aesthetic satisfaction. There were differences found in the SF-12 physical component summary score across all groups (P = 0.033), and a difference was found between the informed and paternalistic groups (P mental component score (P = 0.42). Women undergoing breast reconstruction predominantly used the informed model of decision making. Patients who adopted a more active role, whether using an informed or shared approach, had higher general patient satisfaction and physical component summary scores compared with patients whose decision making was paternalistic. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. A survey of views and practice patterns of dialysis medical directors toward end-of-life decision making for patients with end-stage renal disease.

    Science.gov (United States)

    Fung, Enrica; Slesnick, Nate; Kurella Tamura, Manjula; Schiller, Brigitte

    2016-07-01

    Patients with end-stage renal disease report infrequent end-of-life discussions, and nephrology trainees report feeling unprepared for end-of-life decision making, but the views of dialysis medical directors have not been studied. Our objective is to understand dialysis medical directors' views and practice patterns on end-of-life decision making for patients with ESRD. We administered questionnaires to dialysis medical directors during medical director meetings of three different dialysis organizations in 2013. Survey questions corresponded to recommendations from the Renal Physicians Association clinical practice guidelines on initiation and withdrawal of dialysis. There were 121 medical director respondents from 28 states. The majority of respondents felt "very prepared" (66%) or "somewhat prepared" (29%) to participate in end-of-life decisions and most (80%) endorsed a model of shared decision making. If asked to do so, 70% of the respondents provided prognostic information "often" or "nearly always." For patients with a poor prognosis, 36% of respondents would offer a time-limited trial of dialysis "often" or "nearly always", while 56% of respondents would suggest withdrawal from dialysis "often" or "nearly always" for those with a poor prognosis currently receiving dialysis therapy. Patient resistance and fear of taking away hope were the most commonly cited barriers to end-of-life discussions. Views and reported practice patterns of medical directors are consistent with clinical practice guidelines for end-of-life decision making for patients with end-stage renal disease but inconsistent with patient perceptions. © The Author(s) 2016.

  2. Communication Tools for End-of-Life Decision-Making in Ambulatory Care Settings: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Oczkowski, Simon J; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-01-01

    Patients with serious illness, and their families, state that better communication and decision-making with healthcare providers is a high priority to improve the quality of end-of-life care. Numerous communication tools to assist patients, family members, and clinicians in end-of-life decision-making have been published, but their effectiveness remains unclear. To determine, amongst adults in ambulatory care settings, the effect of structured communication tools for end-of-life decision-making on completion of advance care planning. We searched for relevant randomized controlled trials (RCTs) or non-randomized intervention studies in MEDLINE, EMBASE, CINAHL, ERIC, and the Cochrane Database of Randomized Controlled Trials from database inception until July 2014. Two reviewers independently screened articles for eligibility, extracted data, and assessed risk of bias. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the quality of evidence for each of the primary and secondary outcomes. Sixty-seven studies, including 46 RCTs, were found. The majority evaluated communication tools in older patients (age >50) with no specific medical condition, but many specifically evaluated populations with cancer, lung, heart, neurologic, or renal disease. Most studies compared the use of communication tools against usual care, but several compared the tools to less-intensive advance care planning tools. The use of structured communication tools increased: the frequency of advance care planning discussions/discussions about advance directives (RR 2.31, 95% CI 1.25-4.26, p = 0.007, low quality evidence) and the completion of advance directives (ADs) (RR 1.92, 95% CI 1.43-2.59, pcare desired and care received by patients (RR 1.17, 95% CI 1.05-1.30, p = 0.004, low quality evidence, 2 RCTs). The use of structured communication tools may increase the frequency of discussions about and completion of advance directives, and concordance between

  3. Virtual Place Value

    Science.gov (United States)

    Burris, Justin T.

    2013-01-01

    Technology permeates every aspect of daily life, from the sensors that control the traffic signals to the cameras that allow real-time video chats with family around the world. At times, technology may make life easier, faster, and more productive. However, does technology do the same in schools and classrooms? Will the benefits of technology…

  4. Optimizing medical device buying. Value analysis models can help you improve decision-making process.

    Science.gov (United States)

    Feldstein, Josh; Brooks, Elizabeth

    2010-05-01

    Value Analysis Models (VAMs) are a burgeoning analytical tool that can help materials managers, operating room managers, CFOs and others to make comparative value assessments before reaching a critical purchasing decision. Although relatively new to the hospital field, more and more manufacturers are supporting these initiatives to bring critical information to their customers and the health care industry. VAMs aren't designed to conclude that one product is better than another but to be a tool that can help make the product acquisition process much easier.

  5. A Structured Approach to End-of-Life Decision Making Improves Quality of Care for Patients With Terminal Illness in a Teaching Hospital in Ghana.

    Science.gov (United States)

    Edwin, Ama Kyerewaa; Johnson McGee, Summer; Opare-Lokko, Edwina Addo; Gyakobo, Mawuli Kotope

    2016-03-01

    To determine whether a structured approach to end-of-life decision-making directed by a compassionate interdisciplinary team would improve the quality of care for patients with terminal illness in a teaching hospital in Ghana. A retrospective analysis was done for 20 patients who consented to participate in the structured approach to end-of-life decision-making. Twenty patients whose care did not follow the structured approach were selected as controls. Outcome measures were nociceptive pain control, completing relationships, and emotional response towards dying. These measures were statistically superior in the study group compared to the control group. A structured approach to end-of-life decision-making significantly improves the quality of care for patients with terminal illness in the domains of pain control, completing relationships and emotional responses towards dying. © The Author(s) 2014.

  6. Decision making across the life span

    NARCIS (Netherlands)

    Li, S.C.; Ridderinkhof, K.R.; Samanez-Larkin, G.R.

    2014-01-01

    Learning to choose adaptively between different behavioral options in order to reach goals is a pervasive task in life for people of all ages. Individuals are often confronted with complex, uncertain situations that nonetheless require decisive actions that would facilitate the pursuit of short-term

  7. Shared decision-making at the end of life: A focus group study exploring the perceptions and experiences of multi-disciplinary healthcare professionals working in the home setting.

    Science.gov (United States)

    Brogan, Paula; Hasson, Felicity; McIlfatrick, Sonja

    2018-01-01

    Globally recommended in healthcare policy, Shared Decision-Making is also central to international policy promoting community palliative care. Yet realities of implementation by multi-disciplinary healthcare professionals who provide end-of-life care in the home are unclear. To explore multi-disciplinary healthcare professionals' perceptions and experiences of Shared Decision-Making at end of life in the home. Qualitative design using focus groups, transcribed verbatim and analysed thematically. A total of 43 participants, from multi-disciplinary community-based services in one region of the United Kingdom, were recruited. While the rhetoric of Shared Decision-Making was recognised, its implementation was impacted by several interconnecting factors, including (1) conceptual confusion regarding Shared Decision-Making, (2) uncertainty in the process and (3) organisational factors which impeded Shared Decision-Making. Multiple interacting factors influence implementation of Shared Decision-Making by professionals working in complex community settings at the end of life. Moving from rhetoric to reality requires future work exploring the realities of Shared Decision-Making practice at individual, process and systems levels.

  8. Computers make rig life extension an option

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    The worldwide semisubmersible drilling rig fleet is approaching retirement. But replacement is not an attractive option even though dayrates are reaching record highs. In 1991, Schlumberger Sedco Forex managers decided that an alternative might exist if regulators and insurers could be convinced to extend rig life expectancy through restoration. Sedco Forex chose their No. 704 semisubmersible, an 18-year North Sea veteran, to test their process. The first step was to determine what required restoration, meaning fatigue life analysis of each weld on the huge vessel. If inspected, the task would be unacceptably time-consuming and of questionable accuracy. Instead a suite of computer programs modeled the stress seen by each weld, statistically estimated the sea states seen by the rig throughout its North Sea service and calibrated a beam-element model on which to run their computer simulations. The elastic stiffness of the structure and detailed stress analysis of each weld was performed with ANSYS, a commercially available finite-element analysis program. The use of computer codes to evaluate service life extension is described.

  9. Exploiting Software Tool Towards Easier Use And Higher Efficiency

    Science.gov (United States)

    Lin, G. H.; Su, J. T.; Deng, Y. Y.

    2006-08-01

    In developing countries, using data based on instrument made by themselves in maximum extent is very important. It is not only related to maximizing science returns upon prophase investment -- deep accumulations in every aspects but also science output. Based on the idea, we are exploiting a software (called THDP: Tool of Huairou Data Processing). It is used for processing a series of issues, which is met necessary in processing data. This paper discusses its designed purpose, functions, method and specialities. The primary vehicle for general data interpretation is through various techniques of data visualization, techniques of interactive. In the software, we employed Object Oriented approach. It is appropriate to the vehicle. it is imperative that the approach provide not only function, but do so in as convenient a fashion as possible. As result of the software exploiting, it is not only easier to learn data processing for beginner and more convenienter to need further improvement for senior but also increase greatly efficiency in every phrases include analyse, parameter adjusting, result display. Under frame of virtual observatory, for developing countries, we should study more and newer related technologies, which can advance ability and efficiency in science research, like the software we are developing

  10. Communication tools for end-of-life decision-making in the intensive care unit: a systematic review and meta-analysis.

    Science.gov (United States)

    Oczkowski, Simon J W; Chung, Han-Oh; Hanvey, Louise; Mbuagbaw, Lawrence; You, John J

    2016-04-09

    For many patients admitted to the intensive care unit (ICU), preferences for end-of-life care are unknown, and clinicians and substitute decision-makers are required to make decisions about the goals of care on their behalf. We conducted a systematic review to determine the effect of structured communication tools for end-of-life decision-making, compared to usual care, upon the number of documented goals of care discussions, documented code status, and decisions to withdraw life-sustaining treatments, in adult patients admitted to the ICU. We searched multiple databases including MEDLINE, Embase, CINAHL, ERIC, and Cochrane from database inception until July 2014. Two reviewers independently screened articles, assessed eligibility, verified data extraction, and assessed risk of bias using the tool described by the Cochrane Collaboration and the Newcastle Ottawa Scale. Pooled estimates of effect (relative risk, standardized mean difference, or mean difference), were calculated where sufficient data existed. GRADE was used to evaluate the overall quality of evidence for each outcome. We screened 5785 abstracts and reviewed the full text of 424 articles, finding 168 eligible articles, including 19 studies in the ICU setting. The use of communication tools increased documentation of goals-of-care discussions (RR 3.47, 95% CI 1.55, 7.75, p = 0.020, very low-quality evidence), but did not have an effect on code status documentation (RR 1.03, 95% CI 0.96, 1.10, p = 0.540, low-quality evidence) or decisions to withdraw or withhold life-sustaining treatments (RR 0.98, 95% CI 0.89, 1.08, p = 0.70, low-quality evidence). The use of such tools was associated with a decrease in multiple measures of health care resource utilization, including duration of mechanical ventilation (MD -1.9 days, 95% CI -3.26, -0.54, p = 0.006, very low-quality evidence), length of ICU stay (MD -1.11 days, 95% CI -2.18, -0.03, p = 0.04, very low-quality evidence), and health care costs (SMD -0.32, 95

  11. Process Fragment Libraries for Easier and Faster Development of Process-based Applications

    Directory of Open Access Journals (Sweden)

    David Schumm

    2011-01-01

    Full Text Available The term “process fragment” is recently gaining momentum in business process management research. We understand a process fragment as a connected and reusable process structure, which has relaxed completeness and consistency criteria compared to executable processes. We claim that process fragments allow for an easier and faster development of process-based applications. As evidence to this claim we present a process fragment concept and show a sample collection of concrete, real-world process fragments. We present advanced application scenarios for using such fragments in development of process-based applications. Process fragments are typically managed in a repository, forming a process fragment library. On top of a process fragment library from previous work, we discuss the potential impact of using process fragment libraries in cross-enterprise collaboration and application integration.

  12. Steam explosions of molten iron oxide drops: easier initiation at small pressurizations

    International Nuclear Information System (INIS)

    Nelson, L.S.; Duda, P.M.

    1982-01-01

    Steam explosions caused by hot molten materials contacting liquid water following a possible light water nuclear reactor core overheat have been investigated by releasing single drops of a core melt simulant, molten iron oxide, into liquid water. Small steam explosions were triggered shortly afterwards by applying a pressure pulse to the water. The threshold peak pulse level above which an explosion always occurs was studied at ambient pressures between 0.083 and 1.12 MPa. It was found that the threshold decreased to a minimum in the range 0.2 - 0.8 MPa and then increased again. The effect of easier initiation as ambient pressure increases may have an important role in the triggering and propagation of a large scale steam explosion through a coarsely premixed dispersion of melt in water. (U.K.)

  13. A grey-based group decision-making methodology for the selection of hydrogen technologiess in Life Cycle Sustainability perspective

    DEFF Research Database (Denmark)

    Manzardo, Alessandro; Ren, Jingzheng; Mazzi, Anna

    2012-01-01

    The objective of this research is to develop a grey-based group decision-making methodology for the selection of the best renewable energy technology (including hydrogen) using a life cycle sustainability perspective. The traditional grey relational analysis has been modified to better address...... the issue of uncertainty. The proposed methodology allows multi-person to participate in the decision-making process and to give linguistic evaluation on the weights of the criteria and the performance of the alternative technologies. In this paper, twelve hydrogen production technologies have been assessed...... using the proposed methodology, electrolysis of water technology by hydropower has been considered to be the best technology for hydrogen production according to the decision-making group....

  14. Development of a support system to make economic and technical assessments for the issues relating to plant life extension

    International Nuclear Information System (INIS)

    Takao, T.; Soneda, N.; Sakai, T.

    1994-01-01

    To realize the life extension of nuclear power plants, overall evaluation for the plant is required, which covers technology, economy such as cost of repair or/and replacement of components, and regal regulations for licensing. A prototype of integrated assessment support system for life extension ''INPLEX'' have developed in order to evaluate the technical and economic issues relating to the plant life extension and to make a life extension scenario. Analysis procedure of INPLEX is as follows. A comparison of the cost between the life extension and the reconstruction is made to see whether the life extension is cost effective or not. Next, components required detailed assessments are selected, and the residual life assessment of these components are made. After those procedures life extension measures are selected and the implementation time schedule is set on the basis of the formulas for predicting the degradation of the components and the component reliability data. Finally the implementation time schedule is optimized from the viewpoint of economy, and the life extension scenario is proposed. INPLEX also has the data base ''PRINS'', in which information and data related to life extension are registered, such as component degradation experiences, degradation management methodologies, degradation mitigation measures, and so on. PRINS can be referred at any time during the operation of INPLEX

  15. New Technologies Changing Our Lives

    Indian Academy of Sciences (India)

    20026

    2017-11-03

    Nov 3, 2017 ... creating new industry giants at the cost of old businesses. ○ Start-ups in every area such as Edtech, Fintech, healthcare and entertainment are disrupting ... Making connections is easier, life is more isolated. ○ Cyber security ...

  16. Integrating adolescent girls' voices on sexual decision making in the Life Orientation Sexuality Education Programme / Ronél Koch

    OpenAIRE

    Koch, Ronél

    2012-01-01

    The aim of this research study was to find out how adolescent girls engage in the process of sexual decision making in order to make recommendations for the development and presentation of the current Life Orientation Sexuality Education Programme in South African schools. As the results of this study are aimed at providing guidelines for the development and presentation of this specific programme, a qualitative interpretive descriptive research design was used, because this type of research ...

  17. Making Health Easier: Healthy Schools in Chicago, IL PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-05-21

    To help Chicago schools increase access to healthy food, Health Educator April Lillstrom utilized community partnerships to provide school gardens, salad bars, and nutrition education to students.  Created: 5/21/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/21/2013.

  18. Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

    Directory of Open Access Journals (Sweden)

    Javier Sola-Vera

    2014-01-01

    Full Text Available Background: Cholangioscopy is a useful tool for the study and treatment of biliary pathology. Ultrathin upper endoscopes allow direct peroral cholangioscopy (DPC but have some drawbacks. Objective: The aim of the study was to evaluate the success rate of DPC with an ultrathin endoscope using a balloon catheter to reach the biliary confluence. Material and methods: Prospective observational study. An ultrathin endoscope (Olympus XP180N, outer diameter 5.5 mm, working channel 2 mm was used. To access the biliary tree, free-hand technique was used. To reach the biliary confluence an intraductal balloon catheter (Olympus B5-2Q diameter 1.9 mm and a 0.025 inch guide wire was used. In all cases sphincterotomy and/or sphincteroplasty was performed. The success rate was defined as the percentage of cases in which the biliary confluence could be reached with the ultrathin endoscope. Results: Fifteen patients (8 men/7 women were included. Mean age was 77.7 ± 10.8 years (range 45-91. The indications for cholangioscopy were suspected bile duct stones (n = 9, electrohydraulic lithotripsy for the treatment of difficult choledocholithiasis (n = 5 and evaluation of biliary stricture (n = 1. Access to the bile duct was achieved in 14/15 cases (93.3 %. Biliary confluence was reached in 13/15 cases (86.7 %. One complication was observed in one patient (oxigen desaturation. Conclusions: DPC with an ultrathin endoscope can be done with the free-hand technique. Intraductal balloon-guided DPC allows full examination of the common bile duct in most cases.

  19. On a radioimmunoassay ratio making the diagnosis of dysthyroidism easier

    International Nuclear Information System (INIS)

    Bresson, Y.; Marty, D.; Moullart, V.

    1982-01-01

    The offered ratio is a dimensionless number, independant of kits, or units and usually fluctuates around one. We obtain it by [TBGsub(m)/Tsub(4m)].[T 4 ]/[TBG] and, divided by a constant, it represents the first term of the development in series of the free thyroxin index mathematical expression from which it gives a nearly perfect value. Using this ratio the discrimination between eu- and hyperthyroidism is very apparent as well as the distinction between hypo and euthyroidism. The children from two to fifteen years of age and the women under hormonal contraception treatment show normal value. These results have been confirmed by a statistical investigation including 184 normal subjects, 76 hyperthyroid subjects without treatment, 18 euthyroid women under hormonal contraception treatment and 32 children from birth to fifteen years of age. It is conclued from this statistical investigation that the offered ratio is more accurate and more reliable as a mean of diagnosis than the free thyroxin index when calculated from the T3 uptake test [fr

  20. Young Idea People Mix with Old Idea People to Make the World Better

    Science.gov (United States)

    Hall, M.

    2017-12-01

    Groups of young idea people come to eat, drink, and talk about new ideas that old idea people are working on to change the world for the better. The ideas may fix our body and mind, make our lives easier or harder, and more. The young idea people lead, learn, listen and act, so they can become old idea people. The young idea people scare the old idea people because their ideas are different. And, sometimes, the young idea people have new ideas that the old idea people have not thought about. When this happens it makes the old idea people happy and better at their work. The old idea people get to go places and share their ideas around the world. They make good money and have fun lives. They write about their work and can be well known, or not. The young idea people learn from the old idea people how they can be like them. Together the young and old idea people build things and talk about crazy ideas that may come to be. Sometimes the old idea people talk too much and don't listen. They use big words that can be hard to understand. But, the young idea people help them learn to use known words so everyone learns. We know the young idea people learn and grow from this act and they grow happier about their life. We also know that the old idea people get happy that the young idea people are so bright.

  1. Medical end-of-life decisions in Switzerland 2001 and 2013: Who is involved and how does the decision-making capacity of the patient impact?

    Science.gov (United States)

    Schmid, Margareta; Zellweger, Ueli; Bosshard, Georg; Bopp, Matthias

    2016-01-01

    In Switzerland, the prevalence of medical end-of-life practices had been assessed on a population level only once - in 2001 - until in 2013/14 an identical study was conducted. We aimed to compare the results of the 2001 and 2013 studies with a special focus on shared decision-making and patients' decision-making capacity. Our study encompassed a 21.3% sample of deaths among residents of the German-speaking part of Switzerland aged 1 year or older. From 4998 mailed questionnaires, 3173 (63.5%) were returned. All data were weighted to adjust for age- and sex-specific differences in response rates. Cases with at least one reported end-of-life practice significantly increased from 74.5% (2001) to 82.3% (2013) of all deaths eligible for an end-of-life decision (p Switzerland, there remains potential for further improvement in shared decision-making. Efforts to motivate physicians to involve patients and relatives may be a win-win situation.

  2. Family factors in end-of-life decision-making: family conflict and proxy relationship.

    Science.gov (United States)

    Parks, Susan Mockus; Winter, Laraine; Santana, Abbie J; Parker, Barbara; Diamond, James J; Rose, Molly; Myers, Ronald E

    2011-02-01

    Few studies have examined proxy decision-making regarding end-of-life treatment decisions. Proxy accuracy is defined as whether proxy treatment choices are consistent with the expressed wishes of their index elder. The purpose of this study was to examine proxy accuracy in relation to two family factors that may influence proxy accuracy: perceived family conflict and type of elder-proxy relationship. Telephone interviews with 202 community-dwelling elders and their proxy decision makers were conducted including the Life-Support Preferences Questionnaire (LSPQ), and a measure of family conflict, and sociodemographic characteristics, including type of relationship. Elder-proxy accuracy was associated with the type of elder-proxy relationship. Adult children demonstrated the lowest elder-proxy accuracy and spousal proxies the highest elder-proxy accuracy. Elder-proxy accuracy was associated with family conflict. Proxies reporting higher family conflict had lower elder-proxy accuracy. No interaction between family conflict and relationship type was revealed. Spousal proxies were more accurate in their substituted judgment than adult children, and proxies who perceive higher degree of family conflict tended to be less accurate than those with lower family conflict. Health care providers should be aware of these family factors when discussing advance care planning.

  3. METHOD OF STRATEGIC PLANNING AND MANAGEMENT DECISION-MAKING CONSIDERING THE LIFE CYCLE THEORY

    Directory of Open Access Journals (Sweden)

    Tetiana Kniazieva

    2017-12-01

    are made. Results of the survey are to substantiate the methodology of strategic planning under conditions of external environment uncertainty with the consideration of the life cycle theory. Practical implications: the possibilities of using life-cycle models allow: 1. reasonably predicting sales and plan production program; 2. determining the basic strategies at different stages of development; 3. determining the sequence of stages of enterprise development; 4. ensuring harmonious interaction of organizational characteristics with the external environment factors that influence the process of organizational development. Increasing the sustainability of the organization’s development can be achieved by re-establishment of dynamic changes in the plan in terms of using effective methods for forecasting with the consideration of the life cycle theory. It is necessary to take into account the interconnection between all levels of life cycles: industry, technology, enterprises, product; ensuring the competitive advantage of the organization. Using the theory of optimal solutions making in uncertain conditions under the analysis of long-term projects allows transferring qualitative factors into quantitative indicators that can be used in the future to bring investment projects to the same kind and choose the best. In conditions of increased uncertainty of the external environment, it is necessary to develop the theory of enterprise management, taking into account its life cycle, as well as the life cycle of its separate elements and processes at all levels. Combination of strategic management with the life cycles theory will increase the objectivity and effectiveness of taken management decisions. The accounting of the organization life cycles in strategic planning allows choosing an effective strategy.

  4. There’s a dad for that! : Naming men in work-life balance and entrepreneurial decision-making

    OpenAIRE

    Rice, Joseph; Collinson, David; Gatrell, Caroline

    2017-01-01

    This thesis explores work-family balance in relation to entrepreneurial decision-making using men and masculinities literature as the lens of critical analysis. This research critically examines men’s subjective work-life balance experiences by evaluating their attempts to navigate between their fatherhood and entrepreneurial goals. There has been a flood of research since the introduction of Greenhaus and Beutell’s (1985) sources of conflict between work and family where the central focus is...

  5. Conversion Timing of Seafarer’s Decision-making for Unmanned Ship Navigation

    Directory of Open Access Journals (Sweden)

    Ruolan Zhang

    2017-09-01

    Full Text Available The aim of this study is to construct an unmanned ship swarms monitoring model to improve autonomous decision-making efficiency and safety performance of unmanned ship navigation. A framework is proposed to determine the relationship between on-board decision-making and shore side monitoring, the process of ship data detection, tracking, analysis and loss, and the application of decision-making algorithm, to discuss the different risk responses of specific unmanned ship types under various latent hazard environments, particularly in terms of precise conversion timing in switching over to remote control and full manual monitoring, to ensure safe navigation when the capability of automatic risk response inadequate. This frame-work makes it easier to train data and the adjustment for machine learning based on Bayesian risk prediction. It can be concluded that the automation level can be increased and the workload of shore-based seafarers can be reduced easily.

  6. The Relationship Between Job Satisfaction And Life Satisfaction: Empirical Evidence From Logistics Practitioners In A South African Steel-Making Company

    OpenAIRE

    Chengedzai Mafini

    2014-01-01

    There has been an explosion of research interests centered upon the job satisfaction-life satisfaction nexus within organizations. Be that as it may, there is a relative paucity of research on the job satisfaction of logistics practitioners in general and limited evidence of studies that specifically address the issue of job satisfaction in the steel-making industry in developing countries. The aim of this study was to investigate the structural relationships between job satisfaction and life...

  7. Supporting young people living with cancer to tell their stories in ways that make them stronger: The Beads of Life approach.

    Science.gov (United States)

    Portnoy, Sara; Girling, Isabella; Fredman, Glenda

    2016-04-01

    This article describes the 'Beads of Life' approach--a five-part methodology informed by narrative therapy to enable children and young people to make sense of their cancer journey in ways that make them stronger. Young people are invited to use beads as prompts to tell preferred stories of their identity to create a safe place to stand from which to story their cancer journey. The approach positions young people as experts in their lives. It aims to change their relationship with cancer to reduce its negative impact on life by lessening isolation. By enabling medical staff to get to know the young person apart from the cancer, this approach aims to create hope for the future and improve quality of care. © The Author(s) 2015.

  8. Family factors affect clinician attitudes in pediatric end-of-life decision making: a randomized vignette study.

    Science.gov (United States)

    Ruppe, Michael D; Feudtner, Chris; Hexem, Kari R; Morrison, Wynne E

    2013-05-01

    Conflicts between families and clinicians in pediatric end-of-life (EOL) care cause distress for providers, dissatisfaction for patients' families, and potential suffering for terminally ill children. We hypothesized that family factors might influence clinician decision making in these circumstances. We presented vignettes concerning difficult EOL decision making, randomized for religious objection to therapy withdrawal and perceived level of family involvement, to clinicians working in three Children's Hospital intensive care units. Additionally, attitudes about EOL care were assessed. Three hundred sixty-four respondents completed the questionnaire, for an overall response rate of 54%. Respondents receiving the "involved family" vignette were more likely to agree to continue medical care indefinitely (Pfamilies had nonreligious objections to withdrawal (P=0.05). Respondents who thought that a fear of being sued affected decisions were less likely to pursue unilateral withdrawal (odds ratio 0.8, 95% CI=0.6-0.9). Those who felt personal distress as a result of difficult EOL decision making, thought they often provided "futile" care, or those who felt EOL care was effectively addressed at the institution were less likely to want to defer to the parents' wishes (range of odds ratios 0.7-1). In this randomized vignette study, we have shown that family factors, particularly how involved a family seems to be in a child's life, affect what clinicians think is ethically appropriate in challenging EOL cases. Knowledge of how a family's degree of involvement may affect clinicians should be helpful to the clinical ethics consultants and offer some degree of insight to the clinicians themselves. Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  9. Heuristics: foundations for a novel approach to medical decision making.

    Science.gov (United States)

    Bodemer, Nicolai; Hanoch, Yaniv; Katsikopoulos, Konstantinos V

    2015-03-01

    Medical decision-making is a complex process that often takes place during uncertainty, that is, when knowledge, time, and resources are limited. How can we ensure good decisions? We present research on heuristics-simple rules of thumb-and discuss how medical decision-making can benefit from these tools. We challenge the common view that heuristics are only second-best solutions by showing that they can be more accurate, faster, and easier to apply in comparison to more complex strategies. Using the example of fast-and-frugal decision trees, we illustrate how heuristics can be studied and implemented in the medical context. Finally, we suggest how a heuristic-friendly culture supports the study and application of heuristics as complementary strategies to existing decision rules.

  10. Making the case for talking to patients about the costs of end-of-life care.

    Science.gov (United States)

    Donley, Greer; Danis, Marion

    2011-01-01

    Costs at the end of life disproportionately contribute to health care costs in the United States. Addressing these costs will therefore be an important component in making the U.S. health care system more financially sustainable. In this paper, we explore the moral justifications for having discussions of end-of-life costs in the doctor-patient encounter as part of an effort to control costs. As health care costs are partly shared through pooled resources, such as insurance and taxation, and partly borne by individuals through out-of-pocket expenses, we separate our defense for, and approach to, discussing both pooled and individual aspects of cost. We argue that there needs to be a shift away from formulating the options as a dichotomous choice of paying attention to end-of-life costs versus ignoring such costs. The question should be how personal costs will be managed and how societal expenditures should be allocated. These are issues that we believe patients care about and need to have addressed in a manner with which they are comfortable. Conversations about how money will be spent at the end of life should begin before the end is near. We propose discussing costs from the onset of chronic illness and incorporating financial issues in advance care planning. Through these approaches one can avoid abruptly and insensitively introducing financial issues at the very conclusion of a person's life when one would prefer to address the painful and important issues of spiritual and existential loss that are appropriately the focus when a person is dying. © 2011 American Society of Law, Medicine & Ethics, Inc.

  11. Sexospécificités | Page 34 | CRDI - Centre de recherches pour le ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    These are the words of a woman who has been given a new lease on life, ... University degrees and decent jobs make it easier for women to speak up ... A website is helping Southeast Asian women earn an income and balance their work and ...

  12. Is Shared Decision Making for End-of-Life Decisions Associated With Better Outcomes as Compared to Other Forms of Decision Making? A Systematic Literature Review

    Directory of Open Access Journals (Sweden)

    Negin Hajizadeh MD, MPH

    2016-07-01

    Full Text Available Background: Whether shared decision making (SDM has been evaluated for end-of-life (EOL decisions as compared to other forms of decision making has not been studied. Purpose: To summarize the evidence on SDM being associated with better outcomes for EOL decision making, as compared to other forms of decision making. Data Sources: PubMed, Web of Science, Cochrane Central Register of Controlled Trials, EMBASE, PsycINFO, and CINAHL databases were searched through April 2014. Study Selection: Studies were selected that evaluated SDM, compared to any other decision making style, for an EOL decision. Data Extraction: Components of SDM tested, comparators to SDM, EOL decision being assessed, and outcomes measured. Data Synthesis: Seven studies met the inclusion criteria (three experimental and four observational studies. Results were analyzed using narrative synthesis. All three experimental studies compared SDM interventions to usual care. The four observational studies compared SDM to doctor-controlled decision making, or reported the correlation between level of SDM and outcomes. Components of SDM specified in each study differed widely, but the component most frequently included was presenting information on the risks/benefits of treatment choices (five of seven studies. The outcome most frequently measured was communication, although with different measurement tools. Other outcomes included decisional conflict, trust, satisfaction, and “quality of dying.” Limitations: We could not analyze the strength of evidence for a given outcome due to heterogeneity in the outcomes reported and measurement tools. Conclusions: There is insufficient evidence supporting SDM being associated with improved outcomes for EOL decisions as opposed to other forms of decision making. Future studies should describe which components of SDM are being tested, outline the comparator decision making style, and use validated tools to measure outcomes.

  13. Life-oriented approach for urban policy decision-making: Surveys and applications

    OpenAIRE

    Junyi Zhang; Yubing Xiong; Minh Tu Tran

    2014-01-01

    In this study, we propose an additional approach, called life-oriented approach, for supporting urban policy decisions. The life-oriented approach argues that people's decisions on various life choices are not independent of each other and that an understanding of life choices should not be constrained by the boundary of any single discipline. People's life choices are closely linked with the quality of life (QOL), which can be roughly captured from the perspective of life domains such as res...

  14. Risk taking and adult attention deficit/hyperactivity disorder: A gap between real life behavior and experimental decision making.

    Science.gov (United States)

    Pollak, Yehuda; Shalit, Reut; Aran, Adi

    2018-01-01

    Adults with attention deficit/hyperactivity disorder (ADHD) are prone to suboptimal decision making and risk taking. The aim of this study was to test performance on a theoretically-based probabilistic decision making task in well-characterized adults with and without ADHD, and examine the relation between experimental risk taking and history of real-life risk-taking behavior, defined as cigarette, alcohol, and street drug use. University students with and without ADHD completed a modified version of the Cambridge Gambling Test, in which they had to choose between alternatives varied by level of risk, and reported their history of substance use. Both groups showed similar patterns of risk taking on the experimental decision making task, suggesting that ADHD is not linked to low sensitivity to risk. Past and present substance use was more prevalent in adults with ADHD. These finding question the validity of experimental probabilistic decision making task as a valid model for ADHD-related risk-taking behavior. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. Sensory shelf life estimation of minimally processed lettuce considering two stages of consumers' decision-making process.

    Science.gov (United States)

    Ares, Gastón; Giménez, Ana; Gámbaro, Adriana

    2008-01-01

    The aim of the present work was to study the influence of context, particularly the stage of the decision-making process (purchase vs consumption stage), on sensory shelf life of minimally processed lettuce. Leaves of butterhead lettuce were placed in common polypropylene bags and stored at 5, 10 and 15 degrees C. Periodically, a panel of six assessors evaluated the appearance of the samples, and a panel of 40 consumers evaluated their appearance and answered "yes" or "no" to the questions: "Imagine you are in a supermarket, you want to buy a minimally processed lettuce, and you find a package of lettuce with leaves like this, would you normally buy it?" and "Imagine you have this leaf of lettuce stored in your refrigerator, would you normally consume it?". Survival analysis was used to calculate the shelf lives of minimally processed lettuce, considering both decision-making stages. Shelf lives estimated considering rejection to purchase were significantly lower than those estimated considering rejection to consume. Therefore, in order to be conservative and assure the products' quality, shelf life should be estimated considering consumers' rejection to purchase instead of rejection to consume, as traditionally has been done. On the other hand, results from logistic regressions of consumers' rejection percentage as a function of the evaluated appearance attributes suggested that consumers considered them differently while deciding whether to purchase or to consume minimally processed lettuce.

  16. Decision-making in end of life care. Are we really playing together in the same team?

    Science.gov (United States)

    Lomero-Martínez, M M; Jiménez-Herrera, M F; Bodí-Saera, M A; Llauradó-Serra, M; Masnou-Burrallo, N; Oliver-Juan, E; Sandiumenge-Camps, A

    2018-05-18

    Limitation of life-sustaining treatment is increasingly common in critical care units, and controlled donation after circulatory death is starting to be included as an option within patient care plans. Lack of knowledge and misunderstandings can place a barrier between healthcare professionals. To determine the perceptions, knowledge and attitudes of physicians and nurses working in intensive care units regarding Limitation of life-sustaining treatment and controlled donation after circulatory death. Cross-sectional study carried out in 13 Spanish hospitals by means of an ad hoc questionnaire. Contingency tables, Pearson's chi-squared test, Student's t-test and the Mann-Whitney u-test were used to carry out descriptive, bivariate and multivariate statistical analyses of responses. Although Limitation of life-sustaining treatment is a widespread practice, the survey revealed that nurses feel excluded from the development of protocols and the decision-making process, whilst the perception of physicians is that they have greater knowledge of the topic, and decisions are reached in consensus. Multi-disciplinary training programmes can help critical healthcare providers to work together with greater coordination, thus benefitting patients and their next of kin by providing excellent end-of-life care. Copyright © 2018 Sociedad Española de Enfermería Intensiva y Unidades Coronarias (SEEIUC). Publicado por Elsevier España, S.L.U. All rights reserved.

