Financial Decision Making and Cognition in a Family Context

Science.gov (United States)

Smith, James P.; McArdle, John J.; Willis, Robert

2010-01-01

In this paper, we studied the association of cognitive traits and in particular numeracy of both spouses on financial outcomes of the family. We found significant effects, particularly for numeracy for financial and non-financial respondents alike, but much larger effects for the financial decision maker in the family. We also examined who makes these financial decisions in the family and why. Once again, cognitive traits such as numeracy were an important component of that decision with larger effects of numeracy for husbands compared to wives. PMID:21116477

Decision-making among patients and their family in ALS care: a review.

Science.gov (United States)

Foley, Geraldine; Hynes, Geralyn

2018-05-01

Practice guidelines in ALS care emphasise the role of the patient and their family in the decision-making process. We aimed to examine the ALS patient/family relationship in the decision-making process and to ascertain how patients and their family can shape one another's decisions pertaining to care. We conducted a review of peer-reviewed empirical research, published in full and in English between January 2007 and January 2017, relating to care decision-making among ALS patients and their family. Database sources included: Medline; CINAHL; AMED; PsycINFO; PsycARTICLES; and Social Sciences Full Text. A narrative synthesis was undertaken. Forty-seven studies from the empirical literature were extracted. The family viewpoint was captured primarily from family members with direct care-giving duties. Patients' cognitive status was not routinely assessed. The findings revealed that the decision-making process in ALS care can be contoured by patients' and family caregivers' perceived responsibilities to one another and to the wider family. Greater attention to family member roles beyond the primary caregiver role is needed. Strategies that integrate cognitively-impaired patients into the family decision-making process require investigation. Identification of the domains in which ALS patients and their family members support one another in the decision-making process could facilitate the development of patient/family decision-making tools in ALS care.

Children's influence on family decision-making in food buying and consumption

DEFF Research Database (Denmark)

Mikkelsen, Miguel Romero; Nørgaard, Maria Kümpel

2006-01-01

This study investigates children's participation and influence in the family decision process during food buying and consumption. Danish 10 to 13-year-old children and their parents participated in the study. First, an ethnographic field study was carried out with 20 families. The field worker...... visited children at school and families at home during food buying, cooking and eating. Secondly, a survey was carried out with 451 families. The primary findings are that children participate and gain influence on several decision stages and areas during family food buying and that family everyday...... routines are an explaining factor of children's influence on family food decisions. When families buy and consume food, parents are not the only participants and decision-makers. Children and parents not always agree. Implications are that research should include parents as well as children; and that food...

Kids Market and Children Effects on Family Decisions: The Case of Marmaris

OpenAIRE

KARADAĞ, Levent

2011-01-01

Papers about family decision making process based on some teories like all members of family participate to decision, only parents participate to decision or one of parents dominated to decision. However at the present the children have effected family consumption decision. Nonetheless companies perceive the children as a new market and they have increased new marketing and selling strategies. The purpose of this paper is children effects on family - live in Marmaris and have at least one ki...

Timing of College Enrollment and Family Formation Decisions

DEFF Research Database (Denmark)

Kristoffersen, Jannie H. Grøne; Humlum, Maria Knoth; Vejlin, Rune Majlund

It is likely that the extent of progression in the educational system affects whether or not one decides to start a family at a given point in time. We estimate the effect of enrolling in college in the year of application on later family formation decisions such as the probability of being...... family formation decisions. For example, we find that the effect of enrolling in college on the probability of being a parent at age 27 is about 9 percentage points, corresponding to an increase of about 70 percent....

Family involvement in medical decision-making: Perceptions of nursing and psychology students.

Science.gov (United States)

Itzhaki, Michal; Hildesheimer, Galya; Barnoy, Sivia; Katz, Michael

2016-05-01

Family members often rely on health care professionals to guide and support them through the decision-making process. Although family involvement in medical decisions should be included in the preservice curriculum for the health care professions, perceptions of students in caring professions on family involvement in medical decision-making have not yet been examined. To examine the perceptions of nursing and psychology students on family involvement in medical decision-making for seriously ill patients. A descriptive cross-sectional design was used. First year undergraduate nursing and psychology students studying for their Bachelor of Arts degree were recruited. Perceptions were assessed with a questionnaire constructed based on the Multi-Attribute Utility Theory (MAUT), which examines decision-maker preferences. The questionnaire consisted of two parts referring to the respondent once as the patient and then as the family caregiver. Questionnaires were completed by 116 nursing students and 156 psychology students. Most were of the opinion that family involvement in decision-making is appropriate, especially when the patient is incapable of making decisions. Nursing students were more inclined than psychology students to think that financial, emotional, and value-based considerations should be part of the family's involvement in decision-making. Both groups of students perceived the emotional consideration as most acceptable, whereas the financial consideration was considered the least acceptable. Nursing and psychology students perceive family involvement in medical decision-making as appropriate. In order to train students to support families in the process of decision-making, further research should examine Shared Decision-Making (SDM) programs, which involve patient and clinician collaboration in health care decisions. Copyright © 2016 Elsevier Ltd. All rights reserved.

Putting Families in the Center: Family Perspectives on Decision Making and ADHD and Implications for ADHD Care

Science.gov (United States)

Davis, Catherine C.; Claudius, Milena; Palinkas, Lawrence A.; Wong, John B.; Leslie, Laurel K.

2012-01-01

Objective: To examine components of family-centered care in families' stories about treatment decision making for their child with ADHD. Method: Twenty-eight families participated in qualitative interviews that addressed families' perspectives on (a) the treatment decision-making process, (b) the cause and impact of their child's symptoms, and (c)…

Influence of the Family in Career Decision-Making.

Science.gov (United States)

Chope, Robert C.

2001-01-01

Two recently emerging factors are changing the role of family in career decision making: the revolutionary changes in family structure and increased emphasis on interpersonal relationships in work. Career counselors need new protocols in order to work with clients and family members. (SK)

Myth of the Perfect Family

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... a family group made up of only a father, mother, and children. Although most people tend to think that this particular family structure has always been the dominant one, that is not the case. The nuclear ...

Father- and Mother-Adolescent Decision-Making in Mexican-Origin Families

Science.gov (United States)

Perez-Brena, Norma; Updegraff, Kimberly A.; Umaña-Taylor, Adriana J.

2013-01-01

Understanding the prevalence and correlates of decisional autonomy within specific cultural contexts is necessary to fully understand how family processes are embedded within culture. The goals of this study were to describe mothers’ and fathers’ decision-making with adolescents (M = 12.51 years, SD = 0.58; 51% female), including parent-unilateral, joint, and youth-unilateral decision-making, and to examine the socio-cultural and family characteristics associated with these different types of decision-making in 246 Mexican-origin families. Mothers reported more joint and youth-unilateral decision-making and less parent-unilateral decision-making than did fathers. Fathers reported more youth-unilateral decision-making with sons than with daughters. Further, for mothers, more traditional gender role attitudes and higher levels of mother-adolescent conflict were associated with more parent-unilateral and less joint decision-making. In contrast, for fathers, lower levels of respect values were associated with more youth-unilateral decision-making with sons, and higher levels of parent-adolescent warmth was associated with more youth-unilateral decision-making with daughters. The importance of understanding the different correlates of mothers’ and fathers’ decision-making with sons versus daughters is discussed. PMID:21484288

Whole genome association mapping by incompatibilities and local perfect phylogenies

DEFF Research Database (Denmark)

Mailund, Thomas; Besenbacher, Søren; Schierup, Mikkel Heide

2006-01-01

around each marker that is compatible with a single phylogenetic tree. This perfect phylogenetic tree is treated as a decision tree for determining disease status, and scored by its accuracy as a decision tree. The rationale for this is that the perfect phylogeny near a disease affecting mutation should...... a fast method for accurate localisation of disease causing variants in high density case-control association mapping experiments with large numbers of cases and controls. The method searches for significant clustering of case chromosomes in the "perfect" phylogenetic tree defined by the largest region...... provide more information about the affected/unaffected classification than random trees. If regions of compatibility contain few markers, due to e.g. large marker spacing, the algorithm can allow the inclusion of incompatibility markers in order to enlarge the regions prior to estimating their phylogeny...

Family Decision Making: Benefits to Persons with Developmental Disabilities and Their Family Members

Science.gov (United States)

Neely-Barnes, Susan; Graff, J. Carolyn; Marcenko, Maureen; Weber, Lisa

2008-01-01

Family involvement in planning and choosing services has become a key intervention concept in developmental disability services. This study (N = 547) modeled patterns of family decision making and assessed benefits to persons with developmental disabilities (DDs) and their family members. A latent profile analysis identified 4 classes that were…

Family involvement for breast cancer decision making among Chinese-American women.

Science.gov (United States)

Lee, Shiuyu Katie C; Knobf, M Tish

2016-12-01

To describe family involvement in decision making for primary treatment in Chinese-American women with early-stage breast cancer. Qualitative data were collected in 2003 from semi-structured questions in interviews with a sample of Chinese-American (ChA) women with breast cancer, who were recruited from the metropolitan New York area. Responses to the questions were written in Chinese immediately during the interview and read back to the subject for accuracy and validation. Content analysis was used to inductively code and analyze the data to generate themes. The participants consisted of 123 ChA women with early stage breast cancer with a mean age of 48.7 years (±9.3) and who had lived in the United States a median of 13.6 years. Support and Caring was the major theme that described family involvement in the breast cancer decision-making process. Gathering Information, Being There, Navigating the Health Care System, Maintaining Family Life and Making the Decision described the aspects of family support in the process. The majority of women described the treatment decision making as a collaborative supportive process with the family, but limited English fluency, strong opinions, lack of a shared perspective, distant living proximity and competing work responsibilities of family members were stressful for the women and perceived as non-supportive. Family involvement in health care decision making is culturally embedded in Asian populations. Culturally sensitive patient and family consultation strategies are needed to assist informed treatment decision making in Chinese-American women diagnosed with breast cancer. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015 John Wiley & Sons, Ltd.

Work and family decision-making framework: A motivational perspective

OpenAIRE

Chinchilla, Nuria; Moragas, Maruja; Kim, Sowon

2012-01-01

We introduce motivation theory as a way of understanding the decision-making process in the work and family context. We use core concepts from motivation theory - extrinsic, intrinsic and prosocial motivation - and link them to motivational learning to build our framework. We then propose a framework illustrating motivational factors that influence work-family decision-making and offer propositions focusing on the motivational consequences for individuals which will impact their future decisi...

Incumbent Decisions about Succession Transitions in Family Firms: A Conceptual Model

Directory of Open Access Journals (Sweden)

Britta Boyd

2014-11-01

Full Text Available In the family business literature, succession research has focused on the family member as they enter the leadership role or on the different issues that affect the succession process. Although researchers have acknowledged that succession in family businesses is “punctuated” by decision making events, less attention has been given to understanding how incumbents make decisions about ownership and management transitions. In an effort to continue to understand the succession process it is important to understand how incumbents make decisions about the type of transitions they intend to engage in (i.e., intra-family succession, out of family succession, or no succession. Building on the theory of planned behavior and the socioemotional wealth framework (SEW, this manuscript presents a conceptual framework to understand the factors that influence succession transitions and the role that contextual factors can play in this decision-making process. We present theory driven propositions and discuss the implications for understanding and evaluation of the succession process.

Family matters: effects of birth order, culture, and family dynamics on surrogate decision-making.

Science.gov (United States)

Su, Christopher T; McMahan, Ryan D; Williams, Brie A; Sharma, Rashmi K; Sudore, Rebecca L

2014-01-01

Cultural attitudes about medical decision-making and filial expectations may lead some surrogates to experience stress and family conflict. Thirteen focus groups with racially and ethnically diverse English and Spanish speakers from county and Veterans Affairs hospitals, senior centers, and cancer support groups were conducted to describe participants' experiences making serious or end-of-life decisions for others. Filial expectations and family dynamics related to birth order and surrogate decision-making were explored using qualitative, thematic content analysis, and overarching themes from focus group transcripts were identified. The mean age of the 69 participants was 69 ± 14, and 29% were African American, 26% were white, 26% were Asian or Pacific Islander, and 19% were Latino. Seventy percent of participants engaged in unprompted discussions about birth order and family dynamics. Six subthemes were identified within three overarching categories: communication (unspoken expectations and discussion of death as taboo), emotion (emotional stress and feelings of loneliness), and conflict (family conflict and potential solutions to prevent conflict). These findings suggest that birth order and family dynamics can have profound effects on surrogate stress and coping. Clinicians should be aware of potential unspoken filial expectations for firstborns and help facilitate communication between the patient, surrogate, and extended family to reduce stress and conflict. © Published 2013. This article is a U.S. Government work and is in the public domain in the U.S.A.

Family Matters: Effects of Birth Order, Culture, and Family Dynamics on Surrogate Decision Making

Science.gov (United States)

Su, Christopher T.; McMahan, Ryan D.; Williams, Brie A.; Sharma, Rashmi K.; Sudore, Rebecca L.

2014-01-01

Cultural attitudes about medical decision making and filial expectations may lead some surrogates to experience stress and family conflict. Thirteen focus groups with racially and ethnically diverse English- and Spanish-speakers from county and Veterans hospitals, senior centers, and cancer support groups were conducted to describe participants’ experiences making serious or end-of-life decisions for others. Filial expectations and family dynamics related to birth order and surrogate decision making were explored using qualitative, thematic content analysis and overarching themes from focus group transcripts were identified. The mean age of the 69 participants was 69 years ± 14 and 29% were African American, 26% were White, 26% were Asian/Pacific Islander, and 19% were Latino. Seventy percent of participants engaged in unprompted discussions about birth order and family dynamics. Six subthemes were identified within 3 overarching categories of communication, emotion, and conflict: Communication – (1) unspoken expectations and (2) discussion of death as taboo; Emotion – (3) emotional stress and (4) feelings of loneliness; and Conflict – (5) family conflict and (6) potential solutions to prevent conflict. These findings suggest that birth order and family dynamics can have profound effects on surrogate stress and coping. Clinicians should be aware of potential unspoken filial expectations for firstborns and help facilitate communication between the patient, surrogate, and extended family to reduce stress and conflict. PMID:24383459

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.

Zeroth Poisson Homology, Foliated Cohomology and Perfect Poisson Manifolds

Science.gov (United States)

Martínez-Torres, David; Miranda, Eva

2018-01-01

We prove that, for compact regular Poisson manifolds, the zeroth homology group is isomorphic to the top foliated cohomology group, and we give some applications. In particular, we show that, for regular unimodular Poisson manifolds, top Poisson and foliated cohomology groups are isomorphic. Inspired by the symplectic setting, we define what a perfect Poisson manifold is. We use these Poisson homology computations to provide families of perfect Poisson manifolds.

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.

The role of family decision in internal migration: the case of India.

Science.gov (United States)

Bhattacharyya, B

1985-01-01

This paper analyzes the effects of family decisions and individual decisions on rural-urban migration in India under 2 different rural institutions--family farm and wage labor systems. An analytical framework for explaining family migration decisions reveals that whenever a member of the extended family migrates, he gives up his share in the produce of the family farm. When this happens, the number of adult members on the farm goes down and the total product is affected. 3 case studies of Indian villages are analyzed for this study. 2 empirical relations are examined: 1) if individual migration decisions are predominant, and 2) if family decisions are important in determining the overall flow of migration. Relationships between migration decisions and other variables, such as: 1) number of males in urban areas; 2) urban wages; 3) daily wage rate; 4) average agricultural income; 5) railway distance between rural and urban areas; 6) size of the labor market in destination region; 7) probability that a migrant arriving in an urban area will find a job; and 8) comsumption expenditure, in urban areas estimated by working class consumer price index, are determined. Results show that: 1) the market determined wage variable does not play a very significant role in migration decisions; 2) distance is one of the most important variables in analyzing migration; and 3) the aggregate flow of migration is affected if migration decisions are predominantly family decisions. These findings have relevant policy implications for less developed countries (LDCs), especially because large flows of rural-urban migration in recent years have forced governments to adopt policies for controlling the flows to reduce the burden of unemployment in the urban areas. Government policies affecting rural institutions will have an impact on migration flow; those that lead to a reduction of uncertainty in agriculture will affect average per-capita consumption levels in family farms and hence

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.

Family Structure, Parent-Child Communication, and Adolescent Participation in Family Consumer Tasks and Decisions.

Science.gov (United States)

Lachance, Marie J.; Legault, Frederic; Bujold, Neree

2000-01-01

A study of adolescents from single-mother (n=171) and two-parent (n=1,029) families showed that the former were more involved in family consumer tasks and decisions. The conceptual parenting style was associated with higher adolescent participation. The social style had greater impact on participation in single-parent families. (Contains 88…

Chemotherapy treatment decision-making experiences of older adults with cancer, their family members, oncologists and family physicians: a mixed methods study.

Science.gov (United States)

Puts, Martine T E; Sattar, Schroder; McWatters, Kara; Lee, Katherine; Kulik, Michael; MacDonald, Mary-Ellen; Jang, Raymond; Amir, Eitan; Krzyzanowska, Monika K; Leighl, Natasha; Fitch, Margaret; Joshua, Anthony M; Warde, Padraig; Tourangeau, Ann E; Alibhai, Shabbir M H

2017-03-01

Although comorbidities, frailty, and functional impairment are common in older adults (OA) with cancer, little is known about how these factors are considered during the treatment decision-making process by OAs, their families, and health care providers. Our aim was to better understand the treatment decision process from all these perspectives. A mixed methods multi-perspective longitudinal study using semi-structured interviews and surveys with 29 OAs aged ≥70 years with advanced prostate, breast, colorectal, or lung cancer, 24 of their family members,13 oncologists, and 15 family physicians was conducted. The sample was stratified on age (70-79 and 80+). All interviews were analyzed using thematic analysis. There was no difference in the treatment decision-making experience based on age. Most OAs felt that they should have the final say in the treatment decision, but strongly valued their oncologists' opinion. "Trust in my oncologist" and "chemotherapy as the last resort to prolong life" were the most important reasons to accept treatment. Families indicated a need to improve communication between them, the patient and the specialist, particularly around goals of treatment. Comorbidity and potential side-effects did not play a major role in the treatment decision-making for patients, families, or oncologists. Family physicians reported no involvement in decisions but desired to be more involved. This first study using multiple perspectives showed neither frailty nor comorbidity played a role in the treatment decision-making process. Efforts to improve communication were identified as an opportunity that may enhance quality of care. In a mixed methods study multiple perspective study with older adults with cancer, their family members, their oncologist and their family physician we explored the treatment decision making process and found that most older adults were satisfied with their decision. Comorbidity, functional status and frailty did not impact the

The experiences of family members in the nursing home to hospital transfer decision

Directory of Open Access Journals (Sweden)

Kathleen Abrahamson

2016-11-01

Full Text Available Abstract Background The objective of this study was to better understand the experiences of family members in the nursing home to hospital transfer decision making process. Semi-structured interviews were conducted with 20 family members who had recently been involved in a nursing home to hospital transfer decision. Results Family members perceived themselves to play an advocacy role in their resident’s care and interview themes clustered within three over-arching categories: Family perception of the nursing home’s capacity to provide medical care: Resident and family choices; and issues at ‘hand-off’ and the hospital. Multiple sub-themes were also identified. Conclusions Findings from this study contribute to knowledge surrounding the nursing home transfer decision by illuminating the experiences of family members in the transfer decision process.