  17. PERLINDUNGAN HUKUM OLEH POLRI TERHADAP KORBAN PRAKTEK PENIPUAN MELALUI KARTU KREDIT

    OpenAIRE

    RARU, SALLY RIBKA

    2016-01-01

    Cybercrime is happening nowadays in Indonesia. This happens because Indonesia is geographically located between Asia and Australia and between Pacific and Indian Ocean. This geographic location also makes the trade of goods in Indonesia more complex and various. People tend to obtain their needs instantly in order to make everything in their life easier and faster. Indonesian government through Bank Indonesia has released credit card. Credit card makes people easy to do transaction. Crime in ...

  18. Beyond cultural stereotyping: views on end-of-life decision making among religious and secular persons in the USA, Germany, and Israel.

    Science.gov (United States)

    Schweda, Mark; Schicktanz, Silke; Raz, Aviad; Silvers, Anita

    2017-02-17

    End-of-life decision making constitutes a major challenge for bioethical deliberation and political governance in modern democracies: On the one hand, it touches upon fundamental convictions about life, death, and the human condition. On the other, it is deeply rooted in religious traditions and historical experiences and thus shows great socio-cultural diversity. The bioethical discussion of such cultural issues oscillates between liberal individualism and cultural stereotyping. Our paper confronts the bioethical expert discourse with public moral attitudes. The paper is based on a qualitative study comprising 12 focus group discussions with religious and secular persons in the USA, Germany, and Israel (n = 82). Considering the respective socio-political and legal frameworks, the thematic analysis focuses on moral attitudes towards end-of-life decision making and explores the complex interplay between individual preferences, culture, and religion. Our findings draw attention to the variety and complexity of cultural and religious aspects of end-of-life decision making. Although there is local consensus that goes beyond radical individualism, positions are not neatly matched with national cultures or religious denominations. Instead, the relevance of the specific situatedness of religious beliefs and cultural communities becomes visible: Their status and role in individual situations, for example, as consensual or conflicting on the level of personal perspectives, family relationships, or broader social contexts, e.g., as a majority or minority culture within a political system. As the group discussions indicate, there are no clear-cut positions anchored in "nationality," "culture," or "religion." Instead, attitudes are personally decided on as part of a negotiated context representing the political, social and existential situatedness of the individual. Therefore, more complex theoretical and practical approaches to cultural diversity have to be developed.

  19. Asset life cycle plans: twelve steps to assist strategic decision-making in asset life cycle management

    NARCIS (Netherlands)

    Ruitenburg, Richard Jacob; Braaksma, Anne Johannes Jan; van Dongen, Leonardus Adriana Maria; Carnero, Maria Carmen; Gonzalez-Prida, Vicente

    2017-01-01

    Effective management of physical assets should deliver maximum business value. Therefore, Asset Management standards such as PAS 55 and ISO 55000 ask for a life cycle approach. However, most existing methods focus only on the short term of the asset's life or the estimation of its remaining life.

  20. The need for operating guidelines and a decision making framework applicable to the discovery of non-intelligent extraterrestrial life

    Science.gov (United States)

    Race, Margaret S.; Randolph, Richard O.

    While formal principles have been adopted for the eventuality of detecting intelligent life in our galaxy (SETI Principles), no such guidelines exist for the discovery of non-intelligent extraterrestrial life within the solar system. Current scientifically based planetary protection policies for solar system exploration address how to undertake exploration, but do not provide clear guidance on what to do if and when life is detected. Considering that martian life could be detected under several different robotic and human exploration scenarios in the coming decades, it is appropriate to anticipate how detection of non-intelligent, microbial life could impact future exploration missions and activities, especially on Mars. This paper discusses a proposed set of interim guidelines based loosely on the SETI Principles and addresses issues extending from the time of discovery through future handling and treatment of extraterrestrial life on Mars or elsewhere. Based on an analysis of both scientific and ethical considerations, there is a clear need for developing operating protocols applicable at the time of discovery and a decision making framework that anticipates future missions and activities, both robotic and human. There is growing scientific confidence that the discovery of extraterrestrial life in some form is nearly inevitable. If and when life is discovered beyond Earth, non-scientific dimensions may strongly influence decisions about the nature and scope of future missions and activities. It is appropriate to encourage international discussion and consideration of the issues prior to an event of such historical significance.

  1. Factors Affecting Quality of Life at Different Intervals After Treatment of Localized Prostate Cancer: Unique Influence of Treatment Decision Making Satisfaction, Personality and Sexual Functioning.

    Science.gov (United States)

    Victorson, David E; Schuette, Stephanie; Schalet, Benjamin D; Kundu, Shilajit D; Helfand, Brian T; Novakovic, Kristian; Sufrin, Nathaniel; McGuire, Michael; Brendler, Charles

    2016-11-01

    Using patient reported outcomes measures we identified the most informative set of factors associated with quality of life in a large sample of men treated for localized prostate cancer. We examined relationships with quality of life using FACIT (Functional Assessment of Chronic Illness Therapy). We also hypothesized variables in a sample of men diagnosed with localized prostate cancer who represented different time points since treatment, including less than 12 months in 70, 1 to 3 years in 344, greater than 3 to 5 years in 291 and greater than 5 years in 97. Correlative measures included subscales of MAX-PC (Memorial Anxiety Scale for Prostate Cancer), short forms of PROMIS® and SOMS (Surgical Outcomes Measurement System), TDM-SATS (Treatment Decision-Making Satisfaction Scale) and subscales of the BFI (Big Five Inventory) of personality. Quality of life was significantly associated with hypothesized variables across different time cohorts. In regression models several factors accounted for most of the variability in quality of life scores depending on time since treatment, including 47%, 22%, 29% and 27% at less than 12 months, 1 to 3 years, greater than 3 to 5 years and greater than 5 years, respectively. Upon examining the unique contribution of these variables, treatment decision making satisfaction was the only variable to have a significant and unique contribution to quality of life across all 4 time cohorts (standardized coefficients 0.33, 0.27, 0.31 and 0.49, respectively, p personality style also had unique associations with quality of life (standardized coefficients 0.25 and -0.20, respectively). When considering the short-term and the longer term quality of life of a man after treatment for localized prostate cancer, our findings highlight the importance of treatment decision making satisfaction, erectile function and personality. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights

  2. Making Smart Food Choices

    Science.gov (United States)

    ... turn JavaScript on. Feature: Healthy Aging Making Smart Food Choices Past Issues / Winter 2015 Table of Contents Everyday ... NIH www.nia.nih.gov/Go4Life Making Smart Food Choices To maintain a healthy weight, balance the calories ...

  3. Life extension decision making of safety critical systems: An overview

    OpenAIRE

    Shafiee, Mahmood; Animah, I.

    2017-01-01

    In recent years, the concept of “asset life extension” has become increasingly important to safety critical industries including nuclear power, offshore oil and gas, petrochemical, renewable energy, rail transport, aviation, shipping, electricity distribution and transmission, etc. Extending the service life of industrial assets can offer a broad range of economic, technical, social and environmental benefits as compared to other end-of-life management strategies such as decommissioning and r...

  4. Attitudes, experiences, and beliefs affecting end-of-life decision-making among homeless individuals.

    Science.gov (United States)

    Tarzian, Anita J; Neal, Maggie T; O'Neil, J Anne

    2005-02-01

    Individuals who are homeless may encounter various barriers to obtaining quality end-of-life (EOL) care, including access barriers, multiple sources of discrimination, and lack of knowledge among health care providers (HCPs) of their preferences and decision-making practices. Planning for death with individuals who have spent so much energy surviving requires an understanding of their experiences and preferences. This study sought to increase HCPs' awareness and understanding of homeless or similarly marginalized individuals' EOL experiences and treatment preferences. Focus groups were conducted with homeless individuals using a semi-structured interview guide to elicit participants' EOL experiences, decision-making practices, and personal treatment preferences. Five focus groups were conducted with 20 inner-city homeless individuals (4 per group) at a free urban health care clinic for homeless individuals in the United States. Sixteen of the 20 participants were African American; 4 were Caucasian. None were actively psychotic. All had experienced multiple losses and drug addiction. Five main themes emerged: valuing an individual's wishes; acknowledging emotions; the primacy of religious beliefs and spiritual experience; seeking relationship-centered care; and reframing advance care planning. The narrative process of this qualitative study uncovered an approach to EOL decision-making in which participants' reasoning was influenced by emotions, religious beliefs, and spiritual experience. Relationship-centered care, characterized by compassion and respectful, two-way communication, was obvious by its described absence--reasons for this are discussed. Recommendations for reframing advance care planning include ways for HCPs to transform advance care planning from that of a legal document to a process of goal-setting that is grounded in human connection, respect, and understanding.

  5. 'To do or not to do'? The neurobiology of decision-making in daily life: I. Getting the basics

    Directory of Open Access Journals (Sweden)

    André Palmini

    Full Text Available Abstract The constant conflict between decisions leading to immediate pleasurable consequences versus behaviors aiming at long-term social advantages is reviewed here in the framework of the evolutionary systems regulating behavior. The inescapable temporal perspective in decision-making in everyday life is highlighted and integrated with the role of the executive functions in the modulation of subcortical systems. In particular, the representations of the 'non-existent' future in the prefrontal cortical regions and how these representations can bridge theory and practice in everyday life are addressed. Relevant discussions regarding the battle between emotions and reasons in the determination of more complex decisions in the realm of neuroeconomics and in moral issues have been reserved for a second essay.

  6. Quality of Life Issues for Families Who Make the Decision to Use a Feeding Tube for Their Child with Disabilities.

    Science.gov (United States)

    Brotherson, Mary Jane; And Others

    1995-01-01

    Eight families deciding to use a feeding tube to meet the nutrition needs of their children with disabilities were interviewed over a two-year period. Family decision making in the context of quality of life was examined using a theoretical family systems model. Implications for future interventions are addressed. (Author/SW)

  7. End-of-life care communications and shared decision-making in Norwegian nursing homes--experiences and perspectives of patients and relatives.

    Science.gov (United States)

    Gjerberg, Elisabeth; Lillemoen, Lillian; Førde, Reidun; Pedersen, Reidar

    2015-08-19

    Involving nursing home patients and their relatives in end-of-life care conversations and treatment decisions has recently gained increased importance in several Western countries. However, there is little knowledge about how the patients themselves and their next-of-kin look upon involvement in end-of-life care decisions. The purpose of this paper is to explore nursing home patients' and next-of-kin's experiences with- and perspectives on end-of-life care conversations, information and shared decision-making. The study has a qualitative and explorative design, based on a combination of individual interviews with 35 patients living in six nursing homes and seven focus group interviews with 33 relatives. The data was analysed applying a "bricolage" approach". Participation was based on informed consent, and the study was approved by the Regional Committees for Medical and Health Research Ethics. Few patients and relatives had participated in conversations about end-of-life care. Most relatives wanted such conversations, while the patients' opinions varied. With some exceptions, patients and relatives wanted to be informed about the patient's health condition. The majority wanted to be involved in the decision-making process, but leave the final decisions to the health professionals. Among the patients, the opinion varied; some patients wanted to leave the decisions more or less completely to the nursing home staff. Conversations about end-of-life care issues are emotionally challenging, and very few patients had discussed these questions with their family. The relatives' opinions of the patient's preferences were mainly based on assumptions; they had seldom talked about this explicitly. Both patients and relatives wanted the staff to raise these questions. Nursing home staff should initiate conversations about preferences for end-of-life care, assisting patients and relatives in talking about these issues, while at the same time being sensitive to the diversity in

  8. Adapting the SLIM diabetes prevention intervention to a Dutch real-life setting: joint decision making by science and practice.

    Science.gov (United States)

    Jansen, Sophia C; Haveman-Nies, Annemien; Duijzer, Geerke; Ter Beek, Josien; Hiddink, Gerrit J; Feskens, Edith J M

    2013-05-08

    Although many evidence-based diabetes prevention interventions exist, they are not easily applicable in real-life settings. Moreover, there is a lack of examples which describe the adaptation process of these interventions to practice. In this paper we present an example of such an adaptation. We adapted the SLIM (Study on Lifestyle intervention and Impaired glucose tolerance Maastricht) diabetes prevention intervention to a Dutch real-life setting, in a joint decision making process of intervention developers and local health care professionals. We used 3 adaptation steps in accordance with current adaptation frameworks. In the first step, the elements of the SLIM intervention were identified. In the second step, these elements were judged for their applicability in a real-life setting. In the third step, adaptations were proposed and discussed for those elements which were deemed not applicable. Participants invited for this process included intervention developers and local health care professionals (n=19). In the first adaptation step, a total of 22 intervention elements were identified. In the second step, 12 of these 22 intervention elements were judged as inapplicable. In the third step, a consensus was achieved for the adaptations of all 12 elements. The adapted elements were in the following categories: target population, techniques, intensity, delivery mode, materials, organisational structure, and political and financial conditions. The adaptations either lay in changing the SLIM protocol (6 elements) or the real-life working procedures (1 element), or a combination of both (4 elements). The positive result of this study is that a consensus was achieved within a relatively short time period (nine months) between the developers of the SLIM intervention and local health care professionals on the adaptations needed to make SLIM applicable in a Dutch real-life setting. Our example shows that it is possible to combine the perspectives of scientists and

  9. Informed decision making about predictive DNA tests: arguments for more public visibility of personal deliberations about the good life.

    Science.gov (United States)

    Boenink, Marianne; van der Burg, Simone

    2010-05-01

    Since its advent, predictive DNA testing has been perceived as a technology that may have considerable impact on the quality of people's life. The decision whether or not to use this technology is up to the individual client. However, to enable well considered decision making both the negative as well as the positive freedom of the individual should be supported. In this paper, we argue that current professional and public discourse on predictive DNA-testing is lacking when it comes to supporting positive freedom, because it is usually framed in terms of risk and risk management. We show how this 'risk discourse' steers thinking on the good life in a particular way. We go on to argue that empirical research into the actual deliberation and decision making processes of individuals and families may be used to enrich the environment of personal deliberation in three ways: (1) it points at a richer set of values that deliberators can take into account, (2) it acknowledges the shared nature of genes, and (3) it shows how one might frame decisions in a non-binary way. We argue that the public sharing and discussing of stories about personal deliberations offers valuable input for others who face similar choices: it fosters their positive freedom to shape their view of the good life in relation to DNA-diagnostics. We conclude by offering some suggestions as to how to realize such public sharing of personal stories.

  10. Pushing the limits of signal resolution to make coupling measurement easier.

    Science.gov (United States)

    Herbert Pucheta, José Enrique; Pitoux, Daisy; Grison, Claire M; Robin, Sylvie; Merlet, Denis; Aitken, David J; Giraud, Nicolas; Farjon, Jonathan

    2015-05-07

    Probing scalar couplings are essential for structural elucidation in molecular (bio)chemistry. While the measurement of JHH couplings is facilitated by SERF experiments, overcrowded signals represent a significant limitation. Here, a new band selective pure shift SERF allows access to δ(1)H and JHH with an ultrahigh spectral resolution.

  11. Discovering the Power of Individual-Based Modelling in Teaching and Learning: The Study of a Predator-Prey System

    Science.gov (United States)

    Ginovart, Marta

    2014-01-01

    The general aim is to promote the use of individual-based models (biological agent-based models) in teaching and learning contexts in life sciences and to make their progressive incorporation into academic curricula easier, complementing other existing modelling strategies more frequently used in the classroom. Modelling activities for the study…

  12. A life cycle analysis approach to D and D decision-making

    International Nuclear Information System (INIS)

    Yuracko, K.L.; Gresalfi, M.; Yerace, P.; Krstich, M.; Gerrick, D.

    1998-05-01

    This paper describes a life cycle analysis (LCA) approach that makes decontamination and decommissioning (D and D) of US Department of Energy facilities more efficient and more responsive to the concerns of the society. With the considerable complexity of D and D projects and their attendant environmental and health consequences, projects can no longer be designed based on engineering and economic criteria alone. Using the LCA D and D approach, the evaluation of material disposition alternatives explicitly includes environmental impacts, health and safety impacts, socioeconomic impacts, and stakeholder attitudes -- in addition to engineering and economic criteria. Multi-attribute decision analysis is used to take into consideration the uncertainties and value judgments that are an important part of all material disposition decisions. Use of the LCA D and D approach should lead to more appropriate selections of material disposition pathways and a decision-making process that is both understandable and defensible. The methodology and procedures of the LCA D and D approach are outlined and illustrated by an application of the approach at the Department of Energy's West Valley Demonstration Project. Specifically, LCA was used to aid decisions on disposition of soil and concrete from the Tank Pad D and D Project. A decision tree and the Pollution Prevention/Waste Minimization Users Guide for Environmental Restoration Projects were used to identify possible alternatives for disposition of the soil and concrete. Eight alternatives encompassing source reduction, segregation, treatment, and disposal were defined for disposition of the soil; two alternatives were identified for disposition of the concrete. Preliminary results suggest that segregation and treatment are advantageous in the disposition of both the soil and the concrete. This and other recent applications illustrate the strength and ease of application of the LCA D and D approach

  13. Prioritization of Bioethanol Production Pathways in China based on Life Cycle Sustainability Assessment and Multi-Criteria Decision-Making

    DEFF Research Database (Denmark)

    Ren, Jingzheng; Manzardo, Alessandro; Mazzi, Anna

    2015-01-01

    Purpose The study objectives are two-fold: (i) combining the life cycle sustainability assessment (LCSA) framework and the multi-criteria decision-making (MCDM) methodology for sustainability assessment; (ii) determining the most sustainable scenario for bioethanol production in China according......’s proposed method investigates an illustrative case about three alternative bioethanol production scenarios (wheat-based, corn-based and cassava-based): the prior sequence (based on the sustainability performances) in descending order is cassava-based, corn-based and wheat-based. The proposed methodology...... is to test the combination of a MCDM methodology and LCSA for sustainability decision-making by studying three alternative pathways for bioethanol production in China. The proposed method feasibly enables the decision-makers/stakeholders to find the most sustainable scenario to achieve their objectives among...

  14. Communication skills training for dialysis decision-making and end-of-life care in nephrology.

    Science.gov (United States)

    Schell, Jane O; Green, Jamie A; Tulsky, James A; Arnold, Robert M

    2013-04-01

    Nephrology fellows often face difficult conversations about dialysis initiation or withdrawal but are frequently unprepared for these discussions. Despite evidence that communication skills are teachable, few fellowship programs include such training. A communication skills workshop for nephrology fellows (NephroTalk) focused on delivering bad news and helping patients define care goals, including end-of-life preferences. This 4-hour workshop, held in October and November 2011, included didactics and practice sessions with standardized patients. Participants were nephrology fellows at Duke University and the University of Pittsburgh (n=22). Pre- and post-workshop surveys evaluated efficacy of the curriculum and measured changes in perceived preparedness on the basis on workshop training. Overall, 14% of fellows were white and 50% were male. Less than one-third (6 of 22) reported prior palliative care training. Survey response rate varied between 86% and 100%. Only 36% (8 of 22) and 38% (8 of 21) of respondents had received structured training in discussions for dialysis initiation or withdrawal. Respondents (19 of 19) felt that communication skills were important to being a "great nephrologist." Mean level of preparedness as measured with a five-point Likert scale significantly increased for all skills (range, 0.5-1.14; Pdecision-making and end-of-life care.

  15. Making the link between work-life balance practices and organizational performance

    OpenAIRE

    T. Alexandra Beauregard; Lesley C. Henry

    2009-01-01

    The business case for work-life balance practices, as espoused by many organizations, rests on attracting better applicants and reducing work-life conflict among existing employees in order to enhance organizational performance. This review of the literature provides some evidence for the claim regarding recruitment, but there is insufficient evidence to support the notion that work-life practices enhance performance by means of reduced work-life conflict. We suggest that the business case ma...

  16. Automatically exposing OpenLifeData via SADI semantic Web Services.

    Science.gov (United States)

    González, Alejandro Rodríguez; Callahan, Alison; Cruz-Toledo, José; Garcia, Adrian; Egaña Aranguren, Mikel; Dumontier, Michel; Wilkinson, Mark D

    2014-01-01

    Two distinct trends are emerging with respect to how data is shared, collected, and analyzed within the bioinformatics community. First, Linked Data, exposed as SPARQL endpoints, promises to make data easier to collect and integrate by moving towards the harmonization of data syntax, descriptive vocabularies, and identifiers, as well as providing a standardized mechanism for data access. Second, Web Services, often linked together into workflows, normalize data access and create transparent, reproducible scientific methodologies that can, in principle, be re-used and customized to suit new scientific questions. Constructing queries that traverse semantically-rich Linked Data requires substantial expertise, yet traditional RESTful or SOAP Web Services cannot adequately describe the content of a SPARQL endpoint. We propose that content-driven Semantic Web Services can enable facile discovery of Linked Data, independent of their location. We use a well-curated Linked Dataset - OpenLifeData - and utilize its descriptive metadata to automatically configure a series of more than 22,000 Semantic Web Services that expose all of its content via the SADI set of design principles. The OpenLifeData SADI services are discoverable via queries to the SHARE registry and easy to integrate into new or existing bioinformatics workflows and analytical pipelines. We demonstrate the utility of this system through comparison of Web Service-mediated data access with traditional SPARQL, and note that this approach not only simplifies data retrieval, but simultaneously provides protection against resource-intensive queries. We show, through a variety of different clients and examples of varying complexity, that data from the myriad OpenLifeData can be recovered without any need for prior-knowledge of the content or structure of the SPARQL endpoints. We also demonstrate that, via clients such as SHARE, the complexity of federated SPARQL queries is dramatically reduced.

  17. Making Cancer Health Text on the Internet Easier to Read for Deaf People Who Use American Sign Language.

    Science.gov (United States)

    Kushalnagar, Poorna; Smith, Scott; Hopper, Melinda; Ryan, Claire; Rinkevich, Micah; Kushalnagar, Raja

    2018-02-01

    People with relatively limited English language proficiency find the Internet's cancer and health information difficult to access and understand. The presence of unfamiliar words and complex grammar make this particularly difficult for Deaf people. Unfortunately, current technology does not support low-cost, accurate translations of online materials into American Sign Language. However, current technology is relatively more advanced in allowing text simplification, while retaining content. This research team developed a two-step approach for simplifying cancer and other health text. They then tested the approach, using a crossover design with a sample of 36 deaf and 38 hearing college students. Results indicated that hearing college students did well on both the original and simplified text versions. Deaf college students' comprehension, in contrast, significantly benefitted from the simplified text. This two-step translation process offers a strategy that may improve the accessibility of Internet information for Deaf, as well as other low-literacy individuals.

  18. A decision-making framework for effective maintenance management using life cycle costing (LCC in a rolling stock environment

    Directory of Open Access Journals (Sweden)

    Fourie, Cornelius Jacobus

    2016-12-01

    Full Text Available In this paper, a life cycle costing (LCC framework for effective maintenance management is investigated and developed for use in a railway rolling stock environment. The framework consists of combining typical mission-critical components together with their failure and maintenance history. All costs related to the operation and maintenance of these components throughout their life cycle are also determined. The next step involves considering different scenarios under which the components can be used in relation to operations, maintenance, and replacements. The decision about which scenario to take is based on the one with the most favourable net present value after life cycle costing is performed over a specified period of time. A typical railway rolling-stock maintenance organisation in South Africa was used to highlight the practical implications of such a framework and how the company could make informed and appropriate decisions. The conclusion of this study is that such a framework is useful, and that it can be used as a basis for estimating LCC across a spectrum of critical assets found in the rolling stock environment.

  19. Decision Making Regarding the Place of End-of-Life Cancer Care: The Burden on Bereaved Families and Related Factors.

    Science.gov (United States)

    Yamamoto, Sena; Arao, Harue; Masutani, Eiko; Aoki, Miwa; Kishino, Megumi; Morita, Tatsuya; Shima, Yasuo; Kizawa, Yoshiyuki; Tsuneto, Satoru; Aoyama, Maho; Miyashita, Mitsunori

    2017-05-01

    Decision making regarding the place of end-of-life (EOL) care is an important issue for patients with terminal cancer and their families. It often requires surrogate decision making, which can be a burden on families. To explore the burden on the family of patients dying from cancer related to the decisions they made about the place of EOL care and investigate the factors affecting this burden. This was a cross-sectional mail survey using a self-administered questionnaire. Participants were 700 bereaved family members of patients with cancer from 133 palliative care units in Japan. The questionnaire covered decisional burdens, depression, grief, and the decision-making process. Participants experienced emotional pressure as the highest burden. Participants with a high decisional burden reported significantly higher scores for depression and grief (both P decision making without knowing the patient's wishes and values (P making the decision because of a due date for discharge from a former facility or hospital (P = 0.005). Decision making regarding the place of EOL care was recalled as burdensome for family decision makers. An early decision-making process that incorporates sharing patients' and family members' values that are relevant to the desired place of EOL care is important. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  20. Phylotastic! Making tree-of-life knowledge accessible, reusable and convenient.

    Science.gov (United States)

    Stoltzfus, Arlin; Lapp, Hilmar; Matasci, Naim; Deus, Helena; Sidlauskas, Brian; Zmasek, Christian M; Vaidya, Gaurav; Pontelli, Enrico; Cranston, Karen; Vos, Rutger; Webb, Campbell O; Harmon, Luke J; Pirrung, Megan; O'Meara, Brian; Pennell, Matthew W; Mirarab, Siavash; Rosenberg, Michael S; Balhoff, James P; Bik, Holly M; Heath, Tracy A; Midford, Peter E; Brown, Joseph W; McTavish, Emily Jane; Sukumaran, Jeet; Westneat, Mark; Alfaro, Michael E; Steele, Aaron; Jordan, Greg

    2013-05-13

    Scientists rarely reuse expert knowledge of phylogeny, in spite of years of effort to assemble a great "Tree of Life" (ToL). A notable exception involves the use of Phylomatic, which provides tools to generate custom phylogenies from a large, pre-computed, expert phylogeny of plant taxa. This suggests great potential for a more generalized system that, starting with a query consisting of a list of any known species, would rectify non-standard names, identify expert phylogenies containing the implicated taxa, prune away unneeded parts, and supply branch lengths and annotations, resulting in a custom phylogeny suited to the user's needs. Such a system could become a sustainable community resource if implemented as a distributed system of loosely coupled parts that interact through clearly defined interfaces. With the aim of building such a "phylotastic" system, the NESCent Hackathons, Interoperability, Phylogenies (HIP) working group recruited 2 dozen scientist-programmers to a weeklong programming hackathon in June 2012. During the hackathon (and a three-month follow-up period), 5 teams produced designs, implementations, documentation, presentations, and tests including: (1) a generalized scheme for integrating components; (2) proof-of-concept pruners and controllers; (3) a meta-API for taxonomic name resolution services; (4) a system for storing, finding, and retrieving phylogenies using semantic web technologies for data exchange, storage, and querying; (5) an innovative new service, DateLife.org, which synthesizes pre-computed, time-calibrated phylogenies to assign ages to nodes; and (6) demonstration projects. These outcomes are accessible via a public code repository (GitHub.com), a website (http://www.phylotastic.org), and a server image. Approximately 9 person-months of effort (centered on a software development hackathon) resulted in the design and implementation of proof-of-concept software for 4 core phylotastic components, 3 controllers, and 3 end

  1. Multiple criteria decision making with life cycle assessment for material selection of composites

    Directory of Open Access Journals (Sweden)

    A. S. Milani

    2011-12-01

    Full Text Available With the advancement of interdisciplinary approaches in today’s modern engineering, current efforts in optimal design of composites include seeking material selection protocols that can (1 simultaneously consider a series of mechanical/electrical/chemical cost criteria over a set of alternative material options, and (2 closely take into account environmental aspects of final products including recycling and end-of-life disposal options. In this paper, in addition to a review of some recent experimental and methodological advances in the above areas, a new application of multiple criteria decision making (MCDM is presented to deal with decision conflicts often seen among design criteria in composite material selection with the help of life cycle assessment (LCA. To show the application, an illustrative case study on a plastic gear material selection is conducted where the cost, mechanical and thermal properties along with environmental impact criteria are to be satisfied simultaneously. A pure plastic gear is compared to a Polyethylene terephthalate (PET/aluminum-powder composite alternative. Results suggest that simple MCDM models, including a signal-to-noise measure adapted to MCDM in the same case study, can be used to explore both trade-offs and design break-even points in large decision spaces as the decision maker’s perspective over environmental, material performance and cost attributes change during the design process. More advanced topics including the account of material data uncertainties are addressed.

  2. Architecture is Life... ...Life is Architecture

    OpenAIRE

    Snider, David E

    2001-01-01

    When thinking about architecture, I cannot help but think about my life and the things that have affected my life. How does the environment around us effect the daily decisions we make? How do the experiences throughout our life impact who we are and who we become? The people and surroundings we choose will ultimately decide the type of people we become. When we select our surroundings we are in turn selecting our ideal community. Everyone is trying to achieve community in some sense, from in...

  3. Does making meaning make it better? Narrative meaning-making and well-being in at-risk African-American adolescent females

    Science.gov (United States)

    Sales, Jessica M.; Merrill, Natalie A.; Fivush, Robyn

    2012-01-01

    It has been argued that, for certain people, attempts at making meaning about past life events, especially challenging events, might be detrimental to well-being. In this study we explored the association between narrative indicators of meaning-making and psychological well-being, while also considering the role of individual level factors such as life history, personality characteristics and locus of control, among an at-risk sample of low socioeconomic status inner-city African-American adolescent females with challenging lives. We found that having a more external locus of control and including more cognitive processing language in narratives about a highly negative past experience were associated with increased depressive symptoms. Our findings suggest that certain types of narrative meaning-making language may reflect ongoing and unsuccessful efforts after meaning, and, may be more similar to rumination than to resolution. Additionally, they support claims that for certain individuals from challenging backgrounds, efforts after meaning might not be psychologically healthy. PMID:22897108

  4. Effects of Aqua Exercises Towards Improving The Quality of Life (QoL) of Obese Women in Malaysia

    Science.gov (United States)

    Karim, Noor Liyana Binti; Jalil, Asma Diyana binti Abd; Hasri, Noor Haninah Binti; Rahman, Hezlin Aryani Binti Abd; Shari, Maisarah Binti; Idris, Nur Izzati Binti

    2018-05-01

    Aqua exercise is a form of water exercise, done in the water which is beneficial for weight loss as well as improving the quality of life. It is suitable for all age group and fitness levels whereby due to the water buoyancy makes it easier to perform exercises especially for obese and knee-injured people. However, there was not much study done to measure the effectiveness of the aqua exercises in improving the quality life. Thus, this study aims to investigate and compare the effectiveness of aqua exercises towards obese women within eight domains of the Quality of Life (QoL). This study uses the 36-Items Short Form Health Survey (SF-36) questionnaire and a purposive sample of 61 participants to measure the effectiveness of the aqua exercise before and after 36 days of aqua workout. As the nature of the data collected was not normally distributed, hence the Wilcoxon signed rank test was used as the statistical method of analysis. The findings of this study showed that there was a significant difference between the overall QoL pre and post since the p-value physical functioning, general health, social functioning, mental health, and health transition were the domains showing significant difference between the pre and post-test (p-value < 0.05), and where majority of the participants showed a significant improvement after the aqua workouts. Thus, it can be concluded that aqua exercises is effective in improving the general QoL of obese women.

  5. Determinants of knowledge translation from health technology assessment to policy-making in China: From the perspective of researchers

    Science.gov (United States)

    Liu, Wenbin; Shi, Lizheng; Pong, Raymond W.; Dong, Hengjin; Mao, Yiwei; Tang, Meng; Chen, Yingyao

    2018-01-01

    Background For health technology assessment (HTA) to be more policy relevant and for health technology-related decision-making to be truly evidence-based, promoting knowledge translation (KT) is of vital importance. Although some research has focused on KT of HTA, there is a dearth of literature on KT determinants and the situation in developing countries and transitional societies remains largely unknown. Objective To investigate the determinants of HTA KT from research to health policy-making from the perspective of researchers in China. Design Cross-sectional study. Methods A structured questionnaire which focused on KT was distributed to HTA researchers in China. KT activity levels in various fields of HTA research were compared, using one-way ANOVA. Principal component analysis was performed to provide a basis to combine similar variables. To investigate the determinants of KT level, multiple linear regression analysis was performed. Results Based on a survey of 382 HTA researchers, it was found that HTA KT wasn’t widespread in China. Furthermore, results showed that no significant differences existed between the various HTA research fields. Factors, such as attitudes of researchers toward HTA and evidence utilization, academic ranks and linkages between researchers and policy-makers, had significant impact on HTA KT (p-valuespolicy-makers, policy-relevance of HTA research, practicality of HTA outcomes and making HTA reports easier to understand also contributed to predicting KT level. However, academic nature of HTA research was negatively associated with KT level. Conclusion KT from HTA to policy-making was influenced by many factors. Of particular importance were collaborations between researchers and policy-makers, ensuring policy relevance of HTA and making HTA evidence easier to understand by potential users. PMID:29300753

  6. Coping with Inflammatory Bowel Disease: Engaging with Information to Inform Health-Related Decision Making in Daily Life.

    Science.gov (United States)

    Restall, Gayle J; Simms, Alexandria M; Walker, John R; Haviva, Clove; Graff, Lesley A; Sexton, Kathryn A; Miller, Norine; Targownik, Laura E; Bernstein, Charles N

    2017-08-01

    People with inflammatory bowel disease (IBD) require disease and lifestyle information to make health-related decisions in their daily lives. Derived from a larger qualitative study of the lived experiences of people with IBD, we report on findings that explored how people with IBD engage with health-related information in their daily lives. Participants were recruited primarily from the Manitoba IBD Cohort Study. We used purposive sampling to select people with a breadth of characteristics and experiences. Individual interviews were audio-recorded and transcribed verbatim. Data were analyzed using inductive qualitative methods consistent with a phenomenological approach. Forty-five people with IBD participated; 51% were women. Findings highlighted the temporal and contextual influences on engagement with health-related information. Temporal influences were described as the changing need for health-related information over time. Participants identified 6 contextual factors influencing engagement with information to make health decisions: (1) emotional and attitudinal responses, (2) perceived benefits and risks, (3) trust in the source of the information, (4) knowledge and skills to access and use information, (5) availability of evidence to support decisions, and (6) social and economic environments. Findings illustrate the changing needs for health-related information over the course of IBD, and with evolving health and life circumstances. Practitioners can be responsive to information needs of people with IBD by having high-quality information available at the right time in a variety of formats and by supporting the incorporation of information in daily life.

  7. Physician-related barriers to communication and patient- and family-centred decision-making towards the end of life in intensive care: a systematic review.

    Science.gov (United States)

    Visser, Mieke; Deliens, Luc; Houttekier, Dirk

    2014-11-18

    Although many terminally ill people are admitted to an intensive care unit (ICU) at the end of life, their care is often inadequate because of poor communication by physicians and lack of patient- and family-centred care. The aim of this systematic literature review was to describe physician-related barriers to adequate communication within the team and with patients and families, as well as barriers to patient- and family-centred decision-making, towards the end of life in the ICU. We base our discussion and evaluation on the quality indicators for end-of-life care in the ICU developed by the Robert Wood Johnson Foundation Critical Care End-of-Life Peer Workgroup. Four electronic databases (MEDLINE, Embase, CINAHL and PsycINFO) were searched, using controlled vocabulary and free text words, for potentially relevant records published between 2003 and 2013 in English or Dutch. Studies were included if the authors reported on physician-related and physician-reported barriers to adequate communication and decision-making. Barriers were categorized as being related to physicians' knowledge, physicians' attitudes or physicians' practice. Study quality was assessed using design-specific tools. Evidence for barriers was graded according to the quantity and quality of studies in which the barriers were reported. Of 2,191 potentially relevant records, 36 studies were withheld for data synthesis. We determined 90 barriers, of which 46 were related to physicians' attitudes, 24 to physicians' knowledge and 20 to physicians' practice. Stronger evidence was found for physicians' lack of communication training and skills, their attitudes towards death in the ICU, their focus on clinical parameters and their lack of confidence in their own judgment of their patient's true condition. We conclude that many physician-related barriers hinder adequate communication and shared decision-making in ICUs. Better physician education and palliative care guidelines are needed to enhance

  8. Group decision-making: Factors that affect group effectiveness

    Directory of Open Access Journals (Sweden)

    Juliana Osmani

    2016-03-01

    Full Text Available Organizations are operating in a dynamic and turbulent environment. In these conditions, they have to make decisions for new problems or situations. Most of decisions are therefore non-programmed and unstructured, accompanied by risk and uncertainty. Moreover, the problems and situations are complex. All organizations are oriented towards group decisionmaking processes, as useful tools to cope with uncertainty and complexity. Apart from the necessity, companies are turning towards participatory processes also to benefit from the important advantages that these processes offer. Organizations have realized the importance of group decision-making processes to contribute to the creation of sustainable competitive advantages. Main objective of this paper is to show that group decision-making processes do not offer guarantee for good decisions, because the effectiveness of group is affected by many factors. So, the first thing done in this paper is discussing about the benefits and limitations that accompany the use of groups with decision-making purpose. Afterwards, we stop on the different factors that influence the group’s ability to make good decisions. The aim is to emphasize that regardless of the many advantages of groups, some factors as group size, type of communication within the group, leadership style, the norms, the differentiation of roles and statuses, cohesion and compliance degree should be the main elements to keep into consideration because they affect the effectiveness of group. In this regard, is discussed how such factors influence the quality of decision and then we try to draw some conclusions that can improve and make better and easier group decision-making processes.

  9. Guidance Tools for Use in Nuclear Material Management Decisions Making

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, G. V.; Baker, D. J.; Sorenson, K. B.; Boeke, S. G.

    2002-02-26

    This paper describes the results of Recommendation 14 of the Integrated Nuclear Materials Management Plan (INMMP) which was the product of a management initiative at the highest levels of the Department of Energy responding to a congressional directive to accelerate the work of achieving integration and cutting long-term costs associated with the management of nuclear materials, with the principal focus on excess materials. The INMMP provided direction to ''Develop policy-level decision support tools to support long-term planning and decision making.'' To accomplish this goal a team from the Savannah River Site, Sandia National Laboratories, Idaho National Engineering and Environmental Laboratory (INEEL), and the U.S. Department of Energy experienced in the decision-making process developed a Guidebook to Decision-Making Methods. The goal of the team organized to implement Recommendation 14 was to instill transparency, consistency, rigor, and discipline in the DOE decision process. The guidebook introduces a process and a selection of proven methods for disciplined decision-making so that the results are clearer, more transparent, and easier for reviewers to understand and accept. It was written to set a standard for a consistent decision process.

  10. A Padawan Programmer's Guide to Developing Software Libraries

    DEFF Research Database (Denmark)

    Yurkovich, James T.; Yurkovich, Benjamin J.; Dräger, Andreas

    2017-01-01

    /Shiny, that make it easier to develop scientific software and by open-source licenses that make it easier to release software. But how do you build a software library that people will use? And what characteristics do the best libraries have that make them enduringly popular? Here, we provide a reference guide......With the rapid adoption of computational tools in the life sciences, scientists are taking on the challenge of developing their own software libraries and releasing them for public use. This trend is being accelerated by popular technologies and platforms, such as GitHub, Jupyter, R......, based on our own experiences, for developing software libraries along with real-world examples to help provide context for scientists who are learning about these concepts for the first time. While we can only scratch the surface of these topics, we hope that this article will act as a guide...

  11. ANALYSING THE IMPACT OF THE PRODUCT LIFE CYCLE ON THE IMPORTANCE OF OUTSOURCING DECISION-MAKING CRITERIA: A MANUFACTURING CASE STUDY

    Directory of Open Access Journals (Sweden)

    M. Cheshmberah

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: This study has been carried out to discover the impact of the product life cycle (PLC on the importance of outsourcing decision-making criteria in a manufacturing firm. The four dimensions of outsourcing decision-making were identified, based on a literature review and on the conditions of the firm: (1 core competencies, (2 information leakage risk, (3 technological capability, and (4 cost. A case study and survey research were used, along with two non-parametric tests (Friedman’s test and Kendall’s W. The results show in particular that the importance of ‘technological capability’ and ‘strategic information leakage risk’ does not differ across the various PLC stages. The importance of ‘leakage risk of product volume information’ and ‘total cost’ change over different stages of the product life cycle are also addressed. For the latter two criteria, the probabilities of each rating related to each criterion importance have been estimated by ordinal logistic regression, and the weights of these criteria have been calculated at each stage of the product life cycle.

    AFRIKAANSE OPSOMMING: Die navorsing ondersoek die invloed van produklewensiklus op die gebruik van buite leweransiers deur ’n vervaardigingsonderneming. ’n Besluitvormingsmetode word ontwerp en getoets deur skepping van ’n boeket van wiskundige gereedskap soos, onder andere, ordinale logistiese regressie en die logistieke funksie. Die metode word ten slotte afgerond met ’n keurige gebruik van die Wasigheidsleer.

  12. A Legal and Ethical Analysis of the Effects of Triggering Conditions on Surrogate Decision-Making in End-of-Life Care in the US.

    Science.gov (United States)

    Clint Parker, J; Goldberg, Daniel S

    2016-03-01

    The central claim of this paper is that American states' use of so-called "triggering conditions" to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations (including epistemic difficulties), and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation.

  13. Preferences for care towards the end of life when decision-making capacity may be impaired: A large scale cross-sectional survey of public attitudes in Great Britain and the United States.

    Directory of Open Access Journals (Sweden)

    Gemma Clarke

    Full Text Available There is continuing public debate about treatment preferences at the end of life, and the acceptability and legal status of treatments that sustain or end life. However, most surveys use binary yes/no measures, and little is known about preferences in neurological disease when decision-making capacity is lost, as most studies focus on cancer. This study investigates changes in public preferences for care towards the end of life, with a focus on measures to sustain or end life.Large-scale international public opinion surveys using a six-stage patient vignette, respondents chose a level of intervention for each stage as health and decision-making capacity deteriorated. Cross-sectional representative samples of the general public in Great Britain and the USA (N = 2016. Primary outcome measure: changes in respondents' preferences for care, measured on a four-point scale designed before data collection. The scale ranged from: maintaining life at all costs; to intervention with agreement; to no intervention; to measures for ending life.There were no significant differences between GB and USA. Preference for measures to sustain life at all costs peaked at short-term memory loss (30.2%, n = 610. Respondents selecting 'measures to help me die peacefully' increased from 3.9% to 37.0% as the condition deteriorated, with the largest increase occurring when decision-making capacity was lost (10.3% to 23.0%. Predictors of choosing 'measures to help me die peacefully' at any stage were: previous personal experience (OR = 1.34, p<0.010, and older age (OR = 1.09 per decade, p<0.010. Negative predictors: living with children (OR = 0.72, p<0.010 and being of "black" race/ethnicity (OR = 0.45, p<0.001.Public opinion was uniform between GB and USA, but markedly heterogeneous. Despite contemporaneous capacitous consent providing an essential legal safeguard in most jurisdictions, there was a high prevalence of preference for "measures to end my life peacefully" when

  14. Conceptualizing Surrogate Decision-Making at End of Life in the Intensive Care Unit using Cognitive Task Analysis

    Science.gov (United States)

    Dionne-Odom, J. Nicholas; Willis, Danny G.; Bakitas, Marie; Crandall, Beth; Grace, Pamela J.

    2014-01-01

    Background Surrogate decision-makers (SDMs) face difficult decisions at end of life (EOL) for decisionally incapacitated intensive care unit (ICU) patients. Purpose Identify and describe the underlying psychological processes of surrogate decision-making for adults at EOL in the ICU. Method Qualitative case study design using a cognitive task analysis (CTA) interviewing approach. Participants were recruited from October 2012 to June 2013 from an academic tertiary medical center’s ICU located in the rural Northeastern United States. Nineteen SDMs for patients who had died in the ICU completed in-depth semi-structured CTA interviews. Discussion The conceptual framework formulated from data analysis reveals that three underlying, iterative, psychological dimensions: gist impressions, distressing emotions, and moral intuitions impact a SDM’s judgment about the acceptability of either the patient’s medical treatments or his or her condition. Conclusion The framework offers initial insights about the underlying psychological processes of surrogate decision-making and may facilitate enhanced decision support for SDMs. PMID:25982772

  15. Making texts in electronic health records comprehensible to consumers: a prototype translator.

    Science.gov (United States)

    Zeng-Treitler, Qing; Goryachev, Sergey; Kim, Hyeoneui; Keselman, Alla; Rosendale, Douglas

    2007-10-11

    Narrative reports from electronic health records are a major source of content for personal health records. We designed and implemented a prototype text translator to make these reports more comprehensible to consumers. The translator identifies difficult terms, replaces them with easier synonyms, and generates and inserts explanatory texts for them. In feasibility testing, the application was used to translate 9 clinical reports. Majority (68.8%) of text replacements and insertions were deemed correct and helpful by expert review. User evaluation demonstrated a non-statistically significant trend toward better comprehension when translation is provided (p=0.15).

  16. Rational decision-making about treatment and care in dementia: a contradiction in terms?

    Science.gov (United States)

    Wolfs, Claire A G; de Vugt, Marjolein E; Verkaaik, Mike; Haufe, Marc; Verkade, Paul-Jeroen; Verhey, Frans R J; Stevens, Fred

    2012-04-01

    To gain caregivers' insights into the decision-making process in dementia patients with regard to treatment and care. Four focus group interviews (n=29). The decision-making process consists of three elementary components: (1) identifying an individual's needs; (2) exploring options; and (3) making a choice. The most important phase is the exploration phase as it is crucial for the acceptance of the disease. Furthermore, the decision is experienced more as an emotional choice than a rational one. It is influenced by personal preferences whereas practical aspects do not seem to play a substantial role. Several aspects make decision-making in dementia different from decision-making in the context of other chronic diseases: (1) the difficulty accepting dementia; (2) the progressive nature of dementia; (3) patient's reliance on surrogate decision-making; and (4) strong emotions. Due to these aspects, the decision-making process is very time-consuming, especially the crucial exploration phase. A more active role is required of both the caregiver and the health care professional especially in the exploration phase, enabling easier acceptance and adjustment to the disease. Acceptance is an important condition for reducing anxiety and resistance to care that may offer significant benefits in the future. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  17. Physician self-care | Kirby | South African Medical Journal

    African Journals Online (AJOL)

    They make significant sacrifices in family life, sleep, personal time and hobbies to be able to pursue this ideal. Moving away from cure to compassionate care of dying patients, is a paradigm shift. This can be particularly difficult when caring for children with terminal illness. It is easier to accept death in the elderly as it is part ...

  18. Hospice decision making: diagnosis makes a difference.

    Science.gov (United States)

    Waldrop, Deborah P; Meeker, Mary Ann

    2012-10-01

    This study explored the process of decision making about hospice enrollment and identified factors that influence the timing of that decision. This study employed an exploratory, descriptive, cross-sectional design and was conducted using qualitative methods. In-depth in-person semistructured interviews were conducted with 36 hospice patients and 55 caregivers after 2 weeks of hospice care. The study was guided by Janis and Mann's conflict theory model (CTM) of decision making. Qualitative data analysis involved a directed content analysis using concepts from the CTM. A model of hospice enrollment decision making is presented. Concepts from the CTM (appraisal, surveying and weighing the alternatives, deliberations, adherence) were used as an organizing framework to illustrate the dynamics. Distinct differences were found by diagnosis (cancer vs. other chronic illness, e.g., heart and lung diseases) during the pre-encounter phase or before the hospice referral but no differences emerged during the post-encounter phase. Differences in decision making by diagnosis suggest the need for research about effective means for tailored communication in end-of-life decision making by type of illness. Recognition that decision making about hospice admission varies is important for clinicians who aim to provide person-centered and family-focused care.

  19. Acute acromioclavicular dislocation: a cheaper, easier and all-arthroscopic system. Is it effective in nowadays economical crisis?

    Science.gov (United States)

    Sastre, Sergi; Dada, Michelle; Santos, Simon; Lozano, Lluis; Alemany, Xavier; Peidro, Lluis

    2015-03-01

    The objective of this manuscript is to show an effective, easier and cheaper way to reduce acute acromioclavicular (AC) dislocation type III and V (Rockwood classification). Numerous procedures have been described for surgical management of acromioclavicular joint disruption. Newest devices involve an arthroscopic technique that allows nonrigid anatomic fixation of the acromioclavicular joint. Arthroscopically assisted treatment of acute AC joint dislocation is advantageous because it provides good clinical results and few complications. It also allows reviewing glenohumeral associated lesions. This surgical technique requires no specific implants to achieve a correct AC reduction. Actually, economical advantages are very important factors to decide the use of determinate surgical techniques.

  20. From concept(ion) to life after death/the grave: The 'natural' history and life cycle(s) of novel psychoactive substances (NPS).

    Science.gov (United States)

    Corkery, John Martin; Orsolini, Laura; Papanti, Duccio; Schifano, Fabrizio

    2017-05-01

    A range of information needs should be met in order to better understand and predict the longevity/existence of novel psychoactive substances (NPS). This conceptual paper argues that one way of assessing how long a molecule may be around is to document how the life cycles or natural histories of 'traditional' drugs and NPS evolve. The earliest indication of the possible appearance of a new substance might be evidenced on the DeepWeb. However, this means they are less visible, in line with the clandestine nature of drug use and supply. Therefore, monitoring discussion groups/fora needs the development of new methods compared to those used in the Surface Net. Issues needing consideration in establishing NPS life cycles are outlined here, together with the probable outcomes that could result. The approach advocated means that it should be easier to identify which NPS are likely to come up or are emerging in real time, and, therefore, pre-empt/prevent their supply. Copyright © 2017 John Wiley & Sons, Ltd.

  1. End of Life Issues

    Science.gov (United States)

    Planning for the end of life can be difficult. But by deciding what end-of-life care best suits your needs when you are healthy, you can ... right choices when the time comes. End-of-life planning usually includes making choices about the following: ...

  2. La sociedad del futuro: las tecnologías ubicuas y su impacto en la sociedad

    OpenAIRE

    Feliz González, Diego

    2017-01-01

    Treball Final de Grau en Publicitat i Relacions Públiques. Codi: PU0932. Curs acadèmic: 2016/2017 Pervasive advertisement is presented as a new way of making advertisement that ultimately will shake the world of communication. The latest technological knowledge in computing, the artificial intelligence studies that are being developed and the large amount of devices and sensors will make the future easier to reach a real pervasive daily life. Through the right procedures and all the develo...

  3. STRATEGIC MARKETING PLANNING IN SPORTS – A PERSPECTIVE OF QUALITY OF LIFE IMPROVEMENT

    Directory of Open Access Journals (Sweden)

    Caescu Stefan Claudiu

    2012-12-01

    Full Text Available Strategic marketing planning requires that the marketing objectives strategies for a specific product-market configuration be in full correlation with the directions and the resources allocated at the corporate level or at the strategic business unit one. Such a correlation is more than necessary under the current market conditions, when the economic crisis affects both consumer behavior and corporate decisions. This article focuses on the particularities of strategic marketing planning in sport, given the fact that the vast majority of sports organizations in Romania, although very active on the reference market, do not have a marketing activity correlated with the medium and long term market needs. One of these needs refers to quality of life improvement, knowing that sport activities have positive influence on many dimensions of quality of life, such as health, education, social inclusion, relaxation and leisure. The improvement within the population participation in sport (both as an active participant and as a spectator, the increased duration of leisure and the development of private financing have led to the creation of a large market, where marketing plays a central role. Therefore the marketing management process must also be implemented within the sports organization, in order to make it easier in building and maintaining a relationship with the customer, especially if the organization wants a customer orientation strategy. Such an orientation includes identifying the current needs as well as the future ones in terms of target audience, to offer a series of sports products and services that bring their significant contribution to improving the quality of life. In this paper are highlighted the influences that consumer requirements concerning quality of life have on all components of marketing management process, starting with sports organization mission statement, up to establish strategies for the marketing mix (product, price

  4. Using Option Grids: steps toward shared decision-making for neonatal circumcision.

    Science.gov (United States)

    Fay, Mary; Grande, Stuart W; Donnelly, Kyla; Elwyn, Glyn

    2016-02-01

    To assess the impact, acceptability and feasibility of a short encounter tool designed to enhance the process of shared decision-making and parental engagement. We analyzed video-recordings of clinical encounters, half undertaken before and half after a brief intervention that trained four clinicians how to use Option Grids, using an observer-based measure of shared decision-making. We also analyzed semi-structured interviews conducted with the clinicians four weeks after their exposure to the intervention. Observer OPTION(5) scores were higher at post-intervention, with a mean of 33.9 (SD=23.5) compared to a mean of 16.1 (SD=7.1) for pre-intervention, a significant difference of 17.8 (95% CI: 2.4, 33.2). Prior to using the intervention, clinicians used a consent document to frame circumcision as a default practice. Encounters with the Option Grid conferred agency to both parents and clinicians, and facilitated shared decision-making. Clinician reported recognizing the tool's positive effect on their communication process. Tools such as Option Grids have the potential to make it easier for clinicians to achieve shared decision-making. Encounter tools have the potential to change practice. More research is needed to test their feasibility in routine practice. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Making Daily Mobility

    DEFF Research Database (Denmark)

    Jensen, Ole B.; Wind, Simon

    elucidate aspects of urban everyday mobility that can be utilized in policy and planning perspectives. This knowledge can aid construction of generalized qualitative scenarios that together with quantitative transport models can serve as wider knowledge foundation in decision making process.......In 2012 the average daily transportation distance for every Dane were 40 km (TU Data). Realising how much of life is spend thinking about, planning and performing mobility practices it becomes evident that it is much more than an instrumental physical phenomenon – it has great repercussions on life......, social networks, understanding of places and ultimately ourselves and others. To successfully accomplish everyday life, households have to cope with large number of different activities and mobility in relation to their children, work, social life, obligations, expectations, needs and wishes. Drawing...

  6. What makes a bully a cyberbully? Unravelling the characteristics of cyberbullies across twenty-five European countries

    OpenAIRE

    Görzig, Anke; Ólafsson, Kjartan

    2013-01-01

    The characteristics of bullies who act face-to-face and those who do so in cyberspace were compared directly in one sample across twenty-five countries. The role of cross-country differences in technological infrastructure was also explored. Cyberbullies compared to face-to-face bullies were more likely to engage in risky online activities, spend more time online, and found it easier to be themselves online. Private access to the internet did not make a difference. Gender differences showed g...

  7. A matter of life and death: controversy at the interface between clinical and legal decision-making in prolonged disorders of consciousness.

    Science.gov (United States)

    Turner-Stokes, Lynne

    2017-07-01

    Best interests decision-making and end-of-life care for patients in permanent vegetative or minimally conscious states (VS/MCS) is a complex area of clinical and legal practice, which is poorly understood by most clinicians, lawyers and members of the public. In recent weeks, the Oxford Shrieval lecture by Mr Justice Baker ('A Matter of Life and Death', 11 October 2016) and its subsequent reporting in the public press has sparked debate on the respective roles of clinicians, the Court of Protection and the Mental Capacity Act 2005 in decisions to withhold or withdraw life-sustaining treatments from patients with disorders of consciousness. The debate became polarised and confused by misquotation and inaccurate terminology, and highlighted a lack of knowledge about how patients in VS/MCS die in the absence of court approval. This article sets out the background and discussion and attempts to give a more accurate representation of the facts. In the spirit of transparency, I present a mortality review of all the patients in VS/MCS who have died under the care of my own unit in the last decade-with or without referral to the court, but always in accordance with the law. These data demonstrate that clinicians regularly undertake best interests decision-making in conjunction with families that may include life and death decisions (sometimes even the withdrawal or withholding of clinically assisted nutrition and hydration); and that these can be made within the current legal framework without necessarily involving the court in all cases. This is the first published case series of its kind. 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/.

  8. Light for the islands; Licht fuer die Inseln

    Energy Technology Data Exchange (ETDEWEB)

    Levitin, Michael; Krause, Matthias B.

    2010-10-15

    Electric power from solar cells makes the life of Panama's indigenous populations easier and helps them to hold on to their traditions. Electric lighting helps children to learn longer hours; women have more time for their traditional sewing work and can sell more; medical clinics now have refrigerators, and families save money they would otherwise have spent on kerosene. Hundreds of solar modules have already been installed in the Kuna Yale region; they improve life without affecting the indigenous culture. (orig.)

  9. Online public reactions to fMRI communication with patients with disorders of consciousness: Quality of life, end-of-life decision making, and concerns with misdiagnosis.

    Science.gov (United States)

    Chandler, Jennifer A; Sun, Jeffrey A; Racine, Eric

    2017-01-01

    Recently, the news media have reported on the discovery of covert awareness and the establishment of limited communication using a functional magnetic resonance imaging (fMRI) neuroimaging technique with several brain-injured patients thought to have been in a vegetative state. This discovery has raised many ethical, legal, and social questions related to quality of life, end-of-life decision making, diagnostic and prognostic accuracy in disorders of consciousness, resource allocation, and other issues. This project inquires into the public responses to these discoveries. We conducted a thematic analysis of online comments (n = 779) posted in response to 15 news articles and blog posts regarding the case of a Canadian patient diagnosed for 12 years as in a vegetative state, but who was reported in 2012 as having been able to communicate via fMRI. The online comments were coded using an iteratively refined codebook structured around 14 main themes. Among the most frequent public reactions revealed in the online comments were discussions of the quality of life of patients with disorders of consciousness, whether life-sustaining treatment should be withdrawn (and whether the fMRI communication technique should be used to ask patients about this), and misgivings about the accuracy of diagnosis in disorders of consciousness and brain death. These public perspectives are relevant to the obligations of clinicians, lawyers, and public policymakers to patients, families, and the public. Future work should consider how best to alleviate families' concerns as this type of research shakes their faith in diagnostic accuracy, to clarify the legal rules relating to advance directives in this context, and to address the manner in which public messaging might help to alleviate any indirect impact on confidence in the organ donation system.

  10. Toward an Expanded Definition of Adaptive Decision Making.

    Science.gov (United States)

    Phillips, Susan D.

    1997-01-01

    Uses the lifespan, life-space model to examine the definition of adaptive decision making. Reviews the existing definition of adaptive decision making as "rational" decision making and offers alternate perspectives on decision making with an emphasis on the implications of using the model. Makes suggestions for future theory, research,…

  11. End-of-life decisions in the intensive care unit

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene

    2012-01-01

    be interdisciplinary, but the literature shows that this is not always the case. Research on end-of-life issues in Danish ICUs is limited. Aim The aims of this thesis were to • Examine Danish practices regarding end-of-life decisions in the ICU. • Examine the opinions of nurses and physicians who work in Danish ICUs...... and decision-making. Hypotheses • Nurses, intensivists, and primary physicians have different experiences of interdisciplinary collaboration regarding end-of-life decision-making in the ICU. • Specific interventions targeting end-of-life decision-making in the ICU, such as interdisciplinary audits......Background When making end-of-life decisions in intensive care units, the different staff groups have different roles in the decision-making process and may not always assess the situation identically. Practice recommendations for withholding or withdrawing therapy state that decisions should...

  12. Making Health Easier: Tobacco Free Living in Santa Clara, CA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    2013-05-21

    Instead of walking through clouds of smoke, students in a California community college can now breathe clean air. A college health nurse made it happen with the help of students, faculty, and partners.  Created: 5/21/2013 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/21/2013.

  13. Can evolutionary design of social networks make it easier to be 'green'?

    Science.gov (United States)

    Dickinson, Janis L; Crain, Rhiannon L; Reeve, H Kern; Schuldt, Jonathon P

    2013-09-01

    The social Web is swiftly becoming a living laboratory for understanding human cooperation on massive scales. It has changed how we organize, socialize, and tackle problems that benefit from the efforts of a large crowd. A new, applied, behavioral ecology has begun to build on theoretical and empirical studies of cooperation, integrating research in the fields of evolutionary biology, social psychology, social networking, and citizen science. Here, we review the ways in which these disciplines inform the design of Internet environments to support collective pro-environmental behavior, tapping into proximate prosocial mechanisms and models of social evolution, as well as generating opportunities for 'field studies' to discover how we can support massive collective action and shift environmental social norms. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Making it easier for clean technologies to get returns from GHG credits

    International Nuclear Information System (INIS)

    Baumann, T.

    2009-01-01

    This paper discusses how clean technologies can get returns from greenhouse gases credits. Businesses recognize that climate change opportunity is bigger than information technology. Clean technologies and climate change will transform the economy. Clean technologies will bring business opportunities, revitalize industry and the economy, bring jobs and increase exports.

  15. Making Health Easier: Tobacco Free Living in Santa Clara, CA PSA (:60)

    Centers for Disease Control (CDC) Podcasts

    Instead of walking through clouds of smoke, students in a California community college can now breathe clean air. A college health nurse made it happen with the help of students, faculty, and partners.

  16. Measurement of quality of life II. From the philosophy of life to science.

    Science.gov (United States)

    Ventegodt, Søren; Merrick, Joav; Andersen, Niels Jørgen

    2003-10-13

    We believe it should be possible to make operational the philosophical ideas of the good life in order to make it the object of scientific research. The Quality of Life Research Center in Copenhagen, Denmark has therefore spent the last several years with these questions and tried to find practical and evidence-based scientific solutions. This paper describes the theoretical road taken in moving from the abstract philosophy of life to the actual questionnaire. It presents an important aspect of our work with the quality-of-life (QOL) concept though the last decade. We have developed the quality-of-life philosophy; the SEQOL, QOL5, and QOL1 questionnaires; the quality-of-life theory; and the quality-of-life research methodology. We carried out quality-of-life population surveys and developed techniques for improving quality of life with the chronically sick patient. This paper presents the struggle to create a rating scale for the generic measurement of the global quality of life, based on quality-of-life theory, derived from quality-of-life philosophy. The developed rating scale is a ratio scale combining a Likert scale, a visual analogue scale, and a numerical scale, to a reduced combination scale. This allows for the extraction of as much information from the respondents as possible without exhausting them unduly or demanding more than can be reasonably expected.

  17. Making weapons, talking peace

    International Nuclear Information System (INIS)

    York, H.F.

    1987-01-01

    The memoirs of the author traces his life from his first-year graduate studies in physics at the University of Rochester in 1942 to his present position as Director of the University of California's Institute on Global Conflict and Cooperation. The part of his life involved in making weapons extends from 1942 to 1961. During this period, he worked with E.O. Lawrence on the Manhattan Project and served as director of Livermore after it became the Atomic Energy Commission's second nuclear weapons laboratory. He also served on many government advisory boards and commissions dealing with nuclear and other weapons. In 1961, the combination of a heart attack and changes in administration in Washington led York too return to the University of California for the talking peace portion of his life. He has since become a public exponent of arms control and disarmament and the futility of seeking increased security through more and better nuclear weapons. York's explanation of his move from making weapons to talking peace leaves the reader with a puzzle

  18. Feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation.

    Science.gov (United States)

    Benute, Gláucia R G; Nomura, Roseli M Y; Liao, Adolfo W; Brizot, Maria de Lourdes; de Lucia, Mara C S; Zugaib, M

    2012-08-01

    this study investigated the feelings of women regarding end-of-life decision making after ultrasound diagnosis of a lethal fetal malformation. The aim of this study was to present the decision making process of women that chose for pregnancy termination and to present selected speeches of women about their feelings. open psychological interviews conducted by a psychologist immediately after the diagnosis of fetal malformation by ultrasound. Analysis of the results was performed through a content analysis technique. the study was carried out at a public university hospital in Brazil. 249 pregnant women who had received the diagnosis of a severe lethal fetal malformation. fetal anencephaly was the most frequent anomaly detected in 135 cases (54.3%). Termination of pregnancy was decided by 172 (69.1%) patients and legally authorised by the judiciary (66%). The reason for asking for termination was to reduce suffering in all of them. In the 77 women who chose not to terminate pregnancy (30.9%), the reasons were related to feelings of guilt (74%). the results support the importance of psychological counselling for couples when lethal fetal malformation is diagnosed. The act of reviewing moral and cultural values and elements of the unconscious provides assurance in the decision-making process and mitigates the risk of emotional trauma and guilt that can continue long after the pregnancy is terminated. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Keep the best of your life

    NARCIS (Netherlands)

    Stultiens, Andrea

    Keep the Best of Your Life (for the Rest of Your Life) is part Making Oneself ‘a twofold exhibition of both historical investigations and contemporary showcases of photo studio practises in South and Southeast Asia and Uganda.’ ‘Making Oneself’ was one exhibitions of the Noorderlicht Photo festival

  20. The Impact of Faith Beliefs on Perceptions of End-of-Life Care and Decision Making among African American Church Members.

    Science.gov (United States)

    Johnson, Jerry; Hayden, Tara; True, Jennifer; Simkin, Daren; Colbert, Louis; Thompson, Beverly; Stewart, Denise; Martin, Latoya

    2016-02-01

    African Americans underuse palliative care and hospice services because of a combination of factors including faith beliefs. As the spiritual family for many African Americans, the church presents an opportunity to improve communication about palliative care and hospice and end-of-life (EOL) decision making. We conducted a focus group study to understand the cultural and spiritual perspectives that influence decisions about palliative care and hospice among African American church members who visit and support persons with life-limiting illnesses. Our specific aims were to elicit their perceptions, beliefs, and attitudes about: (1) the relation between faith beliefs and EOL care; (2) emotional and family influences on EOL decision making; (3) palliative care and hospice resources; and (4) opportunities to improve communication among lay persons and health professionals and within families. Seven focus groups using purposeful sampling. We partnered with two African American churches. Of 51 persons, 27 were deacons or deaconesses, 17 were members of health or bereavement ministries, and 7 were other members of the congregations. We found that faith beliefs of African Americans can support discussions about palliative care and hospice. Participants perceived that many of their congregants harbor beliefs, perceptions, and feelings about death and dying that were often not communicated to family members or to health providers. Among African Americans, faith beliefs, emotional issues, family dynamics, and insufficient knowledge of palliative care and hospice are intertwined and influence decision making about palliative care and hospice. Our findings confirm the influence of faith beliefs of African Americans on decisions about palliative care and hospice and demonstrate the opportunity to improve communication about palliative care and hospice and EOL through collaborations with the African American church.

  1. SMART HOME SECURITY SOLUTIONS BASED ON INTERNET OF THINGS (IOT) USING WIFI INTERFACE

    OpenAIRE

    Bhavna1, Dr. Neetu Sharma2

    2018-01-01

    Smart home system is very popular in modern days that give many kind of application that make everything is simple and easy to control. In modern day, home appliances are using wireless technology and can be accessed by internet that will make residents life easier and organized. IoT-based Home Automation System is designed to assist the people with physical disabilities and elderly to provide support as well as to control the electrical appliances and monitor the room temperature using mobil...

  2. Women with Families and Experiences of Business Travel

    OpenAIRE

    Kähkönen, Saara

    2015-01-01

    The thesis studies how female business travellers with children experience business travel. The objective is to find out new ways and tools to make business trips easier for these travel-lers, make them have a better work-life balance and have a less stressful experience not only during their trips, but also after. The method used was semi structured interviews. The interview consisted of questions relat-ed to combining business travelling and family. The interviews took place in Spring 2...

  3. Physician Approaches to Conflict with Families Surrounding End-of-Life Decision-making in the Intensive Care Unit. A Qualitative Study.

    Science.gov (United States)

    Mehter, Hashim M; McCannon, Jessica B; Clark, Jack A; Wiener, Renda Soylemez

    2018-02-01

    Families of critically ill patients are often asked to make difficult decisions to pursue, withhold, or withdraw aggressive care or resuscitative measures, exercising "substituted judgment" from the imagined standpoint of the patient. Conflict may arise between intensive care unit (ICU) physicians and family members regarding the optimal course of care. To characterize how ICU physicians approach and manage conflict with surrogates regarding end-of-life decision-making. Semistructured interviews were conducted with 18 critical care physicians from four academically affiliated hospitals. Interview transcripts were analyzed using methods of grounded theory. Physicians described strategies for engaging families to resolve conflict about end-of-life decision-making and tending to families' emotional health. Physicians commonly began by gauging family receptiveness to recommendations from the healthcare team. When faced with resistance to recommendations for less aggressive care, approaches ranged from deference to family wishes to various persuasive strategies designed to change families' minds, and some of those strategies may be counterproductive or harmful. The likelihood of deferring to family in the event of conflict was associated with the perceived sincerity of the family's "substituted judgment" and the ability to control patient pain and suffering. Physicians reported concern for the family's emotional needs and made efforts to alleviate the burden on families by assuming decision-making responsibility and expressing nonabandonment and commitment to the patient. Physicians were attentive to repairing damage to their relationship with the family in the aftermath of conflict. Finally, physicians described their own emotional responses to conflict, ranging from frustration and anxiety to satisfaction with successful resolution of conflict. Critical care physicians described a complex and multilayered approach to physician-family conflict. The reported strategies

  4. COMPARATIVE ANALYSIS OF THE LIFE INSURANCE IN REPUBLIC OF MACEDONIA AND REPUBLIC OF SERBIA

    Directory of Open Access Journals (Sweden)

    GORDANA VITANOVA

    2015-12-01

    Full Text Available The insurance companies are important participants in the capital market. They have significant contributions in providing financial stability and encouraging competitiveness on the financial market. The insurance companies mobilize huge financial resources, investing them into different financial instruments, and so it is real to expect that they will take a role of leading institutional mediators in future. The insurance companies offer life and common insurance. Policies for life insurance offer possibility to invest into own safety and easier tackling with life challenges and uncertainties. They are especially important for the individual , because he/she is constantly exposed to risks during his/her life and work, that are manifested into decreasing of working ability and lack of resources for life in some defined period. In the developed countries, there is a tradition for possessing policies for life insurance, but it is not a case in R.Macedonia. Therefore, in this study, we shall carry out comparative analysis of life insurance in R. Macedonia and R. Serbia, the politics of insurance companies and supervision of the insurance sector, and we shall give proposals for encouraging development of insurance market in these two countries, and for increasing individual’s awareness of the benefits of having policies for life insurance.

  5. How Reasoning, Judgment, and Decision Making are Colored by Gist-based Intuition: A Fuzzy-Trace Theory Approach.

    Science.gov (United States)

    Corbin, Jonathan C; Reyna, Valerie F; Weldon, Rebecca B; Brainerd, Charles J

    2015-12-01

    Fuzzy-trace theory distinguishes verbatim (literal, exact) from gist (meaningful) representations, predicting that reliance on gist increases with experience and expertise. Thus, many judgment-and-decision-making biases increase with development, such that cognition is colored by context in ways that violate logical coherence and probability theories. Nevertheless, this increase in gist-based intuition is adaptive: Gist is stable, less sensitive to interference, and easier to manipulate. Moreover, gist captures the functionally significant essence of information, supporting healthier and more robust decision processes. We describe how fuzzy-trace theory accounts for judgment-and-decision making phenomena, predicting the paradoxical arc of these processes with the development of experience and expertise. We present data linking gist memory processes to gist processing in decision making and provide illustrations of gist reliance in medicine, public health, and intelligence analysis.

  6. Влияние информационных технологий на финансовый рынок

    OpenAIRE

    Калмыкова, Екатерина Юрьевна; Рябова, А. В.

    2016-01-01

    Fast development of technologies has led to emergence of the new market - FinTech which is today very attractive for investors. By now this market has a great number of different concepts: P2P-crediting, E-wallets, Bitcoins, mPOS-acquiring, T-commerce, mobile banks, etc. Many of these tools are well-known not only for economists but also for majority of our population. So they have already heavily entered in our ordinary life. These tools make life easier, however, they are changing financial...

  7. Evaluation of Sensor Networks in Smart Home

    OpenAIRE

    Arefe Esalat Nejad; Atefe Enteshari; Vahid Amir

    2014-01-01

    Smart homes are no longer design concepts of the future. They are being built now, and they are having a direct impact on the lifestyles of people living in them. The aim of smart home systems is to create an environment that is aware of the activities taking place within it. Beside the healthy people, disabled people also need such systems to make their life easier. Because they encounter with a lot of difficulties in their everyday life especially when they are at home. Accordingly the home...