Reasons for family involvement in elective surgical decision-making in Taiwan: a qualitative study.

Science.gov (United States)

Lin, Mei-Ling; Huang, Chuen-Teng; Chen, Ching-Huey

2017-07-01

To inquire into the reasons for family involvement in adult patients' surgical decision-making processes from the point of view of the patients' family. Making a patient the centre of medical decision-making is essential for respecting individual's autonomy. However, in a Chinese society, family members are often deeply involved in a patient's medical decision-making. Although family involvement has long been viewed as an aspect of the Chinese culture, empirical evidence of the reasons for family involvement in medical decision-making has been lacking. A qualitative study. In order to record and examine reasons for family involvement in adult patients' surgical decision-making, 12 different family members of 12 elective surgery patients were interviewed for collecting and analysing data. Three major reasons for family involvement emerged from the data analyses: (1) to share responsibility; (2) to ensure the correctness of medical information; and (3) to safeguard the patient's well-being. These findings also reveal that culture is not the only reason for family involvement. Making decision to undergo a surgery is a tough and stressful process for a patient. Family may provide the patient with timely psychological support to assist the patient to communicate with his or her physician(s) and other medical personnel to ensure their rights. It is also found that due to the imbalanced doctor-patient power relationship, a patient may be unable, unwilling to, or even dare not, tell the whole truth about his or her illness or feelings to the medical personnel. Thus, a patient would expect his or her family to undertake such a mission during the informed consent and decision-making processes. The results of this study may provide medical professionals with relevant insights into family involvement in adult patients' surgical decision-making. © 2016 John Wiley & Sons Ltd.

Incumbent Decisions about Succession Transitions in Family Firms: A Conceptual Model

OpenAIRE

Britta Boyd; Isabel C. Botero; Tomasz A. Fediuk

2014-01-01

In the family business literature, succession research has focused on the family member as they enter the leadership role or on the different issues that affect the succession process. Although researchers have acknowledged that succession in family businesses is “punctuated” by decision making events, less attention has been given to understanding how incumbents make decisions about ownership and management transitions. In an effort to continue to understand the succession process it is impo...

Children's influence on and participation in the family decision process during food buying

DEFF Research Database (Denmark)

Nørgaard, Maria Kümpel; Brunsø, Karen; Christensen, Pia Haudrup

2007-01-01

Purpose - The purpose of this paper is to contribute to studies of family decision making during food buying. In particular a theoretical framework is proposed for structuring future studies of family decision making that include children's influence and participation at specific stages of the pr......Purpose - The purpose of this paper is to contribute to studies of family decision making during food buying. In particular a theoretical framework is proposed for structuring future studies of family decision making that include children's influence and participation at specific stages...... to 13 using questionnaires for both children and parents. Findings - Family food decision making is often a joint activity, and children's active participation, among other things, determines the influence they gain. Parents and children do not always agree on how much influence children have...... in the various stages of the process, indicating the importance of listening to both parties in research into the family dynamics and processes involved in everyday food buying. Research limitations/implications - Future research should further extend the knowledge about the areas where children have influence...

Planning for outdoor play: Government and family decision-making.

Science.gov (United States)

Sterman, Julia J; Naughton, Geraldine A; Bundy, Anita C; Froude, Elspeth; Villeneuve, Michelle A

2018-03-08

Despite indisputable developmental benefits of outdoor play, children with disabilities can experience play inequity. Play decisions are multifactorial; influenced by children's skills and their familial and community environments. Government agencies have responsibilities for equity and inclusion of people with disabilities; including in play. This multiple-perspective case study aimed to understand outdoor play decision-making for children with disabilities from the perspectives and interactions of: local government and families of primary school-aged children with disabilities. Five mothers, four local government employees, and two not-for-profit organization representatives participated in semi-structured interviews. Inductive and iterative analyzes involved first understanding perspectives of individuals, then stakeholders (local government and families), and finally similarities and differences through cross-case analysis. Local government focused more on physical access, than social inclusion. Local government met only minimal requirements and had little engagement with families. This resulted in poor understanding and action around family needs and preferences when designing public outdoor play spaces. To increase meaningful choice and participation in outdoor play, government understanding of family values and agency around engagement with local government needs to improve. Supporting familial collective capabilities requires understanding interactions between individuals, play, disability, and outdoor play environments.

A perfect fit: connecting family therapy skills to family business needs.

Science.gov (United States)

Cole, Patricia M; Johnson, Kit

2012-06-01

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to couples therapy; (c) discussing how family therapists already have the practice wisdom to be effective in working with family business clients. Limitations of this practice are also discussed along with suggestions for overcoming them. © 2012 American Association for Marriage and Family Therapy.

A Perfect Fit: Connecting Family Therapy Skills to Family Business Needs

Science.gov (United States)

Cole, Patricia M.; Johnson, Kit

2012-01-01

The purpose of this article is to encourage family therapists to become more interested in family business practice. It does so in three ways: (a) highlighting the number of therapists already involved in family business issues; (b) showing the parallels between family business and family therapy by applying family business research findings to…

GENDER ROLE DISTRIBUTION IN RESIDENTIAL REAL ESTATE FAMILY DECISION MAKING

Directory of Open Access Journals (Sweden)

Irina R. KANCHEVA

2017-12-01

Full Text Available Purchase and consumption behavioral patterns of various family formations in different social and cultural contexts have been subject to intensive investigation over the recent years. Residential real estate as a product category represents one of the most complex household purchases incorporating a wide diversity of attributes to be considered in order to match family members’ needs within available resources. The purpose of this paper is to add some insights into spousal perceptions of gender role specialization throughout a residential real estate purchase family decision-making process. The distribution of influence between husbands and wives across three decision-making stages, three sub-decisions and twelve housing attribute choices and the relative importance of twelve residential real estate characteristics are examined using a convenience sample of both spouses in 127 Bulgarian heterosexual married and cohabiting couples.

Family Structures, Relationships, and Housing Recovery Decisions after Hurricane Sandy

Directory of Open Access Journals (Sweden)

Ali Nejat

2016-04-01

Full Text Available Understanding of the recovery phase of a disaster cycle is still in its infancy. Recent major disasters such as Hurricane Sandy have revealed the inability of existing policies and planning to promptly restore infrastructure, residential properties, and commercial activities in affected communities. In this setting, a thorough grasp of housing recovery decisions can lead to effective post-disaster planning by policyholders and public officials. The objective of this research is to integrate vignette and survey design to study how family bonds affected rebuilding/relocating decisions after Hurricane Sandy. Multinomial logistic regression was used to investigate respondents’ family structures before Sandy and explore whether their relationships with family members changed after Sandy. The study also explores the effect of the aforementioned relationship and its changes on households’ plans to either rebuild/repair their homes or relocate. These results were compared to another multinomial logistic regression which was applied to examine the impact of familial bonds on respondents’ suggestions to a vignette family concerning rebuilding and relocating after a hurricane similar to Sandy. Results indicate that respondents who lived with family members before Sandy were less likely to plan for relocating than those who lived alone. A more detailed examination shows that this effect was driven by those who improved their relationships with family members; those who did not improve their family relationships were not significantly different from those who lived alone, when it came to rebuilding/relocation planning. Those who improved their relationships with family members were also less likely to suggest that the vignette family relocate. This study supports the general hypothesis that family bonds reduce the desire to relocate, and provides empirical evidence that family mechanisms are important for the rebuilding/relocating decision

Advance directives: cancer patients' preferences and family-based decision making.

Science.gov (United States)

Xing, Yan-Fang; Lin, Jin-Xiang; Li, Xing; Lin, Qu; Ma, Xiao-Kun; Chen, Jie; Wu, Dong-Hao; Wei, Li; Yin, Liang-Hong; Wu, Xiang-Yuan

2017-07-11

Advance directives are a sensitive issue among traditional Chinese people, who usually refrain from mentioning this topic until it is imperative. Medical decisions for cancer patients are made by their families, and these decisions might violate patients' personal will. This study aimed to examine the acceptance of advance directives among Chinese cancer patients and their families and patient participation in this procedure and, finally, to analyze the moral risk involved. While 246 patients and their family members refused official discussion of an advance directive, the remaining 166 patients and their families accepted the concept of an advance directive and signed a document agreeing to give up invasive treatment when the anti-cancer treatment was terminated. Of these, only 24 patients participated in the decision making. For 101 patients, anti-cancer therapy was ended prematurely with as many as 37 patients not told about their potential loss of health interests. Participants were 412 adult cancer patients from 9 leading hospitals across China. An advance directive was introduced to the main decision makers for each patient; if they wished to sign it, the advance directive would be systematically discussed. A questionnaire was given to the oncologists in charge of each patient to evaluate the interaction between families and patients, patients' awareness of their disease, and participation in an advance directive. Advance directives were not widely accepted among Chinese cancer patients unless anti-cancer therapy was terminated. Most cancer patients were excluded from the discussion of an advance directive.

Coping Strategies and Posttraumatic Stress Symptoms in Post-ICU Family Decision Makers.

Science.gov (United States)

Petrinec, Amy B; Mazanec, Polly M; Burant, Christopher J; Hoffer, Alan; Daly, Barbara J

2015-06-01

To assess the coping strategies used by family decision makers of adult critical care patients during and after the critical care experience and the relationship of coping strategies to posttraumatic stress symptoms experienced 60 days after hospitalization. A single-group descriptive longitudinal correlational study. Medical, surgical, and neurological ICUs in a large tertiary care university hospital. Consecutive family decision makers of adult critical care patients from August 2012 to November 2013. Study inclusion occurred after the patient's fifth day in the ICU. None. Family decision makers of incapacitated adult ICU patients completed the Brief COPE instrument assessing coping strategy use 5 days after ICU admission and 30 days after hospital discharge or death of the patient and completed the Impact of Event Scale-Revised assessing posttraumatic stress symptoms 60 days after hospital discharge. Seventy-seven family decision makers of the eligible 176 completed all data collection time points of this study. The use of problem-focused (p=0.01) and emotion-focused (pstress symptoms than coping strategies 5 days after ICU admission (R2=0.30, p=0.001) controlling for patient and decision-maker characteristics. The role of decision maker for a parent and patient death were the only noncoping predictors of posttraumatic stress symptoms. Avoidant coping use 30 days after hospitalization mediated the relationship between patient death and later posttraumatic stress symptom severity. Coping strategy use is a significant predictor of posttraumatic stress symptom severity 60 days after hospitalization in family decision makers of ICU patients.

The differences in self-efficacy in career decision-making and decision-making styles among secondary school students with different patterns of family attachment

Directory of Open Access Journals (Sweden)

Suvajdžić Katarina

2016-01-01

Full Text Available The decision on the choice of profession is one of the most important life decisions, which is influenced by many factors. One of them which has a very important role is the family. The aim of this study is to examine whether there are differences in self-efficacy in career decision-making and decision-making styles among secondary school students who have different patterns of family attachment, as well as to determine whether self-efficacy in making career decisions can be predicted on the basis of different decision-making styles. The study included 216 fourth-year secondary school students, 39% of boys and 61% of girls. The questionnaire PAVb, made by Brenen and associates and modified by Kamenov and Jelic, was used for the evaluation of family attachment. Decision-making styles were operationalized through the scale of General Decision Making Styles Questionnaire by Scott and Bruce, while a shortened version of the Career Decision Self-Efficacy Scale, made by Betz et al., was used for measuring self-efficacy in making career decisions. The research results have shown that there are no significant differences in self-efficacy in making career decisions regarding the patterns of family attachment. However, there are significant differences in the styles of decision-making. The rational style is the most dominant among the students who have a secure form of family attachment, the avoidant style is characteristic of those with the occupied form, while the spontaneous style is most commonly used by the students who have the fearful form of family attachment. The results suggest that 31% of the variance of self-efficacy in making career decisions can be explained based on decision-making styles. The rational and intuitive styles of decision-making are positive predictors, while the dependent and avoidant styles are negative predictors of self-efficacy in making career decisions.

THE INFLUENCE OF FAMILY RELATIONS ON DECISION MAKING IN FAMILY BUSINESSES

Directory of Open Access Journals (Sweden)

Aleksandra Stoilkovska

2013-03-01

Full Text Available The peculiarity and uniqueness of family businesses set them apart from other businesses in many things. Natural need of man to survive in these harsh circumstances forces him to constantly seek new sources of funding or simply tries to improve the existing. Secure existence is difficult to ensure.The successful family business provides many benefits: reliable operation, to be your own boss, flexible working hours, family members are taken care of, to become successful with your own strengths. Also this kind of business brings a range of difficulties that have to be overcomed.Apart from the daily struggle for enterprise development in the complex conditions of tough competition and rapid changes in the environment, family businesses face problems of internal character. Namely, the parents are thorn between the family relations, the love towards their children and the consistence in the decision making processes. Although this is a modern and very present theme however owners of family businesses rarely dare to speak publicly on the subject.This paper presents an action research conducted on a sample of 26 family businesses in FYROM. This research study is primarily exploratory in nature, and the research instruments include survey through questionnaires with family member and employees that are not family members.

Relational autonomy or undue pressure? Family's role in medical decision-making.

Science.gov (United States)

Ho, Anita

2008-03-01

The intertwining ideas of self-determination and well-being have received tremendous support in western bioethics. They have been used to reject medical paternalism and to justify patients' rights to give informed consent (or refusal) and execute advanced directives. It is frequently argued that everyone is thoroughly unique, and as patients are most knowledgeable of and invested in their own interests, they should be the ones to make voluntary decisions regarding their care. Two results of the strong focus on autonomy are the rejection of the image of patients as passive care recipients and the suspicion against paternalistic influence anyone may have on patients' decision-making process. Although the initial focus in western bioethics was on minimizing professional coercion, there has been a steady concern of family's involvement in adult patients' medical decision-making. Many worry that family members may have divergent values and priorities from those of the patients, such that their involvement could counter patients' autonomy. Those who are heavily involved in competent patients' decision-making are often met with suspicion. Patients who defer to their families are sometimes presumed to be acting out of undue pressure. This essay argues for a re-examination of the notions of autonomy and undue pressure in the contexts of patienthood and relational identity. In particular, it examines the characteristics of families and their role in adult patients' decision-making. Building on the feminist conception of the relational self and examining the context of contemporary institutional medicine, this paper argues that family involvement and consideration of family interests can be integral in promoting patients' overall agency. It argues that, in the absence of abuse and neglect, respect for autonomy and agency requires clinicians to abide by patients' expressed wishes.

Incumbent Decisions about Succession Transitions in Family Firms

DEFF Research Database (Denmark)

Boyd, Britta; Botero, Isabel C.; Fediuk, Tomasz A.

2014-01-01

in (i.e., intra-family succession, out of family succession, or no succession). Building on the theory of planned behavior and the socioemotional wealth framework (SEW), this manuscript presents a conceptual framework to understand the factors that influence succession transitions and the role...... that contextual factors can play in this decision-making process. We present theory driven propositions and discuss the implications for understanding and evaluation of the succession process....

Financing Decisions in Family Businesses: A Review and Suggestions for Developing the Field

OpenAIRE

Michiels, Anneleen; Molly, Vincent

2017-01-01

Motivated by the growing attention to the financing decisions of family firms, this review brings together the two highly relevant research fields of family business and finance. This study critically reviews 131 articles on financing decisions in family businesses, published between 1977 and 2016 in 64 finance and management journals. We develop a state of the art on family business financing literature and present a model to guide extant and future research by identifying gaps across the th...

Physicotechnical potentialities of perfecting roentgenographic research

International Nuclear Information System (INIS)

Chikirdin, Eh.G.; Mishkinis, B.Ya.

1991-01-01

Physicotechnical potentialities of perfecting image quality in X-ray examinations are enumerated. Realization of these potentialities demands interrelated decision of two problems: substantiation of optimizing conditions of survey (postures of a patient, geometry of investigation, image converters, electric regimes), creation of adequate hardware and software components. It is shown that introduction of X-ray feeding device with microprocessor control permits to upgrade the quality of X-ray images and to reduce radiation loads of a patient

A multimethod analysis of shared decision-making in hospice interdisciplinary team meetings including family caregivers.

Science.gov (United States)

Washington, Karla T; Oliver, Debra Parker; Gage, L Ashley; Albright, David L; Demiris, George

2016-03-01

Much of the existing research on shared decision-making in hospice and palliative care focuses on the provider-patient dyad; little is known about shared decision-making that is inclusive of family members of patients with advanced disease. We sought to describe shared decision-making as it occurred in hospice interdisciplinary team meetings that included family caregivers as participants using video-conferencing technology. We conducted a multimethod study in which we used content and thematic analysis techniques to analyze video-recordings of hospice interdisciplinary team meetings (n = 100), individual interviews of family caregivers (n = 73) and hospice staff members (n = 78), and research field notes. Participants in the original studies from which data for this analysis were drawn were hospice family caregivers and staff members employed by one of five different community-based hospice agencies located in the Midwestern United States. Shared decision-making occurred infrequently in hospice interdisciplinary team meetings that included family caregivers. Barriers to shared decision-making included time constraints, communication skill deficits, unaddressed emotional needs, staff absences, and unclear role expectations. The hospice philosophy of care, current trends in healthcare delivery, the interdisciplinary nature of hospice teams, and the designation of a team leader/facilitator supported shared decision-making. The involvement of family caregivers in hospice interdisciplinary team meetings using video-conferencing technology creates a useful platform for shared decision-making; however, steps must be taken to transform family caregivers from meeting attendees to shared decision-makers. © The Author(s) 2015.

A Descriptive Study of Decision-Making Conversations during Pediatric Intensive Care Unit Family Conferences.

Science.gov (United States)

Smith, Michael A; Clayman, Marla L; Frader, Joel; Arenson, Melanie; Haber-Barker, Natalie; Ryan, Claire; Emanuel, Linda; Michelson, Kelly

2018-06-19

Little is known about how decision-making conversations occur during pediatric intensive care unit (PICU) family conferences (FCs). Describe the decision-making process and implementation of shared decision making (SDM) during PICU FCs. Observational study. University-based tertiary care PICU, including 31 parents and 94 PICU healthcare professionals involved in FCs. We recorded, transcribed, and analyzed 14 PICU FCs involving decision-making discussions. We used a modified grounded theory and content analysis approach to explore the use of traditionally described stages of decision making (DM) (information exchange, deliberation, and determining a plan). We also identified the presence or absence of predefined SDM elements. DM involved the following modified stages: information exchange; information-oriented deliberation; plan-oriented deliberation; and determining a plan. Conversations progressed through stages in a nonlinear manner. For the main decision discussed, all conferences included a presentation of the clinical issues, treatment alternatives, and uncertainty. A minority of FCs included assessing the family's understanding (21%), assessing the family's need for input from others (28%), exploring the family's desired decision-making role (35%), and eliciting the family's opinion (42%). In the FCs studied, we found that DM is a nonlinear process. We also found that several SDM elements that could provide information about parents' perspectives and needs did not always occur, identifying areas for process improvement.