  8. Imprinting: When Early Life Memories Make Food Smell Bad.

    Science.gov (United States)

    Rayes, Diego; Alkema, Mark J

    2016-05-09

    A recent study has found that pathogen exposure early in the life of the nematode Caenorhabditis elegans leads to a long-lasting aversion that requires distinct sets of neurons for the formation and retrieval of the imprinted memory. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Method of making a long life high current density cathode from tungsten and iridium powders using a quaternary compound as the impregnant

    International Nuclear Information System (INIS)

    Branovich, L.E.; Smith, B.; Freemen, G.L.; Eckart, D.W.

    1990-01-01

    This patent describes a method of making a long life high current density cathode. It is suitable for operation in microwave devices. It is made from tungsten and iridium powders using a quaternary compound including barium, oxygen, a metal selected from the group consisting of osmium, iridium, rhodium, and rhenium, and a metal selected from the group consisting of strontium, calcium, scandium, and titanium as the impregnant

  10. Making and Changing Wills

    Directory of Open Access Journals (Sweden)

    Cheryl Tilse

    2016-02-01

    Full Text Available Wills are important social, economic, and legal documents. Yet little is known about current will making practices and intentions. A comprehensive national database on the prevalence of will making in Australia was developed to identify who is or is not most likely to draw up a will and triggers for making and changing wills. A national survey of 2,405 adults aged above 18 years was administered by telephone in August and September 2012. Fifty-nine percent of the Australian adult population has a valid will, and the likelihood of will making increases with age and estate value. Efforts to get organized, especially in combination with life stage and asset changes trigger will making; procrastination, rather than a strong resistance, appears to explain not making a will. Understanding will making is timely in the context of predicted significant intergenerational transfers of wealth, changing demographics, and a renewed emphasis on retirement planning.

  11. Extraterrestrial Life: Life on Mars - Then and Now

    Science.gov (United States)

    Arrhenius, Gustaf; Mojzsis, Stephen

    1996-01-01

    The recent claim to have identified possible signs of ancient life on Mars has been widely publicized and discussed. The authors conceded that none of the half-dozen pieces of evidence adduced in their paper individually provided strong support for extraterrestrial life, though they argued that the pieces added up to a case worth considering. Most - perhaps all - of the observed phenomena have counterparts in the inorganic world, so even the combination does not make a compelling case that there was ever life on Mars. Nevertheless, the importance of the problem has justified bringing the results to general attention. The paper has focussed interest on the origin and possible ubiquity of life, and on how we can design techniques capable of giving a more definitive answer to the question of whether there is, or has ever been, life elsewhere in the Universe.

  12. Design and Implementation of a General Decision-Making Model in RoboCup Simulation

    Directory of Open Access Journals (Sweden)

    Changda Wang

    2004-09-01

    Full Text Available The study of the collaboration, coordination and negotiation among different agents in a multi-agent system (MAS has always been the most challenging yet popular in the research of distributed artificial intelligence. In this paper, we will suggest for RoboCup simulation, a typical MAS, a general decision-making model, rather than define a different algorithm for each tactic (e.g. ball handling, pass, shoot and interception, etc. in soccer games as most RoboCup simulation teams did. The general decision-making model is based on two critical factors in soccer games: the vertical distance to the goal line and the visual angle for the goalpost. We have used these two parameters to formalize the defensive and offensive decisions in RoboCup simulation and the results mentioned above had been applied in NOVAURO®, original name is UJDB, a RoboCup simulation team of Jiangsu University, whose decision-making model, compared with that of Tsinghua University, the world champion team in 2001, is a universal model and easier to be implemented.

  13. A solution for heterogeneous domotic systems integration

    OpenAIRE

    Miori, Vittorio; Russo, Dario; Bianchi Bandinelli, Rolando

    2010-01-01

    The Information and Communication technologies spread across our life to make easier our everyday tasks and to increase the quality of our existence in every domain, realizing the Pervasive Computing vision. As in other domains, also in home environments many appliances are rapidly becoming computationally enabled, equipped with different communications protocols, and therefore connected to home networks. Domotic systems, variously called "smart homes", "smart environment systems", "intellige...

  14. Current health and preferences for life-prolonging treatments: an application of prospect theory to end-of-life decision making.

    Science.gov (United States)

    Winter, Laraine; Parker, Barbara

    2007-10-01

    As a substantial body of research attests, the acceptability of life-prolonging treatment (e.g., tube feeding) tends to be greater among people in worse health than among healthier ones. Because a decision for or against a life-prolonging treatment represents a choice between two prospects-life (usually in poor health) and death-we propose a decision model, Prospect Theory, as a theoretical account of this phenomenon. Prospect Theory postulates that pairs of distant prospects are less distinguishable than pairs of closer ones. Thus, to healthy individuals, the prospects of death and life in poor health would both be remote, and therefore, the distinction between them, small. To less healthy individuals, however, the difference between the same pairs of prospects would appear greater, and therefore, life-prolonging treatment may be more acceptable. In a cross-sectional study of 304 community-dwelling people, aged 60 years and over in the Philadelphia area, USA, preferences for 4 life-prolonging treatments in 9 health scenarios were examined in relation to participants' current health, operationalized as number of deficits in physical functioning. As predicted, less healthy people expressed stronger preferences for all life-prolonging treatments compared with healthier ones, with differences greatest in the worse-health scenarios. Preferences also varied by health scenario, with any treatment preferred in the better health scenarios. Treatment preferences did not differ by type of treatment, depressed mood or any demographic characteristic except race, with African-Americans expressing stronger treatment preferences. Implications for advance care planning are discussed.

  15. Negotiation and Decision Making with Collaborative Software: How MarineMap 'Changed the Game' in California's Marine Life Protected Act Initiative.

    Science.gov (United States)

    Cravens, Amanda E

    2016-02-01

    Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study-which draws on data from approximately 60 semi-structured interviews and an online survey--examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

  16. Negotiation and Decision Making with Collaborative Software: How MarineMap `Changed the Game' in California's Marine Life Protected Act Initiative

    Science.gov (United States)

    Cravens, Amanda E.

    2016-02-01

    Environmental managers and planners have become increasingly enthusiastic about the potential of decision support tools (DSTs) to improve environmental decision-making processes as information technology transforms many aspects of daily life. Discussions about DSTs, however, rarely recognize the range of ways software can influence users' negotiation, problem-solving, or decision-making strategies and incentives, in part because there are few empirical studies of completed processes that used technology. This mixed-methods study—which draws on data from approximately 60 semi-structured interviews and an online survey—examines how one geospatial DST influenced participants' experiences during a multi-year marine planning process in California. Results suggest that DSTs can facilitate communication by creating a common language, help users understand the geography and scientific criteria in play during the process, aid stakeholders in identifying shared or diverging interests, and facilitate joint problem solving. The same design features that enabled the tool to aid in decision making, however, also presented surprising challenges in certain circumstances by, for example, making it difficult for participants to discuss information that was not spatially represented on the map-based interface. The study also highlights the importance of the social context in which software is developed and implemented, suggesting that the relationship between the software development team and other participants may be as important as technical software design in shaping how DSTs add value. The paper concludes with considerations to inform the future use of DSTs in environmental decision-making processes.

  17. Quality of life technologies

    DEFF Research Database (Denmark)

    Wac, Katarzyna; Fiordelli, M.; Gustarini, M.

    2015-01-01

    Inevitably, as basic human needs are assured in any developed society, differentiating factors for quality of life (QoL) relate to a greater capacity to make informed decisions across daily life activities, especially those related to health. The availability of powerful, personalized, and wearable...

  18. Ethical Decision Making With End-of-Life Care: Palliative Sedation and Withholding or Withdrawing Life-Sustaining Treatments

    Science.gov (United States)

    Olsen, Molly L.; Swetz, Keith M.; Mueller, Paul S.

    2010-01-01

    Palliative sedation (PS) is the use of medications to induce decreased or absent awareness in order to relieve otherwise intractable suffering at the end of life. Although uncommon, some patients undergoing aggressive symptom control measures still have severe suffering from underlying disease or therapy-related adverse effects. In these circumstances, use of PS is considered. Although the goal is to provide relief in an ethically acceptable way to the patient, family, and health care team, health care professionals often voice concerns whether such treatment is necessary or whether such treatment equates to physician-assisted suicide or euthanasia. In this review, we frame clinical scenarios in which PS may be considered, summarize the ethical underpinnings of the practice, and further differentiate PS from other forms of end-of-life care, including withholding and/or withdrawing life-sustaining therapy and physician-assisted suicide and euthanasia. PMID:20805544

  19. Chinese familial tradition and Western influence: a case study in Singapore on decision making at the end of life.

    Science.gov (United States)

    Ho, Zheng Jie Marc; Radha Krishna, Lalit Kumar; Yee, Chung Pheng Alethea

    2010-12-01

    Decision making for an incompetent patient at the end of life is difficult for both family members and physicians alike. Often, palliative care teams are tasked with weaving through opinions, emotions, and goals in search for an amenable solution. Occasionally, these situations get challenging. We present the case of an elderly Chinese Singaporean with metastatic cancer, whose family and physicians had conflicting goals of care. The former was adamant on treating the patient's disease with an untested drug, whereas the latter aimed to treat his symptoms with more conventional medication. Drug-drug interactions prevented treatment with both. Beginning with a discussion of the patient's best interest, we delve into the Singaporean context to show how culture affects medical decision making. Confucianism and filial piety are the values on which this family's workings were based. In an analysis of what this entails, we attempt to explain the significant and assertive family involvement in the decision-making process and their insistence on using novel medications, having exhausted conventional interventions. Within this mix were Western influences, too. Through the Internet, family members have become more informed and empowered in decision making, wresting the traditional paternalistic role of physicians in favor of "patient autonomy." An understanding of such dynamic facets will help better tailor culturally appropriate approaches to such complex situations. Copyright © 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.

  20. Making Microbiology Even Smaller!

    Science.gov (United States)

    Young, Linda Mull; Motz, Vicki Abrams

    2013-01-01

    We outline protocols for producing slant-minis (SLINIs) and mini-deeps (MEEPs) and examples of their use in simple microbiology experiments suitable for high school students. The principal benefits of these protocols are decreased cost associated with significantly reduced media use; easier, less expensive disposal of waste; and increased safety…

  1. The concept of wrongful life in the law.

    Science.gov (United States)

    Kasper, A S

    1983-01-01

    In the history of the law the concept of wrongful life is not new, but it has become of interest recently due to changing social attitudes and advances in contraceptive and genetic technologies. This discussion tries to assess the effects of wrongful life as a legal concept on the rights of childbearing women and their offspring. An unborn child had no rights under common law, which held that a fetus in utero had no existence separate from its mother. Consequently, a child had no right of action for personal harm brought upon it by another person. On occasion early courts disagreed with this view, but the majority of courts maintained that a child had no existence as a human being during gestation. The effect that this concept of common law would have on current abortion laws would be to make it considerably easier to argue for a woman's right to choose an abortion. The notion of wrongful life initially appeared in cases of illegitimate births. In Zepeda v. Zepeda, 1963, and Williams v. State of New York, 1966, the plaintiffs maintained that the children's births and existence were wrongful because they were unintended and illegitimate. In Williams the court ruled that birth under 1 set of circumstances and not another is not a recoverable injury. These cases failed to meet the requirements of tort law, and the court rejected the notion of children finding legal recourse for being born to a poor family or being born to a less desired race or class. A series of cases followed in which recovery for physical injury or birth deformities were claimed by parents for themselves and their children. In June 1980 a California appeals court reversed the decision of a lower court, addressing the fundamental principles of wrongful life as a legal concept. In Curlender v. Bio-Science Laboratories an infant brought suit alleging that the laboratories failed to correctly inform her parents of their status as carriers of Tay-Sachs disease during the mother's pregnancy. The infant

  2. A Padawan Programmer's Guide to Developing Software Libraries.

    Science.gov (United States)

    Yurkovich, James T; Yurkovich, Benjamin J; Dräger, Andreas; Palsson, Bernhard O; King, Zachary A

    2017-11-22

    With the rapid adoption of computational tools in the life sciences, scientists are taking on the challenge of developing their own software libraries and releasing them for public use. This trend is being accelerated by popular technologies and platforms, such as GitHub, Jupyter, R/Shiny, that make it easier to develop scientific software and by open-source licenses that make it easier to release software. But how do you build a software library that people will use? And what characteristics do the best libraries have that make them enduringly popular? Here, we provide a reference guide, based on our own experiences, for developing software libraries along with real-world examples to help provide context for scientists who are learning about these concepts for the first time. While we can only scratch the surface of these topics, we hope that this article will act as a guide for scientists who want to write great software that is built to last. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Uncharted terrain: preference construction at the end of life.

    Science.gov (United States)

    White, Mary T

    2014-01-01

    Respect for patients' self-determination has long been considered central to efforts to improve end-of-life care, yet efforts to promote advance directives or engage patients in end-of-life discussions are often unsuccessful. In this article, I contend that this is because the shared decision-making approach typically used in healthcare assumes patients' capacity to make rational choices, which is not always possible in end-of-life decisions. Drawing on decision theory, behavioral psychology, and related studies of end-of-life care, I present a growing body of evidence that suggests the novelty, complexity, and uncertainty of end-of-life circumstances make rational and stable preferences difficult to establish. I argue that an effective decision-making approach for the terminally ill must recognize and respond to the unique characteristics of end-of-life choices, including their nonrational dimensions. I conclude with a description of an initiative that appears to do so, resulting in increased patients' satisfaction. Copyright 2014 The Journal of Clinical Ethics. All rights reserved.

  4. Physicians' experiences with end-of-life decision-making: Survey in 6 European countries and Australia

    Directory of Open Access Journals (Sweden)

    Mortier Freddy

    2008-02-01

    Full Text Available Abstract Background In this study we investigated (a to what extent physicians have experience with performing a range of end-of-life decisions (ELDs, (b if they have no experience with performing an ELD, would they be willing to do so under certain conditions and (c which background characteristics are associated with having experience with/or being willing to make such ELDs. Methods An anonymous questionnaire was sent to 16,486 physicians from specialities in which death is common: Australia, Belgium, Denmark, Italy, the Netherlands, Sweden and Switzerland. Results The response rate differed between countries (39–68%. The experience of foregoing life-sustaining treatment ranged between 37% and 86%: intensifying the alleviation of pain or other symptoms while taking into account possible hastening of death between 57% and 95%, and experience with deep sedation until death between 12% and 46%. Receiving a request for hastening death differed between 34% and 71%, and intentionally hastening death on the explicit request of a patient between 1% and 56%. Conclusion There are differences between countries in experiences with ELDs, in willingness to perform ELDs and in receiving requests for euthanasia or physician-assisted suicide. Foregoing treatment and intensifying alleviation of pain and symptoms are practiced and accepted by most physicians in all countries. Physicians with training in palliative care are more inclined to perform ELDs, as are those who attend to higher numbers of terminal patients. Thus, this seems not to be only a matter of opportunity, but also a matter of attitude.

  5. Making Healthy Decisions About Sex

    Science.gov (United States)

    ... For Teens: How to Make Healthy Decisions About Sex Page Content Article Body Before you decide to ... alcohol or use drugs. Are You Ready for Sex? Sex can change your life and relationships. Having ...

  6. BioBlocks: Programming protocols in biology made easier

    OpenAIRE

    Pau, Ivan; Gupta, Vishal; Irimia, Jesus; Rodriguez-Paton, Alfonso

    2016-01-01

    The methods to execute biological experiments are evolving. Affordable fluid handling robots and on-demand biology enterprises are making automating entire experiments a reality. Automation offers the benefit of high-throughput experimentation, rapid prototyping and improved reproducibility of results. However, learning to automate and codify experiments is a difficult task as it requires programming expertise. Here, we present a web-based visual development environment called BioBlocks for d...

  7. Where Should We Look for Life?

    Science.gov (United States)

    Kohler, Susanna

    2018-04-01

    The first challenge in the hunt for life elsewhere in our universe is to decide where to look. In a new study, two scientists examine whether Sun-like stars or low-mass M dwarfs are the best bet for hosting exoplanets with detectable life.Ambiguity of HabitabilityThe habitable zones of cool M-dwarf stars lie much closer in than for Sun-like stars, placing habitable-zone planets around M dwarfs at greater risk of being affected by space weather.Most exoplanet scientists will freely admit frustration with the term habitability its a word that has many different meanings and is easily misinterpreted when it appears in news articles. Just because a planet lies in a stars habitable zone, for instance, doesnt mean its necessarily capable of supporting life.This ambiguity, argue authors Manasvi Lingam and Abraham Loeb (Harvard University and Harvard-Smithsonian Center for Astrophysics), requires us to take a strategic approach when pursuing the search for primitive life outside of our solar system. In particular, we risk losing the enthusiasm and support of the public (and funding sources!) when wefocus on the general search for planets in stellar habitable zones, rather than specifically searching for the planets most likely to have detectable signatures of life.Illustration of the difference between a Sun-like star and a lower-mass, cooler M-dwarf star. [NASAs Goddard Space Flight Center/S. Wiessinger]Weighing Two TargetsSo how do we determine where best to look for planets with detectable biosignatures? To figure out which stars make the optimal targets, Lingam and Loeb suggest an approach based on standard cost-benefit analyses common in economics. Here, whats being balanced is the cost of an exoplanet survey mission against the benefit of different types of stellar targets.In particular, Lingam and Loeb weigh the benefit of targeting solar-type stars against that of targeting stars of any other mass (such as low-mass M-dwarfs, popular targets of many current

  8. External GSM phone calls now made simpler

    CERN Multimedia

    2007-01-01

    On 2 July, the IT/CS Telecom Service introduced a new service making external calls from CERN GSM phones easier. A specific prefix is no longer needed for calls outside CERN. External calls from CERN GSM phones are to be simplified. It is no longer necessary to use a special prefix to call an external number from the CERN GSM network.The Telecom Section of the IT/CS Group is introducing a new system that will make life easier for GSM users. It is no longer necessary to use a special prefix (333) to call an external number from the CERN GSM network. Simply dial the number directly like any other Swiss GSM customer. CERN currently has its own private GSM network with the Swiss mobile operator, Sunrise, covering the whole of Switzerland. This network was initially intended exclusively for calls between CERN numbers (replacing the old beeper system). A special system was later introduced for external calls, allowing them to pass thr...

  9. Making Sustainable Decisions Using The KONVERGENCE Framework

    International Nuclear Information System (INIS)

    Piet, S. J.; Gibson, P. L.; Joe, J. C.; Kerr, T. A.; Nitschke, R. L.; Dakins, M. E.

    2003-01-01

    Hundreds of contaminated facilities and sites must be cleaned up. ''Cleanup'' includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done--some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept ''as is'' or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: (1) Knowledge: what is known about the problem and possible solutions? (2) Values: what is important to those affected by the decision? (3) Resources: what is available to implement possible solutions or improve knowledge? This mental model helps analyze and visualize what is happening as decisions are made and kept. Why is there disagreement? Is there movement toward konvergence? Is a past decision drifting out of konvergence? The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases

  10. Making Sustainable Decisions Using The KONVERGENCE Framework

    Energy Technology Data Exchange (ETDEWEB)

    Piet, S. J.; Gibson, P. L.; Joe, J. C.; Kerr, T. A.; Nitschke, R. L.; Dakins, M. E.

    2003-02-25

    Hundreds of contaminated facilities and sites must be cleaned up. ''Cleanup'' includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done--some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period-from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept ''as is'' or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: (1) Knowledge: what is known about the problem and possible solutions? (2) Values: what is important to those affected by the decision? (3) Resources: what is available to implement possible solutions or improve knowledge? This mental model helps analyze and visualize what is happening as decisions are made and kept. Why is there disagreement? Is there movement toward konvergence? Is a past decision drifting out of konvergence? The framework includes strategic improvements, i.e., expand the spectrum of alternatives to include adaptable alternatives and decision networks. It includes tactical process improvements derived from experience, values, and relevant literature. This paper includes diagnosis and medication (suggested path forward) for intractable cases.

  11. The reality of the women who make our lives easier: experience in a company that assemblies electric motors in Venezuela.

    Science.gov (United States)

    Yanes Escalona, L; Sandia Venot, R; Escalona, E; Yanes, L

    2012-01-01

    intervene a workline throughout ergonomic approach to diminish incidence of Carpal Tunnel Syndrome (CTS). an ergonomic intervention study was developed in workstations with highest index of musculoskeletal disorder (MED) associated to cumulative trauma. The Deparis method, Reba and Ocra check list methods were used, also morbility reviewes. National and international ethics criteria were carried out. workers identified 3 fundamental issues using the Deparis method: repetitive activities, postures adopted and uncomfortable furniture. The analysis of the workstation with Reba and Ocra methods before the changes, evidenciated that 56% of postures adopted were high risk postures, the 44% remaining were medium and low-risk. Following the active pause program (APP), furniture changes and work rhythm decrease, was noted that the risk of suffering MED decreased. The morbility review, drop in consults of musculoskeletal system (MES) related to CTS observed. The APP was well accepted by women, but not initially men. the research show that when the work rhythm decreases, the symptom of MES related to CTS have a remarkable decrease, also that changes in the furniture, generate great ergonomic differences and changes in the work environment are not possible if workers don't empower the tools to make-it.

  12. Hydration and nutrition at the end of life: a systematic review of emotional impact, perceptions, and decision-making among patients, family, and health care staff.

    Science.gov (United States)

    Del Río, M I; Shand, B; Bonati, P; Palma, A; Maldonado, A; Taboada, P; Nervi, F

    2012-09-01

    Decrease in oral intake, weight loss, and muscular weakness in the last phases of a terminal illness, particularly in the context of the cachexia-anorexia syndrome, can be an important source of anxiety for the triad of patient, family, and health staff. The present literature review examines the emotional impact of reduced oral intake as well as perceptions and attitudes toward assisted nutrition and hydration for terminally ill patients(1) at the end of life, among patients, family, and health care staff. We have identified the ways in which emotional and cultural factors influence decision-making about assisted nutrition and hydration. Lack of information and misperceptions of medically assisted nutrition and hydration can play a predominant role in the decision to begin or suspend nutritional or hydration support. Our literature review reveals that these social, emotional, and clinical misperception elements should be considered in the decision-making processes to help the triad develop functional forms of care at this final stage of life. Copyright © 2011 John Wiley & Sons, Ltd. Copyright © 2011 John Wiley & Sons, Ltd.

  13. The effects of the Make a Wish intervention on psychiatric symptoms and health-related quality of life of children with cancer: a randomised controlled trial.

    Science.gov (United States)

    Shoshani, Anat; Mifano, Keren; Czamanski-Cohen, Johanna

    2016-05-01

    Children with life-threatening medical conditions frequently undergo invasive medical procedures that may elicit anxiety and distress. However, there are few empirically validated interventions that reduce mental health symptoms and increase the resilience of children during the acute stages of illness. This study aimed to evaluate the efficacy of the Make a Wish intervention for children with life-threatening cancer. The design was a wait-list-controlled trial with two parallel groups. Sixty-six children aged 5-12 with an initial diagnosis of life-threatening cancer were identified and randomly assigned to the Make a Wish intervention (n = 32) or a wait-list control group (n = 34). Children completed measures of psychiatric and health-related symptoms, positive and negative affect, hope, and optimism pre-intervention and post-intervention. After baseline data collection, children were interviewed and made an authentic wish that they wanted to come true. These wishes were made possible 5-6 months after baseline data collection, to fuel anticipation and excitement over the wish-fulfillment event. The post-intervention assessment point was 5 weeks after wish fulfillment (approximately 7 months after baseline data collection). Children in the intervention group exhibited a significant reduction in general distress (d = 0.54), depression (d = 0.70), and anxiety symptoms (d = 0.41), improved health-related quality of life (d = 0.59), hope (d = 0.71), and positive affect (d = 0.80) compared to decrease in positive affect and no significant changes in the other measures in the control group. These findings emphasize the role of hope and positive emotions in fostering the well-being of children who suffer from serious illnesses.

  14. Regression models for the restricted residual mean life for right-censored and left-truncated data

    DEFF Research Database (Denmark)

    Cortese, Giuliana; Holmboe, Stine A.; Scheike, Thomas H.

    2017-01-01

    The hazard ratios resulting from a Cox's regression hazards model are hard to interpret and to be converted into prolonged survival time. As the main goal is often to study survival functions, there is increasing interest in summary measures based on the survival function that are easier to inter......The hazard ratios resulting from a Cox's regression hazards model are hard to interpret and to be converted into prolonged survival time. As the main goal is often to study survival functions, there is increasing interest in summary measures based on the survival function that are easier...... to interpret than the hazard ratio; the residual mean time is an important example of those measures. However, because of the presence of right censoring, the tail of the survival distribution is often difficult to estimate correctly. Therefore, we consider the restricted residual mean time, which represents...... a partial area under the survival function, given any time horizon τ, and is interpreted as the residual life expectancy up to τ of a subject surviving up to time t. We present a class of regression models for this measure, based on weighted estimating equations and inverse probability of censoring weighted...

  15. Voice as Form of Life and Life Form

    Directory of Open Access Journals (Sweden)

    Sandra Laugier

    2015-10-01

    Full Text Available This paper studies the concept of form of life as central to ordinary language philosophy (as understood in Wittgenstein’s, Austin’s and Stanley Cavell’s work: philosophy of our language as spoken; pronounced by a human voice within a form of life. Such an approach to Wittgenstein’s later philosophy shifts the question of the common use of language – central to Wittgenstein’s Investigations – to the definition of the subject as voice, and to the reinvention of subjectivity in language. The voice is both a subjective and common expression: it is what makes it possible for my individual voice, or claim, to become shared and for our forms of life to be intertwined with a lifeform.

  16. Self-Other Decision Making and Loss Aversion

    Science.gov (United States)

    Polman, Evan

    2012-01-01

    In eight studies, we tested the prediction that making choices for others involves less loss aversion than making choices for the self. We found that loss aversion is significantly lessened among people choosing for others in scenarios describing riskless choice (Study 1), gambling (Studies 2 and 3), and social aspects of life, such as likeably…

  17. Goal Setting and Decision Making by At-Risk Youth

    Science.gov (United States)

    Galotti, Kathleen M.; Kozberg, Steven F.; Gustafon, Mary

    2009-01-01

    Typically, adolescence is a time when individuals begin to make consequential, life-framing decisions. However, much of the decision-making literature focuses on high-risk decisions, such as the use of drugs and alcohol, while much less is known about how adolescents make positive decisions, for example, regarding their educational or career…

  18. Real-life characteristics of asthma inhaler device use in South Korea

    NARCIS (Netherlands)

    Wan Yau Ming, S.; Rhee, C.K.; Park, H.Y.; Yoo, K.H.; Kim, D.K.; Van Boven, J.F.; Price, D.; Park, H.S.

    2016-01-01

    Background and Aims: Historically, dry powder inhalers (DPIs) were considered to provide better airway distribution, easier identification of empty devices, and easier handling when compared to pressurized metered dose inhalers (pMDIs). Prior research into the major handling errors with inhaler

  19. Influence of service life on Life Cycle Assessments

    NARCIS (Netherlands)

    van Nunen, H.; Hendriks, N.A.; Erkelens, P.A.

    2003-01-01

    Environmental assessment is part of present decision making. But, because of difficulties the assessments are not as profound as could be. Life Cycle Assessment (LCA) is a cradle-to-grave approach and consequently a time factor is embedded. Until now this time factor is fixed and calculations are

  20. Alternative Fuels Data Center: Workplace Charging Success: MetLife

    Science.gov (United States)

    future." Several others noted that their decision to purchase or lease a PEV was based on MetLife's : MetLife " By making PEV charging stations more readily available to employees, we can encourage more promote alternative transportation. By making PEV charging stations more readily available to employees

  1. Late Career Decision-Making: A Qualitative Panel Study

    NARCIS (Netherlands)

    Wilmar Schaufeli; Annet de Lange; Juhani Ilmarinen; Per Erik Solem; Trude Furunes; Reidar Mykletun; Astri Syse

    2015-01-01

    The aim of this longitudinal qualitative interview study (3 waves of interviews) was to examine the nature of older workers’ late career decision-making processes, including the main drivers and obstacles for prolonging working life or retiring. Late career decision-making is regarded as a process

  2. Promoting Shared Decision Making through Descriptive Inquiry

    Science.gov (United States)

    Seher, Rachel; Traugh, Cecelia; Cheng, Alan

    2018-01-01

    This article shows how City-As-School, a progressive public school in New York City, used descriptive inquiry to deepen shared decision making, which is a central value of the school and part of a democratic way of life. Descriptive inquiry is a democratic knowledge-making process that was developed at the Prospect School in North Bennington,…

  3. Outside corner and method of making in the making lead brick (plain brick) using rotary table

    International Nuclear Information System (INIS)

    Muhammad Awwaluddin; Samuel Praptoyo

    2009-01-01

    It has been developed a tool that can be used for defining angles on the fabrication of lead bricks. The angles are both outside of the lead bricks that correspond to male and female shape respectively. The lead bricks should be in accordance to ISO 7212-1986 standard which has angle tolerance 90° 0 +15 for male and 90° 0 -15 for female. The accuracy of these angles is very important to maintain the equilibrium position of the bricks so that their arrangement will not lining or collapse. A rotary table is used for the fabrication to make easier in setting up any related working apparatus and to have precision measurement result. However, a lot of operator do not know yet how to operate such a rotary table to produce angle with such an eligible tolerance. Therefore, a method of measurement in machining lead brick process using a rotary table is necessarily required. This method will be used as a reference to have angle accuracy of 0,03° in producing outside and inside angles or male and female lead bricks. (author)

  4. Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

    Science.gov (United States)

    2012-01-01

    Background Little is known about pressure from patients or relatives on physician’s decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs) in cases of continuous sedation after the introduction of the Dutch practice guideline, using a questionnaire survey. Methods A sample of 918 Dutch GPs were invited to fill out a questionnaire about their last patient under continuous sedation. Cases in which GPs experienced pressure from the patient, relatives or other persons were compared to those without pressure. Results 399 of 918 invite GPs (43%) returned the questionnaire and 250 provided detailed information about their most recent case of continuous sedation. Forty-one GPs (16%) indicated to have experienced pressure from the patient, relatives or colleagues. In GPs younger than 50, guideline knowledge was not related to experienced pressure, whereas in older GPs, 15% with and 36% without guideline knowledge reported pressure. GPs experienced pressure more often when patients had psychological symptoms (compared to physical symptoms only) and when patients had a longer estimated life expectancy. A euthanasia request of the patient coincided with a higher prevalence of pressure for GPs without, but not for GPs with previous experience with euthanasia. GPs who experienced pressure had consulted a palliative consultation team more often than GPs who did not experience pressure. Conclusion One in six GPs felt pressure from patients or relatives to start sedation. This pressure was related to guideline knowledge, especially in older GPs, longer life expectancy and the presence of a euthanasia request, especially for GPs without previous experience of euthanasia. PMID:22759834

  5. Examining Community Life "in the Making": Emile Durkheim's "Moral Education"

    Science.gov (United States)

    Prus, Robert

    2011-01-01

    Although often overlooked in sociological circles, Emile Durkheim's ("1902-1903") "Moral Education" provides an important cornerstone in the quest to understand community life. Not only does "Moral Education" give a vibrant realism to the sociological venture in ways that Durkheim's earlier works ("1893", "1895", "1897') fail to achieve, but in…

  6. Using Life Cycle Assessment to Inform Decision-Making for Sustainable Buildings

    Directory of Open Access Journals (Sweden)

    Mieke Vandenbroucke

    2015-05-01

    Full Text Available Because the student residences of the Vrije Universiteit Brussel built in 1973 are not adapted to current comfort standards, the university decided to construct new accommodation facilities at the border of the campus. However, besides demolition, there was no strategy on how to deal with the existing ones. In the search for a more sustainable strategy, the university’s administration assigned the TRANSFORM research team to define various design strategies and to assess the long-term environmental consequences in order to select the best strategy by the use of Life Cycle Environmental Assessment. Current Life Cycle Environmental Assessments generally include maintenance, repair, replacement and operational energy consumption during use, but do not include future refurbishments. However, it is likely that their impact cannot be neglected either. Therefore, this article offers a framework which takes future refurbishments into account, in addition to the standard use impacts: initial and end-of-life impact. We report on the construction assemblies, the results of the assessments conducted and the advice provided. The results confirm that the impact of future refurbishments cannot be neglected. In addition, we observed that there were significant environmental savings when transforming the residences compared to new construction, and long-term benefits of a design enabling the reuse of building elements.

  7. Trends in End-of-Life Decision Making in Patients With and Without Cancer

    NARCIS (Netherlands)

    Pardon, K.; Chambaere, K.; Pasman, H.R.W.; Deschepper, R.; Rietjens, J.; Deliens, L.

    2013-01-01

    Purpose: Because of cancer's high symptom burden and specific disease course, patients with cancer are more likely than other patients to face end-of-life decisions that have possible or certain life-shortening effects (ELDs). This study examines the incidence of ELDs in patients with cancer

  8. Social modulation of decision-making: a cross-species review

    Science.gov (United States)

    van den Bos, Ruud; Jolles, Jolle W.; Homberg, Judith R.

    2013-01-01

    Taking decisions plays a pivotal role in daily life and comprises a complex process of assessing and weighing short-term and long-term costs and benefits of competing actions. Decision-making has been shown to be affected by factors such as sex, age, genotype, and personality. Importantly, also the social environment affects decisions, both via social interactions (e.g., social learning, cooperation and competition) and social stress effects. Although everyone is aware of this social modulating role on daily life decisions, this has thus far only scarcely been investigated in human and animal studies. Furthermore, neuroscientific studies rarely discuss social influence on decision-making from a functional perspective such as done in behavioral ecology studies. Therefore, the first aim of this article is to review the available data of the influence of the social context on decision-making both from a causal and functional perspective, drawing on animal and human studies. Also, there is currently still a gap between decision-making in real life where influences of the social environment are extensive, and decision-making as measured in the laboratory, which is often done without any (deliberate) social influences. However, methods are being developed to bridge this gap. Therefore, the second aim of this review is to discuss these methods and ways in which this gap can be increasingly narrowed. We end this review by formulating future research questions. PMID:23805092

  9. Shared decision-making in end-stage renal disease: a protocol for a multi-center study of a communication intervention to improve end-of-life care for dialysis patients.

    Science.gov (United States)

    Eneanya, Nwamaka D; Goff, Sarah L; Martinez, Talaya; Gutierrez, Natalie; Klingensmith, Jamie; Griffith, John L; Garvey, Casey; Kitsen, Jenny; Germain, Michael J; Marr, Lisa; Berzoff, Joan; Unruh, Mark; Cohen, Lewis M

    2015-06-12

    End-stage renal disease carries a prognosis similar to cancer yet only 20 % of end-stage renal disease patients are referred to hospice. Furthermore, conversations between dialysis team members and patients about end-of-life planning are uncommon. Lack of provider training about how to communicate prognostic data may contribute to the limited number of end-of-life care discussions that take place with this chronically ill population. In this study, we will test the Shared Decision-Making Renal Supportive Care communication intervention to systematically elicit patient and caretaker preferences for end-of-life care so that care concordant with patients' goals can be provided. This multi-center study will deploy an intervention to improve end-of-life communication for hemodialysis patients who are at high risk of death in the ensuing six months. The intervention will be carried out as a prospective cohort with a retrospective cohort serving as the comparison group. Patients will be recruited from 16 dialysis units associated with two large academic centers in Springfield, Massachusetts and Albuquerque, New Mexico. Critical input from patient advisory boards, a stakeholder panel, and initial qualitative analysis of patient and caretaker experiences with advance care planning have informed the communication intervention. Rigorous communication training for hemodialysis social workers and providers will ensure that standardized study procedures are performed at each dialysis unit. Nephrologists and social workers will communicate prognosis and provide advance care planning in face-to-face encounters with patients and families using a social work-centered algorithm. Study outcomes including frequency and timing of hospice referrals, patient and caretaker satisfaction, quality of end-of-life discussions, and quality of death will be assessed over an 18 month period. The Shared Decision-Making Renal Supportive Care Communication intervention intends to improve discussions

  10. Wains: a pattern-seeking artificial life species.

    Science.gov (United States)

    de Buitléir, Amy; Russell, Michael; Daly, Mark

    2012-01-01

    We describe the initial phase of a research project to develop an artificial life framework designed to extract knowledge from large data sets with minimal preparation or ramp-up time. In this phase, we evolved an artificial life population with a new brain architecture. The agents have sufficient intelligence to discover patterns in data and to make survival decisions based on those patterns. The species uses diploid reproduction, Hebbian learning, and Kohonen self-organizing maps, in combination with novel techniques such as using pattern-rich data as the environment and framing the data analysis as a survival problem for artificial life. The first generation of agents mastered the pattern discovery task well enough to thrive. Evolution further adapted the agents to their environment by making them a little more pessimistic, and also by making their brains more efficient.

  11. Decision-Making and the Iowa Gambling Task: Ecological validity in individuals with substance dependence

    Directory of Open Access Journals (Sweden)

    Antonio Verdejo-Garcia

    2006-03-01

    Full Text Available Substance Dependent Individuals (SDIs usually show deficits in real-life decision-making, as illustrated by their persistence in drug use despite a rise in undesirable consequences. The Iowa Gambling Task (IGT is an instrument that factors a number of aspects of real-life decision-making. Although most SDIs are impaired on the IGT, there is a subgroup of them who perform normally on this task. One possible explanation for this differential performance is that impairment in decision-making is largely detected on the IGT when the use of drugs escalates in the face of rising adverse consequences. The aim of this study is to test this hypothesis, by examining if several real-life indices associated with escalation of addiction severity (as measured by the Addiction Severity Index -ASI- are predictive of risky decisions, as revealed by impaired performance on different versions of the IGT. We administered the ASI and different versions of the IGT (the main IGT version, a variant IGT version, and two parallel versions of each to a large sample of SDI. We used regression models to examine the predictive effects of the seven real-life domains assessed by the ASI on decision-making performance as measured by the IGT. We included in regression models both ASI-derived objective and subjective measures of each problem domain. Results showed (i that several aspects of real-life functioning associated with addiction severity were moderate predictors of IGT decision-making performance; (ii that the combined assessment of decision-making using different versions of the IGT yielded better predictive measures than assessment using isolated versions of the IGT; and (iii that objective measures of real-life functioning were better predictors of decision-making performance on the IGT than subjective measures based on SDI's insight about their problems. These results support the notion that decision-making deficits as measured by the IGT are associated with a rise in

  12. Life histories in occupational therapy clinical practice.

    Science.gov (United States)

    Frank, G

    1996-04-01

    This article defines and compares several narrative methods used to describe and interpret patients' lives. The biographical methods presented are case histories, life-charts, life histories, life stories, assisted autobiography, hermeneutic case reconstruction, therapeutic employment, volitional narratives, and occupational storytelling and story making. Emphasis is placed the clinician as a collaborator and interpreter of the patient's life through ongoing interactions and dialogue.

  13. History Making: The Historian as Consultant

    Directory of Open Access Journals (Sweden)

    Jorma Kalela

    2013-11-01

    Full Text Available History is not just a genre of knowledge but also a basic feature of human life. Accounting for the past, or creating histories, to quote David Thelen, is ‘as natural a part of life as eating or breathing’. Casual references to what has taken place make up the vast majority of these accounts. But there are also a great number of deliberately created expositions of the past. They are produced in every field of society and by a wide variety of actors, from private persons to, for example, politicians and various media. The totality of them can be called everyday history. These accounts of the past serve present purposes – histories have innumerable functions and are of countless types. Divergent accounts also influence each other, and my suggestion is that their interaction be called the never-ending social process of history-making. History making, in other words, is not the preserve of academically-trained historians. They are experts but not outside observers. Scholarly historians are inescapably involved in the social process of history making. Their work goes beyond prevailing histories: they seek interpretations that make better sense of the past than the existing ones. Embedded in this effort is another constructivist function: they demonstrate ways to think about the past and how to use it. When demonstrating ‘that’s not how it was’, historians at the same display ‘how the presentation should have been constructed’. Even if they don’t think of themselves as consultants on history making they act in this capacity.

  14. Review of life-cycle approaches coupled with data envelopment analysis: launching the CFP + DEA method for energy policy making.

    Science.gov (United States)

    Vázquez-Rowe, Ian; Iribarren, Diego

    2015-01-01

    Life-cycle (LC) approaches play a significant role in energy policy making to determine the environmental impacts associated with the choice of energy source. Data envelopment analysis (DEA) can be combined with LC approaches to provide quantitative benchmarks that orientate the performance of energy systems towards environmental sustainability, with different implications depending on the selected LC + DEA method. The present paper examines currently available LC + DEA methods and develops a novel method combining carbon footprinting (CFP) and DEA. Thus, the CFP + DEA method is proposed, a five-step structure including data collection for multiple homogenous entities, calculation of target operating points, evaluation of current and target carbon footprints, and result interpretation. As the current context for energy policy implies an anthropocentric perspective with focus on the global warming impact of energy systems, the CFP + DEA method is foreseen to be the most consistent LC + DEA approach to provide benchmarks for energy policy making. The fact that this method relies on the definition of operating points with optimised resource intensity helps to moderate the concerns about the omission of other environmental impacts. Moreover, the CFP + DEA method benefits from CFP specifications in terms of flexibility, understanding, and reporting.

  15. An Extended TOPSIS Method for the Multiple Attribute Decision Making Problems Based on Interval Neutrosophic Set

    Directory of Open Access Journals (Sweden)

    Pingping Chi

    2013-03-01

    Full Text Available The interval neutrosophic set (INS can be easier to express the incomplete, indeterminate and inconsistent information, and TOPSIS is one of the most commonly used and effective method for multiple attribute decision making, however, in general, it can only process the attribute values with crisp numbers. In this paper, we have extended TOPSIS to INS, and with respect to the multiple attribute decision making problems in which the attribute weights are unknown and the attribute values take the form of INSs, we proposed an expanded TOPSIS method. Firstly, the definition of INS and the operational laws are given, and distance between INSs is defined. Then, the attribute weights are determined based on the Maximizing deviation method and an extended TOPSIS method is developed to rank the alternatives. Finally, an illustrative example is given to verify the developed approach and to demonstrate its practicality and effectiveness.

  16. Use of Integrative Oncology, Involvement in Decision-Making, and Breast Cancer Survivor Health-Related Quality of Life in the First 5 Years Postdiagnosis.

    Science.gov (United States)

    Andersen, M Robyn; Sweet, Erin; Hager, Shelly; Gaul, Marcia; Dowd, Fred; Standish, Leanna J

    2018-03-01

    This study sought to describe changes in the health-related quality of life (HRQOL) of women who do and do not seek naturopathic oncology (NO) complementary and alternative medicine (CAM) care during and immediately after breast cancer treatment, and to explore the predictive role of NO CAM care, demographic characteristics, and involvement in decision-making on HRQOL in breast cancer survivors. Matched cohorts of breast cancer survivors who did and did not choose to supplement their breast cancer treatment with NO care within 2 years of diagnosis participated. NO users were identified through naturopathic doctors' clinics and usual care (UC) controls with similar prognosis were identified through a cancer registry. The registry provided information about all participants' age, race, ethnicity, marital status, stage of cancer at time of diagnosis, date of diagnosis, and use of conventional medical treatments (surgery, chemotherapy, radiation, and endocrine therapy). Data of participants' self-reported involvement in decision-making and HRQOL were collected at study enrollment and at 6-month follow-up. At 6-month follow-up, the NO patients reported significantly more involvement in decision-making about care and better general health than did UC patients ( P decision-making about cancer treatment was associated with better role-physical, role-emotional, and social-functional well-being ( P decision-making about cancer treatment may be associated with better HRQOL in breast cancer survivors.

  17. Making of Magnet Barium Ferit Anisotropic

    International Nuclear Information System (INIS)

    Idayati, Novrita; Dedi

    2003-01-01

    Barium Hexa ferrite (BaFe 12 O 19 ) is ceramic and materials which usually used for making of permanent magnet. In this research Barium Hexa ferrite were made Anisotropic, and applied for loudspeaker, electro motors, dynamo, KWh metre, etc. this Magnet is commonly used due to its high Induction of Remanen (Br) and coercivity (high Hc). Besides it applies a more simple and easier process technology, cheaper raw material, and easy to find it, hence the magnetic component is much cheaper. Powder Metallurgy was used for the process technology, by reacting all materials in the powder (oxide), with a certain size distribution and a tight preparation step. The next step was mixing ferrite and Barium Carbonate (in the form of oxide), calcination, compaction, cantering and characterisation. The Anisotropic particle effects a high Induce Remanen (Br) and of koersifitas (high Hc). All the process steps will is determine physical and chemical characteristics of the magnet. The best Magnet characteristic of the magnet produced in this research is Induction of Remanen (Br) = 4,27 kg, Coercivity (Hc) = 1,745 kOe, Energy Product max (BHmaks) = 2,31 MGOe

  18. Projects to get you off the grid rain barrels, chicken coops, and solar panels

    CERN Document Server

    Instructablescom

    2014-01-01

    Instructables is back with this compact book focused on a series of projects designed to get you thinking creatively about thinking green. Twenty Instructables illustrate just how simple it can be to make your own backyard chicken coop, or turn a wine barrel into a rainwater collector.Illustrated with dozens of full-color photographs per project accompanying easy-to-follow instructions, this Instructables collection utilizes the best that the online community has to offer, turning a far-reaching group of people into a mammoth database churning out ideas to make life better, easier, and in this

  19. Conducting everyday life

    DEFF Research Database (Denmark)

    Juhl, Pernille

    , they are involved in preventive interventions. I conducted participatory observations with the children in their everyday life. Overall, the study stresses that even small children must be perceived as active participants who act upon and struggle with different conditions and meaning making processes across......In the paper I discuss how small children (0-4 year) develop through ‘conducting everyday life’ across contexts (Holzkamp 2013). I discuss how this process of conducting everyday life is essential when discussing the ‘good life for children’ from a child perspective. These issues are addressed...... contexts (home, day care, part-time foster family) and in relation to other co-participants....

  20. End-of-life decision making in respiratory failure. The therapeutic choices in chronic respiratory failure in a 7-item questionnaire

    Directory of Open Access Journals (Sweden)

    Dagmar Elfriede Rinnenburger

    2012-01-01

    Full Text Available INTRODUCTION: The transition from paternalistic medicine to a healthcare culture centred on the patient's decision making autonomy presents problems of communication and understanding. Chronic respiratory failure challenges patients, their families and caregivers with important choices, such as invasive and non-invasive mechanical ventilation and tracheostomy, which, especially in the case of neuromuscular diseases, can significantly postpone the end of life. MATERIAL AND METHODS: A 7-item questionnaire was administered to 100 patients with advanced COPD, neuromuscular diseases and pulmonary fibrosis, all of them on oxygen therapy and receiving day-hospital treatment for respiratory failure. The objective was to find out whether or not patients, if faced with a deterioration of their health condition, would want to take part in the decision making process and, if so, how and with whom. RESULTS. Results showed that: 90% of patients wanted to be interviewed, 10% preferred not to be interviewed, 82% wanted to be regularly updated on their clinical situation, 75% wanted to be intubated, if necessary, and 56% would also agree to have a tracheostomy. These choices have been confirmed one year later, with 93% of respondents accepting the questionnaire and considering it useful. CONCLUSIONS: It is possible to conclude that a simple questionnaire can be a useful tool contributing to therapeutic decision making in respiratory failure.

  1. Life on Mars

    Science.gov (United States)

    McKay, Christopher P.; Cuzzi, Jeffrey (Technical Monitor)

    1996-01-01

    Although the Viking results may indicate that Mars has no life today, the possibility exists that Mars may hold the best record of the events that led to the origin of life. There is direct geomorphological evidence that in the past Mars had large amounts of liquid water on its surface. Atmospheric models would suggest that this early period of hydrological activity was due to the presence of a thick atmosphere and the resulting warmer temperatures. From a biological perspective the existence of liquid water, by itself motivates the question of the origin of life on Mars. From studies of the Earth's earliest biosphere we know that by 3.5 Gyr. ago, life had originated on Earth and reached a fair degree of biological sophistication. Surface activity and erosion on Earth make it difficult to trace the history of life before the 3.5 Gyr timeframe. If Mars did maintain a clement environment for longer than it took for life to originate on Earth, then the question of the origin of life on Mars follows naturally.

  2. End-of-Life Decisions and Advanced Old Age

    Directory of Open Access Journals (Sweden)

    Stoyles

    2014-07-01

    Full Text Available Despite the fact that most people die in advanced old age, little attention is given to cases involving older people in debates about the moral and legal dimensions of end-of-life decision making. The purpose of this paper is to establish some of the ways our discussions should change as we pay attention to important factors influencing end-of-life decisions for people in advanced old age. Focusing on the prevalence of comorbidities and the likelihood that people in advanced old age will experience an extended period of declining function before death, I argue that our debates should be expanded to include greater consideration of how we want to live in the final stages of life. With this, I am arguing against the tendency to think that “end-of-life” decision making concerns only making decisions about when and how it is appropriate to terminate a person’s life. I argue, further, that we should move away from the medicalization of dying.

  3. Vivência com pais de adolescentes: uma proposta de curso que facilita o relacionamento Vivencia con padres de adolescentes: una propuesta de curso que facilita el relacionamiento An experience of life with parents of adolescents: a proposal of a course which makes the relationship easier

    Directory of Open Access Journals (Sweden)

    Célia Maria Ferreira da Silva Teixeira

    1996-07-01

    los aspectos de la adolescencia, la repercusión de ésta en el contexto familiar, así como, propició intercambio de opiniones, compartir dudas, sentimientos de inseguridad frente a la tarea de ser padres de adolescentes, permitiendo la construcción de nuevas formas de percibir por parte de los padres, sentir expresar sus afectos.The author describes an experience of a short term course for parents of adolescents and professionals, who deal with this age group. Participants were mothers of different professions: a principal of an elementary school, a pedagogic coordinator of an elementary and a high school, pedagogues, a student of pedagogy and students of phsyco pedagogy. The reasons for the choice presented by the participants centered in difficulties in the relationship between parents and their children and in the search for more satisfactory and functional forms of the parents-children dyad. The author made use of systemic referential about the adolescence and the phsyco dramatic methodology with the objective of making easier the understanding of the thematic in question. The course not only offered information about the aspects of adolescence, its repercussion in the family context, but also propitiated exchanges of opinions, sharing of doubts, odd feelings of insecurity faced with the task of being parents of adolescents allowing the construction of new ways for the parents o perceive, feel and express their friendship.

  4. Life quality time allocation index-an equilibrium economy consistent version of the current life quality index

    DEFF Research Database (Denmark)

    Ditlevsen, Ove; Friis-Hansen, Peter

    2005-01-01

    The definition the Life Quality Index for a country as originally suggested by Nathwani, Lind and Pandey is based on the gross domestic product (GDP), the expected life in good health at birth, and the fraction of life time the anonymous citizen of the country is occupied with money making work...... a further development casting the definition into dimensionless quantities that make the index get a pure unit of time and not the somewhat obscure unit as a power product of a money unit and a time unit. To avoid confusion, this new variant of the LQI is called the Life Quality Time Allocation Index (LQTAI...... of the variables themselves, the relative increment of the LQI becomes defined as a convex combination of the two relative increments. The combination parameter is obtained by an optimality argument about the anonymous citizen’s distribution of his or her time between free time and work time. In the original...

  5. Plant life management in Hungary

    International Nuclear Information System (INIS)

    Gillemot, F.

    1998-01-01

    The life management in Hungary is in an early stage. The preparation of a suitable database, development of maintenance systems and education of the plant and consultant staff is essential. The Act of Nuclear Safety, the introduction of the 10 years periodic safety review system (periodic licence extension) is a good basis for life management. At the same time the economic changes in the country make the life management difficult. Presently most important task is to prepare the technical environment and the methodology for NPP Life management, and within a few years, when the economy would be consolidated, a real life management will be performed

  6. The Life Cycle Analysis Toolbox

    International Nuclear Information System (INIS)

    Bishop, L.; Tonn, B.E.; Williams, K.A.; Yerace, P.; Yuracko, K.L.

    1999-01-01

    The life cycle analysis toolbox is a valuable integration of decision-making tools and supporting materials developed by Oak Ridge National Laboratory (ORNL) to help Department of Energy managers improve environmental quality, reduce costs, and minimize risk. The toolbox provides decision-makers access to a wide variety of proven tools for pollution prevention (P2) and waste minimization (WMin), as well as ORNL expertise to select from this toolbox exactly the right tool to solve any given P2/WMin problem. The central element of the toolbox is a multiple criteria approach to life cycle analysis developed specifically to aid P2/WMin decision-making. ORNL has developed numerous tools that support this life cycle analysis approach. Tools are available to help model P2/WMin processes, estimate human health risks, estimate costs, and represent and manipulate uncertainties. Tools are available to help document P2/WMin decision-making and implement programs. Tools are also available to help track potential future environmental regulations that could impact P2/WMin programs and current regulations that must be followed. An Internet-site will provide broad access to the tools

  7. Pressure during decision making of continuous sedation in end-of-life situations in Dutch general practice

    Directory of Open Access Journals (Sweden)

    Blanker Marco H

    2012-07-01

    Full Text Available Abstract Background Little is known about pressure from patients or relatives on physician’s decision making of continuous palliative sedation. We aim to describe experienced pressure by general practitioners (GPs in cases of continuous sedation after the introduction of the Dutch practice guideline, using a questionnaire survey. Methods A sample of 918 Dutch GPs were invited to fill out a questionnaire about their last patient under continuous sedation. Cases in which GPs experienced pressure from the patient, relatives or other persons were compared to those without pressure. Results 399 of 918 invite GPs (43% returned the questionnaire and 250 provided detailed information about their most recent case of continuous sedation. Forty-one GPs (16% indicated to have experienced pressure from the patient, relatives or colleagues. In GPs younger than 50, guideline knowledge was not related to experienced pressure, whereas in older GPs, 15% with and 36% without guideline knowledge reported pressure. GPs experienced pressure more often when patients had psychological symptoms (compared to physical symptoms only and when patients had a longer estimated life expectancy. A euthanasia request of the patient coincided with a higher prevalence of pressure for GPs without, but not for GPs with previous experience with euthanasia. GPs who experienced pressure had consulted a palliative consultation team more often than GPs who did not experience pressure. Conclusion One in six GPs felt pressure from patients or relatives to start sedation. This pressure was related to guideline knowledge, especially in older GPs, longer life expectancy and the presence of a euthanasia request, especially for GPs without previous experience of euthanasia.

  8. The Effect of Sport on Decision Making Strategies

    Science.gov (United States)

    Tozoglu, Erdogan

    2013-01-01

    The decisions people make in the face of circumstances they encounter influence their life in favourable or unfavourable ways. The aim of this study is to examine the relationship between sporting habits and decision making strategies among university students. The research involved 1298 students (526 women and 772 men) studying during 2011-2012…

  9. How to Live a Happy Life

    Science.gov (United States)

    ... or small) that you make a difference. Live life based on the values that are important to you. Take time to think of what really matters to you (like helping others or protecting the planet). In what way do you want to make ...

  10. Visualization in medicine and life sciences III towards making an impact

    CERN Document Server

    Hamann, Bernd; Hege, Hans-Christian

    2016-01-01

    The book discusses novel visualization techniques driven by the needs in medicine and life sciences as well as new application areas and challenges for visualization within these fields. It presents ideas and concepts for visual analysis of data from scientific studies of living organs or to the delivery of healthcare. Target scientific domains include the entire field of biology at all scales - from genes and proteins to organs and populations - as well as interdisciplinary research based on technological advances such as bioinformatics, biomedicine, biochemistry, or biophysics. Moreover, they comprise the field of medicine and the application of science and technology to healthcare problems. This book does not only present basic research pushing the state of the art in the field of visualization, but it also documents the impact in the fields of medicine and life sciences.

  11. Social modulation of decision-making: a cross-species review

    Directory of Open Access Journals (Sweden)

    Ruud eVan Den Bos

    2013-06-01

    Full Text Available Taking decisions plays a pivotal role in daily life and comprises a complex process of assessing and weighing short-term and long-term costs and benefits of competing actions. Decision-making has been shown to be affected by factors such as sex, age, genotype and personality. Importantly, also the social environment affects decisions, both via social interactions (e.g. social learning, cooperation and competition and social stress effects. Although everyone is aware of this social modulating role on daily life decisions, this has thus far only scarcely been investigated in human and animal studies. Furthermore, neuroscientific studies rarely discuss social influence on decision-making from a functional perspective such as done in behavioural ecology studies. Therefore, the first aim of this article is to review the available data of the influence of the social context on decision-making both from a causal and functional perspective, drawing on animal and human studies. Also, there is currently still a gap between decision-making in real life where influences of the social environment are extensive, and decision-making as measured in the laboratory, which is often done without any (deliberate social influences. However, methods are being developed to bridge this gap. Therefore, the second aim of this review is to discuss these methods and ways in which this gap can be increasingly narrowed. We end this review by formulating future research questions.

  12. Life Style Assessment: So What!

    Science.gov (United States)

    Aubry, William E.

    The construct life style was used by Alfred Adler to describe the characteristic way in which individuals act and think. Followers of his theories are now collecting evidence to support or validate his contentions. The assessment of client life styles serves: (1) to make the client aware of his misconceptions, (2) as a reference point for therapy,…

  13. Eliciting regret improves decision making at the end of life.

    Science.gov (United States)

    Djulbegovic, Benjamin; Tsalatsanis, Athanasios; Mhaskar, Rahul; Hozo, Iztok; Miladinovic, Branko; Tuch, Howard

    2016-11-01

    Management choices at the end of life are high-stake decisions fraught with emotions, chief among is regret. Our objective in this paper is to test the utility of a regret-based model to facilitate referral to hospice care while helping patients clarify their preferences on how they wish to spend the remaining days of their lives. A prospective cohort study that enrolled consecutive adult patients (n = 178) aware of the terminal nature of their disease. The patients were at the point in care where they had to decide between continuing potentially 'curative/life-prolonging' treatment (Rx) versus hospice care. Preferences were elicited using a Dual Visual Analog Scale regarding the level of regret of omission versus commission (RgO/RgC) towards hospice care and Rx. Each patient's RgO/RgC was contrasted against the predictive probability of death to suggest a management plan, which was then compared with the patient's actual choice. The probability of death was estimated using validated Palliative Performance Scale predictive model. Eighty-five percent (151/178) of patients agreed with the model's recommendations (p < 0.000001). Model predicted the actual choices for 72% (128/178) of patients (p < 0.00001). Logistic regression analysis showed that people who were initially inclined to be referred to hospice and were predicted to choose hospice over disease-directed treatment by the regret model have close to 98% probability of choosing hospice care at the end of their lives. No other factors (age, gender, race, educational status and pain level) affected their choice. Using regret to elicit choices in the end-of-life setting is both descriptively and prescriptively valid. People with terminal disease who are initially inclined to choose hospice and do not regret such a choice will select hospice care with high level of certainty. Copyright © 2016 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  14. Information du Contexte comme une Ressource : Une Approche Orientée Service pour la Sensibilité au Contexte

    OpenAIRE

    Romero , Daniel

    2011-01-01

    Nowadays, ubiquitous environments become part of our daily lives. At home, work, cars, hotels, supermarkets and others public spaces we find technologies (electronics and computational elements) that try to make our life simpler and easier in a transparent way. In recent years, the potential of these environments is more and more exploited with the advent and widespread usage of smartphones. This kind of devices enables the execution of applications that are able to adapt seamlessly to the cu...

  15. Audito rizikos modelių naudojimo galimybės

    OpenAIRE

    Jankūnaitė, Rita; Kanapickienė, Rasa; Gipienė, Gailutė

    2005-01-01

    Different audit risk evaluation models presented in the literature and looks into their advantages and disadvantages are analysed. However, scientific works do not offer a universal audit risk evaluation model to make the auditor’s life easier when the audit risk has to be evaluated. Following the research of audit risk evaluation performed by Lithuanian auditors and in view of the related models provided in the literature, some improvements to the audit risk model are proposed, which enable ...

  16. Texture drafting possibilities in Action Script 2.0

    OpenAIRE

    Zajančkauskas, Renaldas

    2005-01-01

    Modern head in these days can‘t even imagine his life without a computer. Since the day of the first computer was created software companies like Microsoft, Apple and other are trying to make computer software faster, more stable, reliable and easier to understand. Faster micro processors enables graphic projection, three dimensional modeling or just graphical edition programs to run fast enough on home computers. System and graphical processors are getting faster and faster. In our days the ...

  17. The environmental degradation caused by the inadequate dispose of plastic packs: a case study

    OpenAIRE

    Silva, Claudionor Oliveira; Santos, Gilbertânia Mendonça; Silva, Lucicleide Neves

    2013-01-01

    Modern society is accustomed to living with the ease and versatility that high consumption forms offer. Given a high level of consumption, globalization, technological innovations that seek every day to ensure your space in the market, and thereby contribute to the socioeconomic balance. The modernization making life easier for the general public and the other side may generate environmental disorders is the case of plastic packaging has on the environment long term. With their disuse and dis...

  18. Parental decision-making for medically complex infants and children: an integrated literature review.

    Science.gov (United States)

    Allen, Kimberly A

    2014-09-01

    Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms 'parents and decision-making' to obtain English language publications from 2000 to June 2013. The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent-provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital heart disease. Thus comparisons across other child

  19. COMPETENCYTHE FORMATION FOR LIFE

    Directory of Open Access Journals (Sweden)

    Milagros Mederos-Piñeiro

    2016-07-01

    Full Text Available The formation of life competences is the result of a quality education that prepares students to meet the challenges of a fast moving world where equality and equal opportunities should constitute premises of education; training them is a challenge teachers to assume new generations contribute actively to a better world. In Cuba are important research on the formation of communication competences and self-regulated learning in primary school. The paper shows the result of an investigation that provides a methodology for the formation of life competences in primary school education, used as an essential pathway research activity. The methodological approach of research has a quantitative approach and an explanatory scope to establish and make sense of understanding the causal relationship between the direction of research activity and training of life competences. Theoretical, empirical and mathematical-statistical, for characterizing the initial state, processing of results and analysis: research methods are used. The application of the methodology for the formation of life competences makes teachers lead the teaching-learning process with a research and transforming teaching concept, where the school is the protagonist of their learning and causes changes in their performances, which are evident in the formed competences related to effective and affective communication; the solution of problems related to life; the use of means in obtaining the knowledge and the expression of a behavior consistent with school and social demands. The effectiveness of the methodology confirms that there is a causal relationship between the direction of research activity by teachers and the formation of life competences in school.

  20. Modelling in life insurance a management perspective

    CERN Document Server

    Norberg, Ragnar; Planchet, Frédéric

    2016-01-01

    Focussing on life insurance and pensions, this book addresses various aspects of modelling in modern insurance: insurance liabilities; asset-liability management; securitization, hedging, and investment strategies. With contributions from internationally renowned academics in actuarial science, finance, and management science and key people in major life insurance and reinsurance companies, there is expert coverage of a wide range of topics, for example: models in life insurance and their roles in decision making; an account of the contemporary history of insurance and life insurance mathematics; choice, calibration, and evaluation of models; documentation and quality checks of data; new insurance regulations and accounting rules; cash flow projection models; economic scenario generators; model uncertainty and model risk; model-based decision-making at line management level; models and behaviour of stakeholders. With author profiles ranging from highly specialized model builders to decision makers at chief ex...

  1. Saccadic eye movements as an index of perceptual decision-making.

    Science.gov (United States)

    McSorley, Eugene; McCloy, Rachel

    2009-10-01

    One of the most common decisions we make is the one about where to move our eyes next. Here we examine the impact that processing the evidence supporting competing options has on saccade programming. Participants were asked to saccade to one of two possible visual targets indicated by a cloud of moving dots. We varied the evidence which supported saccade target choice by manipulating the proportion of dots moving towards one target or the other. The task was found to become easier as the evidence supporting target choice increased. This was reflected in an increase in percent correct and a decrease in saccade latency. The trajectory and landing position of saccades were found to deviate away from the non-selected target reflecting the choice of the target and the inhibition of the non-target. The extent of the deviation was found to increase with amount of sensory evidence supporting target choice. This shows that decision-making processes involved in saccade target choice have an impact on the spatial control of a saccade. This would seem to extend the notion of the processes involved in the control of saccade metrics beyond a competition between visual stimuli to one also reflecting a competition between options.

  2. Histoires de vie et Formation de Nouveaux Savoirs Vitaux (Life Histories and the Formation of New Life Knowledge).

    Science.gov (United States)

    Pineau, Gaston

    1994-01-01

    Describes the use of life histories as a means for making sense of personal events and their application to education. Distinguishes three models for the use of life histories in education: the biographical model, the autobiographical model, and the dialectical model. (22 citations) (MAB)

  3. Migrant life stories and the Web

    DEFF Research Database (Denmark)

    Marselis, Randi

    2013-01-01

    The life stories of migrants are increasingly being told, as part of the work of cultural organizations, and websites are well suited to making such life story projects accessible to the public. However, by using the lives of real people as raw material in a public forum, Web projects raise...

  4. Cardiopulmonary resuscitation knowledge and opinions on end of life decision making of older adults admitted to an acute medical service.

    Science.gov (United States)

    Sharma, Rupali; Jayathissa, Sisira; Weatherall, Mark

    2016-01-08

    To determine the knowledge in cardiopulmonary resuscitation (CPR) process, preference for CPR, and desire to participate in end-of-life decision making amongst older hospitalised patients. We prospectively interviewed 100 participants above 65 years of age awaiting discharge from acute medical ward and collected demographics, knowledge of CPR and opinion on CPR in various clinical scenarios. Amongst the participants, 58% had good understanding of all components of CPR and 91% overestimated its success. Fifty-eight percent wished to have CPR in current health status, but this declined if they were presented a hypothetical scenario of critical illness (46%), functional impairment (17%), terminal illness (13%) and dementia (13%). Tertiary education, male gender and not living alone were associated with accepting CPR. Ninety-three percent were comfortable discussing CPR and 84% felt comfortable documenting their wishes in the medical notes. Seventy percent wished such discussion to include themselves and their family. Older inpatients have a reasonable understanding of the components of CPR and wish to be involved in CPR decision-making. Clinical scenarios with poor prognosis may lead to patients declining CPR. Discussion and documentation of resuscitation wishes is useful in routine assessment process among elderly hospitalised patients.

  5. Cost per quality-adjusted life year and disability-adjusted life years: the need for a new paradigm.

    Science.gov (United States)

    Bevan, Gwyn; Hollinghurst, Sandra

    2003-08-01

    Two different paradigms have been proposed for setting priorities for access to healthcare: cost per quality-adjusted life year based on interventions, and disability-adjusted life years based on the burden of disease in a population. These formal paradigms make explicit the assumptions made implicitly every day in delivering and hence rationing access to healthcare. This paper outlines each paradigm's methodological problems and argues that each paradigm is incomplete in terms of providing the information necessary for making budgetary decisions on healthcare. It argues that a scientific revolution is required to create a new paradigm by combining the strengths of each.

  6. Decision making about medical interventions in the end-of-life care of people with intellectual disabilities: a national survey of the considerations and beliefs of GPs, ID physicians and care staff.

    NARCIS (Netherlands)

    Bekkema, N.; Veer, A.J.E. de; Wagemans, A.M.A.; Hertogh, C.M.P.M.; Francke, A.L.

    2014-01-01

    Objective: This paper explores the personal beliefs and specific considerations of professionals regarding decisions about potentially burdensome medical interventions in the end-of-life care for people with intellectual disabilities (ID). Methods: A survey questionnaire covering decision making

  7. Decision making about medical interventions in the end-of-life care of people with intellectual disabilities: A national survey of the considerations and beliefs of GPs, ID physicians and care staff

    NARCIS (Netherlands)

    Bekkema, N.; de Veer, A.J.E.; Wagemans, A.M.A.; Hertogh, C.M.P.M.; Francke, A.L.

    2014-01-01

    Objective: This paper explores the personal beliefs and specific considerations of professionals regarding decisions about potentially burdensome medical interventions in the end-of-life care for people with intellectual disabilities (ID). Methods: A survey questionnaire covering decision making

  8. Do neonatologists limit parental decision-making authority? A Canadian perspective.

    Science.gov (United States)

    Albersheim, Susan G; Lavoie, Pascal M; Keidar, Yaron D

    2010-12-01

    According to the principles of family-centered care, fully informed parents and health care professionals are partners in the care of sick neonates. The aim of this study was to assess the attitudes of Canadian neonatologists towards the authority of parents to make life-and-death decisions for their babies. We interviewed 121 (74%) of the 164 practicing neonatologists in Canada (June 2004-March 2005), using scripted open-ended questions and common clinical scenarios. Data analysis employed interpretive description methodology. The main outcome measure was the intention of neonatologists to limit parental life-and-death decision-making authority, when they disagree with parental decisions. Neonatologists' self-rated respect for parental decision-making authority was 8/10. Most neonatologists thought that parents should be either primary decision-makers or part of the decision-making team. Fifty-six percent of neonatologists would limit parental decision-making authority if the parents' decision is not in the baby's "best interest". In response to common neonatal severe illness scenarios, up to 18% of neonatologists said they would limit parental decision-making, even if the chance of intact survival is very poor. For clinical scenarios with equally poor long-term outcomes, neonatologists were more likely to comply with parental wishes early in the life of a baby, particularly with documented brain injury. Canadian neonatologists espouse high regard for parental decision-making authority, but are prepared to limit parental authority if the parents' decision is not thought to be in the baby's best interest. Although neonatologists advise parents that treatment can be started at birth, and stopped later, this was only for early severe brain injury. Copyright © 2010 Elsevier Ltd. All rights reserved.

  9. Toward a Psychology of Surrogate Decision Making.

    Science.gov (United States)

    Tunney, Richard J; Ziegler, Fenja V

    2015-11-01

    In everyday life, many of the decisions that we make are made on behalf of other people. A growing body of research suggests that we often, but not always, make different decisions on behalf of other people than the other person would choose. This is problematic in the practical case of legally designated surrogate decision makers, who may not meet the substituted judgment standard. Here, we review evidence from studies of surrogate decision making and examine the extent to which surrogate decision making accurately predicts the recipient's wishes, or if it is an incomplete or distorted application of the surrogate's own decision-making processes. We find no existing domain-general model of surrogate decision making. We propose a framework by which surrogate decision making can be assessed and a novel domain-general theory as a unifying explanatory concept for surrogate decisions. © The Author(s) 2015.

  10. Decision-making under Ambiguity in Neurodegenerative Disease

    OpenAIRE

    Rogers, Denise

    2011-01-01

    Decision-making is a complex skill that is essential for daily life. Yet the complexities of this process are often overlooked in favour of more obvious cognitive deficits during neuropsychological assessment, such as memory or attention impairments. Decision-making involves affective and motivational aspects of executive functions (Happaney, Zelazo & Stuss, 2004). Executive functions include a range of abilities that can be divided into three categories: 1) goal setting and planning, 2) acti...