Family Decision Making and Self-Determination Among Consumers With Schizophrenia in China: Cross-Cultural Implications.

Science.gov (United States)

Chen, Ying; Lam, Chow S; Deng, Hong; Corrigan, Patrick W; Yau, Eva

2018-04-01

Self-determination is viewed as an important ingredient of successful recovery in psychiatric rehabilitation. The concept of autonomy, a key component of self-determination, may be of less importance in Chinese cultures, whereby an individual's choices may be in conflict with the family's expectations. This study aimed to develop an instrument to measure opinions about self-determination among Chinese consumers and their family members. A 27-item questionnaire, the Consumer and Family Decision Making Scale (CFDMS), was constructed to measure consumers' and family members' views of self-determination in various aspects of daily life. A total of 364 (182 consumers of psychiatric services with a diagnosis of schizophrenia and 182 of their family members) participated in the study. The CFDMS was found to possess good psychometric properties and appears to be a reliable and valid instrument for assessment of consumers' decision making. (The Cronbach's alphas of psychiatric care and treatment factor, personal and social function factor, community and daily living factor, and money management factor were as follows: .86, .89, .87 and .76. The respective test-retest reliabilities were as follows: .81, .89, .80, and .88). Chinese consumers preferred autonomous decision making in regard to personal and social functioning and community and daily living but preferred to defer decisions regarding psychiatric care and treatment and money management to others. Family members and consumers had similar views. Deferring decisions to family members is common in Chinese families. The emphasis on autonomy in Western health care may need to be reconsidered in the treatment of Chinese consumers. Chinese families have a strong influence on treatment decisions, and providers must respect this style and remain nonjudgmental when dealing with situations or decisions that may be contradictory to their own culture and values.

Political ideology and labor arbitrators' decision making in work-family conflict cases.

Science.gov (United States)

Biernat, Monica; Malin, Martin H

2008-07-01

Labor arbitrators were asked to render decisions about grievances brought by employees who had been fired because of problems created by work conflicts with family responsibilities. The study examined the effects of experimentally manipulated grievant attributes (gender, type of work-family conflict) as well as arbitrator attributes (gender, political ideology) on decision making. When employees were depicted as having had child care problems, liberal arbitrators tended to favor female over male grievants, and political conservatism predicted more favorable judgments rendered toward male grievants. Overall, the data suggest that child care responsibilities cue different patterns of gender bias among liberal and conservative decision makers.

Faculty Sense of Agency in Decisions about Work and Family

Science.gov (United States)

O'Meara, KerryAnn; Campbell, Corbin M.

2011-01-01

Over the last decade, many research universities have adopted policies and support mechanisms to help academic parents balance work and family. This study sought to understand what facilitates faculty agency in making decisions about work and family, including parental leave. We conducted 20 interviews with 5 men and 15 women at a research…

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.

Quantum perfect correlations

International Nuclear Information System (INIS)

Ozawa, Masanao

2006-01-01

The notion of perfect correlations between arbitrary observables, or more generally arbitrary POVMs, is introduced in the standard formulation of quantum mechanics, and characterized by several well-established statistical conditions. The transitivity of perfect correlations is proved to generally hold, and applied to a simple articulation for the failure of Hardy's nonlocality proof for maximally entangled states. The notion of perfect correlations between observables and POVMs is used for defining the notion of a precise measurement of a given observable in a given state. A longstanding misconception on the correlation made by the measuring interaction is resolved in the light of the new theory of quantum perfect correlations

A qualitative study of factors in nurses' and physicians' decision-making related to family presence during resuscitation.

Science.gov (United States)

Twibell, Renee; Siela, Debra; Riwitis, Cheryl; Neal, Alexis; Waters, Nicole

2018-01-01

To explore the similarities and differences in factors that influence nurses' and physicians' decision-making related to family presence during resuscitation. Despite the growing acceptance of family presence during resuscitation worldwide, healthcare professionals continue to debate the risks and benefits of family presence. As many hospitals lack a policy to guide family presence during resuscitation, decisions are negotiated by resuscitation teams, families and patients in crisis situations. Research has not clarified the factors that influence the decision-making processes of nurses and physicians related to inviting family presence. This is the first study to elicit written data from healthcare professionals to explicate factors in decision-making about family presence. Qualitative exploratory-descriptive. Convenience samples of registered nurses (n = 325) and acute care physicians (n = 193) from a Midwestern hospital in the United States of America handwrote responses to open-ended questions about family presence. Through thematic analysis, decision-making factors for physicians and nurses were identified and compared. Physicians and nurses evaluated three similar factors and four differing factors when deciding to invite family presence during resuscitation. Furthermore, nurses and physicians weighted the factors differently. Physicians weighted most heavily the family's potential to disrupt life-saving efforts and compromise patient care and then the family's knowledge about resuscitations. Nurses heavily weighted the potential for the family to be traumatised, the potential for the family to disrupt the resuscitation, and possible family benefit. Nurses and physicians considered both similar and different factors when deciding to invite family presence. Physicians focused on the patient primarily, while nurses focused on the patient, family and resuscitation team. Knowledge of factors that influence the decision-making of interprofessional colleagues

Bereaved donor families' experiences of organ and tissue donation, and perceived influences on their decision making.

Science.gov (United States)

Sque, Magi; Walker, Wendy; Long-Sutehall, Tracy; Morgan, Myfanwy; Randhawa, Gurch; Rodney, Amanda

2018-06-01

To elicit bereaved families' experiences of organ and tissue donation. A specific objective was to determine families' perceptions of how their experiences influenced donation decision-making. Retrospective, qualitative interviews were undertaken with 43 participants of 31 donor families to generate rich, informative data. Participant recruitment was via 10 National Health Service Trusts, representative of five regional organ donation services in the UK. Twelve families agreed to DBD, 18 agreed to DCD, 1 unknown. Participants' responses were contextualised using a temporal framework of 'The Past', which represented families' prior knowledge, experience, attitudes, beliefs, and intentions toward organ donation; 'The Present', which incorporated the moment in time when families experienced the potential for donation; and 'The Future', which corresponded to expectations and outcomes arising from the donation decision. Temporally interwoven experiences appeared to influence families' decisions to donate the organs of their deceased relative for transplantation. The influence of temporality on donation-decision making is worthy of consideration in the planning of future education, policy, practice, and research for improved rates of family consent to donation. Copyright © 2018 Elsevier Inc. All rights reserved.

Involvement of Family Members and Professionals in Older Women's Post-Fall Decision Making.

Science.gov (United States)

Bergeron, Caroline D; Hilfinger Messias, DeAnne K; Friedman, Daniela B; Spencer, S Melinda; Miller, Susan C

2018-03-01

This exploratory, descriptive study examined involvement of family members and professionals in older women's post-fall decision making. We conducted semistructured interviews with 17 older women who had recently fallen and 11 individuals these women identified as being engaged in their post-fall decision-making processes. Qualitative data analysis involved open and axial coding and development of themes. After experiencing a fall, these older women's openness to others' opinions and advice; their assessments of types and credibility of potential information sources; and the communication practices they established with these sources influenced how they accessed, accepted, or rejected information from family members and professionals. Increased awareness of the involvement of others in post-fall decision making could enhance communication with older women who fall. Developing and implementing practical strategies to help family members and professionals initiate and engage in conversations about falls and their consequences could lead to more open decision making and improved post-fall quality of life among older women.

Collective familial decision-making in times of trouble: intergenerational solidarity in Ghana.

Science.gov (United States)

McGadney-Douglass, Brenda F; Douglass, Richard L

2008-06-01

In post-colonial populations the retention of the nuclear family concept of collectivism as the basis for decision-making is associated with familial and cultural survival. Collectivism within familial contexts provides intergenerational access to experience, information, resources, and sound decision making during times of conflict or dealing with the consequences of poverty. In contemporary Ghana inter-ethnic wars and conflict have marginalized minority groups, causing substantial internal displacement of people. Poverty and cultural issues have caused a persistently high level of child malnutrition and mortality in all areas of Ghana, including urban centers where appropriate food is in abundance. In each of these circumstances the senior women, particularly the grandmothers, have been found to be essential for child survival, protecting the family from dissolution, and ensuring intergenerational cultural transmission. This paper discusses the place of collective decision-making processes of older African women in two studies in Ghana that assessed the: (1) indigenous methods used for understanding and arresting violent ethnic conflict by internally displaced women who survived the 1994/95 Guinea Fowl War; and (2) parenting and grandparenting strategies from families who insured the survival of children suffering from kwashiorkor, a severe form of childhood malnutrition. In this paper, findings from qualitative interview data will include narratives and illustrative cases.

Primary Care Physician Involvement in Shared Decision Making for Critically Ill Patients and Family Satisfaction with Care.

Science.gov (United States)

Huang, Kevin B; Weber, Urs; Johnson, Jennifer; Anderson, Nathanial; Knies, Andrea K; Nhundu, Belinda; Bautista, Cynthia; Poskus, Kelly; Sheth, Kevin N; Hwang, David Y

2018-01-01

An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients. We compared the mean score for the survey subsection regarding shared decision making (graded on a 100-point scale), as well as individual survey items, between those who reported the patient's PCP involvement in any medical decision making versus those who did not. Among 263 respondents, there was no difference in mean overall decision-making satisfaction scores for those who reported involvement (81.1; SD = 15.2) versus those who did not (80.1; SD = 12.8; P = .16). However, a higher proportion reporting involvement felt completely satisfied with their 1) inclusion in the ICU decision making process (75.9% vs 61.4%; P = .055), and 2) control over the care of the patient (73.6% vs 55.6%; P = .02), with no difference regarding consistency of clinical information provided by the medical team (64.8% vs 63.5%; P = 1.00). Families who report involvement of a patient's PCP in medical decision making for critically ill patients may be more satisfied than those who do not with regard to specific aspects of ICU decision making. Further research would help understand how best to engage PCPs in shared decisions. © Copyright 2018 by the American Board of Family Medicine.

Decision aids for familial breast cancer: exploring women's views using focus groups.

NARCIS (Netherlands)

Rapport, F.; Iredale, R.; Jones, W.; Sivell, S.; Edwards, A.; Gray, J.; Elwyn, G.

2006-01-01

BACKGROUND: There is increasing need for accessible information about familial breast cancer for those facing complex decisions around genetic testing, screening and treatment. Information currently includes leaflets and computerized decision aids, offering interactive interfaces to clarify complex

Attitudes Toward Family Involvement in Cancer Treatment Decision Making: The Perspectives of Patients, Family Caregivers, and Their Oncologists.

Science.gov (United States)

Shin, Dong Wook; Cho, Juhee; Roter, Debra L; Kim, So Young; Yang, Hyung Kook; Park, Keeho; Kim, Hyung Jin; Shin, Hee-Young; Kwon, Tae Gyun; Park, Jong Hyock

2017-06-01

To investigate how cancer patients, family caregiver, and their treating oncologist view the risks and benefits of family involvement in cancer treatment decision making (TDM) or the degree to which these perceptions may differ. A nationwide, multicenter survey was conducted with 134 oncologists and 725 of their patients and accompanying caregivers. Participant answered to modified Control Preferences Scale and investigator-developed questionnaire regarding family involvement in cancer TDM. Most participants (>90%) thought that family should be involved in cancer TDM. When asked if the oncologist should allow family involvement if the patient did not want them involved, most patients and caregivers (>85%) thought they should. However, under this circumstance, only 56.0% of oncologists supported family involvement. Patients were significantly more likely to skew their responses toward patient rather than family decisional control than were their caregivers (P family decisional control than caregivers (P family involvement is helpful and neither hamper patient autonomy nor complicate cancer TDM process. Oncologists were largely positive, but less so in these ratings than either patients or caregivers (P family caregivers, and, to a lesser degree, oncologists expect and valued family involvement in cancer TDM. These findings support a reconsideration of traditional models focused on protection of patient autonomy to a more contextualized form of relational autonomy, whereby the patient and family caregivers can be seen as a unit for autonomous decision. Copyright © 2016 John Wiley & Sons, Ltd.

Training family physicians and residents in family medicine in shared decision making to improve clinical decisions regarding the use of antibiotics for acute respiratory infections: protocol for a clustered randomized controlled trial

Directory of Open Access Journals (Sweden)

Frémont Pierre

2011-01-01

Full Text Available Abstract Background To explore ways to reduce the overuse of antibiotics for acute respiratory infections (ARIs, we conducted a pilot clustered randomized controlled trial (RCT to evaluate DECISION+, a training program in shared decision making (SDM for family physicians (FPs. This pilot project demonstrated the feasibility of conducting a large clustered RCT and showed that DECISION+ reduced the proportion of patients who decided to use antibiotics immediately after consulting their physician. Consequently, the objective of this study is to evaluate, in patients consulting for ARIs, if exposure of physicians to a modified version of DECISION+, DECISION+2, would reduce the proportion of patients who decide to use antibiotics immediately after consulting their physician. Methods/design The study is a multi-center, two-arm, parallel clustered RCT. The 12 family practice teaching units (FPTUs in the network of the Department of Family Medicine and Emergency Medicine of Université Laval will be randomized to a DECISION+2 intervention group (experimental group or to a no-intervention control group. These FPTUs will recruit patients consulting family physicians and residents in family medicine enrolled in the study. There will be two data collection periods: pre-intervention (baseline including 175 patients with ARIs in each study arm, and post-intervention including 175 patients with ARIs in each study arm (total n = 700. The primary outcome will be the proportion of patients reporting a decision to use antibiotics immediately after consulting their physician. Secondary outcome measures include: 1 physicians and patients' decisional conflict; 2 the agreement between the parties' decisional conflict scores; and 3 perception of patients and physicians that SDM occurred. Also in patients, at 2 weeks follow-up, adherence to the decision, consultation for the same reason, decisional regret, and quality of life will be assessed. Finally, in both patients

Decision making in young people at familial risk of depression.

Science.gov (United States)

Mannie, Z N; Williams, C; Browning, M; Cowen, P J

2015-01-01

Major depression is associated with abnormalities in reward processing at neural and behavioural levels. Neural abnormalities in reward have been described in young people at familial risk of depression but behavioural changes in reward-based decision making have been less studied in this group. We studied 63 young people (mean age 18.9 years) with a parent with a diagnosis of major depression but who had never been depressed themselves, that is with a positive family history of depression (the FH+ group). Participants performed the Cambridge Gambling Task (CGT), which provides several measures of decision making including deliberation time, quality of decision making, risk taking, risk adjustment and delay aversion. A control group of 49 age- and gender-matched young people with no history of mood disorder in a first-degree relative undertook the same task. Both FH+ participants and controls had low and equivalent scores on anxiety and depression self-rating scales. Compared to controls, the FH+ participants showed overall lower risk taking, although like controls they made more risky choices as the odds of a favourable outcome increased. No other measures of decision making differed between the two groups. Young people at increased familial risk of depression have altered risk taking that is not accounted for by current affective symptomatology. Lowered risk taking might represent an impairment in reward seeking, which is one of several changes in reward-based behaviours seen in acutely depressed patients; however, our findings suggest that decreased reward seeking could be part of a risk endophenotype for depression.

Male Involvement in Family Planning Decision Making in Ile-Ife ...

African Journals Online (AJOL)

Erah

spousal communication, and investigated the correlates of men's opinion in family planning decision making in ... questionnaire to collect information from 402 male study participants. ..... who attained post-secondary education were more.

Patient and family involvement in decision making for management of cancer patients at a centre in Singapore.

Science.gov (United States)

Chong, Jia An; Quah, Yan Ling; Yang, Grace Meijuan; Menon, Sumytra; Radha Krishna, Lalit Kumar

2015-12-01

The practice of patient autonomy within the prevailing bioethical framework in the West appears increasingly at odds with the prominent influence of the family in medical decision making in the Asian culture. The actual extent of involvement of patient versus the family in the decision making process for cancer management in clinical practice is largely unknown in Asia. (1) To describe patient and family involvement in healthcare decision making in actual practice, and to determine whether those practices are consistent with Singapore law; and (2) to act as a pilot for a larger prospective study examining the preferences of cancer patients on the decision making process, and the reasons for excluding patients from that process. A retrospective review of patients who died in an oncology ward in Singapore General Hospital from February to April 2011. Patient and family involvement in discussions on (1) disclosure of diagnosis, (2) initial treatment decisions and (3) initiation of a 'maximum ward management' order was evaluated by reviewing case notes completed by healthcare professionals. Data were collected for 55 patients. Involvement of patients and families at first disclosure of diagnosis was noted in 61% and 64% of cases, respectively. In 12% of cases, the family requested withholding of the diagnosis from the patient. 86% of patients were involved in the initial treatment decisions, and their family was involved in 65% of cases. Only 9% of the 32 alert patients were consulted in end of life decisions. Factors associated with lower patient involvement were advanced age and inability to speak English. While most cancer patients are involved in the healthcare decision making process during the early phase, familial involvement gains prominence as the disease progresses. 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/

Influence Strategies Used When Couples Make Work-Family Decisions and Their Importance for Marital Satisfaction.

Science.gov (United States)

Zvonkovic, Anisa M.; And Others

1994-01-01

Investigated how marital partners influenced each other concerning work and family decisions and connected influence strategies to martial satisfaction in 61 married couples who had faced work-family decisions in past 6 months. Found that gender role ideology and indirect influence strategies were related to marital satisfaction. Variables related…

Gender differences in the family-relatedness of relocation decisions

NARCIS (Netherlands)

Ullrich, J.; Pluut, Helen; Büttgen, M.

2015-01-01

Using a dyadic study design, the present study draws on research into the family-relatedness of work decisions to examine the impact of the spouse's characteristics on an employee's willingness to engage in job-related relocation. With a sample of 1234 employees, the results show that spousal

Perfect imaging without negative refraction

OpenAIRE

Leonhardt, Ulf

2009-01-01

Perfect imaging has been believed to rely on negative refraction, but here we show that an ordinary positively-refracting optical medium may form perfect images as well. In particular, we establish a mathematical proof that Maxwell's fish eye in two-dimensional integrated optics makes a perfect instrument with a resolution not limited by the wavelength of light. We also show how to modify the fish eye such that perfect imaging devices can be made in practice. Our method of perfect focusing ma...

Children Involvement on Family Purchase Decision Making

OpenAIRE

Jostein, Revina Wintry

2013-01-01

Children take big involvement in family decision making process today. There are several factors that make this phenomenon happen, such as media influence. Currently, the development of information and communication technology is so fast, indirectly encourages all parties, including the children to be able to follow the changes. There are two main objectives that will be examined, related with all the stated problems at the previous section, which are to analyze which product category does ch...