  11. Meaning making in cancer survivors: a focus group study.

    Directory of Open Access Journals (Sweden)

    Nadia van der Spek

    Full Text Available BACKGROUND: Confrontation with a life-threatening disease like cancer can evoke existential distress, which can trigger a search for meaning in people after having survived this disease. METHODS: In an effort to gain more insight in the meaning making process, we conducted four focus groups with 23 cancer survivors on this topic. Participants responded to questions about experienced meaning making, perceived changes in meaning making after cancer and the perceived need for help in this area. RESULTS: Most frequently mentioned meaning making themes were relationships and experiences. We found that, in general, cancer survivors experienced enhanced meaning after cancer through relationships, experiences, resilience, goal-orientation and leaving a legacy. Some participants, however, also said to have (also experienced a loss of meaning in their lives through experiences, social roles, relationships and uncertainties about the future. CONCLUSIONS: The results indicated that there is a group of cancer survivors that has succeeded in meaning making efforts, and experienced sometimes even more meaning in life than before diagnosis, while there is also a considerable group of survivors that struggled with meaning making and has an unmet need for help with that. The results of this study contribute to develop a meaning centered intervention for cancer survivors.

  12. Attitudes of Dutch nurses towards their involvement in end-of-life decisions with a possible life-shortening effect.

    NARCIS (Netherlands)

    Albers, G.; Francke, A.L.; Veer, A.J. de; Onwuteaka-Philipsen, B.D.

    2012-01-01

    Background: Nurses are often involved in end-of-life decision making as they play an important role in caring for terminally ill patients. Aim: To investigate nurses’ attitudes towards their involvement in end-of-life decisions with a possible lifeshortening effect, and a possible relationship with

  13. Assessment of decisions in the context of life attitudes

    Directory of Open Access Journals (Sweden)

    Klamut Ryszard

    2012-01-01

    Full Text Available Presented article attempts to show sense of life perspective as a determinant of decision making. It is assumed that the sense of life perspective described as life attitudes is significant in assessment of decision problem defined in the predecision phase of the decision making process. The predicted dependence was analysed in three categories of decision: self-development, financial and voting. The research was conducted on two groups of 186 and 86 participants. Two methods were used in the research: the Life Attitude Profile -Revised (LAP-R and the Decision Assessment Questionnaire. In statistical analysis, the canonical correlation analysis was used. The scores show that the life attitudes (especially: Purpose, Coherence, Life Control and Existential Vacuum are correlated with the assessment factor (especially: Cognitive Analysis and Affective Assessment of each tested category of decision. However, the most significant relationship is found in the self-development decision.

  14. End-of-life decisions: Christian perspectives.

    Science.gov (United States)

    Stempsey, William E

    1997-12-01

    While legal rights to make medical treatment decisions at the end of one's life have been recognized by the courts, particular religious traditions put axiological and metaphysical meat on the bare bones of legal rights. Mere legal rights do not capture the full reality, meaning and importance of death. End-of-life decisions reflect not only the meaning we find in dying, but also the meaning we have found in living. The Christian religions bring particular understandings of the vision of life as a gift from God, human responsibility for stewardship of that life, the wholeness of the person, and the importance of the dying process in preparing spiritually for life beyond earthly life, to bear on end-of-life decisions.

  15. Evaluate the use of tanning agent in leather industry using material flow analysis, life cycle assessment and fuzzy multi-attribute decision making (FMADM)

    Science.gov (United States)

    Alfarisi, Salman; Sutono, Sugoro Bhakti; Sutopo, Wahyudi

    2017-11-01

    Tanning industry is one of the companies that produce many pollutants and cause the negative impact on the environment. In the production process of tanning leather, the use of input material need to be evaluated. The problem of waste, not only have a negative impact on the environment, but also human health. In this study, the impact of mimosa as vegetable tanning agent evaluated. This study will provide alternative solutions for improvements to the use of vegetable tanning agent. The alternative solution is change mimosa with indusol, gambier, and dulcotan. This study evaluate the vegetable tanning of some aspects using material flow analysis and life cycle assessment approach. Life cycle assessment (LCA) is used to evaluate the environmental impact of vegetable tanning agent. Alternative solution selection using fuzzy multi-attribute decision making (FMADM) approach. Results obtained by considering the environment, human toxicity, climate change, and marine aquatic ecotoxicity, is to use dulcotan.

  16. eLearning and eMaking: 3D Printing Blurring the Digital and the Physical

    Directory of Open Access Journals (Sweden)

    Jennifer Loy

    2014-02-01

    Full Text Available This article considers the potential of 3D printing as an eLearning tool for design education and the role of eMaking in bringing together the virtual and the physical in the design studio. eLearning has matured from the basics of lecture capture into sophisticated, interactive learning activities for students. At the same time, laptops and internet enabled phones have made computer-based learning mobile, invading classroom learning, changing communication between students, enabling on the spot research, and making the recording of ideas and activities easier. The barriers between online and offline are becoming blurred in a combined digital and physical learning environment. Three-dimensional printing is part of this unification and can be an empowering learning tool for students, changing their relationship with the virtual and the physical, allowing them to take ideas and thinking from screen to reality and back again in an iterative, connected process, however, from an eLearning point of view it is, more importantly, a transformative technology with the potential to change the relationship of the learner to their learning and the scope and nature of their work. Examples from Griffith Product Design student learning illustrate the potential of eMaking to enhance combined learning in a digital age.

  17. Life is hard: countering definitional pessimism concerning the definition of life

    Science.gov (United States)

    Smith, Kelly C.

    2016-10-01

    Cleland and Chyba published a classic piece in 2002 that began a movement I call definitional pessimism, where it is argued that there is no point in attempting anything like a general definition of life. This paper offers a critical response to the pessimist position in general and the influential arguments offered by Cleland and her collaborators in particular. One such argument is that all definitions of life fall short of an ideal in which necessary and sufficient conditions produce unambiguous categorizations that dispose of all counterexamples. But this concept of definition is controversial within philosophy; a fact that greatly diminishes the force of the admonition that biologists should conform to such an ideal. Moreover, biology may well be fundamentally different from logic and the physical sciences from which this ideal is drawn, to the point where definitional conformity misrepresents biological reality. Another idea often pushed is that the prospects for definitional success concerning life are on a par with medieval alchemy's attempts to define matter - that is, doomed to fail for lack of a unifying scientific theory. But this comparison to alchemy is both historically inaccurate and unfair. Planetary science before the discovery of the first exoplanets offers a much better analogy, with much more optimistic conclusions. The pessimists also make much of the desirability of using microbes as models for any universal concept of life, from which they conclude that certain types of 'Darwinian' evolutionary definitions are inadequate. But this argument posits an unrealistic ideal, as no account of life can both be universal and do justice to the sorts of precise causal mechanisms microbes exemplify. The character of biology and the demand for universality in definitions of life thus probably accords better with functional rather than structural categories. The bottom line is that there is simply no viable alternative, either pragmatically or

  18. Nomophobia Prevalence among Pre-service Teachers: A case of Trakya University

    OpenAIRE

    GEZGİN, Deniz Mertkan; ŞUMUER, Evren; ARSLAN, Okan; YILDIRIM, Soner

    2017-01-01

    Mobile phones has become an indispensable tool for modern society. Although usage of cellular and smart phones make individual’s life easier, they may also create some negative consequences such as addiction, anxiety, fear or unrest due to overuse. Nomophobia, which is called as phobia of modern era, is defined as fear and anxiety feelings that an individual feels while he/she cannot access or reach to mobile devices. Especially, with the prevalence of smart phones, it is thought that increas...

  19. Využívání médií a digitálních technologií ve vzdělávání se zaměřením na učitele ZŠ MČ Praha 7

    OpenAIRE

    Novák, Jakub

    2016-01-01

    The end of the twentieth century is the beginning of significant development in the area of digital technologies. Modern technologies make our everyday life easier, they enable us to work more effectively, and they are a source of fun for all the age groups. Modern technologies have a great impact on us and our environment and thus they deserve our attention. Children, who are in everyday contact with modern technologies since the day they were born, are an especially sensitive group exposed ...

  20. Otizmle Yaşamı Ne Kadar Anlıyoruz?

    OpenAIRE

    AKGÜL, Esra Macaroğlu

    2013-01-01

    The paper includes an introduction to “autism” for those who do not have an adequate information about it or who would like to understand the situation with all details. Parents and schools are the two important agencies that can make life easier for children with autism. Therefore; it is necessary to understand how parents of children with autism think and behave, as well as understanding how teachers and other individuals in schools act towards them. The paper describes autism in the first ...

  1. Making Sustainable Decisions Using the KONVERGENCE Framework

    Energy Technology Data Exchange (ETDEWEB)

    Piet, Steven James; Gibson, Patrick Lavern; Joe, Jeffrey Clark; Kerr, Thomas A; Nitschke, Robert Leon; Dakins, Maxine Ellen

    2003-02-01

    Hundreds of contaminated facilities and sites must be cleaned up. “Cleanup” includes decommissioning, environmental restoration, and waste management. Cleanup can be complex, expensive, risky, and time-consuming. Decisions are often controversial, can stall or be blocked, and are sometimes re-done - some before implementation, some decades later. Making and keeping decisions with long time horizons involves special difficulties and requires new approaches, including: • New ways (mental model) to analyze and visualize the problem, • Awareness of the option to shift strategy or reframe from a single decision to an adaptable network of decisions, and • Improved tactical processes that account for several challenges. These include the following: • Stakeholder values are a more fundamental basis for decision making and keeping than “meeting regulations.” • Late-entry players and future generations will question decisions. • People may resist making “irreversible” decisions. • People need “compelling reasons” to take action in the face of uncertainties. Our project goal is to make cleanup decisions easier to make, implement, keep, and sustain. By sustainability, we mean decisions that work better over the entire time-period—from when a decision is made, through implementation, to its end point. That is, alternatives that can be kept “as is” or adapted as circumstances change. Increased attention to sustainability and adaptability may decrease resistance to making and implementing decisions. Our KONVERGENCE framework addresses these challenges. The framework is based on a mental model that states: where Knowledge, Values, and Resources converge (the K, V, R in KONVERGENCE), you will find a sustainable decision. We define these areas or universes as follows: • Knowledge: what is known about the problem and possible solutions? • Values: what is important to those affected by the decision? • Resources: what is available to implement

  2. Keystone Life Orientation (LO) teachers: Implications for educational ...

    African Journals Online (AJOL)

    Keystone Life Orientation (LO) teachers: Implications for educational, social, and ... characteristics and support networks needed by keystone Life Orientation (LO) ... In this study “keystone” refers to LO teachers who make a positive impact in ...

  3. BWR internals life assurance

    International Nuclear Information System (INIS)

    Herrera, M.L.; Stancavage, P.P.

    1988-01-01

    Boiling water reactor (BWR) internal components play an important role in power plant life extension. Many important internals were not designed for easy removal and changes in material properties and local environmental effects due to high radiation makes stress corrosion cracking more likely and more difficult to correct. Over the past several years, operating experience has shown that inspection, monitoring and refurbishment can be accomplished for internal structures with existing technology. In addition, mitigation techniques which address the causes of degradation are available to assure that life extension targets can be met. This paper describes the many considerations and aspects when evaluating life extension for reactor vessel internals

  4. Parental decision-making for medically complex infants and children: An integrated literature review

    Science.gov (United States)

    Allen, Kimberly A.

    2014-01-01

    Background Many children with life-threatening conditions who would have died at birth are now surviving months to years longer than previously expected. Understanding how parents make decisions is necessary to prevent parental regret about decision-making, which can lead to psychological distress, decreased physical health, and decreased quality of life for the parents. Objective The aim of this integrated literature review was to describe possible factors that affect parental decision-making for medically complex children. The critical decisions included continuation or termination of a high-risk pregnancy, initiation of life-sustaining treatments such as resuscitation, complex cardiothoracic surgery, use of experimental treatments, end-of-life care, and limitation of care or withdrawal of support. Design PubMed, Cumulative Index of Nursing and Allied Health Literature, and PsycINFO were searched using the combined key terms ‘parents and decision-making’ to obtain English language publications from 2000 to June 2013. Results The findings from each of the 31 articles retained were recorded. The strengths of the empirical research reviewed are that decisions about initiating life support and withdrawing life support have received significant attention. Researchers have explored how many different factors impact decision-making and have used multiple different research designs and data collection methods to explore the decision-making process. These initial studies lay the foundation for future research and have provided insight into parental decision-making during times of crisis. Conclusions Studies must begin to include both parents and providers so that researchers can evaluate how decisions are made for individual children with complex chronic conditions to understand the dynamics between parents and parent–provider relationships. The majority of studies focused on one homogenous diagnostic group of premature infants and children with complex congenital

  5. Can electronic stability control replace studded tyres?

    DEFF Research Database (Denmark)

    Elvik, Rune

    2015-01-01

    Highlights • Electronic stability control can substitute studded tyres. • This makes it easier to discourage the use of studded tyres. • A certain level of use of studded tyres makes roads less slippery.......Highlights • Electronic stability control can substitute studded tyres. • This makes it easier to discourage the use of studded tyres. • A certain level of use of studded tyres makes roads less slippery....

  6. Feminism and Psychological Autonomy: A Study in Decision-Making.

    Science.gov (United States)

    Sacks, Susan R.; Eisenstein, Hester

    Women seeking to realize the feminist goal of autonomy, defined as self-interested decision-making, encounter conflict and anxiety. This study reports a group experience, using life-space drawings and force-field analyses to reduce anxiety and foster autonomous decision-making. Of the 15 women participants in the year-long study, 100% reported at…

  7. Sex and life expectancy.

    Science.gov (United States)

    Seifarth, Joshua E; McGowan, Cheri L; Milne, Kevin J

    2012-12-01

    A sexual dimorphism in human life expectancy has existed in almost every country for as long as records have been kept. Although human life expectancy has increased each year, females still live longer, on average, than males. Undoubtedly, the reasons for the sex gap in life expectancy are multifaceted, and it has been discussed from both sociological and biological perspectives. However, even if biological factors make up only a small percentage of the determinants of the sex difference in this phenomenon, parity in average life expectancy should not be anticipated. The aim of this review is to highlight biological mechanisms that may underlie the sexual dimorphism in life expectancy. Using PubMed, ISI Web of Knowledge, and Google Scholar, as well as cited and citing reference histories of articles through August 2012, English-language articles were identified, read, and synthesized into categories that could account for biological sex differences in human life expectancy. The examination of biological mechanisms accounting for the female-based advantage in human life expectancy has been an active area of inquiry; however, it is still difficult to prove the relative importance of any 1 factor. Nonetheless, biological differences between the sexes do exist and include differences in genetic and physiological factors such as progressive skewing of X chromosome inactivation, telomere attrition, mitochondrial inheritance, hormonal and cellular responses to stress, immune function, and metabolic substrate handling among others. These factors may account for at least a part of the female advantage in human life expectancy. Despite noted gaps in sex equality, higher body fat percentages and lower physical activity levels globally at all ages, a sex-based gap in life expectancy exists in nearly every country for which data exist. There are several biological mechanisms that may contribute to explaining why females live longer than men on average, but the complexity of the

  8. Measurement control is one component of laboratory quality assurance: What are the others

    International Nuclear Information System (INIS)

    Delvin, W.L.

    1986-01-01

    The value of a quality assurance program is that the overlooking, ignoring, or downgrading of useful functions and practices will be minimized. The principles of quality assurance make a great tool for minimizing problems and for helping to find and correct deficiencies and problems when they occur. Finding and correcting deficiencies and problems while they are still small - before they become monsters - will certainly make life easier in the operation of a laboratory. This takes diligence in being aware of what is going on in the laboratory and firm resolve by management to take effective corrective actions when necessary. It takes more than applying band aids to problems. 4 refs

  9. iPad For Seniors For Dummies

    CERN Document Server

    Muir, Nancy C

    2010-01-01

    The full-color guide to the exciting new iPad, written specifically with the needs of seniors in mind!. The iPad is the perfect device for the senior market, combining the Web, e-mail, photos, video, and book reading into an intuitive, portable device. Written by veteran Dummies author Nancy Muir, this fun and friendly guide shows you how to use the many features and capabilities of the iPad to make life easier! You'll learn how to use the multitouch screen to zoom in and out on Web pages and choose a font and size that makes reading comfortable so that you can get directions, plan vacations,

  10. Python profiling 101

    CERN Multimedia

    CERN. Geneva

    2014-01-01

    Python code is much easier to write than C, yet much less efficient. It's often assumed that Python is not performance-oriented and therefore making effort to optimize it doesn't pay off. While in many cases it's true, at a certain moment of a development, especially right before reaching production-ready state, it might turn out that a Python code runs slowly and one needs to find a culprit. In this talk I'll not tell how to make your program faster. Instead, I'll show different techniques to look for the bottlenecks in the code. The presentation will be built around a live demo using real-life Python code.

  11. Quality of Life Theory II. Quality of Life as the Realization of Life Potential: A Biological Theory of Human Being

    Directory of Open Access Journals (Sweden)

    Soren Ventegodt

    2003-01-01

    Full Text Available This review presents one of the eight theories of the quality of life (QOL used for making the SEQOL (self-evaluation of quality of life questionnaire or the quality of life as realizing life potential. This theory is strongly inspired by Maslow and the review furthermore serves as an example on how to fulfill the demand for an overall theory of life (or philosophy of life, which we believe is necessary for global and generic quality-of-life research.Whereas traditional medical science has often been inspired by mechanical models in its attempts to understand human beings, this theory takes an explicitly biological starting point. The purpose is to take a close view of life as a unique entity, which mechanical models are unable to do. This means that things considered to be beyond the individual's purely biological nature, notably the quality of life, meaning in life, and aspirations in life, are included under this wider, biological treatise. Our interpretation of the nature of all living matter is intended as an alternative to medical mechanism, which dates back to the beginning of the 20th century. New ideas such as the notions of the human being as nestled in an evolutionary and ecological context, the spontaneous tendency of self-organizing systems for realization and concord, and the central role of consciousness in interpreting, planning, and expressing human reality are unavoidable today in attempts to scientifically understand all living matter, including human life.

  12. Relationship between life satisfaction and quality of life in Turkish nursing school students.

    Science.gov (United States)

    Yildirim, Yasemin; Kilic, Serap Parlar; Akyol, Asiye Durmaz

    2013-12-01

    The aim of this study was to evaluate the relationship between life satisfaction and quality of life of nursing students. This descriptive and cross-sectional study was conducted with a research population of 396 nursing students who received education at a school of nursing. The research data were collected between May and June of the 2007-2008 academic year. The data collection tools included "Student Description Form," Life Satisfaction Scale, and WHOQOL-BREF (TR) Quality of Life (QOL) Scale. The mean score of life satisfaction was 22.90 ± 5.74. Participants' QOL mean scores were 67.16 ± 15.29 in the physical domain, 64.33 ± 14.72 in the psychological domain, 62.81 ± 19.12 in the social relationships domain, and 60.59 ± 12.59 in the environmental domain. There was a significant correlation between life satisfaction and the four main domains of quality of life scores (P life satisfaction and quality of life among nursing students. In addition, it was determined that being a nursing student had a positive effect on students' life satisfaction and quality of life. Therefore, the education system is recommended to be redesigned in such a way as to make students more active and to improve their life satisfaction and quality of life. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Media life of the young

    DEFF Research Database (Denmark)

    Westlund, Oscar; Bjur, Jakob

    2014-01-01

    This is a thorough investigation into contemporary young people and their media life. The article conceptualizes a typology of media life, drawing on a theoretical body involving the sociology of generations, life course research, media life and individualization. This empirically derived typology...... makes a strong instrument for an understanding of the media life of the young, furnishing insights into how they have constructed their use of media. The investigation is based on a robust national survey with Swedes born 1994–2001, conducted in 2010, and focusing on four media: television, gaming......, the Internet and mobile devices. Two of the findings are particularly surprising. Firstly, the results reveal that the young generally lead heterogeneous media lives, varying with age and sex. Secondly, although some young people literarily live their life in media, there are also de facto young who live...

  14. Toward a psychology of surrogate decision-making

    OpenAIRE

    Tunney, Richard J.; Ziegler, Fenja

    2016-01-01

    Many of the decisions that we make in everyday life are made for the benefit of other people. However, research suggests that people often make decisions on behalf of other people that are different from those that the other person would choose for himself or herself. This raises practical problems in the case of legally designated surrogate decision-makers who may not meet the legal normative benchmark — the substituted judgment standard. We review evidence from our own ...

  15. The Influence of Management's Work-Life Balance on the Organizational Behavior of Employees in Small and Medium-sized Enterprises : Empirical Analysis Focusing on Spillover and Crossover Effects

    OpenAIRE

    平野, 光俊; 余合, 淳

    2017-01-01

    This study investigates the crossover effect of work-life balance (WLB) in the relationship between the management of small and medium-sized enterprises (SMEs) and their employees. SMEs are smaller in scale and have fewer employees than large enterprises, resulting in a close relationship between management and employees. In SMEs, it is easier for employees to observe the daily behavior of the management. Therefore, if management's WLB satisfaction is high, the positive attitude of the manage...

  16. Life Is Strange : a mediated game reception analysis

    OpenAIRE

    Mänder, Leili

    2017-01-01

    In this essay a mediated video game reception of the game Life Is Strange is made, with the purpose of examining the players' meaning-making processes from a gender perspective. The materials of this essay consist of videos from six different YouTube channels where each player film themselves whilst playing through Life Is Strange as a way to review and share the gaming experience. The results show how the meaning-making processes are littered with gender discourses and affects. The affects o...

  17. GET A SECOND CHANCE TO MAKE A FIRST IMPRESSION: Eradicate the Poverty Level of the Women Farmer in Bangladesh

    Directory of Open Access Journals (Sweden)

    Zobaida AKHTER

    2008-01-01

    Full Text Available ABSTRACT In the socio-economic context of Bangladesh, involvement of women in agriculture is very important. It would be easier to control rural-urban migration by engaging women in agricultural activities to a greater extent. Women play a vital role in agricultural production throughout the Bangladesh, making a significant contribution to the basic productivity of their communities. The paper argues that efforts to promote women in farming are confronted by challenges including poverty, misconception regarding education, training, farming etc. The paper also states that the utilization and development of distance education would effectively address the problem of education and training aimed at rural women.

  18. Nuclear unit life extension: technico-economic considerations

    International Nuclear Information System (INIS)

    Bertron, L.

    1987-01-01

    The outstanding place of PWR power plants among the overall power generating facilities indicates the need for particular attention to be paid to assessing their expected useful life. The more so as they are not, in the medium term, exposed to the risk of becoming financially absolute which might result from more efficient generating tools entering the market. Yet, in no case should plant life extension affect safety in operation. This makes it necessary to ascertain and produce evidence that the various items of equipment remain equal to their function in terms of safety. Components ageing problems should be steadily monitored and ageing indicators adopted, allowing decisions of refurbishing or replacement to be made to avert plant shutdown. The alternative between repair works or shutdown will possibly arise in the case of heavy equipment likely to require protracted repairs and intricate works in radioactive environment. A technico-economic study, making allowance for anticipated savings in life extension through replacement operations, should help make the most appropriate decision [fr

  19. [Thinking from the end - Does the diagnosis "cancer" make a difference to patients and carers?].

    Science.gov (United States)

    Bausewein, Claudia

    2013-01-01

    The diagnosis of cancer is often associated with pain, suffering and dying. Many of these aspects also apply to patients dying from non-malignant disease. Being confronted with a malignancy posts an existential threat for many patients that is linked with loss of control, challenge of autonomy and fear of the future. In contrast, patients with non-malignant disease do not realise the scope of their diagnosis and the potentially life-limiting nature of their disease. The prognosis of patients with chronic organ failure is often shorter than that of some patients with malignancies. Patients with malignant and non-malignant disease suffer from pain and many other symptoms. Tumour-oriented therapies, side effects and changes of the body image add to the suffering of cancer patients. Although consequences of the disease and the therapies are often not visible in patients with non-malignant disease, the increasing functional decline, psychosocial burden, lack of co-ordination of care, and information needs burden patients. Wishes at the end of life are similar in cancer and non-cancer patients. Access to palliative care is much easier for cancer patients than for non-cancer patients. Copyright © 2013. Published by Elsevier GmbH.

  20. An Evaluation of Factors Affecting Decision Making among 4th Grade Elementary School Students with Low Socio-Economic Status

    Science.gov (United States)

    Kaskaya, Alper; Calp, Sükran; Kuru, Oguzhan

    2017-01-01

    Decision making is one of the most important life skills. While making correct, timely, accurate and appropriate decisions lead to positive changes in one's life, making incorrect decisions may have a negative impact. It is an important issue to examine what the 4th grade students in primary school have about the decision-making ability to be…

  1. Maximizers versus satisficers: Decision-making styles, competence, and outcomes

    OpenAIRE

    Andrew M. Parker; Wändi Bruine de Bruin; Baruch Fischhoff

    2007-01-01

    Our previous research suggests that people reporting a stronger desire to maximize obtain worse life outcomes (Bruine de Bruin et al., 2007). Here, we examine whether this finding may be explained by the decision-making styles of self-reported maximizers. Expanding on Schwartz et al.\\ (2002), we find that self-reported maximizers are more likely to show problematic decision-making styles, as evidenced by self-reports of less behavioral coping, greater dependence on others when making decision...

  2. Life cycle of transformer oil

    OpenAIRE

    Đurđević Ksenija R.; Vojinović-Miloradov Mirjana; Sokolović Slobodan M.

    2008-01-01

    The consumption of electric power is constantly increasing due to industrialization and population growth. This results in much more severe operating conditions of transformers, the most important electrical devices that make integral parts of power transmission and distribution systems. The designed operating life of the majority of worldwide transformers has already expired, which puts the increase of transformer reliability and operating life extension in the spotlight. Transformer oil pla...

  3. [Shared decision-making in medical practice--patient-centred communication skills].

    Science.gov (United States)

    van Staveren, Remke

    2011-01-01

    Most patients (70%) want to participate actively in important healthcare decisions, the rest (30%) prefer the doctor to make the decision for them. Shared decision-making provides more patient satisfaction, a better quality of life and contributes to a better doctor-patient relationship. Patients making their own decision generally make a well considered and medically sensible choice. In shared decision-making the doctor asks many open questions, gives and requests much information, asks if the patient wishes to participate in the decision-making and explicitly takes into account patient circumstances and preferences. Shared decision-making should remain an individual choice and should not become a new dogma.

  4. WORK / LIFE BALANCE REFLECTIONS ON EMPLOYEE SATISFACTION

    OpenAIRE

    Selvarani; Kamalanabhan; Sakthivel Rani

    2011-01-01

    The aim of this research is to analyze the relationship between employee satisfaction andwork/life balance. The construct used for this research consists of career opportunity, recognition,work tasks, payments, benefits, superior subordinate relationship, employee satisfaction, andwork/life balance. The study was conducted on a total of 210 respondents working in IT organization.This study makes a contribution to join two distinct research streams, namely employee satisfaction,and work/life b...

  5. What influences parents' decisions to limit or withdraw life support?

    Science.gov (United States)

    Sharman, Mahesh; Meert, Kathleen L; Sarnaik, Ashok P

    2005-09-01

    Decisions to forgo life support from critically ill children are commonly faced by parents and physicians. Previous research regarding parents' perspectives on the decision-making process has been limited by retrospective methods and the use of closed-ended questionnaires. We prospectively identified and described parents' self-reported influences on decisions to forgo life support from their children. Deeper understanding of parents' views will allow physicians to focus end-of-life discussions on factors important to parents and help resolve conflicts. Prospective, qualitative pilot study. Pediatric intensive care unit of a university-affiliated children's hospital. A total of 14 parents of ten children whose pediatric intensive care unit physician had made a recommendation to limit or withdraw life support. : In-depth, semistructured interviews were conducted with parents during their decision-making process. Factors influencing the parents in this study in their decision to forgo life support included their previous experience with death and end-of-life decision making for others, their personal observations of their child's suffering, their perceptions of their child's will to survive, their need to protect and advocate for their child, and the family's financial resources and concerns regarding life-long care. Parents in this study expressed the desire to do what is best for their child but struggled with feelings of selfishness, guilt, and the need to avoid agony and sorrow. Physician recommendations, review of options, and joint formulation of a plan helped parents gain a sense of control over their situation. Parents of eight children agreed to forgo life support and parents of two did not. Prospective interviews with open-ended questions identified factors influencing parents' decision making not previously described in the critical care literature such as parents' past experiences with end-of-life decisions and their anticipated emotional adjustments and

  6. International rules: new treaty ratified by Canada, makes honesty the best policy everywhere

    International Nuclear Information System (INIS)

    Lorenz, A.

    1999-01-01

    The 'Convention on combatting bribery of foreign public officials in international business transactions' and its effect on conducting business abroad is discussed. The Convention was ratified by Canada and signed into law on February 14, 1999. It means that there is now a mechanism for sharing information and prosecuting foreign or domestic companies that bribe third-world officials in the course of doing business and make it impossible for others to compete in a legal way. OECD members agreed to work together to prosecute bribe-givers in an attempt to change attitudes towards an age-old problem. The law establishes that anyone who possesses property or proceeds obtained or derived from bribery of foreign public officials or from laundering that property or proceeds is guilty of a criminal offence. Although the new law has not yet been tested in Canada, it is expected that its existence will act as a deterrent and prevent any company from taking the risk, for it is not farfetched to imagine a rival company learning of the bribe, placing an anonymous call to the authorities. Existence of the Convention also makes it easier to say 'NO' to any foreign official asking for a bribe. It is no longer just a case of 'I don't want to'. The new law makes it possible to say: 'I can't'

  7. International rules: new treaty ratified by Canada, makes honesty the best policy everywhere

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, A.

    1999-05-03

    The `Convention on combatting bribery of foreign public officials in international business transactions` and its effect on conducting business abroad is discussed. The Convention was ratified by Canada and signed into law on February 14, 1999. It means that there is now a mechanism for sharing information and prosecuting foreign or domestic companies that bribe third-world officials in the course of doing business and make it impossible for others to compete in a legal way. OECD members agreed to work together to prosecute bribe-givers in an attempt to change attitudes towards an age-old problem. The law establishes that anyone who possesses property or proceeds obtained or derived from bribery of foreign public officials or from laundering that property or proceeds is guilty of a criminal offence. Although the new law has not yet been tested in Canada, it is expected that its existence will act as a deterrent and prevent any company from taking the risk, for it is not farfetched to imagine a rival company learning of the bribe, placing an anonymous call to the authorities. Existence of the Convention also makes it easier to say `NO` to any foreign official asking for a bribe. It is no longer just a case of `I don`t want to`. The new law makes it possible to say: `I can`t`.

  8. STRATEGIC DECISION MAKING IN THE MANAGEMENT OF PROJECTS, AIMED AT THE BIM

    Directory of Open Access Journals (Sweden)

    Burneo Valarezo Servio

    2016-12-01

    Full Text Available Decision making in the management of projects aimed at Building Information Modeling, represents the main action to be developed during the development of the investment lifecycle, from inception to the development of life, decision marking is present in all phases of project management. In the Fund's shares of the production system by projects, decision making integrated from the priorities of the projects play an important role in the success of the company. The present work has as objective the development of a procedure for decision making during the life cycle of the project, the conditions for its implementation and the process for its development, with the purpose of raising their quality, to ensure decision making effective, consistent with the current development of the techniques of management.

  9. Making marketing difficult

    DEFF Research Database (Denmark)

    Meyer, Gitte

    2005-01-01

    embraced by the market-place, while maintaining the old scientific alienation from political life. The case is made that modern science was born ambiguous towards the market-place, and that such ambivalence - relating to different interpretations of the idea of knowledge as a common good - is still...... to be encountered among scientists. Drawing on series of interviews with scientists from bioscience and biotechnology it is argued that, on the one hand, scientists are into marketing and PR exercises; but, on the other hand, they also voice a demand that journalists should make such marketing difficult...

  10. HIV inhibition by lactobacilli: easier in a test tube than in real life.

    Science.gov (United States)

    Witkin, Steven S; Linhares, Iara M

    2015-10-06

    A lactobacillus-dominant vaginal microbiota has been shown to decrease heterosexual HIV transmission. Nunn et al. now report that a vaginal microbiota dominated by Lactobacillus crispatus is associated with a relative inability of HIV pseudoviral particles to transverse cervicovaginal mucus (CVM) in vitro [mBio 6(5):e01084-15, 2015, doi:10.1128/mBio.01084-15]. The purported inhibitory mechanism is the interaction between carboxyl groups present on HIV and in CVM that occurred only under acidic conditions when carboxyl groups were protonated. L. crispatus produces high levels of lactic acid and results in the lowest vaginal pH when it is the dominant vaginal bacterium. In addition, high levels of lactic acid inhibit the proliferation of other bacteria that might negatively affect CVM structure. The utility of enhancing L. crispatus dominance to inhibit HIV transmission awaits assessment of the influence of ejaculated semen on this property and investigations on the role of Lactobacillus products such as d-lactic acid in this property. Copyright © 2015 Witkin and Linhares.

  11. BioBlocks: Programming Protocols in Biology Made Easier.

    Science.gov (United States)

    Gupta, Vishal; Irimia, Jesús; Pau, Iván; Rodríguez-Patón, Alfonso

    2017-07-21

    The methods to execute biological experiments are evolving. Affordable fluid handling robots and on-demand biology enterprises are making automating entire experiments a reality. Automation offers the benefit of high-throughput experimentation, rapid prototyping, and improved reproducibility of results. However, learning to automate and codify experiments is a difficult task as it requires programming expertise. Here, we present a web-based visual development environment called BioBlocks for describing experimental protocols in biology. It is based on Google's Blockly and Scratch, and requires little or no experience in computer programming to automate the execution of experiments. The experiments can be specified, saved, modified, and shared between multiple users in an easy manner. BioBlocks is open-source and can be customized to execute protocols on local robotic platforms or remotely, that is, in the cloud. It aims to serve as a de facto open standard for programming protocols in Biology.

  12. Counting is easier while experiencing a congruent motion.

    Directory of Open Access Journals (Sweden)

    Luisa Lugli

    Full Text Available Several studies suggest that numerical and spatial representations are intrinsically linked. Recent findings demonstrate that also motor actions interact with number magnitude processing, showing a motor-to-semantic effect. The current study assesses whether calculation processes can be modulated by motions performed with the whole body. Participants were required to make additions or subtractions while performing (on-line condition or after having experienced (off-line condition an ascending or descending motion through a passive (i.e., taking the elevator or an active (i.e., taking the stairs mode. Results show a congruency effect between the type of calculation and the direction of the motion depending on: a the off-line or on-line condition, b the passive or active mode and c the real or imagined task. Implications of the results for an embodied and grounded perspective view will be discussed.

  13. Developing Students' Understanding of Industrially Relevant Economic and Life Cycle Assessments

    Science.gov (United States)

    Bode, Claudia J.; Chapman, Clint; Pennybaker, Atherly; Subramaniam, Bala

    2017-01-01

    Training future leaders to understand life cycle assessment data is critical for effective research, business, and sociopolitical decision-making. However, the technical nature of these life cycle reports often makes them challenging for students and other nonexperts to comprehend. Therefore, we outline here the key takeaways from recent economic…

  14. Effect of the Contents in Advance Directives on Individuals' Decision-Making.

    Science.gov (United States)

    Park, Jae Yoon; Lim, Chi-Yeon; Puurveen, Gloria; Kim, Do Yeun; Lee, Jae Hang; Do, Han Ho; Kim, Kyung Soo; Yoo, Kyung Don; Kim, Hyo Jin; Kim, Yunmi; Shin, Sung Joon

    2018-01-01

    Completing an advance directive offers individuals the opportunity to make informed choices about end-of-life care. However, these decisions could be influenced in different ways depending on how the information is presented. We randomly presented 185 participants with four distinct types of advance directive: neutrally framed (as reference), negatively framed, religiously framed, and a combination. Participants were asked which interventions they would like to receive at the end of life. Between 60% and 70% of participants responded "accept the special interventions" on the reference form. However, the majority (70%-90%) chose "refuse the interventions" on the negative form. With respect to the religious form, 70% to 80% chose "not decided yet." Participants who refused special life-sustaining treatments were older, female, and with better prior knowledge about advance directives. Our findings imply that the specific content of advance directives could affect decision-making with regard to various interventions for end-of-life care.

  15. APPROACHES TO QUALITY OF LIFE ANALYSISQUANTICATION

    Directory of Open Access Journals (Sweden)

    Larisa E. Danilina

    2015-01-01

    Full Text Available The paper reviews different approaches to quality of life measurement used in Russian and international statistics. It outlines the essence of J. Stiglitz’s recommendations on development of quality of life statistical indicators, analyses proposals and practical application of innovative approaches of quality of life measurement by the French National Institute for Statistics and Economic Studies (INSEE. The paper reviews Rosstat’s (Russian Federal State Statistics Service new research as well as an independent research in the area of quality of life research. The authors make proposals to extend the list of aspects analyzed an quality of life research and underline the importance of such a review through regional specifics. They suggest extending the system of quality of life statistical indicators by certain coefficients characterizing economic development disparity and its influence on the quality of life.

  16. Culture as meaning-making

    OpenAIRE

    Lenkauskienė, Rūta; Liubinienė, Vilmantė

    2002-01-01

    The present paper analyses the role of social and cultural background knowledge in the cognition of meaning. Language and culture integrated studies have long been in the focus of attention. In order to study the language of a target culture, one should understand how human beings construct meanings, understand processes of meaning-making, account for different meanings, and examine their effects in social life. The language cannot be interpreted in the right way without taking the target cul...

  17. Application of medical cases in general genetics teaching in universities.

    Science.gov (United States)

    He, Zhumei; Bie, Linsai; Li, Wei

    2018-01-20

    General genetics is a core course in life sciences, medicine, agriculture and other related fields. As one of the most fast-developing disciplines of life sciences in the 21th century, the influence of the genetics knowledge on daily life is expanding, especially on human health and reproduction. In order to make it easier for students to understand the profound principles of genetics and to better apply the theories to daily life, we have introduced appropriate medical cases in general genetics teaching and further extended them combined with theoretical basis of genetics. This approach will be beneficial to enhance students' abilities of genetic analysis and promote their enthusiasm to learn and master practical skills. In this paper, we enumerate medical cases related to the modern genetics teaching system to provide a reference for genetics teaching in general and normal universities.

  18. WORK / LIFE BALANCE REFLECTIONS ON EMPLOYEE SATISFACTION

    Directory of Open Access Journals (Sweden)

    Selvarani

    2011-03-01

    Full Text Available The aim of this research is to analyze the relationship between employee satisfaction andwork/life balance. The construct used for this research consists of career opportunity, recognition,work tasks, payments, benefits, superior subordinate relationship, employee satisfaction, andwork/life balance. The study was conducted on a total of 210 respondents working in IT organization.This study makes a contribution to join two distinct research streams, namely employee satisfaction,and work/life balance. Findings suggest that high correlation exists between work task and employeesatisfaction with a mediator variable namely work-life balance.

  19. Learning for Life

    Science.gov (United States)

    Robotham, Dan

    2011-01-01

    People working in the field of education know well the positive effects adult and community learning can have on mental health and wellbeing. Participating in adult and community learning can help to widen social networks and improve life and employment chances; it makes for better general health; and can strengthen the learner's self-confidence,…

  20. Lack of support structures in prioritization decision making concerning patients and resources. Interviews with Swedish physicians.

    Science.gov (United States)

    Werntoft, Elisabet; Edberg, Anna-Karin

    2011-08-01

    To investigate physicians' experiences in relation to prioritization and financing in health care in order to gain a deeper understanding of the reasons behind their standpoints. Eighteen physicians, seven women and eleven men, aged 30 to 69 years were interviewed and the text was analyzed using an inductive approach, also described as conventional qualitative content analysis. Experience of setting healthcare priorities and difficult decision making differed widely among the physicians and seemed to be related to the number of years in professional practice. Their view of how resources should be allocated between disciplines/patients showed that they wanted politicians to make the decisions, with support from medical professions. The overwhelming impression of their reasoning showed that they lacked support structures for their decision making and could be understood under the following categories: prioritisation, easier in theory than in practice, and increasing costs threaten the Swedish welfare model. The findings of this study highlight the importance of practical national guidelines concerning vertical prioritization, also as an important measure to make prioritization more distinct and transparent. The physicians further had a need for tools to increase patients' awareness of their health. The findings of this study also showed that an awareness of the actual costs involved might increase the responsibility among both physicians and patients. The physicians' lack of support structures implies an urgent need for practical national guidelines, especially concerning vertical prioritization. This will also make prioritization appear clear and transparent for citizens.

  1. Design Rules for Life Support Systems

    Science.gov (United States)

    Jones, Harry

    2002-01-01

    This paper considers some of the common assumptions and engineering rules of thumb used in life support system design. One general design rule is that the longer the mission, the more the life support system should use recycling and regenerable technologies. A more specific rule is that, if the system grows more than half the food, the food plants will supply all the oxygen needed for the crew life support. There are many such design rules that help in planning the analysis of life support systems and in checking results. These rules are typically if-then statements describing the results of steady-state, "back of the envelope," mass flow calculations. They are useful in identifying plausible candidate life support system designs and in rough allocations between resupply and resource recovery. Life support system designers should always review the design rules and make quick steady state calculations before doing detailed design and dynamic simulation. This paper develops the basis for the different assumptions and design rules and discusses how they should be used. We start top-down, with the highest level requirement to sustain human beings in a closed environment off Earth. We consider the crew needs for air, water, and food. We then discuss atmosphere leakage and recycling losses. The needs to support the crew and to make up losses define the fundamental life support system requirements. We consider the trade-offs between resupplying and recycling oxygen, water, and food. The specific choices between resupply and recycling are determined by mission duration, presence of in-situ resources, etc., and are defining parameters of life support system design.

  2. CANTEEN MANAGEMENT SYSTEM USING RFID TECHNOLOGY BASED ON CLOUD COMPUTING

    OpenAIRE

    Lavina Mall*, Nihal Shaikh

    2017-01-01

    We are currently in the midst of a technological and computing revolution that will drastically change our lives and potentially redefine what it means to be human. Automation in many fields has replaced the old school pen and paper and at the same time proved to be more efficient, correct and less cumbersome making our life much easier. This automation process when applied on an integral part of the working people i.e. “canteen” helps reduce the service time, eliminates queues, there is no b...

  3. Sustainable Public Procurement of Medical Technology and Green Logistics

    DEFF Research Database (Denmark)

    Vettorato, Giovanna; Hsuan, Juliana

    This paper investigates design for remanufacture in terms of both detailed new product design and the environmental performance in which modularization and reversed production may operate. We examine the medical equipment industry and their potential contributions to the implementation of green...... supply chain in the healthcare sector. An exploratory case study of medical equipment supply chain is presented when considering the life cycle of the product can be managed through the modularization strategies. Preliminary findings indicate that design-for-disassembly of modules make equipment easier...

  4. GM ethical decision making in practice

    Directory of Open Access Journals (Sweden)

    Donald Bruce

    2002-09-01

    Full Text Available Celia Deane-Drummond's case for wisdom as an approach to ethical decision making and her doubts about case-oriented methodology are critiqued with reference to the SRT Project's Engineering Genesis study. Its approach is explored in practical decisions on various real life examples of genetic modification in crops and animals. It involved both intrinsic and consequential approaches, and identified key value positions behind different policies and stakeholders. The paper also clarifies the relationship between reactive (cost-benefit and precautionary risk assessment, explaining their strengths and limitations, and the role of underlying values in both forms of risk decision making.

  5. Shaping the Curriculum: The Power of a Library's Digital Resources

    Science.gov (United States)

    Kirkwood, Patricia

    2011-01-01

    Researchers were the first adopters of digital resources available through the library. Online journals and databases make finding research articles much easier than when this author started as a librarian more than 20 years ago. Speedier interlibrary loan due to digital delivery means research materials are never far away. Making it easier for…

  6. Development and Validation of the Life Sciences Assessment: A Measure of Preschool Children's Conceptions of Basic Life Sciences

    Science.gov (United States)

    Maherally, Uzma Nooreen

    2014-01-01

    The purpose of this study was to develop and validate a science assessment tool termed the Life Sciences Assessment (LSA) in order to assess preschool children's conceptions of basic life sciences. The hypothesis was that the four sub-constructs, each of which can be measured through a series of questions on the LSA, will make a significant…

  7. Life Contexts Make a Difference : Emotional Stability in Younger and Older Adults

    NARCIS (Netherlands)

    Brose, Annette; Scheibe, Susanne; Schmiedek, Florian

    Emotional stability, as indicated by low affect variability and low affective reactivity to daily events, for example, tends to increase across the adult life span. This study investigated a contextual explanation for such age differences, relating affect variability and affective reactivity to

  8. Single versus Multiple Objective(s) Decision Making: An Application ...

    African Journals Online (AJOL)

    Rahel

    rather than exception in many real life decision-making circumstances. For example ...... stakeholders' relative importance of various attributes in the utility function. (Steuer 1986). ..... Multiple Criteria Optimization: Theory, Computation and.

  9. When concretized emotion-belief complexes derail decision-making capacity.

    Science.gov (United States)

    Halpern, Jodi

    2012-02-01

    There is an important gap in philosophical, clinical and bioethical conceptions of decision-making capacity. These fields recognize that when traumatic life circumstances occur, people not only feel afraid and demoralized, but may develop catastrophic thinking and other beliefs that can lead to poor judgment. Yet there has been no articulation of the ways in which such beliefs may actually derail decision-making capacity. In particular, certain emotionally grounded beliefs are systematically unresponsive to evidence, and this can block the ability to deliberate about alternatives. People who meet medico-legal criteria for decision-making capacity can react to health and personal crises with such capacity-derailing reactions. One aspect of this is that a person who is otherwise cognitively intact may be unable to appreciate her own future quality of life while in this complex state of mind. This raises troubling ethical challenges. We cannot rely on the current standard assessment of cognition to determine decisional rights in medical and other settings. We need to understand better how emotionally grounded beliefs interfere with decision-making capacity, in order to identify when caregivers have an obligation to intervene. © 2010 Blackwell Publishing Ltd.

  10. Individual variations in maternal care early in life correlate with later life decision-making and c-fos expression in prefrontal subregions of rats.

    NARCIS (Netherlands)

    van Hasselt, F.N.; Visser, L.; Tieskens, J.M.; Cornelisse, S.; Baars, A.M.; Lavrijsen, M.; Krugers, H.J.; van den Bos, R.; Joëls, M.

    2012-01-01

    Early life adversity affects hypothalamus-pituitary-adrenal axis activity, alters cognitive functioning and in humans is thought to increase the vulnerability to psychopathology-e.g. depression, anxiety and schizophrenia- later in life. Here we investigated whether subtle natural variations among

  11. Individual variations in maternal care early in life correlate with later life decision-making and c-fos expression in prefrontal subregions of rats

    NARCIS (Netherlands)

    van Hasselt, F.N.; de Visser, L.; Tieskens, J.M.; Cornelisse, S.; Baars, A.M.; Lavrijsen, M.; Krugers, H.J.; van den Bos, R.; Joëls, M.

    2012-01-01

    Early life adversity affects hypothalamus-pituitary-adrenal axis activity, alters cognitive functioning and in humans is thought to increase the vulnerability to psychopathology--e.g. depression, anxiety and schizophrenia--later in life. Here we investigated whether subtle natural variations among

  12. Negotiating Life Chances

    DEFF Research Database (Denmark)

    Korzenevica, Marina

    to and negotiate both educational and labour mobility - both of which are associated with the chance of a better life. This thesis is about young people (aged 16-31): How they negotiate their life chances and how they contribute to transformations of the socio-political space of their communities in two villages...... becoming. Aspirations prevail over political interests: young people navigate and negotiate their engagement in party and community politics by making calculations concerning their own mobility, life strategies and obligations to kin. In this way, young men engage in, but also balance and shift......, conversely, can only aspire to educational mobility due to gender norms. Furthermore, many of their hopes of ‘becoming somebody’ collapse upon marriage. Women find that they cannot continue their education, nor use the skills they have acquired in local politics, as they need to follow traditional...

  13. Role of Advance Care Planning in Proxy Decision Making Among Individuals With Dementia and Their Family Caregivers.

    Science.gov (United States)

    Kwak, Jung; De Larwelle, Jessica A; Valuch, Katharine O'Connell; Kesler, Toni

    2016-01-01

    Health care proxies make important end-of-life decisions for individuals with dementia. A cross-sectional survey was conducted to examine the role of advance care planning in proxy decision making for 141 individuals with cognitive impairment, Alzheimer's disease, or other types of dementia. Proxies who did not know the preferences of individuals with dementia for life support treatments reported greater understanding of their values. Proxies of individuals with dementia who did not want life support treatments anticipated receiving less support and were more uncertain in decision making. The greater knowledge proxies had about dementia trajectory, family support, and trust of physicians, the more informed, clearer, and less uncertain they were in decision making. In addition to advance care planning, multiple factors influence proxy decision making, which should be considered in developing interventions and future research to support informed decision making for individuals with dementia and their families. Copyright 2016, SLACK Incorporated.

  14. Parental views on withdrawing life-sustaining therapies in critically ill children.

    Science.gov (United States)

    Michelson, Kelly Nicole; Koogler, Tracy; Sullivan, Christine; Ortega, María del Pilar; Hall, Emily; Frader, Joel

    2009-11-01

    To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. Quantitative and qualitative analysis of semi-structured one-on-one interviews. The PICUs at 2 tertiary care hospitals. English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. Semi-structured one-on-one interviews. Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision.

  15. Life Cycle Environmental Management

    DEFF Research Database (Denmark)

    Pedersen, Claus Stig; Jørgensen, Jørgen; Pedersen, Morten Als

    1996-01-01

    A precondition for environmentally conscious management is the awareness of the environmental impact potentials created by an industrial company. There is an obvious need for management tools to support the implementation of relevant environmental criteria into the industrial decision making...... processes. The discipline of life cycle environmental management (LCEM) focuses on the incorporation of environmental criteria from the life cycles of products and other company activities into the company management processes. This paper introduces the concept of LCEM as an important element...... of the complete set of environmental objects in an industrial manufacturing company....

  16. The Relationship between Work-Life-Balance and the Perception of ...

    African Journals Online (AJOL)

    The relationship between the perception of Quality of Work life (QWL) and work effectiveness ... work life balance, group cohesiveness, motivation, communication, decision- making, conflict management, and organizational culture and ethics.

  17. A model for emergency department end-of-life communications after acute devastating events--part II: moving from resuscitative to end-of-life or palliative treatment.

    Science.gov (United States)

    Limehouse, Walter E; Feeser, V Ramana; Bookman, Kelly J; Derse, Arthur

    2012-11-01

    The model for emergency department (ED) end-of-life communications after acute devastating events addresses decision-making capacity, surrogates, and advance directives, including legal definitions and application of these steps. Part II concerns communications moving from resuscitative to palliative and end-of-life treatments. After completing the steps involved in determining decision-making, emergency physicians (EPs) should consider starting palliative measures versus continuing resuscitative treatment. As communications related to these end-of-life decisions increasingly fall within the scope of emergency medicine (EM) practice, we need to become educated about and comfortable with them. © 2012 by the Society for Academic Emergency Medicine.

  18. Most common usability mistakes coders make

    CERN Multimedia

    CERN. Geneva

    2017-01-01

    This presentation contains an overview of bad practises in interface design. Though real-life screenshots elements like ‘setting up your page’, ‘forms’, ‘navigation and interactions’ and ‘colours’ will be covered. It’s easy to point out the negative aspects so a solution on how to make the examples will be given in addition.

  19. Qualidade de vida e medidas de utilidade: parâmetros clínicos para as tomadas de decisão em saúde Quality of life and utility measures: clinical parameters for decision-making in health

    Directory of Open Access Journals (Sweden)

    Alessandro Gonçalves Campolina

    2006-02-01

    Full Text Available In recent decades, the international scientific community has become increasingly interested in the concept of quality of life. One of the most important implications of the focus on quality of life is a shift from "cure" to "a guarantee of a better life" as a health care goal, as well as the inclusion of individuals' preferences for certain health states in the decision-making process associated with treatments, diagnostic strategies, and health spending. This is especially important as the prevalence of chronic diseases increases as a result of the aging of the population. This piece describes the main concepts and applications related to this new health paradigm, including quality of life itself, utility measures, quality-adjusted life years (QALYs, and health decision analysis.

  20. Building the Encyclopedia of Life

    Science.gov (United States)

    Mangiafico, P. A.; Patterson, D. J.

    2010-04-01

    The Encyclopedia of Life (EOL) is a collaborative project that indexes information about species, and makes it freely accessible to anyone. In order to accomplish this, EOL is building collaborative tools and infrastructure to unify the information.

  1. Making Space, Making Place: Digital Togetherness and the Redefinition of Migrant Identities Online

    Directory of Open Access Journals (Sweden)

    Sara Marino

    2015-12-01

    Full Text Available Immigrants have played a fundamental role in shaping the life and form of urban public spaces for generations. Their efforts, as many scholars have observed, mostly aimed at creating places of comfort in new and sometimes hostile receiving countries. In recent years, the combined contribution of the built environment and screen-based experiences have shaped migrants’ sense of community and belonging, thus making the concept of online community central to ideas about space and public life. Drawing upon a 3-year online ethnography, the article discusses to what extent new media constitute spaces of digital togetherness , where diasporic experiences and transnational identities are constructed and negotiated. It presents a transnational model of creative media consumption, which helps give insight as to how diasporas and ethnic minorities contribute to the transformation of public space in the Digital Age.

  2. Work-life balance of Eastern European migrants in Portugal

    OpenAIRE

    Flenova, Vera

    2017-01-01

    his study is devoted to the balance between work and life the Eastern European migrants manage to obtain. Work and life balance is considered as one of the core factors for the quality of life of the individual. Processes of migration and integration of migrants make the attainment of the work-life balance even more complicated and involve more resources. In this work the work and personal life balance of migrants is being analysed from the following perspectives: occupation, f...

  3. Attentional Filter Training but Not Memory Training Improves Decision-Making

    OpenAIRE

    Schmicker, Marlen; M?ller, Patrick; Schwefel, Melanie; M?ller, Notger G.

    2017-01-01

    Decision-making has a high practical relevance for daily performance. Its relation to other cognitive abilities such as executive control and memory is not fully understood. Here we asked whether training of either attentional filtering or memory storage would influence decision-making as indexed by repetitive assessments of the Iowa Gambling Task (IGT). The IGT was developed to assess and simulate real-life decision-making (Bechara et al., 2005). In this task, participants gain or lose money...

  4. Comparative life cycle assessment and life cycle costing of lodging in the Himalaya

    NARCIS (Netherlands)

    Bhochhibhoya, Silu; Pizzol, Massimo; Achten, Wouter M.J.; Maskey, Ramesh Kumar; Zanetti, Michela; Cavalli, Raffaele

    2017-01-01

    Purpose: The main aim of the study is to assess the environmental and economic impacts of the lodging sector located in the Himalayan region of Nepal, from a life cycle perspective. The assessment should support decision making in technology and material selection for minimal environmental and

  5. Putting health metrics into practice: using the disability-adjusted life year for strategic decision making.

    Science.gov (United States)

    Longfield, Kim; Smith, Brian; Gray, Rob; Ngamkitpaiboon, Lek; Vielot, Nadja

    2013-01-01

    Implementing organizations are pressured to be accountable for performance. Many health impact metrics present limitations for priority setting; they do not permit comparisons across different interventions or health areas. In response, Population Services International (PSI) adopted the disability-adjusted life year (DALY) averted as its bottom-line performance metric. While international standards exist for calculating DALYs to determine burden of disease (BOD), PSI's use of DALYs averted is novel. It uses DALYs averted to assess and compare the health impact of its country programs, and to understand the effectiveness of a portfolio of interventions. This paper describes how the adoption of DALYs averted influenced organizational strategy and presents the advantages and constraints of using the metric. Health impact data from 2001-2011 were analyzed by program area and geographic region to measure PSI's performance against its goal of doubling health impact between 2007-2011. Analyzing 10 years of data permitted comparison with previous years' performance. A case study of PSI's Asia and Eastern European (A/EE) region, and PSI/Laos, is presented to illustrate how the adoption of DALYs averted affected strategic decision making. Between 2007-2011, PSI's programs doubled the total number of DALYs averted from 2002-2006. Most DALYs averted were within malaria, followed by HIV/AIDS and family planning (FP). The performance of PSI's A/EE region relative to other regions declined with the switch to DALYs averted. As a result, the region made a strategic shift to align its work with countries' BOD. In PSI/Laos, this redirection led to better-targeted programs and an approximate 50% gain in DALYs averted from 2009-2011. PSI's adoption of DALYs averted shifted the organization's strategic direction away from product sales and toward BOD. Now, many strategic decisions are based on "BOD-relevance," the share of the BOD that interventions can potentially address. This switch

  6. Students' and Teachers' Participation in Decision-Making and ...

    African Journals Online (AJOL)

    User

    2011-04-19

    Apr 19, 2011 ... responsibility of school leaders, and the way and manner in which they .... bearing to his being is fundamental to our democratic way of life and must be ... school administrators, then, the decision-making style of the school ...

  7. Naturalistic decision making in forensic science: toward a better understanding of decision making by forensic team leaders.

    Science.gov (United States)

    Helsloot, Ira; Groenendaal, Jelle

    2011-07-01

    This study uses the naturalistic decision-making (NDM) perspective to examine how Dutch forensic team leaders (i.e., the officers in charge of criminal forensic research from the crime scene until the use of laboratory assistance) make decisions in real-life settings and identifies the contextual factors that might influence those decisions. First, a focus group interview was conducted to identify four NDM mechanisms in day-to-day forensic decision making. Second, a serious game was conducted to examine the influence of three of these contextual mechanisms. The results uncovered that forensic team leaders (i) were attracted to obtain further information when more information was initially made available, (ii) were likely to devote more attention to emotionally charged cases, and (iii) used not only forensic evidence in the decision making but also tactical, unverified information of the police inquiry. Interestingly, the measured contextual influences did not deviate significantly from a control group of laypeople. © 2011 American Academy of Forensic Sciences.

  8. FRAMEWORK FOR ENVIRONMENTAL DECISION-MAKING, FRED: A TOOL FOR ENVIRONMENTALLY-PREFERABLE PURCHASING

    Science.gov (United States)

    In support of the Environmentally Preferable Purchasing Program of the US EPA, the Systems Analysis Branch has developed a decision-making tool based on life cycle assessment. This tool, the Framework for Responsible Environmental Decision-making or FRED streamlines LCA by choosi...

  9. Absolute symbolic addressing, a structure making time-sharing easier; Adressage symbolique absolu, structure facilitant le travail en partage de temps

    Energy Technology Data Exchange (ETDEWEB)

    Debraine, P [Commissariat a l' Energie Atomique, 91 - Saclay (France). Centre d' Etudes Nucleaires, services scientifiques

    1968-08-01

    Time-sharing of computers asks for a certain number of conditions, particularly, an efficient dynamic loading of programs and data. This paper indicates a paging method making linkages with a minimum of table-looking operations. The principle is to use associative memory registers for calling blocks of physical memory, the block address being given by the concatenation of a file number (located in a base register) and a page number (located in the instruction proper). The position within the block is given by a displacement located in the instruction. A second associated base register contains the local part (page number + displacement) of the base address. This extended base register system allows executing programs in a very large programming complex without loss of time. The addresses are fixed at assembly time and the blocks can be loaded anywhere without modification for execution. The various problems associated with the execution of complex programs are presented in this context and shown to be easily solved by the proposed system, the realization of which would be very easy starting from the computer structures existing now. (author) [French] Le partage de temps des ordinateurs demande la realisation d'un certain nombre de conditions, en particulier, un chargement dynamique efficace des programmes et des donnees. Cet article indique une methode de pagination realisant les liaisons avec un minimum de consultations de tables. Le principe consiste a utiliser une memoire associative composee de registres pour appeler les blocs de la memoire physique, l'adresse de bloc etant donnee par concatenation d'un no de fichier (loge dans un registre de base) et d'un no de page (loge dans l'instruction proprement dite). La position a l'interieur du bloc est donnee par un deplacement loge dans l'instruction. Un second registre de base, associe au premier, contient la partie locale (no de page + deplacement) de l'adresse de base. Ce systeme d'extension de registre de base

  10. "It's like playing with your destiny": Bosnian immigrants' views of advance directives and end-of-life decision-making.

    Science.gov (United States)

    Searight, H Russell; Gafford, Jennifer

    2005-07-01

    Patient autonomy is a primary value in US health care. It is assumed that patients want to be fully and directly informed about serious health conditions and want to engage in advance planning about medical care at the end-of-life. Written advance directives and proxy decision-makers are vehicles to promote autonomy when patients are no longer able to represent their wishes. Cross-cultural studies have raised questions about the universal acceptance of these health care values among all ethnicities. In the current investigation, Bosnian immigrants were interviewed about their views of physician-patient communication, advance directives, and locus of decision-making in serious illness. Many of the respondents indicated that they did not want to be directly informed of a serious illness. There was an expressed preference for physician- or family-based health care decisions. Advance directives and formally appointed proxies were typically seen as unnecessary and inconsistent with many respondents' personal values. The findings suggest that the value of individual autonomy and control over the health care decisions may not be applicable to cultures with a collectivist orientation.

  11. Subjective Quality of Life and Perceived Adequacy of Social Support ...

    African Journals Online (AJOL)

    One such major concern pertains to the very general experiences of life of the elderly and associated factors. The purpose of this study was then to specifically assess the subjective quality of life and perceived adequacy of social support and the possible socio-demographic factors making differences in quality of life.

  12. Biotechnology and Consumer Decision-Making.

    Science.gov (United States)

    Sax, Joanna K

    Society is facing major challenges in climate change, health care and overall quality of life. Scientific advances to address these areas continue to grow, with overwhelming evidence that the application of highly tested forms of biotechnology is safe and effective. Despite scientific consensus in these areas, consumers appear reluctant to support their use. Research that helps to understand consumer decision-making and the public’s resistance to biotechnologies such as vaccines, fluoridated water programs and genetically engineered food, will provide great social value. This article is forward-thinking in that it suggests that important research in behavioral decision-making, specifically affect and ambiguity, can be used to help consumers make informed choices about major applications of biotechnology. This article highlights some of the most controversial examples: vaccinations, genetically engineered food, rbST treated dairy cows, fluoridated water, and embryonic stem cell research. In many of these areas, consumers perceive the risks as high, but the experts calculate the risks as low. Four major thematic approaches are proposed to create a roadmap for policymakers to consider for policy design and implementation in controversial areas of biotechnology. This article articulates future directions for studies that implement decision-making research to allow consumers to appropriately assign risk to their options and make informed decisions.

  13. Parental Views on Withdrawing Life-Sustaining Therapies in Critically Ill Children

    Science.gov (United States)

    Michelson, Kelly Nicole; Koogler, Tracy; Sullivan, Christine; del Pilar Ortega, María; Hall, Emily; Frader, Joel

    2009-01-01

    Objective To broaden existing knowledge of pediatric end-of-life decision making by exploring factors described by parents of patients in the pediatric intensive care unit (PICU) as important/influential if they were to consider withdrawing life-sustaining therapies. Design Quantitative and qualitative analysis of semi-structured one-on-one interviews. Setting The PICUs at 2 tertiary care hospitals. Participants English- or Spanish-speaking parents who were older than 17 years and whose child was admitted to the PICU for more than 24 hours to up to 1 week. Intervention Semi-structured one-on-one interviews. Results Forty of 70 parents (57%) interviewed said they could imagine a situation in which they would consider withdrawing life-sustaining therapies. When asked if specific factors might influence their decision making, 64% of parents said they would consider withdrawing life-sustaining therapies if their child were suffering; 51% would make such a decision based on quality-of-life considerations; 43% acknowledged the influence of physician-estimated prognosis in their decision; and 7% said financial burden would affect their consideration. Qualitative analysis of their subsequent comments identified 9 factors influential to parents when considering withdrawing life-sustaining therapies: quality of life, suffering, ineffective treatments, faith, time, financial considerations, general rejection of withdrawing life-sustaining therapies, mistrust/doubt toward physicians, and reliance on self/intuition. Conclusion Parents describe a broad range of views regarding possible consideration of withdrawing life-sustaining therapies for their children and what factors might influence such a decision. PMID:19884588

  14. An experimental 'Life' for an experimental life: Richard Waller's biography of Robert Hooke (1705).

    Science.gov (United States)

    Moxham, Noah

    2016-03-01

    Richard Waller's 'Life of Dr Robert Hooke', prefixed to his edition of Hooke's Posthumous Works (1705), is an important source for the life of one of the most eminent members of the early Royal Society. It also has the distinction of being one of the earliest biographies of a man of science to be published in English. I argue that it is in fact the first biography to embrace the subject's natural-philosophical work as the centre of his life, and I investigate Waller's reasons for adopting this strategy and his struggle with the problem of how to represent an early experimental philosopher in print. I suggest that Waller eschews the 'Christian philosopher' tradition of contemporary biography - partly because of the unusually diverse and fragmentary nature of Hooke's intellectual output - and draws instead upon the structure of the Royal Society's archive as a means of organizing and understanding Hooke's life. The most quoted phrase from Waller's biography is that Hooke became 'to a crime close and reserved' in later life; this essay argues that Waller's biographical sketch was fashioned in order to undo the effects of that reserve. In modelling his approach very closely on the structure of the society's records he was principally concerned with making Hooke's work and biography accessible, intelligible and useful to the fellowship in a context familiar to them, a context which had provided the institutional framework for most of Hooke's adult life. I argue that Waller's 'Life' was also intended to make the largest claims for Hooke's intellectual standing that the author dared in the context of the enmity between Hooke and Isaac Newton once the latter became president of the Royal Society. However, I also adduce fresh manuscript evidence that Waller actually compiled, but did not publish, a defence of Hooke's claim to have discovered the inverse square law of gravity, allowing us to glimpse a much more assertive biography of Hooke than the published version.

  15. Advances in fuzzy decision making theory and practice

    CERN Document Server

    Skalna, Iwona; Gaweł, Bartłomiej; Basiura, Beata; Duda, Jerzy; Opiła, Janusz; Pełech-Pilichowski, Tomasz

    2015-01-01

    This book shows how common operation management methods and algorithms can be extended to deal with vague or imprecise information in decision-making problems. It describes how to combine decision trees, clustering, multi-attribute decision-making algorithms and Monte Carlo Simulation with the mathematical description of imprecise or vague information, and how to visualize such information. Moreover, it discusses a broad spectrum of real-life management problems including forecasting the apparent consumption of steel products, planning and scheduling of production processes, project portfolio selection and economic-risk estimation. It is a concise, yet comprehensive, reference source for researchers in decision-making and decision-makers in business organizations alike.

  16. Risky decision making in Attention-Deficit/Hyperactivity Disorder : A meta-regression analysis

    NARCIS (Netherlands)

    Dekkers, T.J.; Popma, A.; Agelink van Rentergem, J.A.; Bexkens, A.; Huizenga, H.M.

    ADHD has been associated with various forms of risky real life decision making, for example risky driving, unsafe sex and substance abuse. However, results from laboratory studies on decision making deficits in ADHD have been inconsistent, probably because of between study differences. We therefore

  17. The right to life

    Directory of Open Access Journals (Sweden)

    Dr.Sc. Stavri Sinjari

    2013-06-01

    Full Text Available The right to life constitutes one of the main human rights and freedoms, foreseen by article 21 of the Albanian Constitution and article 2 of European Human Rights Convention. No democratic or totalitarian society can function without guarantees and protection of the human right to life We intend to address these issues on our article: What is life. What we legally understand with life. When the life starts and finish. How this right has evolved. Which is the state interest on protecting the life. Should we consider that the life is the same for all. Should the state interfere at any cost to protect the life. Is there any criminal charge for responsible persons to the violation of this right. Is this issue treated by European Human Rights Court. What are the Albanian legal provisions on protection of this right. This research is performed mainly according to a comparative and analytical methodology. Comperative analysis will be present almost throughout the paper. Treatment of issues of this research will be achieved through a system comparable with international standards in particular and the most advanced legislation in this area. At the same time, this research is conducted by analytical and statistical data processing. We believe that our research will make a modest contribution, not only to the legal literature, but also to criminal policy makers, law makers, lawyers and attorneys.

  18. Residential Preferences and Moving Behavior: A Family Life Cycle Analysis.

    Science.gov (United States)

    McAuley, William J.; Nutty, Cheri L.

    The relationship of family life cycle changes to housing preferences and residential mobility is examined. Two residential decision-making issues are explored in detail--how family life cycle stages influence what people view as important to their choice of residential setting and what individuals at different family life cycle stages view as the…

  19. Do Proxies for the Neurotransmitter Cortisol Predict Adaptation to Life with Chronic Pain?

    Science.gov (United States)

    Deamond, Wade

    Among the numerous difficulties encountered by chronic pain patients, impulsive and dysfunctional decision-making complicate their already difficult life situations yet remains relatively understudied. This study examined a recently published neurobiological decision making model that identifies eight specific neurotransmitters and hormones (Dopamine, Testosterone, Endogenous Opioids Glutamate, Serotonin, Norepinephrine, Cortisol, and GABA) linked to unsound decision making related to cognitive, motivational and emotional dysregulation (Nussbaum et al., 2011) (see Appendix 2). The Perceived Stress Scale (PSS), a proxy for the cortisol element in the pharmacological decision making model was analyzed for the neurotransmitter's relationship to functionality and quality of life in a group of 37 chronic pain patients. Participants were comprised of males and females ranging from 23 to 52 years of age and were classified with respect to levels of adjustment to living with chronic pain based on the Quality of Life Scale (QLS), the Dartmouth WONCA COOP Charts and the Global Assessment of Functioning (GAF). The Iowa Gambling Task (IGT) and Frontal System Behavioral Scale (FSBS) measured decision making related to immediate gratification and daily living respectively. Results suggest that emotional dysregulation, as measured by the PSS is a significant predictor for adaptation to life with chronic pain and the PSS is superior to predicting adaptation to life with chronic pain than reported levels of pain as measured by the McGill Pain Questionnaire.

  20. Women in public life.

    Science.gov (United States)

    1992-01-01

    The UN Division for the Advancement of Women publication has devoted an issue to the role of women in public lie based on an analysis of women's status in industrialized countries presented in Vienna, Austria, in May 1991. Women already contribute to political life and make a difference in politics, but societal institutions and government processes have not yet adapted to this fact. Women's nongovernmental organizations promote women's interests at the governmental level, but often do not have the economic or political power as do other interests groups such as trade unions. Women often participation public life via their membership in women's organizations, community action groups, voluntary organizations, and other close to home groups. They prefer to participate in activities which are problem solving rather than institution building. These activities and groups operate outside established political institutions and are not considered as part of public and political life. Society's exclusion of women from leadership positions in public life keeps it from benefiting from the special contributions that women bring to decision making. Women show a tendency to have different leadership styles than men (e.g., ability to relate to people affected by their decisions), which are most needed for the modern world. They often do not campaign just for women's issues, but, once in office, they do tend to become more involved in women's issues. Women have affected positive changes in career and child care, often on a non-Socialist agenda, in various countries (e.g. Norway). This effect is referred to as the politics of motherhood. More access to politics and public life calls for removal of structural and situational barriers including the glass ceiling, discrimination, insufficient funds, and bearing most of the responsibility for child care. The UN women's groups has drafted a platform for interregional consultation on women's role in public life and scheduled the 4th

  1. Making existential meaning in transition to motherhood

    DEFF Research Database (Denmark)

    Prinds, Christina Lange; Mogensen, Ole; Hvidt, Niels Christian

    2013-01-01

    living, and to some women also being interpreted as a spiritual experience. However, in present maternity services there is a predominant focus on biomedical issues, which sets the arena for motherhood transition, and the issues related to potentially existentially changing experiences......) outcome measures, and (g) results. Measurements: The studies were synthesised in a thematisation on the basis of the existential psychotherapist and philosopher Emmy van Deurzen's concepts of four interwoven life dimensions, through which we experience, interpret, and act in the world: Umwelt, Mitwelt......, Eigenwelt, and Überwelt. Key conclusions: The findings in this review suggest that transition to motherhood is considered a pivotal and paradoxical life event. Through the lens of existential psychology it can be interpreted as an existentially changing event, reorganising values and what makes life worth...