Work, family, and happiness : essays on interdependencies within families, life events, and time allocation decisions

OpenAIRE

Pouwels, B.

2011-01-01

In this thesis we investigate how today’s work and family life influence people’s happiness – or the lack thereof. We contribute to the research agenda by focusing on three underexplored issues in the literature, namely i) interdependencies within families, ii) life events, and iii) time allocation decisions. Using data of the Dutch Time Competition Survey 2003 and the German Socio-Economic Panel 1984 – 2005 (GSOEP), this thesis shows that the happiness of partners in marital relationships is...

Toward shared decision making: using the OPTION scale to analyze resident-patient consultations in family medicine

NARCIS (Netherlands)

Pellerin, M.A.; Elwyn, G.; Rousseau, M.; Stacey, D.; Robitaille, H.; Legare, F.

2011-01-01

PURPOSE: Do residents in family medicine practice share decision making with patients during consultations? This study used a validated scale to score family medicine residents' shared decision-making (SDM) skills in primary care consultations and to determine whether residents' demographic

'The family is only one part …': understanding the role of family in young Thai women's sexual decision making.

Science.gov (United States)

Bangpan, Mukdarut; Operario, Don

2014-01-01

This study aims to understand young Thai women's perspectives about family influences on their sexual decisions with the goal of informing the future development of HIV programmes and interventions for young Thai women in urban areas. Eight focus groups were conducted with 40 young single women aged 18-25 years, recruited through a peer network of key informants from four sites across Bangkok: universities, government offices, slums and garment factories. Predetermined topics relating to family, sexual decisions and HIV were discussed with 4-5 participants in each group. Qualitative thematic and framework-analysis techniques were used to explore participants' narratives. Findings suggest that young Thai women's sexual decisions are complex and take place under a wide range of personal, familial and social influences. Parents were perceived as a barrier to parent-child communication about sex and HIV. Young women regarded mothers as more supportive and receptive than fathers when discussing sensitive topics. Young Thai women described a tension between having a strong sense of self and modern sexual norms versus traditionally conservative relational orientations. Future HIV interventions could benefit by developing strategies to consider barriers to parent-child communication, strengthening family relationships and addressing the coexistence of conflicting sexual norms in the Thai context.

Does empowering resident families or nursing home employees in decision making improve service quality?

Science.gov (United States)

Hamann, Darla J

2014-08-01

This research examines how the empowerment of residents' family members and nursing home employees in managerial decision making is related to service quality. The study was conducted using data from 33 nursing homes in the United States. Surveys were administered to more than 1,000 employees on-site and mailed to the primary-contact family member of each resident. The resulting multilevel data were analyzed using hierarchical linear modeling. The empowerment of families in decision making was positively associated with their perceptions of service quality. The empowerment of nursing staff in decision making was more strongly related to service quality than the empowerment of nonnursing staff. Among nursing staff, the empowerment of nursing assistants improved service quality more than the empowerment of nurses. © The Author(s) 2013.

PERFECT DEMAND ILLUSION

Directory of Open Access Journals (Sweden)

Alexander Yu. Sulimov

2015-01-01

Full Text Available The article is devoted to technique «Perfect demand illusion», which allows to strengthen the competitive advantageof retailers. Also in the paper spells out the golden rules of visual merchandising.The definition of the method «Demand illusion», formulated the conditions of its functioning, and is determined by the mainhypothesis of the existence of this method.Furthermore, given the definition of the «Perfect demand illusion», and describes its additional conditions. Also spells out the advantages of the «Perfect demandillusion», before the «Demand illusion».

Client Satisfaction And Decision Making Amongst Females Visiting Family Planning Clinics In Hyderabad, Pakistan.

Science.gov (United States)

Memon, Arbia; Hamid, Saima; Kumar, Ramesh

2017-01-01

Family Planning is the basic right of the human being. It involves decision regarding the number of children and desired space between children by the couple themselves. Quality services involving multiple dimensions build the confidence of the clients and lack of quality is one of the constraints behind incomplete coverage of family planning. Objectives of the current study were to determine the client satisfaction, decision-making process and various influences on clients in adopting family planning methods. This cross-sectional study was conducted at Family Planning Centre of Liaquat University Hospital, Hyderabad in 2016. Quality of the family planning services and satisfaction with the services were assessed through responses obtained from women selected purposively and visiting family planning centre through exit interviews with structured pretested and reliable questionnaire after taking the written consent. Access to Family Planning Centre was not an issue in 92% cases but only 31% respondents were appropriately greeted, 77% faced blank expression and 13% received sufficient privacy. Health problems and socioeconomic conditions were inquired by 41% and18% providers respectively, while motivating force for service use was mother in law in most 35% cases. Health workers were successful in clarifying misinformation (86%) and explaining side effects (71%) but only 21% respondents were satisfied with services. Respondents are influenced by family and health care providers while making decision and type of influence was considered positive by 83% respondents. Training and monitoring system be strengthened at family planning centres to improve quality of services while important influencing relations be focused for family planning education to improve utilization of services.

Protocol for implementation of family health history collection and decision support into primary care using a computerized family health history system

Directory of Open Access Journals (Sweden)

Agbaje Astrid B

2011-10-01

Full Text Available Abstract Background The CDC's Family History Public Health Initiative encourages adoption and increase awareness of family health history. To meet these goals and develop a personalized medicine implementation science research agenda, the Genomedical Connection is using an implementation research (T3 research framework to develop and integrate a self-administered computerized family history system with built-in decision support into 2 primary care clinics in North Carolina. Methods/Design The family health history system collects a three generation family history on 48 conditions and provides decision support (pedigree and tabular family history, provider recommendation report and patient summary report for 4 pilot conditions: breast cancer, ovarian cancer, colon cancer, and thrombosis. All adult English-speaking, non-adopted, patients scheduled for well-visits are invited to complete the family health system prior to their appointment. Decision support documents are entered into the medical record and available to provider's prior to the appointment. In order to optimize integration, components were piloted by stakeholders prior to and during implementation. Primary outcomes are change in appropriate testing for hereditary thrombophilia and screening for breast cancer, colon cancer, and ovarian cancer one year after study enrollment. Secondary outcomes include implementation measures related to the benefits and burdens of the family health system and its impact on clinic workflow, patients' risk perception, and intention to change health related behaviors. Outcomes are assessed through chart review, patient surveys at baseline and follow-up, and provider surveys. Clinical validity of the decision support is calculated by comparing its recommendations to those made by a genetic counselor reviewing the same pedigree; and clinical utility is demonstrated through reclassification rates and changes in appropriate screening (the primary outcome

Improving family satisfaction and participation in decision making in an intensive care unit.

Science.gov (United States)

Huffines, Meredith; Johnson, Karen L; Smitz Naranjo, Linda L; Lissauer, Matthew E; Fishel, Marmie Ann-Michelle; D'Angelo Howes, Susan M; Pannullo, Diane; Ralls, Mindy; Smith, Ruth

2013-10-01

Background Survey data revealed that families of patients in a surgical intensive care unit were not satisfied with their participation in decision making or with how well the multidisciplinary team worked together. Objectives To develop and implement an evidence-based communication algorithm and evaluate its effect in improving satisfaction among patients' families. Methods A multidisciplinary team developed an algorithm that included bundles of communication interventions at 24, 72, and 96 hours after admission to the unit. The algorithm included clinical triggers, which if present escalated the algorithm. A pre-post design using process improvement methods was used to compare families' satisfaction scores before and after implementation of the algorithm. Results Satisfaction scores for participation in decision making (45% vs 68%; z = -2.62, P = .009) and how well the health care team worked together (64% vs 83%; z = -2.10, P = .04) improved significantly after implementation. Conclusions Use of an evidence-based structured communication algorithm may be a way to improve satisfaction of families of intensive care patients with their participation in decision making and their perception of how well the unit's team works together.

A qualitative exploration of patient and family views and experiences of treatment decision-making in bipolar II disorder.

Science.gov (United States)

Fisher, Alana; Manicavasagar, Vijaya; Sharpe, Louise; Laidsaar-Powell, Rebekah; Juraskova, Ilona

2018-02-01

Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. To explore patient and family perspectives of treatment decision-making in BPII. Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Four inter-related themes emerged: (1) Attitudes and response to diagnosis and treatment; (2) Influences on decision-making; (3) The nature and flow of decision-making; (4) Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients' current mood symptoms. This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared.

Review of Family Financial Decision Making: Suggestions for Future Research and Implications for Financial Education

Science.gov (United States)

Kim, Jinhee; Gutter, Michael S.; Spangler, Taylor

2017-01-01

This article reviews the theories and literature in intrahousehold financial decisions, spousal partners and financial decision making, family system and financial decision process, children, and financial decisions. The article draws conclusions from the literature review and discusses directions for future research and educational programs. Most…

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.

Probabilistic scenario-based decision making for water resources planning and management

NARCIS (Netherlands)

Dong, C.

2014-01-01

Uncertainty is an unavoidable part of decision making. Decisions always have to be made before perfect knowledge on their consequences is known. However, there is no ‘perfect knowledge’ in hindsight. To research uncertainty and take actions proactively becomes the challenge to scientists and

Perfect imaging without negative refraction

Energy Technology Data Exchange (ETDEWEB)

Leonhardt, Ulf [School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews KY16 9SS (United Kingdom)], E-mail: ulf@st-andrews.ac.uk

2009-09-15

Perfect imaging has been believed to rely on negative refraction, but here we show that an ordinary positively refracting optical medium may form perfect images as well. In particular, we establish a mathematical proof that Maxwell's fish eye in two-dimensional (2D) integrated optics makes a perfect instrument with a resolution not limited by the wavelength of light. We also show how to modify the fish eye such that perfect imaging devices can be made in practice. Our method of perfect focusing may also find applications outside of optics, in acoustics, fluid mechanics or quantum physics, wherever waves obey the 2D Helmholtz equation.

Trusting families: Responding to Mary Ann Meeker, "Responsive care management: family decision makers in advanced cancer".

Science.gov (United States)

Nelson, James Lindemann

2011-01-01

Mary Ann Meeker's article admirably reminds readers that family members are involved in--or "responsively manage"--the care of relatives with severe illness in ways that run considerably beyond the stereotypes at play in many bioethical discussions of advance directives. Her observations thus make thinking about the role of families in healthcare provision more adequate to the facts, and this is an important contribution. There's reason to be worried, however, that one explicit aim of the article--to ease the standing anxieties that many clinicians and ethicists have about the reliability of family members as proxy decision makers--will be frustrated by its very success. Those already inclined to suspicion may tend to think that the more intricate and pervasive the ways in which families influence the healthcare decision making of their sick, the more chances they have for altering the connection between patients' interests and the actions of professional providers. To determine whether and when such alterations are something to be concerned about, we'll need to supplement a better grasp of the pertinent facts with a deeper sense of how human agency works and why we value it. We may also need some reminders about the defensibility of diverse moral understandings. Although both professionals and family members may profess an ethic that sets patients' interests above those of non-patients--as Meeker's own results suggest--any strict allegiance to such a framework may be more notional than normative--as her findings also hint. The actual working norms (among professionals, as well as within families) will likely be more complex, but not necessarily any the less defensible for that.

Aid to Families with Dependent Children Quality Control Review Panel Decisions

Data.gov (United States)

U.S. Department of Health & Human Services — Decisions issued by the Aid to Families with Dependent Children (AFDC) Quality Control Review Panel of the Departmental Appeals Board concerning the AFDC program...

Male Involvement in Family Planning Decision Making in Ile-Ife ...

African Journals Online (AJOL)

This study assessed men's awareness, attitude, and practice of modern contraceptive methods, determined the level of spousal communication, and investigated the correlates of men's opinion in family planning decision making in Ile-Ife, Nigeria. Quantitative methodology was employed in this cross-sectional descriptive ...

Perfect sequences over the real quaternions

OpenAIRE

Kuznetsov, Oleg

2017-01-01

In this Thesis, perfect sequences over the real quaternions are first considered. Definitions for the right and left periodic autocorrelation functions are given, and right and left perfect sequences introduced. It is shown that the right (left) perfection of any sequence implies the left (right) perfection, so concepts of right and left perfect sequences over the real quaternions are equivalent. Unitary transformations of the quaternion space ℍ are then considered. Using the equivalence of t...

Patient and family communication during consultation visits: The effects of a decision aid for treatment decision-making for localized prostate cancer.

Science.gov (United States)

Song, Lixin; Tyler, Christina; Clayton, Margaret F; Rodgiriguez-Rassi, Eleanor; Hill, Latorya; Bai, Jinbing; Pruthi, Raj; Bailey, Donald E

2017-02-01

To analyze the effects of a decision aid on improving patients' and family members' information giving and question asking during consultations for prostate cancer treatment decision-making. This study is a secondary analysis of archived audio-recorded real-time consultation visits with participants from a randomized clinical trial. Participants were randomly assigned into three groups: TD-intervention targeted patient-only; TS-intervention targeted patients and family members; and control-a handout on staying healthy during treatment. We conducted content analysis using a researcher-developed communication coding system. Using SAS 9.3, we conducted Chi-square/Fisher's exact test to examine whether information giving and question asking among patients and family members varied by groups when discussing different content/topics. Compared with those in the TS and control groups, significantly higher percentages of participants in the TD group demonstrated information giving in discussing topics about diagnosis, treatment options, risks and benefits, and preferences; and engaged in question asking when discussing diagnosis, watchful waiting/active surveillance, risks and benefits, and preferences for treatment impacts. Information support and communication skills training for patients were effective in improving communication during treatment decision-making consultations. Providing information about prostate cancer and communication skills training empower patients and their family members. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Supportive families versus support from families: The decision to have a child in the Netherlands

Directory of Open Access Journals (Sweden)

Susan Schaffnit

2017-08-01

Full Text Available Background: Support from families can reduce costs of reproduction and may therefore be associated with higher fertility for men and women. Family supportiveness, however, varies both between families - some families are more supportive than others - and within families over time - as the needs of recipients and the abilities of support givers change. Distinguishing the effects of time-invariant between-family supportiveness and time-varying within-family supportiveness on fertility can help contribute to an understanding of how family support influences fertility. Objective: We distinguish 'between' and 'within' families for several types of support shared between parents and adult children and test whether between- and within-family variation in support associates with birth timings. Methods: We use seven years of annually collected LISS panel data from the Netherlands on 2,288 reproductive-aged men and women to investigate the timing of first and subsequent births. Results: We find between-family support is more often associated with fertility than is within-family support, particularly for first births and for women. Emotional support is generally associated with earlier first births for both men and women, while results for financial and reciprocal emotional support are mixed. There is some indication that the latter kind of support positively predicts births for men and negatively for women. Conclusions: Our results suggest that feeling supported may be more important than actual support in reproductive decision-making in this high-income setting. Contribution: We apply a method novel to human demography to address both a conceptual and methodological issue in studies of families and fertility.

Male involvement in family planning decision making in sub-Saharan Africa- what the evidence suggests

Science.gov (United States)

Vouking, Marius Zambou; Evina, Christine Danielle; Tadenfok, Carine Nouboudem

2014-01-01

The World Health Organization (WHO) estimated in 2012 that 287,000 maternal deaths occurred in 2010; sub-Saharan Africa (56%) and Southern Asia (29%) accounted for the global burden of maternal deaths. Men are also recognized to be responsible for the large proportion of ill reproductive health suffered by their female partners. Male involvement helps not only in accepting a contraceptive but also in its effective use and continuation. The objectives were to assess men's knowledge, attitude, and practice of modern contraceptive methods; determine the level of spousal communication about family planning decision making; and investigate the correlates of men's opinion about their roles in family planning decision making. We searched the following electronic databases from January 1995 to December 2013: Medline, Embase, CINAHL, LILAS, International Bibliography of Social Sciences, Social Services Abstracts, and Sociological Abstracts. Along with MeSH terms and relevant keywords, we used the Cochrane Highly Sensitive Search Strategy for identifying reports of articles in PubMed. There were no restrictions to language or publication status. Of 137 hits, 7 papers met the inclusion criteria. The concept of family planning was well known to men. In the Nigerian study, almost (99%) men were aware of the existence of modern contraceptives, and most of them were aware of at least two modern methods. Awareness of the condom was highest (98%). In the Malawi study, all of the participants reported that they were not using contraception before the intervention. In Ethiopia, above 90% of male respondents have supported and approved using and choosing family planning methods, but none of them practiced terminal methods. Generally, more male respondents disagreed than agreed that men should make decisions about selected family planning issues in the family. Decision-making dynamics around method choice followed a slightly different pattern. According to female participants

Family involvement in decision making for people with dementia in residential aged care: a systematic review of quantitative literature.

Science.gov (United States)

Petriwskyj, Andrea; Gibson, Alexandra; Parker, Deborah; Banks, Susan; Andrews, Sharon; Robinson, Andrew

2014-06-01

Ensuring older adults' involvement in their care is accepted as good practice and is vital, particularly for people with dementia, whose care and treatment needs change considerably over the course of the illness. However, involving family members in decision making on people's behalf is still practically difficult for staff and family. The aim of this review was to identify and appraise the existing quantitative evidence about family involvement in decision making for people with dementia living in residential aged care. The present Joanna Briggs Institute (JBI) metasynthesis assessed studies that investigated involvement of family members in decision making for people with dementia in residential aged care settings. While quantitative and qualitative studies were included in the review, this paper presents the quantitative findings. A comprehensive search of 15 electronic databases was performed. The search was limited to papers published in English, from 1990 to 2013. Twenty-six studies were identified as being relevant; 10 were quantitative, with 1 mixed method study. Two independent reviewers assessed the studies for methodological validity and extracted the data using the JBI Meta Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI). The findings were synthesized and presented in narrative form. The findings related to decisions encountered and made by family surrogates, variables associated with decisions, surrogates' perceptions of, and preferences for, their roles, as well as outcomes for people with dementia and their families. The results identified patterns within, and variables associated with, surrogate decision making, all of which highlight the complexity and variation regarding family involvement. Attention needs to be paid to supporting family members in decision making in collaboration with staff.

Perfect simulation of Hawkes processes

DEFF Research Database (Denmark)

Møller, Jesper; Rasmussen, Jakob Gulddahl

2005-01-01

Our objective is to construct a perfect simulation algorithm for unmarked and marked Hawkes processes. The usual straightforward simulation algorithm suffers from edge effects, whereas our perfect simulation algorithm does not. By viewing Hawkes processes as Poisson cluster processes and using...... their branching and conditional independence structures, useful approximations of the distribution function for the length of a cluster are derived. This is used to construct upper and lower processes for the perfect simulation algorithm. A tail-lightness condition turns out to be of importance...... for the applicability of the perfect simulation algorithm. Examples of applications and empirical results are presented....