  2. International rules: new treaty ratified by Canada, makes honesty the best policy everywhere

    Energy Technology Data Exchange (ETDEWEB)

    Lorenz, A

    1999-05-03

    The 'Convention on combatting bribery of foreign public officials in international business transactions' and its effect on conducting business abroad is discussed. The Convention was ratified by Canada and signed into law on February 14, 1999. It means that there is now a mechanism for sharing information and prosecuting foreign or domestic companies that bribe third-world officials in the course of doing business and make it impossible for others to compete in a legal way. OECD members agreed to work together to prosecute bribe-givers in an attempt to change attitudes towards an age-old problem. The law establishes that anyone who possesses property or proceeds obtained or derived from bribery of foreign public officials or from laundering that property or proceeds is guilty of a criminal offence. Although the new law has not yet been tested in Canada, it is expected that its existence will act as a deterrent and prevent any company from taking the risk, for it is not farfetched to imagine a rival company learning of the bribe, placing an anonymous call to the authorities. Existence of the Convention also makes it easier to say 'NO' to any foreign official asking for a bribe. It is no longer just a caseof 'I don't want to'. The new law makes it possible to say: 'I can't'.

  3. A New Dynamic Multicriteria Decision-Making Approach for Green Supplier Selection in Construction Projects under Time Sequence

    Directory of Open Access Journals (Sweden)

    Shi Yin

    2017-01-01

    Full Text Available Nowadays, due to the lack of natural resources and environment problems which have been appearing increasingly, green building is more and more involved in the construction industry. The evaluation and selection of green supplier are a significant part of the development of green building. In this paper, we propose a new dynamic multicriteria decision-making approach in construction projects under time sequence to deal with these problems. First, the paper establishes 4 main criteria and 17 subcriteria for green supplier selection in construction projects. Then, a method considering interaction between criteria and the influence of constructors subjective preference and objective criteria information is proposed. It uses the interval-valued intuitionistic fuzzy geometric weighted Heronian means (IVIFGWHM operator and multitarget nonlinear programming model to calculate the comprehensive evaluation results of potential green suppliers. The proposed method is much easier for constructors to select green supplier and make the localization of green supplier more practical and accurate in construction projects. Finally, a case study about a green building project is given to verify practicality and effectiveness of the proposed approach.

  4. Research on Group Decision-Making Mechanism of Internet Emergency Management

    Science.gov (United States)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  5. Quality of life: patient-reported outcomes after total replacement of the temporomandibular joint.

    Science.gov (United States)

    Kunjur, J; Niziol, R; Matthews, N S

    2016-09-01

    Since publication of the UK guidelines on total replacement of the temporomandibular joint (TMJ) in 2008 by the British Association of Oral and Maxillofacial Surgeons (BAOMS), pain scores, mouth opening, and diet have been used as markers of success. We have looked at quality of life (QoL) as another. We analysed the data from a single surgeon on patients who had had joints replaced and devised a questionnaire to find out about the subjective, functional, psychological, and social aspects of TMJ disease. A total of 18 patients who had the same operation were included (mean (range) age 50 (33 - 73) years, mean (range) follow up 30 (18 - 48) months). Jaw function and facial aesthetics had improved, and patients needed less analgesia. Overall, they reported a better QoL with improvements in mood and social interaction, and the activities of daily life were easier. The NHS uses QoL questionnaires to measure success in fields such as orthopaedic surgery, but currently we know of no nationally accepted questionnaire that measures success after total replacement of the TMJ. Copyright © 2016 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  6. [Limiting life sustaining therapies].

    Science.gov (United States)

    Azoulay, E

    2006-09-01

    Intensivists are increasingly implementing end-of-life decisions in patients who remain dependent on life sustaining therapies without hope for recovery. Descriptive studies have provided epidemiological data on ICU end-of-life care, identifying areas for improvement. Qualitative studies have highlighted the complexity of the decision making process. In addition to considering the legal and ethical issues involved, this review describes cultural, religious and individual variations observed in ICU end-of-life care. It is important for intensivists to respect patients' preferences and values, but also, in some family members, to avoid increasing the burden and the guilt of sharing the decision. Intensivists should improve their ability to meet the needs of dying patients and their family members. Each situation, patient, family and caregiver is unique, and therefore needs a specific approach. Introducing palliative care and multidisciplinary teams into the ICU might provide an additional opportunity for patients and families to be informed and listened to.

  7. Healthcare professionals' dilemmas: judging patient's decision making competence in day-to-day care of patients suffering from Korsakoff's syndrome.

    Science.gov (United States)

    van den Hooff, Susanne; Buijsen, Martin

    2014-11-01

    Patient's decision making competence (PDMC) is a widely discussed subject. Issues of competence, autonomy, well-being and protection of the patient come up every day. In this article we analyse what role PDMC plays in Dutch legislation and what dilemmas healthcare professionals may experience, notably in patients suffering from Korsakoff's syndrome. Dilemmas emerge if professionals want to meet the requirements mentioned in Dutch law and the desires of their patients. The autonomy of the patient and the healthcare professionals' duty to take care of their patient's best interests, create a tension and lead to uncomfortable situations. Healthcare professionals describe difficulty finding a balance between these issues and assessing the degree of mental competence still present. In long term care situations, quality of the relationship between healthcare professionals and their patients seems to be of much more importance in decision making on minor issues of competence than simply relying on legal or house rules. In being committed to their cases, professionals will be more sensitive to individuals habits, abilities, welfare and dignity, which will make it easier to decide on issues of competence, and to find creative solutions to their dilemmas.

  8. Meaning in Work Life

    DEFF Research Database (Denmark)

    Ravn, Ib

    meaningful is still lacking (Harpaz & Fu, 2002), as are definitions of key terms. Here, I define meaning as the experience that something fits into a wider context or coheres within a larger whole.     I conceptualize meaning in work life as deriving from four factors, each of which helps us contribute...... to something larger than ourselves (Seligman, 2002) through our work. Thus, a person experiences meaning in work life when she... A. is able to use her signature strengths at work (Peterson and Seligman, 2004), B. makes an important contribution to the workplace (Drucker, 1999), C. participates in a productive...

  9. Why Quality of Work Life Doesn't Always Mean Quality.

    Science.gov (United States)

    Cohen, Deborah Shaw

    1981-01-01

    From participatory management to autonomous work groups, the quality of work life movement has made an impact on U.S. corporations. To make the quality of work life connection, commitment must originate with top management. (Author)

  10. Cognitive IoT incorporating intelligence in building smart environment

    Science.gov (United States)

    Sarker, Dishari; Sumathy, S.

    2017-11-01

    The Internet of Things (IoT) is an invention of this century which also can be called as Internet which makes life more logical and electronic. According to research in the industrial field about which aspect in IoT contributes more for GDP is the concept which can be applied in various aspects of our life to make life logical and easier. We are very much aware of the increasing population and the pollution that is caused by the vehicles and many other sources such as harmful gas producers. So, this work focuses in determining the level of pollution in a specific area and predict how much more greenery has to be increased in that area. With its widespread application, this paper proposes an idea with a social cause in order to exhibit the concern towards the environment and mankind. This proposal will benefit farmers and others in polluted cities. The language to be used is Embedded C programming and Arduino IDE open source platform with both hardware and software interaction. The display will involve an android app called Blynk App.

  11. Discussion on life extension of nuclear power plant around the world

    International Nuclear Information System (INIS)

    Chen Ming; Zhang Yuansi

    2010-01-01

    The very Paper introduces the concept, basic working flow and fundamental elements of the life extension of nuclear power plant (NPP) around the world; and it generally collects and summarizes the status datum of life extension of NPPs. Afterwards, the Paper analyses the present status of life extension of NPP in various countries with strong nuclear power industry, i.e. the United States, France, Germany, Russia Federation, Japan, South Korea and Canada. At the end, the Paper make a conclusion that whether an operating NPP will adopt life extension at the end of its design life, this issue depends on the factor of economy, safety and technical feasibility of life extension on the NPP. According to latest datum collected in 2009, the nuclear power units around the world, which have exceeded the design lives or are close to design life ends, most of them (about 64%) have selected to extend their service lives; based on this statistical data, we concludes that when an operating nuclear unit is facing with the issue of to extend life or to retire itself, it will be apt to make life extension. (authors)

  12. Decision making in neonatologia.

    Science.gov (United States)

    Paterlini, G; Tagliabue, P

    2010-06-01

    The field of neonatology presents a fascinating context in which hugely important decisions have to be made on the basis of physicians' assessments of the long term consequences of various possible choices. In many cases such assessments cannot be derived from a consensual professional opinion; the situation is characterized by a high level of uncertainty. A sample of neonatologists in different countries received a questionnaire including vignette cases for which no clear consensus exists regarding the (probabilistic) prognosis. They were asked to (I) assess the probability of various outcomes (death, severe impairment) and (II) choose a treatment to be offered to the parents. Information on the physicians' professional and socio-demographic characteristics and their ethical "values" was also collected. The goal of this international survey is to understand the prognosis and to analyze decision making by professionals in the context of life and death in medicine. The availability of an identical technology in different social and institutional contexts should help identifying the convergences and differences under consideration. Seventy percent of those invited responded to the questionnaire (International 60-80%). Italian neonatologists seem to be quite pessimistic about the prognosis of infants at high risk of death or long term disabilities, they show a pro-life attitude, but in a certain proportion are willing to change their minds if requested by parents. Furthermore personal opinions predominate in the decision-making process and the contribution of team meeting and/or ethic consultation seem not significantly modify the decisions.

  13. Multi-Criteria Decision-Making Model for the Material Flow of Resonant Wood Production

    Directory of Open Access Journals (Sweden)

    Patrik Aláč

    2017-03-01

    Full Text Available This paper proposes a multi-criteria decision-making model, for the selection and evaluation of the most valuable wooden input—resonant wood. Application of a given model can improve the process of input valuation as well as impact and improve particular economic indicators for the resonant wood manufacturer. We have tried to describe and evaluate the supply chain of resonant wood manufacturing and production of musical instruments. Particular value-added and non-value-added activities have been chosen according to the logical sequence of technology. Then, concrete criteria were specified and their significance weightings. Another important part of our paper is the description of resonant wood, specifications, and demands on log and wood species. There are some important physical and mechanical properties which should be taken into account and evaluated during the production of musical instruments. By the application of this model, a particular enterprise can reach an enhanced tool for the continuous evaluation of the product flowing through the supply chain. Visibility of particular operations and their logical sequence, presented by Petri nets, can lead to easier detection of possible defects in these operations and their origin. So, the main purpose of the paper lies in the suggestion of an objective and quantified managerial tool for the decision making.

  14. Early Life Microbiota, Neonatal Immune Maturation and Hematopoiesis

    DEFF Research Database (Denmark)

    Kristensen, Matilde Bylov

    Emerging epidemiologic data supports the hypothesis that early life colonization is a key player in development of a balanced immune system. Events in early life, as birth mode and infant diet, are shown to influence development of immune related diseases, like asthma, diabetes and inflammatory...... bowl disease, later in life. The intestinal epithelium makes up a physical and biochemical barrier between the bacteria in the gut lumen and the immune cells in the submocusal tissue. This monolayer of intestinal epithelial cells (IEC) makes up an extremely large surface and is highly important...... for the synergistic coexistence between trillions of bacteria in the gastrointestinal tract and their mammalian hosts. The IEC actively communicate with the microbiota of the gut lumen and tolerance establishment in the intestine is induced as a result of a balanced and controlled communication between IEC...

  15. Managing partnerships and impact on decision-making: the example of health technology assessment in genetics.

    Science.gov (United States)

    Blancquaert, Ingeborg

    2006-01-01

    For an emerging field such as Public Health Genetics, the partnerships that will be developed with stakeholders are of strategic importance, since they may affect long-term impact on policy-making. A concrete example in the field of health technology assessment in genetics was chosen to illustrate how the context in which scientific advisory bodies operate and the nature of partnerships developed over time influence the impact on decision-making at different levels, from the micro (professional) level through the meso (institutional) level to the macro (policy) level. As pointed out in the knowledge transfer literature, impact is not only reflected by instrumental use of knowledge, but also by problem-framing and strategic use of knowledge. Solid partnerships at the micro level, with researchers and health care professionals, are essential to build credibility and trust, and they lay the groundwork for contextualized and relevant advice and potential impact at the policy level. Even though maintaining the necessary critical distance with respect to all stakeholders is easier for institutions that are at arm's length from government, achieving the right balance between an institution's independence and service relationship is a real challenge. Copyright (c) 2006 S. Karger AG, Basel.

  16. Managing Time-Based Conflict Across Life Domains In Nigeria: A ...

    African Journals Online (AJOL)

    Managing Time-Based Conflict Across Life Domains In Nigeria: A Decision Making Perspective. ... which employees in a developing country attempt to resolve time-based conflict between work, family and other activities. A decision making ...

  17. Human life support for advanced space exploration

    Science.gov (United States)

    Schwartzkopf, S. H.

    1997-01-01

    -term technologies are adequate to implement a Lunar Base CELSS. There are no apparent "show-stoppers" which require the development of new technologies. However, there are several areas in which new materials and technologies could be used for a more efficient implementation of the system, e.g., by decreasing mass or power requirement and increasing recycling efficiency. These areas must be further addressed through research and development. Finally, although this study focused on the development of a Lunar Base CELSS, the same technologies and a nearly identical design would be appropriate for a Mars base. Actually, except for the distance of transportation, the implementation of a CELSS on Mars would even be easier than it would be on the Moon. The presence of atmospheric CO2 on Mars, although in low concentration, coupled with the fact that the day/night cycle on Mars is very similar to that on Earth, makes the use of light-weight, greenhouse-like structures for growing food plants even more feasible than on the Moon. There are some environmental problems, which would have to be dealt with, like dust storms and the large amount of the ultraviolet radiation incident on the planet's surface. However, the materials and methods are largely available today to develop such a life support system for a Mars base.

  18. Molten Salt Fuel Version of Laser Inertial Fusion Fission Energy (LIFE)

    International Nuclear Information System (INIS)

    Moir, R.W.; Shaw, H.F.; Caro, A.; Kaufman, L.; Latkowski, J.F.; Powers, J.; Turchi, P.A.

    2008-01-01

    Molten salt with dissolved uranium is being considered for the Laser Inertial Confinement Fusion Fission Energy (LIFE) fission blanket as a backup in case a solid-fuel version cannot meet the performance objectives, for example because of radiation damage of the solid materials. Molten salt is not damaged by radiation and therefore could likely achieve the desired high burnup (>99%) of heavy atoms of 238 U. A perceived disadvantage is the possibility that the circulating molten salt could lend itself to misuse (proliferation) by making separation of fissile material easier than for the solid-fuel case. The molten salt composition being considered is the eutectic mixture of 73 mol% LiF and 27 mol% UF 4 , whose melting point is 490 C. The use of 232 Th as a fuel is also being studied. ( 232 Th does not produce Pu under neutron irradiation.) The temperature of the molten salt would be ∼550 C at the inlet (60 C above the solidus temperature) and ∼650 C at the outlet. Mixtures of U and Th are being considered. To minimize corrosion of structural materials, the molten salt would also contain a small amount (∼1 mol%) of UF 3 . The same beryllium neutron multiplier could be used as in the solid fuel case; alternatively, a liquid lithium or liquid lead multiplier could be used. Insuring that the solubility of Pu 3+ in the melt is not exceeded is a design criterion. To mitigate corrosion of the steel, a refractory coating such as tungsten similar to the first wall facing the fusion source is suggested in the high-neutron-flux regions; and in low-neutron-flux regions, including the piping and heat exchangers, a nickel alloy, Hastelloy, would be used. These material choices parallel those made for the Molten Salt Reactor Experiment (MSRE) at ORNL. The nuclear performance is better than the solid fuel case. At the beginning of life, the tritium breeding ratio is unity and the plutonium plus 233 U production rate is ∼0.6 atoms per 14.1 MeV neutron

  19. Decision Making in Children and Adolescents: Impaired Iowa Gambling Task Performance in Early Adolescence

    Science.gov (United States)

    Smith, Dana G.; Xiao, Lin; Bechara, Antoine

    2012-01-01

    Disadvantageous decision making is cited as one of the premier problems in childhood development, underlying risky behavior and causing adolescents to make poor choices that could prove detrimental later in life. However, there are relatively few studies looking at the development of decision making in children and adolescents, and fewer still…

  20. Satisficing in Split-Second Decision Making Is Characterized by Strategic Cue Discounting

    Science.gov (United States)

    Oh, Hanna; Beck, Jeffrey M.; Zhu, Pingping; Sommer, Marc A.; Ferrari, Silvia; Egner, Tobias

    2016-01-01

    Much of our real-life decision making is bounded by uncertain information, limitations in cognitive resources, and a lack of time to allocate to the decision process. It is thought that humans overcome these limitations through "satisficing," fast but "good-enough" heuristic decision making that prioritizes some sources of…

  1. HIV, self-transcendence, and quality of life.

    Science.gov (United States)

    Mellors, M P; Riley, T A; Erlen, J A

    1997-01-01

    Self-transcendence is a developmental characteristic that expands one's boundaries of the self to take on broader life perspectives, activities, and purposes that help one discover or make meaning of one's life. However, no quantitative studies were found in the research literature that focused on self-transcendence or on the relationship between self-transcendence and quality of life in people infected with HIV. To examine these variables in this population, 46 HIV-positive subjects completed Reed's Self-Transcendence Scale and Ferrans and Powers' Quality of Life Index. The results demonstrated that overall self-transcendence for this sample was relatively high; quality of life was higher than that reported in previous research; and there were some significant group differences among the three HIV clinical categories.

  2. An Economic Model of Mortality Salience in Personal Financial Decision Making: Applications to Annuities, Life Insurance, Charitable Gifts, Estate Planning, Conspicuous Consumption, and Healthcare

    Directory of Open Access Journals (Sweden)

    Russell N James III

    2016-12-01

    Full Text Available The study of personal mortality salience and the denial of death have a long history in psychology leading to the modern field of Terror Management Theory. However, a simple consumer utility function predicts many of the outcomes identified in experimental research in this field. Further, this economic approach explains a range of otherwise unexpected financial decision-making behaviors in areas as diverse as annuities, life insurance, charitable gifts and bequests, intra-family gifts and bequests, conspicuous consumption, and healthcare. With its relevance to such a wide range of personal financial decisions, understanding the impact of mortality salience can be particularly useful to advisors in related fields.

  3. A Decision Making Account for the Cognitive Processing of Demorgan´S Laws

    Directory of Open Access Journals (Sweden)

    Razumiejczyk, Eugenia

    2010-07-01

    Full Text Available The aim of this contribution is to propose a preliminary account for the intuitive recognition of the logical equivalences attributed to Augustus DeMorgan. Such equivalences concerned with the negation of conjunctions and disjunctions have been previoulsy studied only in the context of syllogistic tasks, but not from the perspective of decision making. An on-line exploratory study was conducted to test two hypotheses. The first hypothesis states that DeMorgan´s law for the negation of conjunctions is easier to recognize than the corresponding law for the disjunctions case. The second hypothesis states that spontaneous errors in the recognition of DeMorgan´s laws follow a cognitive pattern. The results obtained for the first hypothesis suggest that the disjunctions case is more intuitive than the conjunctions case. An heuristic explanation for such unexpected result is suggested. The second hypothesis testing results suggest that the observed errors are not random. Suggestions for future research are proposed.

  4. Extraterrestrial Life in the Microbial Age

    Science.gov (United States)

    Gronstal, Aaron L.

    Humankind has long been fascinated with the potential for alien civilizations within the Solar System and beyond (e.g., Crowe and Dowd 2013; Sullivan 2013). Despite the early optimism for life beyond Earth, humankind has yet to make first contact with an alien race. Historical discourse on the topic of alien life can provide some useful input into questions about how the people of Earth today might respond to contact with alien life (e.g., Dick 2013). However, this discourse is primarily devoted to understanding humankind's response to intelligent life. We must recognize that the search for life's potential beyond Earth has dramatically changed since the dawn of the Space Age. We now know that advanced civilizations are not common on planets in our solar system. The search for life on nearby worlds is now limited to non-intelligent, microbial life. Any chance we have of contacting intelligent life lies in receiving transmissions from distant worlds, and contact with such cultures would be greatly limited by the vast expanse of space. This chapter discusses the need for more attention paid to the possible social, economic, and legal ramifications that the discovery of non-intelligent, alien microbial life might bring.

  5. Insights on Adolescence from a Life Course Perspective

    Science.gov (United States)

    Johnson, Monica Kirkpatrick; Crosnoe, Robert; Elder, Glen H., Jr.

    2011-01-01

    In this essay, we argue that viewing adolescence within the full life course will improve our understanding of both adolescence itself and the life course more generally. Such an approach makes explicit how adolescence is linked to developmental processes in the years both before and after adolescence in ways that are shaped by broader patterns of…

  6. End-of-life decisions for people with intellectual disabilities, an interview study with patient representatives

    NARCIS (Netherlands)

    Wagemans, A.M.; Schrojenstein Lantman-de Valk, H.M. van; Proot, I.M.; Metsemakers, J.; Tuffrey-Wijne, I.; Curfs, L.M.G.

    2013-01-01

    Background: Not much is known about the process of end-of-life decision-making for people with intellectual disabilities. Aim: To clarify the process of end-of-life decision-making for people with intellectual disabilities from the perspective of patient representatives. Design: A qualitative study

  7. Decision-Making for Supply Chain Integration Supply Chain Integration

    CERN Document Server

    Lettice, Fiona; Durowoju, Olatunde

    2012-01-01

    Effective supply chain integration, and the tight co-ordination it creates, is an essential pre-requisite for successful supply chain management.  Decision-Making for Supply Chain Integration is a practical reference on recent research in the area of supply chain integration focusing on distributed decision-making problems. Recent applications of various decision-making tools for integrating supply chains are covered including chapters focusing on: •Supplier selection, pricing strategy and inventory decisions in multi-level supply chains, •RFID-enabled distributed decision-making, •Operational risk issues and time-critical decision-making for sensitive logistics nodes, Modelling end to end processes to improve supply chain integration, and •Integrated systems to improve service delivery and optimize resource use. Decision-Making for Supply Chain Integration provides an insight into the tools and methodologies of this field with support from real-life case studies demonstrating successful application ...

  8. Designing Human-Centered Systems for Reflective Decision Making

    NARCIS (Netherlands)

    Pommeranz, A.

    2012-01-01

    Taking major life decisions, e.g. what career to follow, is difficult and sometimes emotional. One has to find out what exactly one wants, consider the long-term consequences of the decisions and be empathetic for loved ones affected by the decisions. Decision making also deals with establishing and

  9. The Past, Present, and Future of Artificial Life

    Directory of Open Access Journals (Sweden)

    Wendy eAguilar

    2014-10-01

    Full Text Available For millennia people have wondered what makes the living different from the non-living. Beginning in the mid-1980s, artificial life has studied living systems using a synthetic approach: build life in order to understand it better, be it by means of software, hardware, or wetware. This review provides a summary of the advances that led to the development of artificial life, its current research topics, and open problems and opportunities. We classify artificial life research into fourteen themes: origins of life, autonomy, self-organization, adaptation (including evolution, development, and learning, ecology, artificial societies, behavior, computational biology, artificial chemistries, information, living technology, art, and philosophy. Being interdisciplinary, artificial life seems to be losing its boundaries and merging with other fields.

  10. Pregnancy and Beyond: Make Healthy Choices for Yourself and Your Baby

    Science.gov (United States)

    ... meaning advice from family, friends, and even total strangers. You may feel a mix of emotions. Whether ... may find that changes like eliminating alcohol or cutting back on caffeinated coffee is easier than before ...

  11. Participation and Life Satisfaction in Aged People with Spinal Cord Injury: Does Age at Onset Make a Difference?

    Science.gov (United States)

    Post, Marcel W M; Reinhardt, Jan D

    2015-01-01

    Few studies have reported on outcomes in samples of elderly people with SCI and the impact of the age at onset of SCI is unclear. To study levels of participation and life satisfaction in individuals with SCI aged 65 years or older and to analyze differences in participation and life satisfaction scores between individuals injured before or after 50 years of age. This cross-sectional survey included 128 individuals with SCI who were at least 65 years old. Age at onset was dichotomized as scale of the Utrecht Scale for Evaluation-Participation, and life satisfaction was measured with 5 items of the World Health Organization Quality of Life abbreviated form. Participants who were injured before 50 years of age showed similar levels of functional status and numbers of secondary health conditions but higher participation and life satisfaction scores compared to participants injured at older age. In the multiple regression analysis of participation, lower current age, higher education, and having paraplegia were significant independent determinants of increased participation (explained variance, 25.7%). In the regression analysis of life satisfaction, lower age at onset and higher education were significant independent determinants of higher life satisfaction (explained variance, 15.3%). Lower age at onset was associated with better participation and life satisfaction. This study did not reveal indications for worsening participation or life satisfaction due to an accelerated aging effect in this sample of persons with SCI.

  12. NDE and plant life extension

    International Nuclear Information System (INIS)

    Liu, S.N.; Ammirato, F.V.; Nottingham, L.D.

    1991-01-01

    Component life extension is the process of making run-repair-replace decisions for plant components and includes a thorough analysis of the capability of the component to perform throughout the projected lifetime. For many critical plant components, nondestructive evaluation (NDE) is essential in determining whether the component can be operated safely and economically in the extended life period and to help utilities determine safe and economic inspection intervals. NDE technology is required for not only detecting defects that could grow to a size of concern during extended lifetimes, but also will be called upon to measure and monitor accumulating material degradation that strongly affects component reliability. This paper discusses the role of NDE in life extension by reviewing three examples--a reactor pressure vessel, steam turbine-generator rotors, and generator retaining rings. In each example, the contribution of NDE to life extension decisions is described. (author)

  13. On the value of human life

    Directory of Open Access Journals (Sweden)

    Višňovský Emil

    2017-06-01

    Full Text Available The author reflects on the issue of the value of human life in the contexts of current “posthuman” era. There is a host of evidence that the value of human for human beings themselves has been radically reduced or ignored, or replaced by other non-human values, and even neglected. The axiological crisis of humanity, as envisioned by Nietzsche, has become the existential and moral crisis of humanity today. No matter how contemporary technological culture challenges the traditional values, the ancient questions of “how to live?”, “what makes us happy?”, and “what makes life significant?” are still here with us and provide even greater challenges to every individual. The author points to pluralist ways of how to deal with these questions including the “stoic pragmatism” among them.

  14. Decision-making in diabetes mellitus type 1.

    Science.gov (United States)

    Rustad, James K; Musselman, Dominique L; Skyler, Jay S; Matheson, Della; Delamater, Alan; Kenyon, Norma S; Cáceda, Ricardo; Nemeroff, Charles B

    2013-01-01

    Decreased treatment adherence in patients with diabetes mellitus type 1 (type 1 DM) may reflect impairments in decision-making and underlying associated deficits in working memory and executive functioning. Other factors, including comorbid major depression, may also interfere with decision-making. The authors sought to review the clinically relevant characteristics of decision-making in type 1 DM by surveying the literature on decision-making by patients with type 1 DM. Deficiencies in decision-making in patients with type 1 DM or their caregivers contribute to treatment nonadherence and poorer metabolic control. Animal models of type 1 DM reveal deficits in hippocampal-dependent memory tasks, which are reversible with insulin. Neurocognitive studies of patients with type 1 DM reveal lowered performance on ability to apply knowledge to solve problems in a new situation and acquired scholarly knowledge, psychomotor efficiency, cognitive flexibility, visual perception, speed of information-processing, and sustained attention. Other factors that might contribute to poor decision-making in patients with type 1 DM, include "hypoglycemia unawareness" and comorbid major depression (given its increased prevalence in type 1 DM). Future studies utilizing novel treatment strategies to help patients with type 1 DM make better decisions about their disease may improve their glycemic control and quality of life, while minimizing the impact of end-organ disease.

  15. LIFE: Life Investigation For Enceladus A Sample Return Mission Concept in Search for Evidence of Life.

    Science.gov (United States)

    Tsou, Peter; Brownlee, Donald E; McKay, Christopher P; Anbar, Ariel D; Yano, Hajime; Altwegg, Kathrin; Beegle, Luther W; Dissly, Richard; Strange, Nathan J; Kanik, Isik

    2012-08-01

    Life Investigation For Enceladus (LIFE) presents a low-cost sample return mission to Enceladus, a body with high astrobiological potential. There is ample evidence that liquid water exists under ice coverage in the form of active geysers in the "tiger stripes" area of the southern Enceladus hemisphere. This active plume consists of gas and ice particles and enables the sampling of fresh materials from the interior that may originate from a liquid water source. The particles consist mostly of water ice and are 1-10 μ in diameter. The plume composition shows H(2)O, CO(2), CH(4), NH(3), Ar, and evidence that more complex organic species might be present. Since life on Earth exists whenever liquid water, organics, and energy coexist, understanding the chemical components of the emanating ice particles could indicate whether life is potentially present on Enceladus. The icy worlds of the outer planets are testing grounds for some of the theories for the origin of life on Earth. The LIFE mission concept is envisioned in two parts: first, to orbit Saturn (in order to achieve lower sampling speeds, approaching 2 km/s, and thus enable a softer sample collection impact than Stardust, and to make possible multiple flybys of Enceladus); second, to sample Enceladus' plume, the E ring of Saturn, and the Titan upper atmosphere. With new findings from these samples, NASA could provide detailed chemical and isotopic and, potentially, biological compositional context of the plume. Since the duration of the Enceladus plume is unpredictable, it is imperative that these samples are captured at the earliest flight opportunity. If LIFE is launched before 2019, it could take advantage of a Jupiter gravity assist, which would thus reduce mission lifetimes and launch vehicle costs. The LIFE concept offers science returns comparable to those of a Flagship mission but at the measurably lower sample return costs of a Discovery-class mission.

  16. SIMPLE LIFE AND RELIGION

    Directory of Open Access Journals (Sweden)

    Ahmet YILDIRIM

    2014-07-01

    Full Text Available Individuals in terms of the economy in which we live is one of the most important phenomenon of the century. This phenomenon present itself as the only determinant of people's lives by entering almost makes itself felt. The mo st obvious objective needs of the economy by triggering motive is to induce people to consume . Consumer culture pervades all aspects of the situation are people . Therefore, these people have the blessing of culture , beauty and value all in the name of w hatever is consumed. This is way out of the siege of moral and religious values we have is to go back again . Referred by local cultural and religious values, based on today increasingly come to the fore and the Muslim way of life appears to be close to th e plain / lean preferred by many people life has been a way of life. Even the simple life , a way of life in the Western world , a conception of life , a philosophy, a movement as it has become widely accepted. Here in determining the Muslim way of life Pr ophet. Prophet (sa lived the kind of life a very important model, sample, and determining which direction is known. Religious values, which is the carrier of the prophets, sent to the society they have always been examples and models. Because every aspect of human life, his life style and the surrounding area has a feature. We also value his life that he has unknowingly and without learning and skills and to understand it is not possible to live our religion . We also our presentation, we mainly of Islam o utlook on life and predicted life - style, including the Prophet of Islam 's (sa simple life to scrutinize and lifestyle issues related to reveal , in short Islam's how life has embraced and the Prophet. Prophet's will try to find answers to questions reg arding how to live.

  17. Black smokers and the Tree of Life

    Science.gov (United States)

    Linich, Michael

    The molecular biology revolution has turned the classification of life on its head. Is Whittaker's five-kingdom scheme for the classification of living things no longer relevant to life science education? Coupled with this is the discovery that most microscopic life cannot yet be brought into culture. One of the key organisms making this knowledge possible is Methanococcus jannishi a microorganism found in black smokers. This workshop presents the development of the Universal Tree of Life in a historical context and then links together major concepts in the New South Wales senior science programs of Earth and Environmental Science and Biology by examining the biological and geological aspects of changes to black smokers over geological time.

  18. Decision Making About Gastrostomy and Noninvasive Ventilation in Amyotrophic Lateral Sclerosis.

    Science.gov (United States)

    Martin, Naomi H; Lawrence, Vanessa; Murray, Joanna; Janssen, Anna; Higginson, Irene; Lyall, Rebecca; Burman, Rachel; Leigh, P Nigel; Al-Chalabi, Ammar; Goldstein, Laura H

    2016-08-01

    We used thematic analysis to investigate factors affecting decision making about gastrostomy and noninvasive ventilation (NIV) by people with Amyotrophic Lateral Sclerosis (ALS) from the viewpoint of the health care professionals (HCPs) supporting them. We conducted 20 in-depth interviews with 19 HCPs nominated by people with ALS who had made a decision to accept or decline NIV or gastrostomy. We found the main themes influencing decision making were patient-centric, caregiver-related or related to HCPs' own beliefs, perspectives, and actions. HCPs felt patients should be, and were, in control of decision making, although caregivers and HCPs played a role. The patient's evaluation of quality of life, the desirability of prolonging life, and acceptance of the disease and its progression by both patient and caregiver were the most important factors identified by HCPs. HCPs should be aware of the importance of multiprofessional discussions, and the potential influences (identified above) that might require discussion with patients and caregivers. © The Author(s) 2015.

  19. Life's end: Ethnographic perspectives.

    Science.gov (United States)

    Goodwin-Hawkins, Bryonny; Dawson, Andrew

    2018-01-01

    In this introduction to the special issue, Life's End: Ethnographic Perspectives, we review the field of anthropological studies of death and dying. We make the argument that, largely because of its sub-disciplining into the larger field of the anthropology of religion, ritual and symbolism, the focus of anthropological research on death has been predominantly on post- rather than pre-death events, on death's beginnings rather than life's ends. Additionally, we argue that an anthropological aversion to the study of dying may also lie in the intimacy of the discipline's principal method, ethnography. Contrastingly, we argue that this very methodological intimacy can be a source of insight, and we offer this as a rationale for the special issue as a whole, which comprises eight ethnographic studies of dying and social relations at life's end from across Africa, Australia, Europe, and North America. Each of these studies is then summarized, and a rationale for their presentation around the themes of "structures of dying," "care for the dying," "hope in dying," and "ending life" is presented.

  20. Emergence of Life

    Directory of Open Access Journals (Sweden)

    Marie-Paule Bassez

    2011-09-01

    Full Text Available Indeed, even if we know that many individual components are necessary for life to exist, we do not yet know what makes life emerge. One goal of this journal Life is to juxtapose articles with multidisciplinary approaches and perhaps to answer in the near future this question of the emergence of life. Different subjects and themes will be developed, starting of course with the multiple definitions of life and continuing with others such as: life diversity and universality; characteristics of living systems; thermodynamics with energy and entropy; kinetics and catalysis; water in its different physical states; circulation of sap and blood and its origin; the first blood pump and first heart; the first exchange of nutrients between cells, sap and blood; essential molecules of living systems; chirality; molecular asymmetry and its origin; formation of enantiomer excess and amplification; microscopic observations on a micrometer and sub-micrometer scales, at molecular and atomic levels; the first molecules at the origin of genetic information, viroids, circular RNA; regions of space or the area inside membranes and cells capable of initiating and maintaining life; phenomena at the origin of the emergence of life; molecules studied in the traditional field of chemistry and in the recent field of nanoscience governed by new laws; interaction between the individual molecules and components of living systems; interaction between living systems and the environment; transfer of information through generations; continuation of life from one generation to the next; prebiotic chemistry and prebiotic signatures on Earth, on Mars, on other planets; biosignatures of the first forms of life; fossils and pseudofossils dating 3.5 Ga ago and more recent ones; experimental fossilization; pluricellular eukaryotes dating 2.1 Ga ago; sudden increase in oxygen in the atmosphere around 2.0 to 2.5 Ga ago and its relation to geology; shell symmetry; aging with