Extended families of 2D arrays with near optimal auto and low cross-correlation

Science.gov (United States)

Svalbe, I. D.; Tirkel, A. Z.

2017-12-01

Families of 2D arrays can be constructed where each array has perfect autocorrelation, and the cross-correlation between any pair of family members is optimally low. We exploit equivalent Hadamard matrices to construct many families of p p × p arrays, where p is any 4k-1 prime. From these families, we assemble extended families of arrays with members that exhibit perfect autocorrelation and next-to-optimally low cross-correlation. Pseudo-Hadamard matrices are used to construct extended families using p = 4k + 1 primes. An optimal family of 31 31 × 31 perfect arrays can provide copyright protection to uniquely stamp a robust, low-visibility watermark within every frame of each second of high-definition, 30 fps video. The extended families permit the embedding of many more perfect watermarks that have next-to-minimal cross-correlations.

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.

Cochlear Implant: the complexity involved in the decision making process by the family.

Science.gov (United States)

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

Family Background and Optimal Schooling Decisions.

Science.gov (United States)

Lazear, Edward

1980-01-01

Examines whether variations in the levels of attained schooling across groups can be explained by a model that assumes that captial markets are perfect and that individuals maximize wealth. Available from Editorial Office, Review of Economics and Statistics, M-8 Littauer Center, Cambridge, MA 02138. (Author/IRT)

Impact of Childbearing Decisions on Family Size of Korean Women with Systemic Lupus Erythematosus.

Science.gov (United States)

Kim, In Je; Kim, Hyoun-Ah; Suh, Chang-Hee; Park, Yong-Wook; Lee, Hye-Soon; Bang, So-Young; Bae, Sang-Cheol; Kang, Young Mo; Lee, Won Kyung; Park, Hyesook; Lee, Jisoo

2016-05-01

Systemic lupus erythematosus (SLE) predominantly affects women in their reproductive years and has a significant impact on childbearing. We investigated the influence of personal decision on family size among Korean women with SLE and factors that affect the decisions. A case-control study comparing childbearing history and decisions of 112 SLE patients and 135 controls was performed. Women with SLE participating in the Network for Lupus Clinical Research in South Korea and matching controls between ages of 18-45, who are/were married or living with a partner were included. Data regarding socio-demographics, reproductive history, and childbearing decisions were collected through a survey using a standardized questionnaire and medical record review. More women with SLE reported at least one pregnancy (85.7% vs. 71.9%, P = 0.009) or at least one live birth (85.7% vs. 71.9%, P = 0.003) compared with controls. Mean number of pregnancies was significantly higher (2.4 ± 1.6 vs. 1.4 ± 1.3, P family size and childbearing decisions among Korean women with SLE.

Zero Action on Perfect Crystals for U_q(G_2^{(1}

Directory of Open Access Journals (Sweden)

Kailash C. Misra

2010-03-01

Full Text Available The actions of 0-Kashiwara operators on the U_q(G_2^{(1}-crystal B_l in [Yamane S., J. Algebra 210 (1998, 440-486] are made explicit by using a similarity technique from that of a U_q'(D_4^{(3}-crystal. It is shown that {B_l}_{l ≥ 1} forms a coherent family of perfect crystals.

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.

Inhomogeneous generalizations of Bianchi Type VIh universes with stiff perfect fluid and radiation

Science.gov (United States)

Roy, S. R.; Prasad, A.

1995-03-01

Families of inhomogeneous models filled with a stiff perfect fluid and radiation have been derived in which there is no flow of total momentum. The models are generalizations of those of Bianchi Type VIh and are discussed for some particular forms of the arbitrary functions appearing in them.

Cochlear Implant: the complexity involved in the decision making process by the family

Directory of Open Access Journals (Sweden)

Sheila de Souza Vieira

2014-06-01

Full Text Available OBJECTIVE: to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child.METHOD: qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants.RESULTS: knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant.CONCLUSION: deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention.

No perfect tools: trade-offs of sustainability principles and user requirements in designing support tools for land-use decisions between greenfields and brownfields.

Science.gov (United States)

Bartke, Stephan; Schwarze, Reimund

2015-04-15

The EU Soil Thematic Strategy calls for the application of sustainability concepts and methods as part of an integrated policy to prevent soil degradation and to increase the re-use of brownfields. Although certain general principles have been proposed for the evaluation of sustainable development, the practical application of sustainability assessment tools (SATs) is contingent on the actual requirements of tool users, e.g. planners or investors, to pick up such instruments in actual decision making. We examine the normative sustainability principles that need to be taken into account in order to make sound land-use decisions between new development on greenfield sites and the regeneration of brownfields - and relate these principles to empirically observed user requirements and the properties of available SATs. In this way we provide an overview of approaches to sustainability assessment. Three stylized approaches, represented in each case by a typical tool selected from the literature, are presented and contrasted with (1) the norm-oriented Bellagio sustainability principles and (2) the requirements of three different stakeholder groups: decision makers, scientists/experts and representatives of the general public. The paper disentangles some of the inevitable trade-offs involved in seeking to implement sustainable land-use planning, i.e. between norm orientation and holism, broad participation and effective communication. It concludes with the controversial assessment that there are no perfect tools and that to be meaningful the user requirements of decision makers must take precedence over those of other interest groups in the design of SATs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Chinese Adolescents' Reasoning about Democratic and Authority-Based Decision Making in Peer, Family, and School Contexts.

Science.gov (United States)

Helwig, Charles C.; Arnold, Mary Louise; Tan, Dingliang; Boyd, Dwight

2003-01-01

This study explored judgments and reasoning of Chinese 13- to 18-year-olds regarding making decisions involving children in peer, family, and school contexts. Findings indicated that judgments and reasoning about decision-making varied by social context and by the decision under consideration. Evaluations of procedures became more differentiated…

Managing Family Conflict over Career Decisions: The Experience of Asian Americans

Science.gov (United States)

Ma, Pei-Wen Winnie; Desai, Uttara; George, Login S.; San Filippo, Alyssa A.; Varon, Samantha

2014-01-01

Conflict over career decisions is a main source of intergenerational conflict among Asian American families. This qualitative study explored the topic using consensual qualitative research methodology in a sample of eight Asian Americans. Results indicated that participants experienced feelings of guilt and indebtedness due to conflicting values,…

A Single Father's Shopping Bag: Purchasing Decisions in Single-Father Families

Science.gov (United States)

Ziol-Guest, Kathleen M.

2009-01-01

Using data from the 1980 to 2003 panels of the Consumer Expenditure Survey, this article examines purchasing decisions in father-headed single-parent families. Single-father expenditures are compared to both married-parent expenditures and single-mother expenditures on 17 broad categories of household-level goods and services. Multivariate…

The Family-Relatedness of Work Decisions: A Framework and Agenda for Theory and Research

Science.gov (United States)

Greenhaus, Jeffrey H.; Powell, Gary N.

2012-01-01

Due to global trends such as the increased labor force participation of women, the growing presence of dual-earner couples and single parents in the labor force, and changing values regarding the importance of life balance, individuals' work decisions are being increasingly influenced by family considerations. However, the "family-relatedness" of…

Perfect simulation of Hawkes processes

DEFF Research Database (Denmark)

Møller, Jesper; Rasmussen, Jakob Gulddahl

This article concerns a perfect simulation algorithm for unmarked and marked Hawkes processes. The usual stratihtforward simulation algorithm suffers from edge effects, whereas our perfect simulation algorithm does not. By viewing Hawkes processes as Poisson cluster processes and using...... their branching and conditional independence structure, useful approximations of the distribution function for the length of a cluster are derived. This is used to construct upper and lower processes for the perfect simulation algorithm. Examples of applications and empirical results are presented....

Methodological decisions and the evaluation of possible effects of different family structures on children: The new family structures survey (NFSS).

Science.gov (United States)

Schumm, Walter R

2012-11-01

Every social science researcher must make a number of methodological decisions when planning and implementing research projects. Each such decision carries with it both advantages and limitations. The decisions faced and made by Regnerus (2012) are discussed here in the wider context of social science literature regarding same-sex parenting. Even though the apparent outcomes of Regnerus's study were unpopular, the methodological decisions he made in the design and implementation of the New Family Structures Survey were not uncommon among social scientists, including many progressive, gay and lesbian scholars. These decisions and the research they produced deserve considerable and continued discussion, but criticisms of the underlying ethics and professionalism are misplaced because nearly every methodological decision that was made has ample precedents in research published by many other credible and distinguished scholars. Copyright © 2012 Elsevier Inc. All rights reserved.

Generating perfect fluid spheres in general relativity

Science.gov (United States)

Boonserm, Petarpa; Visser, Matt; Weinfurtner, Silke

2005-06-01

Ever since Karl Schwarzschild’s 1916 discovery of the spacetime geometry describing the interior of a particular idealized general relativistic star—a static spherically symmetric blob of fluid with position-independent density—the general relativity community has continued to devote considerable time and energy to understanding the general-relativistic static perfect fluid sphere. Over the last 90 years a tangle of specific perfect fluid spheres has been discovered, with most of these specific examples seemingly independent from each other. To bring some order to this collection, in this article we develop several new transformation theorems that map perfect fluid spheres into perfect fluid spheres. These transformation theorems sometimes lead to unexpected connections between previously known perfect fluid spheres, sometimes lead to new previously unknown perfect fluid spheres, and in general can be used to develop a systematic way of classifying the set of all perfect fluid spheres.

Generating perfect fluid spheres in general relativity

International Nuclear Information System (INIS)

Boonserm, Petarpa; Visser, Matt; Weinfurtner, Silke

2005-01-01

Ever since Karl Schwarzschild's 1916 discovery of the spacetime geometry describing the interior of a particular idealized general relativistic star--a static spherically symmetric blob of fluid with position-independent density--the general relativity community has continued to devote considerable time and energy to understanding the general-relativistic static perfect fluid sphere. Over the last 90 years a tangle of specific perfect fluid spheres has been discovered, with most of these specific examples seemingly independent from each other. To bring some order to this collection, in this article we develop several new transformation theorems that map perfect fluid spheres into perfect fluid spheres. These transformation theorems sometimes lead to unexpected connections between previously known perfect fluid spheres, sometimes lead to new previously unknown perfect fluid spheres, and in general can be used to develop a systematic way of classifying the set of all perfect fluid spheres

Cochlear Implant: the complexity involved in the decision making process by the family1

Science.gov (United States)

Vieira, Sheila de Souza; Bevilacqua, Maria Cecília; Ferreira, Noeli Marchioro Liston Andrade; Dupas, Giselle

2014-01-01

Objective to understand the meanings the family attributes to the phases of the decision-making process on a cochlear implant for their child. Method qualitative research, using Symbolic Interactionism and Grounded Theory as the theoretical and methodological frameworks, respectively. Data collection instrument: semistructured interview. Nine families participated in the study (32 participants). Results knowledge deficit, difficulties to contextualize benefits and risks and fear are some factors that make this process difficult. Experiences deriving from interactions with health professionals, other cochlear implant users and their relatives strengthen decision making in favor of the implant. Conclusion deciding on whether or not to have the implant involves a complex process, in which the family needs to weigh gains and losses, experience feelings of accountability and guilt, besides overcoming the risk aversion. Hence, this demands cautious preparation and knowledge from the professionals involved in this intervention. PMID:25029052

Parental role in decision making about pediatric cardiac transplantation: familial and ethical considerations.

Science.gov (United States)

Higgins, S S

2001-10-01

Parents of children with complex or terminal heart conditions often face agonizing decisions about cardiac transplantation. There are differences in the level of involvement that parents prefer when making such decisions. The purpose of this study was to identify and describe parents' preferences for their roles in decisions related to cardiac transplantation. A prospective ethnographic method was used to study 24 parents of 15 children prior to their decision of accepting or rejecting the transplant option for their children. Findings revealed that the style of parent decision making ranged from a desire to make an independent, autonomous choice to a wish for an authoritarian, paternalistic choice. Nurses and physicians can best support families in this situation, showing sensitivity to the steps that parents use to make their decisions. An ethical model of decision making is proposed that includes respect for differences in beliefs and values of all persons involved in the transplantation discussion. Copyright 2001 by W.B. Saunders Company

The applicability of the decisional conflict scale in nursing home placement decision among Chinese family caregivers: A mixed methods approach

Directory of Open Access Journals (Sweden)

Yu-Ping Chang

2017-12-01

Full Text Available This study aimed to 1 examine relationships between uncertainty, perceived information, personal values, social support, and filial obligation among Chinese family caregivers faced with nursing home placement of an older adult family member with dementia; and 2 describe the applicability of the Decisional Conflict Scale in nursing home placement decision making among Chinese family caregivers through the integration of quantitative and qualitative data. We used a mixed-methods approach. Quantitative data analysis consisted of descriptive and correlational statistics. We utilized a thematic analysis for the qualitative data. Data transformation and data comparison techniques were used to combine qualitative and quantitative data. Thirty Chinese family caregivers living in Taiwan caring for an older adult with dementia participated in this study. We found a significant association among the quantitative findings, which indicated that perceived information, personal values, social support, and filial obligation, and nursing home placement decisional conflict. Mixed-method data analysis additionally revealed that conflicting differences existed between the traditional role of Chinese family collective decision making and the contemporary role of single family member surrogate decision making. Although the Decisional Conflict Scale can be utilized when exploring nursing home placement for an older adult with dementia among Chinese family caregivers, applicability issues existed regarding cultural beliefs and values related to filial piety and family collectivism. Findings strongly support the need for researchers to consider cultural beliefs and values when selecting tools that assess health-related decision making across cultures. Further research is needed to explore the role culture plays in nursing home decision making.

"It was an Emotional Baby": Previvors' Family Planning Decision-Making Styles about Hereditary Breast and Ovarian Cancer Risk.

Science.gov (United States)

Dean, Marleah; Rauscher, Emily A

2017-12-01

Women who test positive for a BRCA genetic mutation are at an increased risk for developing hereditary breast and ovarian cancer and have a 50% chance of passing on their genetic mutation to their children. The purpose of this study was to investigate how women who test positive for a BRCA mutation but have not been diagnosed with cancer make decisions regarding family planning. Analysis of interviews with 20 women revealed they engage in logical and emotional decision-making styles. Although women want to be logical to reduce their hereditary cancer risk, emotions often complicate their decision-making. Women experience fear and worry about a future cancer diagnosis, yet also desire to create a family, particularly having children through natural conception. That is, women negotiate having preventative surgeries in a logical doctor-recommended timeframe but also organize those decisions around emotional desires of motherhood. Overall, this study demonstrates the complex decisions women who test positive for a BRCA mutation must make in regards to genetic testing timing, family planning, and overall quality of life.

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.

Who has the final say? Decisions on adolescent behaviour within the family

NARCIS (Netherlands)

Bosma, H.A.; Jackson, A.E.; Zijsling, D.H.; Zani, B; Cicognani, E; Xerri, M.L; Honess, T.M; Charman, L

The transition to adolescence involves significant changes for the family. To date, research on these changes and how they occur has been restricted by lack of suitable measures. An instrument-the Perspectives on Adolescent Decision-Making questionnaire-was designed for such research. It examines 21

When families cannot "let go": ethical decision-making at the bedside.

Science.gov (United States)

Thomas, J E; Latimer, E J

1989-09-01

Shared decision-making at the bedside is now a regular feature of medical practice. When disagreements arise between a patient and family members caregivers sometimes find themselves caught in a complex tangle of human relationships that strains monochrome ethical thinking. The patient's expressed wishes are often compromised for the sake of the family's needs. Conversely, a unilateral appeal for patient autonomy may prove insensitive to the hurt and the needs of the family. We describe a relatively unsuccessful attempt by a patient's caregivers to buy time to maximize the interests of the patient and her family and discuss the way in which the family dynamics militated against the rather obvious solution of promoting the patient's right to refuse treatment. The purpose of this article is not to evoke sympathy for health care professionals in dealing with such conflicts but rather to heighten awareness of the issues at stake and to stimulate thinking about ways and means to bring about a more favourable outcome than the one described here.

Shared decision making after severe stroke-How can we improve patient and family involvement in treatment decisions?

Science.gov (United States)

Visvanathan, Akila; Dennis, Martin; Mead, Gillian; Whiteley, William N; Lawton, Julia; Doubal, Fergus Neil

2017-12-01

People who are well may regard survival with disability as being worse than death. However, this is often not the case when those surviving with disability (e.g. stroke survivors) are asked the same question. Many routine treatments provided after an acute stroke (e.g. feeding via a tube) increase survival, but with disability. Therefore, clinicians need to support patients and families in making informed decisions about the use of these treatments, in a process termed shared decision making. This is challenging after acute stroke: there is prognostic uncertainty, patients are often too unwell to participate in decision making, and proxies may not know the patients' expressed wishes (i.e. values). Patients' values also change over time and in different situations. There is limited evidence on successful methods to facilitate this process. Changes targeted at components of shared decision making (e.g. decision aids to provide information and discussing patient values) increase patient satisfaction. How this influences decision making is unclear. Presumably, a "shared decision-making tool" that introduces effective changes at various stages in this process might be helpful after acute stroke. For example, by complementing professional judgement with predictions from prognostic models, clinicians could provide information that is more accurate. Decision aids that are personalized may be helpful. Further qualitative research can provide clinicians with a better understanding of patient values and factors influencing this at different time points after a stroke. The evaluation of this tool in its success to achieve outcomes consistent with patients' values may require more than one clinical trial.

Exploring morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones.

Science.gov (United States)

Gammon, D; Christiansen, E K; Wynn, R

2009-07-01

Patient self-management of disease is increasingly supported by technologies that can monitor a wide range of behavioural and biomedical parameters. Incorporated into everyday devices such as cell phones and clothes, these technologies become integral to the psychosocial aspects of everyday life. Many technologies are likely to be marketed directly to families with ill members, and families may enlist the support of clinicians in shaping use. Current ethical frameworks are mainly conceptualised from the perspective of caregivers, researchers, developers and regulators in order to ensure the ethics of their own practices. This paper focuses on families as autonomous decision-makers outside the regulated context of healthcare. We discuss some morally relevant issues facing families in their decisions to monitor the health-related behaviours of loved ones. An example - remote parental monitoring of adolescent blood glucose - is presented and discussed through the lens of two contrasting accounts of ethics; one reflecting the predominant focus on health outcomes within the health technology assessment (HTA) framework and the other that attends to the broader sociocultural contexts shaping technologies and their implications. Issues discussed include the focus of assessments, informed consent and child assent, and family co-creation of system characteristics and implications. The parents' decisions to remotely monitor their child has relational implications that are likely to influence conflict levels and thus also health outcomes. Current efforts to better integrate outcome assessments with social and ethical assessments are particularly relevant for informed decision-making about health monitoring technologies in families.

Decision-making in a death investigation: Emotion, families and the coroner.

Science.gov (United States)

Tait, Gordon; Carpenter, Belinda; Quadrelli, Carol; Barnes, Michael

2016-03-01

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

Multi-channel coherent perfect absorbers

KAUST Repository

Bai, Ping

2016-05-18

The absorption efficiency of a coherent perfect absorber usually depends on the phase coherence of the incident waves on the surfaces. Here, we present a scheme to create a multi-channel coherent perfect absorber in which the constraint of phase coherence is loosened. The scheme has a multi-layer structure such that incident waves in different channels with different angular momenta can be simultaneously and perfectly absorbed. This absorber is robust in achieving high absorption efficiency even if the incident waves become "incoherent" and possess "random" wave fronts. Our work demonstrates a unique approach to designing highly efficient metamaterial absorbers. © CopyrightEPLA, 2016.

Multi-channel coherent perfect absorbers

KAUST Repository

Bai, Ping; Wu, Ying; Lai, Yun

2016-01-01

The absorption efficiency of a coherent perfect absorber usually depends on the phase coherence of the incident waves on the surfaces. Here, we present a scheme to create a multi-channel coherent perfect absorber in which the constraint of phase coherence is loosened. The scheme has a multi-layer structure such that incident waves in different channels with different angular momenta can be simultaneously and perfectly absorbed. This absorber is robust in achieving high absorption efficiency even if the incident waves become "incoherent" and possess "random" wave fronts. Our work demonstrates a unique approach to designing highly efficient metamaterial absorbers. © CopyrightEPLA, 2016.

The myth of macho dominance in decision making within Mexican and Chicano families.

Science.gov (United States)

Cromwell, R E; Ruiz, R A

1979-10-01

The myth concerning Hispanic family life which prevails in the social science literature can best be summarized by abbreviated quotations attributed to Alvirez and Bean. The Mexican or Chicano husband is a macho autocrat who rules as "absolute head of the family with full authority over the wife and children" where "all major decisions are his responsibility." Domination by husbands in marriage is logically consistent with their wives' submissivesness accompanied by passive acceptance of the future, strong religious beliefs, and a tendency to reside in the temporal present. The myth is also deeply imbedded in the social pathology model: differences between Hispanics and Anglos are assumed to reflect negatively on Hispanics. The myth, it should be noted, is seldom subjected to the scrutiny of empirical inquiry. The review of 4 studies on both Mexican and Chicano samples fails to support the notion of male dominance in marital desision making. Refutation of the hypothesis of masculine dominance in marital decision making calls other components of the myth into question. Research among Hispanics on alledged female submissiveness, fatalism, eligiosity, and temporal perspective are called for. More sophisicated designs involving experimental manipulations are needed. Experimental studies on the process of decision making, actual behaviors involved in economic or budgetary negotiations, and parental interaction around childrearing would also be of interest. While the data reviewed may suggest that Hispanic males may behave differently from nonHispanic males in their family and marital lives, the behavior is not in the inappropriate fashion suggested by the myth with its strong connotations of social deviance. Additional research is recommended among Hispanics on sex role behavior among both men and women, with special emphasis on how it influences family life and marriage.

Married women's decision making power on family planning use and associated factors in Mizan-Aman, South Ethiopia: a cross sectional study.

Science.gov (United States)

Belay, Abeba Daniel; Mengesha, Zelalem Birhanu; Woldegebriel, Manay Kifle; Gelaw, Yalemzewod Assefa

2016-03-08

Women's use of family planning service is influenced by many factors, especially by their decision making power. A woman's decision-making power, be it individual or decision made in collaboration with a partner, is the most important factor in the use of family planning in a household. The purpose of this study was to assess the impact of women's decision making power on family planning use and its associated factors. A community-based cross-sectional study was conducted on married women in the child bearing age. The women who were living in Mizan city were selected using the simple random sampling method. Trained nurses collected the data by interview, using a structured and pre-tested questioner. Bivariable and multivariable binary logistic regression analysis was used to identify the associated factors, and the odds ratio with a 95% CI was computed to assess the strength of the association. Collinearity was also assessed by looking at standard errors in the final fitted model. Overall, more than two-thirds [67.2%: 95% CI (63-71%)] of the married women were found to be more autonomous to decide family planning use. Secondary education [AOR: 9.04, 95% CI: (4.50, 18.16)], government employment [AOR: 4.84, 95% CI: (2.03, 11.52)], being wives of government employed spouses [AOR 2.71, 95% CI: (1.24, 7.97)], having husbands with college or university education [AOR: 11.29, 95% CI: (4.66, 27.35)], and being in the younger age [AOR: 0.27, 95% CI :(0.09, 0.75)] were significantly associated with women's decision-making power on family planning. In this study, women had a high decision making power in family planning use. Age category (34-44-years), formal education, and occupational status had effects on women's decision making power. Promoting parental adult education and engaging women in out of house employment is essential to improve their decision making power in using family planning.

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

"I'd Know That My Child Was Out There": Egg Donation, the Institutionalized "Ideal" Family, and Health Care Decision Making.

Science.gov (United States)

Rauscher, Emily A; Young, Stephanie L; Durham, Wesley T; Barbour, Joshua B

2017-05-01

This study investigates how young women of egg-donating age perceive egg donation. Using institutional theory, this study demonstrates how participants frame a health care decision, such as egg donation, utilizing familial ideals. Results revealed that women expressed the importance of ownership over their genetic material and that familial ideals encourage an ideal way to create a family, which egg donation only fits as a last resort. Results show that familial ideals reach past the institution of family into broader decision making, such as that of health care. Further, results show that as more families are constructed through assisted reproductive technologies, attempts should be made to gradually alter the familial ideal to encompass novel medical technologies such as egg donation.

Re-Thinking the Role of the Family in Medical Decision-Making.

Science.gov (United States)

Cherry, Mark J

2015-08-01

This paper challenges the foundational claim that the human family is no more than a social construction. It advances the position that the family is a central category of experience, being, and knowledge. Throughout, the analysis argues for the centrality of the family for human flourishing and, consequently, for the importance of sustaining (or reestablishing) family-oriented practices within social policy, such as more family-oriented approaches to consent to medical treatment. Where individually oriented approaches to medical decision-making accent an ethos of isolated personal autonomy family-oriented approaches acknowledge the central social and moral reality of the family. I argue that the family ought to be appreciated as more than a mere network of personal relations and individual undertakings; the family possesses a being that is social and moral such that it realizes a particular structure of human good and sustains the necessary conditions for core areas of human flourishing. Moreover, since the family exists as a nexus of face-to-face relationships, the consent of persons, including adults, to be members of a particular family, subject to its own respective account of family sovereignty, is significantly more amply demonstrated than the consent of citizens to be under the authority of a particular state. As a result, in the face of a general Western bioethical affirmation of the autonomy of individuals, as if adults and children were morally and socially isolated agents, this paper argues that social space must nevertheless be made for families to choose on behalf of their own members. © The Author 2015. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Who Has the Final Say? Decisions on Adolescent Behaviour within the Family.

Science.gov (United States)

Bosma, Harke A.; And Others

1996-01-01

Utilizes the Perspectives on Adolescent Decision-Making Questionnaire to study the transition to adolescence and the changes it involves for the family. The instrument examines 21 issues that can lead to conflict. The instrument was completed by 500 Italian adolescents ages 13 and 15. Sensitivity to age and sex differences was examined.…

Examining the Feasibility and Utility of Estimating Partial Expected Value of Perfect Information (via a Nonparametric Approach) as Part of the Reimbursement Decision-Making Process in Ireland: Application to Drugs for Cancer.

Science.gov (United States)

McCullagh, Laura; Schmitz, Susanne; Barry, Michael; Walsh, Cathal

2017-11-01

�million, respectively. This research demonstrates that the estimation of partial expected value of perfect information via this computationally inexpensive approach could be considered feasible as part of the health technology assessment process for reimbursement purposes within the Irish healthcare system. It might be a useful tool in prioritising future research to decrease decision uncertainty.

On 4-critical t-perfect graphs

OpenAIRE

Benchetrit, Yohann

2016-01-01

It is an open question whether the chromatic number of $t$-perfect graphs is bounded by a constant. The largest known value for this parameter is 4, and the only example of a 4-critical $t$-perfect graph, due to Laurent and Seymour, is the complement of the line graph of the prism $\\Pi$ (a graph is 4-critical if it has chromatic number 4 and all its proper induced subgraphs are 3-colorable). In this paper, we show a new example of a 4-critical $t$-perfect graph: the complement of the line gra...

Communicating with the coroner: how religion, culture, and family concerns may influence autopsy decision making.

Science.gov (United States)

Carpenter, Belinda; Adkins, Glenda; Barnes, Michael; Naylor, Charles; Begum, Nelufa

2011-04-01

Based on coronial data gathered in the state of Queensland in 2004, this article reviews how a change in legislation may have impacted autopsy decision making by coroners. More specifically, the authors evaluated whether the requirement that coronial autopsy orders specify the level of invasiveness of an autopsy to be performed by a pathologist was affected by the further requirement that coroners take into consideration a known religion, culture, and/or raised family concern before making such an order. Preliminary data reveal that the cultural status of the deceased did not affect coronial autopsy decision making. However, a known religion with a proscription against autopsy and a raised family concern appeared to be taken into account by coroners when making autopsy decisions and tended to decrease the invasiveness of the autopsy ordered from a full internal examination to either a partial internal examination or an external-only examination of the body. The impact of these findings is briefly discussed.

Family and physician influence on asthma research participation decisions for adolescents: the effects of adolescent gender and research risk.

Science.gov (United States)

Brody, Janet L; Scherer, David G; Annett, Robert D; Turner, Charles; Dalen, Jeanne

2006-08-01

There is considerable ethical and legal ambiguity surrounding the role of adolescents in the decision-making process for research participation. Depending on the nature of the study and the regulations involved, adolescents may have independent responsibility for providing informed consent, they may be asked to provide their assent, or they may be completely excluded from the decision-making process. This study examined parent and adolescent perceptions of decision-making authority and sources of influence on adolescent research participation decisions, and examined whether perceptions of influence differed based on adolescent gender and level of research risk. Adolescents (n = 36) with asthma and their parents reviewed 9 pediatric research protocols, decided whether they would choose to participate, rated the extent they would be responsible for the actual decision, and indicated the ability of family and physician to influence their decisions. Multivariate analyses of variance were used to evaluate differences in perceptions of decision-making authority and sources of influence on the decisions. Adolescents were less willing to cede decision making authority to parents than parents anticipated. Parents and adolescents acknowledged a greater openness to influence from physicians than from family for above minimal risk studies. Parents were more willing to consider opinions from male adolescents. Adolescents desire responsibility for research participation decisions, though parents may not share these views. Physicians' views on research participation are important to families, especially for above minimal risk studies. Parents may grant more decision-making autonomy to adolescent males than to females. Researchers, physicians, and institutions play a key role in facilitating the ethical enrollment of adolescents into biomedical research. Educational, policy, and oversight processes that support both adolescent autonomy and parental responsibility for research

An advance care plan decision support video before major surgery: a patient- and family-centred approach.

Science.gov (United States)

Isenberg, Sarina R; Crossnohere, Norah L; Patel, Manali I; Conca-Cheng, Alison; Bridges, John F P; Swoboda, Sandy M; Smith, Thomas J; Pawlik, Timothy M; Weiss, Matthew; Volandes, Angelo E; Schuster, Anne; Miller, Judith A; Pastorini, Carolyn; Roter, Debra L; Aslakson, Rebecca A

2018-06-01

Video-based advanc care planning (ACP) tools have been studied in varied medical contexts; however, none have been developed for patients undergoing major surgery. Using a patient- and family-centredness approach, our objective was to implement human-centred design (HCD) to develop an ACP decision support video for patients and their family members when preparing for major surgery. The study investigators partnered with surgical patients and their family members, surgeons and other health professionals to design an ACP decision support video using key HCD principles. Adapting Maguire's HCD stages from computer science to the surgical context, while also incorporating Elwyn et al 's specifications for patient-oriented decision support tool development, we used a six-stage HCD process to develop the video: (1) plan HCD process; (2) specify where video will be used; (3) specify user and organisational requirements; (4) produce and test prototypes; (5) carry out user-based assessment; (6) field test with end users. Over 450 stakeholders were engaged in the development process contributing to setting objectives, applying for funding, providing feedback on the storyboard and iterations of the decision tool video. Throughout the HCD process, stakeholders' opinions were compiled and conflicting approaches negotiated resulting in a tool that addressed stakeholders' concerns. Our patient- and family-centred approach using HCD facilitated discussion and the ability to elicit and balance sometimes competing viewpoints. The early engagement of users and stakeholders throughout the development process may help to ensure tools address the stated needs of these individuals. NCT02489799. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Picture perfect

DEFF Research Database (Denmark)

Pless, Mette; Sørensen, Niels Ulrik

’Picture perfect’ – when perfection becomes the new normal This paper draws on perspectives from three different studies. One study, which focuses on youth life and lack of well-being (Sørensen et al 2011), one study on youth life on the margins of society (Katznelson et al 2015) and one study...

Inter-Faith Reading of Perfect Man With Mystical Approach

Directory of Open Access Journals (Sweden)

Fatemeh Musavi

2010-12-01

Full Text Available The expression Insan –e kamil (perfect man is often said to have first been used by Muhyiddin ibn 'Arabi (1165 -1240AD, though the concept of the term is much older. In his theosophical teaching, the doctrine of insan e- kamil, is held a prominent place. After him two other great Sufis, Aziz Nasafi (1300AD and 'Abd al- karim ibn Ibrahim al- Jili (1366 – 1424 AD, each wrote a work on this very issue. These works are regarded as explanations of Ibn Arabi’s teachings on human perfection. In Islamic mysticism, Perfect man is the one who within their soul possesses all God's names and attributes. Thus the perfect man’s existence, reality and inner might become a clear mirror and a complete reflection of the Perfection, Beauty and Glory of the Essence of the One, so that he becomes Godlike. However, the idea of human perfectibility going back to other religions and human schools even before Islam. In Abrahimic religions there are some joint teachings that could be considered as main statements for the doctrine of Perfect Man In Jewish scriptures the notion of human creation in God's image suggests that the human being is able to be God's like and the perfection is available to him. However, Jews do not believe a perfect man. They hold that even Moses is not a perfect man. In Christianity, Although Jesus encourages his followers to be perfect like their heavenly fathers, the doctrine of original sin to be considered as an obstacle for human perfectibility.This essay examines some significant element in human perfectibility from the view points of some scholars of Judaism, Christianity and Islam and presents some similarities and differences of their view points.

Inter-Faith Reading of Perfect Man With Mystical Approach

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Mohammadkazem Shaker

2011-01-01

Full Text Available   The expression Insan –e kamil (perfect man is often said to have first been used by Muhyiddin ibn 'Arabi (1165 -1240AD, though the concept of the term is much older. In his theosophical teaching, the doctrine of insan e- kamil, is held a prominent place. After him two other great Sufis, Aziz Nasafi (1300AD and 'Abd al- karim ibn Ibrahim al- Jili (1366 – 1424 AD, each wrote a work on this very issue. These works are regarded as explanations of Ibn Arabi’s teachings on human perfection. In Islamic mysticism, Perfect man is the one who within their soul possesses all God's names and attributes. Thus the perfect man’s existence, reality and inner might become a clear mirror and a complete reflection of the Perfection, Beauty and Glory of the Essence of the One, so that he becomes Godlike. However, the idea of human perfectibility going back to other religions and human schools even before Islam. In Abrahimic religions there are some joint teachings that could be considered as main statements for the doctrine of Perfect Man In Jewish scriptures the notion of human creation in God's image suggests that the human being is able to be God's like and the perfection is available to him. However, Jews do not believe a perfect man. They hold that even Moses is not a perfect man. In Christianity, Although Jesus encourages his followers to be perfect like their heavenly fathers, the doctrine of original sin to be considered as an obstacle for human perfectibility.This essay examines some significant element in human perfectibility from the view points of some scholars of Judaism, Christianity and Islam and presents some similarities and differences of their view points.

Inter-Faith Reading of Perfect Man With Mystical Approach

Directory of Open Access Journals (Sweden)

Shaker, M.K

2011-01-01

Full Text Available The expression Insan –e kamil (perfect man is often said to have first been used by Muhyiddin ibn 'Arabi (1165 -1240AD, though the concept of the term is much older. In his theosophical teaching, the doctrine of insan e- kamil, is held a prominent place. After him two other great Sufis, Aziz Nasafi (1300AD and 'Abd al- karim ibn Ibrahim al- Jili (1366 – 1424 AD, each wrote a work on this very issue. These works are regarded as explanations of Ibn Arabi’s teachings on human perfection. In Islamic mysticism, Perfect man is the one who within their soul possesses all God's names and attributes. Thus the perfect man’s existence, reality and inner might become a clear mirror and a complete reflection of the Perfection, Beauty and Glory of the Essence of the One, so that he becomes Godlike. However, the idea of human perfectibility going back to other religions and human schools even before Islam. In Abrahimic religions there are some joint teachings that could be considered as main statements for the doctrine of Perfect Man In Jewish scriptures the notion of human creation in God's image suggests that the human being is able to be God's like and the perfection is available to him. However, Jews do not believe a perfect man. They hold that even Moses is not a perfect man. In Christianity, Although Jesus encourages his followers to be perfect like their heavenly fathers, the doctrine of original sin to be considered as an obstacle for human perfectibility.This essay examines some significant element in human perfectibility from the view points of some scholars of Judaism, Christianity and Islam and presents some similarities and differences of their view points.

Perfect secure domination in graphs

Directory of Open Access Journals (Sweden)

S.V. Divya Rashmi

2017-07-01

Full Text Available Let $G=(V,E$ be a graph. A subset $S$ of $V$ is a dominating set of $G$ if every vertex in $Vsetminus  S$ is adjacent to a vertex in $S.$ A dominating set $S$ is called a secure dominating set if for each $vin Vsetminus S$ there exists $uin S$ such that $v$ is adjacent to $u$ and $S_1=(Ssetminus{u}cup {v}$ is a dominating set. If further the vertex $uin S$ is unique, then $S$ is called a perfect secure dominating set. The minimum cardinality of a perfect secure dominating set of $G$ is called the perfect  secure domination number of $G$ and is denoted by $gamma_{ps}(G.$ In this paper we initiate a study of this parameter and present several basic results.

Critical phenomena at perfect and non-perfect surfaces

International Nuclear Information System (INIS)

Pleimling, M

2004-01-01

In the past, perfect surfaces have been shown to yield local critical behaviour that differs from bulk critical behaviour. On the other hand, surface defects, whether they are of natural origin or created artificially, are known to modify local quantities. It is therefore important to clarify whether these defects are relevant or irrelevant for the surface critical behaviour. The purpose of this review is two-fold. In the first part we summarize some of the important results on surface criticality at perfect surfaces. Special attention is thereby paid to new developments such as for example the study of the surface critical behaviour in systems with competing interactions or of surface critical dynamics. In the second part the effect of surface defects (presence of edges, steps, quenched randomness, lines of adatoms, regular geometric patterns) on local critical behaviour in semi-infinite systems and in thin films is discussed in detail. Whereas most of the defects commonly encountered are shown to be irrelevant, some notable exceptions are highlighted. It is shown furthermore that under certain circumstances non-universal local critical behaviour may be observed at surfaces. (topical review)

Modern problems of perfection of elite light athletic sportsmen’s technical skillfulness perfection

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A.V. Kolot

2016-04-01

Full Text Available Purpose: perfection of elite sportsmen’s technical skillfulness in competition kinds of light athletic. Material: the data of more than 60 literature sources were systemized. Expert questioning of 36 coaches, having experience of work with elite sportsmen, was carried out; documents of training process planning were analyzed as well as sportsmen’s diaries (n=244. Results: we have presented main principles of sportsmen’s technical skillfulness perfection and elucidated characteristics of technical training methodic. We have determined main priorities of technical training building for light athletes at every stage of many years’ perfection. Dynamic of competition practice volume has been found as well as main requirements to selection of training means of technical orientation. The data of bio-mechanical criteria of sportsmen’s technical skillfulness assessment have been supplemented. Conclusions: effectiveness of sportsmen’s training methodic is determined by realization of previous stages’ technical potential in final competition results. It can be achieved by determination of means of and methods of different orientation rational correlation.

Modern problems of perfection of elite light athletic sportsmen’s technical skillfulness perfection

Directory of Open Access Journals (Sweden)

Kolot A.V.

2016-02-01

Full Text Available Purpose: perfection of elite sportsmen’s technical skillfulness in competition kinds of light athletic. Material: the data of more than 60 literature sources were systemized. Expert questioning of 36 coaches, having experience of work with elite sportsmen, was carried out; documents of training process planning were analyzed as well as sportsmen’s diaries (n=244. Results: we have presented main principles of sportsmen’s technical skillfulness perfection and elucidated characteristics of technical training methodic. We have determined main priorities of technical training building for light athletes at every stage of many years’ perfection. Dynamic of competition practice volume has been found as well as main requirements to selection of training means of technical orientation. The data of bio-mechanical criteria of sportsmen’s technical skillfulness assessment have been supplemented. Conclusions: effectiveness of sportsmen’s training methodic is determined by realization of previous stages’ technical potential in final competition results. It can be achieved by determination of means of and methods of different orientation rational correlation.

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

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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.

[The decision making process of ESRD families during the dialysis withdrawal period].

Science.gov (United States)

Lin, Tsai-Rung

2011-08-01

Hemodialysis is a financial burden to the state and families and the cause of much suffering in patients. It is a life prolonging therapy and death-delaying treatment. When the burdens of therapy substantially outweigh its benefits, withdrawal from dialysis is an appropriate option. However, considering the ethical and legal concerns of doing such is something families must face. There has been little research and little understanding of the process of decision-making within families in Taiwan. The process is full of conflicts, worries, guilt, shame, and lack of consensus. Effective communication with the medical team to resolve the conflict and describe the prognosis is necessary in order to reach a consensus and move toward palliative care. The article uses a case report and discusses the process. Finally, the author suggests an approach to making the situation better in the future.

Why doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?

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Hirschman, Karen B; Kapo, Jennifer M; Karlawish, Jason H T

2006-08-01

The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. Thirty family members of patients with advanced dementia from an Alzheimer disease center and a suburban long-term care facility were interviewed using a semistructured interview. All interviews were audiotaped, transcribed, and analyzed using qualitative data analysis techniques. Family members were split almost evenly in the standard they used when making medical decisions for their relative: substituted judgment (43%) or best interests (57%). However, few who used the substituted judgment standard viewed it as distinct from best interests. Instead, both standards were taken into consideration when making medical decisions. In addition to not having discussions about healthcare preferences, the reasons for not using a substituted judgment included: the need for family consensus, unrealistic expectations of the patient, the need to incorporate their relative's quality of life into the decision, and the influence of healthcare professionals. Family members who did not have discussions about healthcare preferences identified various barriers to the discussion, including waiting too long, avoiding the topic, and the patient's denial of dementia. These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.

[Tianjin issues decision on family planning].

Science.gov (United States)

1981-05-08

The Tianjin Municipal People's Government (China) recently issued a decision on family planning issues regarding encouragement of late childbirth and controlling the birth of a 2nd child. The decision indicated that newlyweds who decide to have their 1st child when they are at least 25 years old will be regarded as practicing late childbirth. A total of 34 days will be added to the present 56-day maternity leave for those newlyweds practicing late childbirth. Some prerequisites for having a 2nd child include the following: the 1st child has a nonhereditary deformity; of a newly married couple, for 1 party this is a 1st marriage while the other party has only 1 child from his or her previous marriage; and a married woman who has a medical certificate on sterility issued by medical and health units at or above the district level and has adopted a child with the approval of departments concerned is now allowed to have a 2nd child. To have a 2nd child without official approval is considered as giving birth to an unplanned child. Each parent of an unplanned child has to pay a special levy for 5 years from the day the child is born. If the interval between the 1st child and the 2nd child of a woman is less than 4 years, this woman and her husband will have to pay the special levies for 5 years and will have to pay levies to make up for the deficiencies caused by the insufficient interval between their 1st and 2nd child. Due to the great differences in economic conditions existing in the rural counties, every rural county People's Government may formulate its own stipulations concerning the length and amount of levies in accordance with local conditions.

Lattice-Like Total Perfect Codes

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Araujo Carlos

2014-02-01

Full Text Available A contribution is made to the classification of lattice-like total perfect codes in integer lattices Λn via pairs (G, Φ formed by abelian groups G and homomorphisms Φ: Zn → G. A conjecture is posed that the cited contribution covers all possible cases. A related conjecture on the unfinished work on open problems on lattice-like perfect dominating sets in Λn with induced components that are parallel paths of length > 1 is posed as well.

The roles of family members, health care workers, and others in decision-making processes about genetic testing among individuals at risk for Huntington disease.

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Klitzman, Robert; Thorne, Deborah; Williamson, Jennifer; Marder, Karen

2007-06-01

To understand how individuals at risk for Huntington disease view the roles of others, e.g., family members and health care workers, in decision making about genetic testing. Twenty-one individuals (eight mutation-positive, four mutation-negative, and nine not tested) were interviewed for approximately 2 hours each. Interviewees illuminated several key aspects of the roles of family members and health care workers (in genetics and other fields) in decision making about testing that have been underexplored. Family members often felt strongly about whether an individual should get tested. Health care workers provided information and assistance with decision making and mental health referrals that were often helpful. Yet health care workers varied in knowledge and sensitivity regarding testing issues, and the quality of counseling and testing experiences can range widely. At times, health care workers without specialized knowledge of Huntington disease offered opinions of whether to test. Input from families and health care workers could also conflict with each other and with an individual's own preferences. Larger institutional and geographic contexts shaped decisions as well. Decision-making theories applied to Huntington disease testing have frequently drawn on psychological models, yet the current data highlight the importance of social contexts and relationships in testing decisions. This report, the first to our knowledge to explore individuals' perceptions of social factors (particularly family and health care worker involvement) in Huntington disease testing decisions, has critical implications for practice, education, research, and policy.

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

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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)

Prediction of Risk Behaviors in HIV-infected Patients Based on Family Functioning: The Mediating Roles of Lifestyle and Risky Decision Making

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Fariba Ebrahim Babaei

2017-09-01

Full Text Available Background and Objective: Risk behaviors are more common in the HIV-positive patients than that in the general population. These behaviors are affected by various factors, such as biological, familial, and social determinants, peer group, media, and lifestyle. Low family functioning is one of the important factors predicting risk behaviors. Regarding this, the present study aimed to investigate the role of family functioning in predicting risk behaviors in the HIV-infected patients based on the mediating roles of risky decision making and lifestyle. Materials and Methods: This descriptive correlational study was conducted on 147 HIV-positive patients selected through convenience sampling technique. The data were collected using the health promoting lifestyle profile-2 (HPLP-2, family adaptability and cohesion scale IV (FACES-IV, balloon analogue risk task (BART, and risk behavior assessment in social situation. The data were analyzed using structural equation modeling method in LISREL 8.8 software. Results: According to the results, there was an indirect relationship between family functioning and risk behaviors. Furthermore, family functioning both directly and indirectly affected the risk behaviors through two mediators of lifestyle and risky decision making. Conclusion: As the findings indicated, family functioning directly contributed to risk behaviors. Moreover, this variable indirectly affected risk behaviors through the mediating roles of risky decision making and lifestyle. Consequently, the future studies should focus more deeply on family functioning role in the risk behaviors of the HIV-infected patients.

Thinking Ethically about Families, Communities, and Technology.

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Frankel, Mark S.

2000-01-01

The merger of science and commerce has become the dominant global force, giving rise to concerns about the use of genetic knowledge; ethical issues concerning justice, destiny, and perfectability; and the consequences for families and communities. Family and consumer science professionals should work to combat misunderstanding and misuse of…

PERFECTED enhanced recovery (PERFECT-ER) care versus standard acute care for patients admitted to acute settings with hip fracture identified as experiencing confusion: study protocol for a feasibility cluster randomized controlled trial.

Science.gov (United States)

Hammond, Simon P; Cross, Jane L; Shepstone, Lee; Backhouse, Tamara; Henderson, Catherine; Poland, Fiona; Sims, Erika; MacLullich, Alasdair; Penhale, Bridget; Howard, Robert; Lambert, Nigel; Varley, Anna; Smith, Toby O; Sahota, Opinder; Donell, Simon; Patel, Martyn; Ballard, Clive; Young, John; Knapp, Martin; Jackson, Stephen; Waring, Justin; Leavey, Nick; Howard, Gregory; Fox, Chris

2017-12-04

Health and social care provision for an ageing population is a global priority. Provision for those with dementia and hip fracture has specific and growing importance. Older people who break their hip are recognised as exceptionally vulnerable to experiencing confusion (including but not exclusively, dementia and/or delirium and/or cognitive impairment(s)) before, during or after acute admissions. Older people experiencing hip fracture and confusion risk serious complications, linked to delayed recovery and higher mortality post-operatively. Specific care pathways acknowledging the differences in patient presentation and care needs are proposed to improve clinical and process outcomes. This protocol describes a multi-centre, feasibility, cluster-randomised, controlled trial (CRCT) to be undertaken across ten National Health Service hospital trusts in the UK. The trial will explore the feasibility of undertaking a CRCT comparing the multicomponent PERFECTED enhanced recovery intervention (PERFECT-ER), which acknowledges the differences in care needs of confused older patients experiencing hip fracture, with standard care. The trial will also have an integrated process evaluation to explore how PERFECT-ER is implemented and interacts with the local context. The study will recruit 400 hip fracture patients identified as experiencing confusion and will also recruit "suitable informants" (individuals in regular contact with participants who will complete proxy measures). We will also recruit NHS professionals for the process evaluation. This mixed methods design will produce data to inform a definitive evaluation of the intervention via a large-scale pragmatic randomised controlled trial (RCT). The trial will provide a preliminary estimate of potential efficacy of PERFECT-ER versus standard care; assess service delivery variation, inform primary and secondary outcome selection, generate estimates of recruitment and retention rates, data collection difficulties, and

The willingness and actual situation of Chinese cancer patients and their family members participating in medical decision-making.

Science.gov (United States)

Zhang, Jie; Yang, Dan; Deng, Yaotiao; Wang, Ying; Deng, Lei; Luo, Xinmei; Zhong, Wuning; Liu, Jie; Wang, Yuqing; Jiang, Yu

2015-12-01

In China, not only patients and physicians are involved in medical decision-making (MDM) but also the patients' family members. The objective is to investigate the willingness and actual situation of cancer patients and their family members participating in the MDM process. In this cross-sectional study, questionnaires were administered to 247 pairs of cancer inpatients and their relatives. Information regarding participants' willingness and actual experience during the decision-making process was documented. Eligible participants were cancer inpatients or their relatives, 18 years of age or older, and informed of the cancer diagnosis. All the patients should have received chemotherapy. The effective response rate was 72.9% (180/247). Over half of the patients (53.3%) and family members (57.8%) were willing to be part of the MDM process. In contrast, only 35.0% of patients and 46.1% of family members actually experienced this process (p = 0.001 and p = 0.011, respectively). Fewer family members (42.2%) than patients (53.3%) believed that patients should be involved in the MDM process (p family (odds ratio 2.577, 95% CI 1.198-5.556, p = 0.015) experienced more involvement in MDM. Although more than half of Chinese cancer patients and family members wanted to be part of MDM, the actual participation was below their expectation. Majority of family members do not want the patients to be involved in the process of MDM. Copyright © 2015 John Wiley & Sons, Ltd.

Circuital model for the spherical geodesic waveguide perfect drain

Science.gov (United States)

González, Juan C.; Grabovičkić, Dejan; Benítez, Pablo; Miñano, Juan C.

2012-08-01

The perfect drain for the Maxwell fish eye (MFE) is a non-magnetic dissipative region placed in the focal point to absorb all the incident radiation without reflection or scattering. The perfect drain was recently designed as a material with complex permittivity that depends on frequency. However, this material is only a theoretical material, so it cannot be used in practical devices. The perfect drain has been claimed as necessary for achieving super-resolution (Leonhardt 2009 New J. Phys. 11 093040), which has increased the interest in practical perfect drains suitable for manufacturing. Here, we present a practical perfect drain that is designed using a simple circuit (made of a resistance and a capacitor) connected to the coaxial line. Moreover, we analyze the super-resolution properties of a device equivalent to the MFE, known as a spherical geodesic waveguide, loaded with this perfect drain. The super-resolution analysis for this device is carried out using COMSOL Multiphysics. The results of simulations predict a super-resolution of up to λ/3000.

Circuital model for the spherical geodesic waveguide perfect drain

International Nuclear Information System (INIS)

González, Juan C; Grabovičkić, Dejan; Benítez, Pablo; Miñano, Juan C

2012-01-01

The perfect drain for the Maxwell fish eye (MFE) is a non-magnetic dissipative region placed in the focal point to absorb all the incident radiation without reflection or scattering. The perfect drain was recently designed as a material with complex permittivity that depends on frequency. However, this material is only a theoretical material, so it cannot be used in practical devices. The perfect drain has been claimed as necessary for achieving super-resolution (Leonhardt 2009 New J. Phys. 11 093040), which has increased the interest in practical perfect drains suitable for manufacturing. Here, we present a practical perfect drain that is designed using a simple circuit (made of a resistance and a capacitor) connected to the coaxial line. Moreover, we analyze the super-resolution properties of a device equivalent to the MFE, known as a spherical geodesic waveguide, loaded with this perfect drain. The super-resolution analysis for this device is carried out using COMSOL Multiphysics. The results of simulations predict a super-resolution of up to λ/3000. (paper)

Assessment of satisfaction with care and decision-making among English and Spanish-speaking family members of neuroscience ICU patients.

Science.gov (United States)

Hagerty, Thomas A; Velázquez, Ángela; Schmidt, J Michael; Falo, Cristina

2016-02-01

Patients' and family members' experiences of hospital care are important indicators of quality. "Black, Asian, and Hispanic patients are more at risk than White patients for decreased satisfaction with care." In addition, of any of these groups, Hispanic patients were most likely to report a lack of patient-centered care. In the intensive care setting, (ICU) previous research has indicated that the needs and satisfaction of family members of neurological ICU patients are different from those of family members of other types of ICU patients. The purpose of this study was to determine if there were any differences between English-speaking and Spanish-speaking family members of patients in a neurological ICU. This study was a single center prospective study conducted over a 10-month period from April 2013 to February 2014 in the 18-bed neuroscience ICU of a large, urban, academic medical center. The Family Satisfaction with ICU (FS-ICU) questionnaire was used; it provides an overall score and has two factors: satisfaction with care and satisfaction with decision-making. There was no statistical significance between the two groups in overall satisfaction or in satisfaction with care, however Spanish-speakers (n=22) were significantly less satisfied (p=.04) than English-speakers (n=50) with decision-making. There were three other discreet variables in which Spanish-speakers were also less satisfied: (a) management of patients' pain (OR 3.16, 95% CI [1.12, 8.9]) (b) management of patients' breathlessness (OR 3.5, 95% CI [1.23, 9.96]) as well as (c) ease of getting information (OR 3.25, 95% CI [1.09, 9.64]). Using a standardized survey it was found that Spanish-speakers were statistically less satisfied with decision-making than English-speakers. Additionally, Spanish-speakers were statistically less satisfied with management of patients' pain and breathlessness and ease of getting information. Based on these findings, increased vigilance is recommended regarding decision

The Perfect Text.

Science.gov (United States)

Russo, Ruth

1998-01-01

A chemistry teacher describes the elements of the ideal chemistry textbook. The perfect text is focused and helps students draw a coherent whole out of the myriad fragments of information and interpretation. The text would show chemistry as the central science necessary for understanding other sciences and would also root chemistry firmly in the…

Learned helplessness among families and surrogate decision-makers of patients admitted to medical, surgical, and trauma ICUs.

Science.gov (United States)

Sullivan, Donald R; Liu, Xinggang; Corwin, Douglas S; Verceles, Avelino C; McCurdy, Michael T; Pate, Drew A; Davis, Jennifer M; Netzer, Giora

2012-12-01

We sought to determine the prevalence of and clinical variables associated with learned helplessness, a psychologic state characterized by reduced motivation, difficulty in determining causality, and depression, in family members of patients admitted to ICUs. We conducted an observational survey study of a prospectively defined cohort of family members, spouses, and partners of patients admitted to surgical, medical, and trauma ICUs at a large academic medical center. Two validated instruments, the Learned Helplessness Scale and the Perceived Stress Scale, were used, and self-report of patient clinical characteristics and subject demographics were collected. Four hundred ninety-nine family members were assessed. Of these, 238 of 460 (51.7%) had responses consistent with a significant degree of learned helplessness. Among surrogate decision-makers, this proportion was 50% (92 of 184). Characteristics associated with significant learned helplessness included grade or high school education (OR, 3.27; 95% CI, 1.29-8.27; P = .01) and Perceived Stress Scale score > 18 (OR, 4.15; 95% CI, 2.65-6.50; P learned helplessness (OR, 0.56; 95% CI, 0.32-0.98; P = .05). The majority of family members of patients in the ICU experience significant learned helplessness. Risk factors for learned helplessness include lower educational levels, absence of an advance directive or DNR order, and higher stress levels among family members. Significant learned helplessness in family members may have negative implications in the collaborative decision-making process.

Family planning and contraceptive decision-making by economically disadvantaged, African-American women

Science.gov (United States)

Hodgson, Eric J.; Collier, Charlene; Hayes, Laura; Curry, Leslie; Fraenkel, Liana

2013-01-01

Background Significant racial disparities exist in the US unplanned pregnancy rate. We conducted a qualitative study using the theory of planned behavior as a framework to describe how low-income, African-American women approach family planning. Study Design Structured focus groups were held with adult, low-income, non-pregnant, African-American women in Connecticut. Data were collected using a standardized discussion guide, and audio-taped and transcribed. Four, independent researchers coded the transcripts using the constant comparative method. Codes were organized into over-arching themes. Results Contraceptive knowledge was limited with formal education often occurring after sexual debut. Attitudes about contraception were overtly negative with method effectiveness being judged by the experience of side effects. Family and friends strongly influence contraceptive decisions while male partners are primarily seen as a barrier. Contraceptive pills are perceived as readily accessible although compliance is considered a barrier. Conclusions Contraception education should occur before sexual debut, should involve trusted family and community members, and should positively frame issues in terms of achieving life goals. PMID:23177266

Overlapped optics induced perfect coherent effects

Science.gov (United States)

Li, Jian Jie; Zang, Xiao Fei; Mao, Jun Fa; Tang, Min; Zhu, Yi Ming; Zhuang, Song Lin

2013-12-01

For traditional coherent effects, two separated identical point sources can be interfered with each other only when the optical path difference is integer number of wavelengths, leading to alternate dark and bright fringes for different optical path difference. For hundreds of years, such a perfect coherent condition seems insurmountable. However, in this paper, based on transformation optics, two separated in-phase identical point sources can induce perfect interference with each other without satisfying the traditional coherent condition. This shifting illusion media is realized by inductor-capacitor transmission line network. Theoretical analysis, numerical simulations and experimental results are performed to confirm such a kind of perfect coherent effect and it is found that the total radiation power of multiple elements system can be greatly enhanced. Our investigation may be applicable to National Ignition Facility (NIF), Inertial Confined Fusion (ICF) of China, LED lighting technology, terahertz communication, and so on.

A Study of the Relationship between Family Communication Patterns and Adolescents’ Pre-Purchase Decision-Making Process

OpenAIRE

Shahriar Azizi; Abasali Haji Karimi; Saedeh Haji Ebrahimi; Amin Dini

2013-01-01

Introduction Today's adolescents have a great influence on the family purchasing behavior. Adolescent's critical role is based on the four pillars: 1) they have more money for purchasing, 2) they are potential consumers in the future, 3) adolescents influence family purchasing decisions (Hawkins, 2006), and 4) they receive more attention from their parents. According to the last statistics of IRAN general census in 2006, adolescents (aged 15-19) composed %38.12 .of the total population. So...

A new characterization of trivially perfect graphs

Directory of Open Access Journals (Sweden)

Christian Rubio Montiel

2015-03-01

Full Text Available A graph $G$ is \\emph{trivially perfect} if for every induced subgraph the cardinality of the largest set of pairwise nonadjacent vertices (the stability number $\\alpha(G$ equals the number of (maximal cliques $m(G$. We characterize the trivially perfect graphs in terms of vertex-coloring and we extend some definitions to infinite graphs.

Lattice fluid dynamics from perfect discretizations of continuum flows

International Nuclear Information System (INIS)

Katz, E.; Wiese, U.

1998-01-01

We use renormalization group methods to derive equations of motion for large scale variables in fluid dynamics. The large scale variables are averages of the underlying continuum variables over cubic volumes and naturally exist on a lattice. The resulting lattice dynamics represents a perfect discretization of continuum physics, i.e., grid artifacts are completely eliminated. Perfect equations of motion are derived for static, slow flows of incompressible, viscous fluids. For Hagen-Poiseuille flow in a channel with a square cross section the equations reduce to a perfect discretization of the Poisson equation for the velocity field with Dirichlet boundary conditions. The perfect large scale Poisson equation is used in a numerical simulation and is shown to represent the continuum flow exactly. For nonsquare cross sections one can use a numerical iterative procedure to derive flow equations that are approximately perfect. copyright 1998 The American Physical Society

Abortion in Turkey: a matter of state, family or individual decision.

Science.gov (United States)

Gürsoy, A

1996-02-01

This paper gives a historical, international and cultural outlook on the debate related to the 1982 legalization of abortion in the modern democratic republic of Turkey. A belief that the country is under-populated and subsequent pro-natalist concerns of the turn of the century seem to have strongly influenced the legal prohibition of abortion. The paper first discusses the widespread social practice and the permissive attitudes towards abortion in the late Ottoman Empire and in contemporary Turkey. The contrast between the above social situation and until recently the strict, non-permissive religious and secular attitudes are presented with a discussion of the effects of the westernization and secularization processes in the late Ottoman Empire. Moral concerns and judgements regarding abortion seem to have penetrated Ottoman society as part of the above processes beginning in the nineteenth century. The present day official religious interpretations seem to conform with the more conservative Islamic schools of thought rather than the more liberal Islamic interpretations. Furthermore, the 1982 laws which legalize abortion until the eight week of pregnancy consider family planning to be a family issue and bring the restriction of making married women have their husband's permission before preceding with abortion. As such, the present legal platform opens to question the rationales and population control motives behind the law and the importance of who it is that can make the decision to proceed with abortion. Thus, in the last 70 years a historical and ideological progression can be discerned in the line of assuming first the state and then the family to have decision making legitimacy as regards reproductive choices. Today, the platform of radical discussion has shifted to evaluating the importance of individual women in making this reproductive choice. In this context, in conclusion, the paper discussed the rationale and the logic behind and the implications for

Finding common ground to achieve a "good death": family physicians working with substitute decision-makers of dying patients. A qualitative grounded theory study.

Science.gov (United States)

Tan, Amy; Manca, Donna

2013-01-22

Substitute decision-makers are integral to the care of dying patients and make many healthcare decisions for patients. Unfortunately, conflict between physicians and surrogate decision-makers is not uncommon in end-of-life care and this could contribute to a "bad death" experience for the patient and family. We aim to describe Canadian family physicians' experiences of conflict with substitute decision-makers of dying patients to identify factors that may facilitate or hinder the end-of-life decision-making process. This insight will help determine how to best manage these complex situations, ultimately improving the overall care of dying patients. Grounded Theory methodology was used with semi-structured interviews of family physicians in Edmonton, Canada, who experienced conflict with substitute decision-makers of dying patients. Purposeful sampling included maximum variation and theoretical sampling strategies. Interviews were audio-taped, and transcribed verbatim. Transcripts, field notes and memos were coded using the constant-comparative method to identify key concepts until saturation was achieved and a theoretical framework emerged. Eleven family physicians with a range of 3 to 40 years in clinical practice participated.The family physicians expressed a desire to achieve a "good death" and described their role in positively influencing the experience of death.Finding Common Ground to Achieve a "Good Death" for the Patient emerged as an important process which includes 1) Building Mutual Trust and Rapport through identifying key players and delivering manageable amounts of information, 2) Understanding One Another through active listening and ultimately, and 3) Making Informed, Shared Decisions. Facilitators and barriers to achieving Common Ground were identified. Barriers were linked to conflict. The inability to resolve an overt conflict may lead to an impasse at any point. A process for Resolving an Impasse is described. A novel framework for developing

California's Perfect Storm

Science.gov (United States)

Bacon, David

2010-01-01

The United States today faces an economic crisis worse than any since the Great Depression of the 1930s. Nowhere is it sharper than in the nation's schools. Last year, California saw a perfect storm of protest in virtually every part of its education system. K-12 teachers built coalitions with parents and students to fight for their jobs and their…

Optimal simulation of a perfect entangler

International Nuclear Information System (INIS)

Yu Nengkun; Duan Runyao; Ying Mingsheng

2010-01-01

A 2 x 2 unitary operation is called a perfect entangler if it can generate a maximally entangled state from some unentangled input. We study the following question: How many runs of a given two-qubit entangling unitary operation are required to simulate some perfect entangler with one-qubit unitary operations as free resources? We completely solve this problem by presenting an analytical formula for the optimal number of runs of the entangling operation. Our result reveals an entanglement strength of two-qubit unitary operations.

Optically Modulated Multiband Terahertz Perfect Absorber

DEFF Research Database (Denmark)

Seren, Huseyin R.; Keiser, George R.; Cao, Lingyue

2014-01-01

response of resonant metamaterials continues to be a challengingendeavor. Resonant perfect absorbers have flourished as one of the mostpromising metamaterial devices with applications ranging from power har-vesting to terahertz imaging. Here, an optically modulated resonant perfectabsorber is presented....... Utilizing photo-excited free carriers in silicon padsplaced in the capacitive gaps of split ring resonators, a dynamically modu-lated perfect absorber is designed and fabricated to operate in reflection.Large modulation depth (38% and 91%) in two absorption bands (with 97%and 92% peak absorption...

The myth of perfection: the image of TV-Globo newscasters

Directory of Open Access Journals (Sweden)

Sean Hagen

2005-12-01

Full Text Available The focus of this article is on the mythical image of perfection of the newscasters of the Jornal Nacional – Globo Television Network – constructed by the Brazilian media. Both as soft as well as hard news in magazines, newspapers and information sites, Fátima Bernardes and William Bonner are structured as a couple completely fulfi lled in the profession, in love and in family relationships. This reading is possible due to the overlapping of journalism and mythical thought. Using discourse analysis concepts as a support, we have analyzed 168 texts between 1998 and 2004, pointing out how the media have constructed this image and what meanings they have mobilized on attributing to the couple a special place in the pantheon of mass culture celebrities. Three distinct formations stand out: a love, fame and beauty; b talent and professional success; c family and morals. More than just journalists, the newscasters are portrayed as stars with impeccable morals, diff erent from the vulgar celebrities present in the current media.

Few opportunities to influence decisions regarding the care and treatment of an older hospitalized family member: a qualitative study among family members.

Science.gov (United States)

Nyborg, Ingrid; Danbolt, Lars Johan; Kirkevold, Marit

2017-08-31

The drive towards patient involvement in health services has been increasingly promoted. The World Health Organisation emphasizes the family's perspective in comprehensive care. Internationally there is an increased emphasis on what patients and their family tell about the hospital experiences. However, current literature does not adequately address the question of participation experiences among relatives of older hospitalized family members. There is a paucity of research with a generational perspective on relatives' opportunities to exert influence. The aim of the study was to explore relatives' experiences of opportunities to participate in decisions about the care and treatment of older hospitalized family members and whether there are different experiences of influence to the relatives' age. This was an explorative study applying individual qualitative interviews. The interviews were analysed following hermeneutic methodological principles. Two Norwegian geriatric wards participated: one at a university hospital and one at a local hospital. Twelve participants, six women and six men, were purposively selected. The relatives were aged from 36 to 88 (mean age 62) and were spouses, children and/or children-in-law of patients. The relatives' experienced opportunities to exert influence were distributed along a continuum ranging from older relatives being reactive waiting for an initiative from health professionals, to younger adults being proactive securing influence. Older "invisible" carers appeared to go unnoticed by the health professionals, establishing few opportunities to influence decisions. The middle-aged relatives also experienced limited influence, but participated when the hospital needed it. However, limited participation seemed to have less impact on their lives than in the older relatives. Middle-aged relatives and younger adults identified strategies in which visibility was the key to increasing the odds of gaining participation. The exceptional

Everybody's Different Nobody's Perfect

Science.gov (United States)

... traten ni qué edad tengan — eso se llama “DISCAPACIDAD.” Some kids have a disability because their muscles ... have one? ¿Conoces a alguien que tenga una discapacidad? ¿Tienes una tú? Everybody’s different, nobody’s perfect. So ...

Visible light broadband perfect absorbers

Energy Technology Data Exchange (ETDEWEB)

Jia, X. L.; Meng, Q. X.; Yuan, C. X.; Zhou, Z. X.; Wang, X. O., E-mail: wxo@hit.edu.cn [School of Science, Harbin Institute of Technology, Harbin 150001 (China)

2016-03-15

The visible light broadband perfect absorbers based on the silver (Ag) nano elliptical disks and holes array are studied using finite difference time domain simulations. The semiconducting indium silicon dioxide thin film is introduced as the space layer in this sandwiched structure. Utilizing the asymmetrical geometry of the structures, polarization sensitivity for transverse electric wave (TE)/transverse magnetic wave (TM) and left circular polarization wave (LCP)/right circular polarization wave (RCP) of the broadband absorption are gained. The absorbers with Ag nano disks and holes array show several peaks absorbance of 100% by numerical simulation. These simple and flexible perfect absorbers are particularly desirable for various potential applications including the solar energy absorber.

Two-perfect fluid interpretation of an energy tensor

International Nuclear Information System (INIS)

Ferrando, J.J.; Morales, J.A.; Portilla, M.

1990-01-01

There are many topics in General Relativity where matter is represented by a mixture of two fluids. In fact, some astrophysical and cosmological situations need to be described by an energy tensor made up of the sum of two or more perfect fluids rather than that with only one. The paper contains the necessary and sufficient conditions for a given energy tensor to be interpreted as a sum of two perfect fluids. Given a tensor of this class, the decomposition in two perfect fluids (which is determined up to a couple of real functions) is obtained

Inside the Family Firm

DEFF Research Database (Denmark)

Bennedsen, Morten; Nielsen, Kasper; Pérez-González, Francisco

2005-01-01

This paper uses a unique dataset from Denmark to investigate (1) the role of family characteristics in corporate decision making, and (2) the consequences of these decisions on firm performance. We focus on the decision to appoint either a family or an external chief executive officer (CEO). We...... show that a departing CEO's family characteristics have a strong predictive power in explaining CEO succession decisions: family CEOs are more frequently selected the larger the size of the family, the higher the ratio of male children and when the departing CEOs had only had one spouse. We...... then analyze the impact of family successions on performance. We overcome endogeneity and omitted variables problems of previous papers in the literature by using the gender of a departing CEO's first-born child as an instrumental variable (IV) for family successions. This is a plausible IV as male first...

Decision conflict and regret among surrogate decision makers in the medical intensive care unit.

Science.gov (United States)

Miller, Jesse J; Morris, Peter; Files, D Clark; Gower, Emily; Young, Michael

2016-04-01

Family members of critically ill patients in the intensive care unit face significant morbidity. It may be the decision-making process that plays a significant role in the psychological morbidity associated with being a surrogate in the ICU. We hypothesize that family members facing end-of-life decisions will have more decisional conflict and decisional regret than those facing non-end-of-life decisions. We enrolled a sample of adult patients and their surrogates in a tertiary care, academic medical intensive care unit. We queried the surrogates regarding decisions they had made on behalf of the patient and assessed decision conflict. We then contacted the family member again to assess decision regret. Forty (95%) of 42 surrogates were able to identify at least 1 decision they had made on behalf of the patient. End-of-life decisions (defined as do not resuscitate [DNR]/do not intubate [DNI] or continuation of life support) accounted for 19 of 40 decisions (47.5%). Overall, the average Decision Conflict Scale (DCS) score was 21.9 of 100 (range 0-100, with 0 being little decisional conflict and 100 being great decisional conflict). The average DCS score for families facing end-of-life decisions was 25.5 compared with 18.7 for all other decisions. Those facing end-of-life decisions scored higher on the uncertainty subscale (subset of DCS questions that indicates level of certainty regarding decision) with a mean score of 43.4 compared with all other decisions with a mean score of 27.0. Overall, very few surrogates experienced decisional regret with an average DRS score of 13.4 of 100. Nearly all surrogates enrolled were faced with decision-making responsibilities on behalf of his or her critically ill family member. In our small pilot study, we found more decisional conflict in those surrogates facing end-of-life decisions, specifically on the subset of questions dealing with uncertainty. Surrogates report low levels of decisional regret. Copyright © 2015 Elsevier

A cross-linguistic discourse analysis of the perfect

NARCIS (Netherlands)

Swart, Henriëtte de

2007-01-01

Since Reichenbach (1947), the Present Perfect has been discussed in relation to the Simple Past. The Reichenbachian characterization E-R,S has led to the view that the English Present Perfect, with its restrictions on modification by time adverbials and its resistance to narrative structure is the

Obsession with perfection: Body dysmorphia.

Science.gov (United States)

Vashi, Neelam A

The deeply rooted fascination with beauty penetrates society worldwide. The indulgence to look and feel beautiful pervades all ages, genders, and nationalities, with research conferring a remarkable tendency to agree on measures of attractiveness among these disparate groups. Research has found that beautiful people do, in fact, receive more desirable outcomes in life and job satisfaction, family formation, and overall happiness. Humans have a tendency to respond to attractive persons more favorably, driving many patients to our clinics. Although some dissatisfaction with one's appearance is common and normal, excessive concern with certain facial or body attributes can be sign of an underlying disorder. Body dysmorphic disorder (BDD) is a disorder of self-perception. It is the obsession with perfection. Defined as the impairing preoccupation with a nonexistent or minimal flaw in appearance, BDD affects 0.7-2.4% of the general population and a much larger percentage of those attempting to receive aesthetic treatments. Clinicians should be aware of this disorder and remain vigilant because such patients will not be satisfied with corrective procedures. Although not involving cosmetic intervention, the treatment of BDD does involve psychiatric referral and psychopharmacologic therapy, with patients receiving these having a much better prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Development of a perfect prognosis probabilistic model for ...

Indian Academy of Sciences (India)

A prediction model based on the perfect prognosis method was developed to predict the probability of lightning and probable time of its occurrence over the south-east Indian region. In the perfect prognosis method, statistical relationships are established using past observed data. For real time applications, the predictors ...

A note on perfect scalar fields

International Nuclear Information System (INIS)

Unnikrishnan, Sanil; Sriramkumar, L.

2010-01-01

We derive a condition on the Lagrangian density describing a generic, single, noncanonical scalar field, by demanding that the intrinsic, nonadiabatic pressure perturbation associated with the scalar field vanishes identically. Based on the analogy with perfect fluids, we refer to such fields as perfect scalar fields. It is common knowledge that models that depend only on the kinetic energy of the scalar field (often referred to as pure kinetic models) possess no nonadiabatic pressure perturbation. While we are able to construct models that seemingly depend on the scalar field and also do not contain any nonadiabatic pressure perturbation, we find that all such models that we construct allow a redefinition of the field under which they reduce to pure kinetic models. We show that, if a perfect scalar field drives inflation, then, in such situations, the first slow roll parameter will always be a monotonically decreasing function of time. We point out that this behavior implies that these scalar fields cannot lead to features in the inflationary, scalar perturbation spectrum.

Who Decides: Me or We? Family Involvement in Medical Decision Making in Eastern and Western Countries.

Science.gov (United States)

Alden, Dana L; Friend, John; Lee, Ping Yein; Lee, Yew Kong; Trevena, Lyndal; Ng, Chirk Jenn; Kiatpongsan, Sorapop; Lim Abdullah, Khatijah; Tanaka, Miho; Limpongsanurak, Supanida

2018-01-01

Research suggests that desired family involvement (FI) in medical decision making may depend on cultural values. Unfortunately, the field lacks cross-cultural studies that test this assumption. As a result, providers may be guided by incomplete information or cultural biases rather than patient preferences. Researchers developed 6 culturally relevant disease scenarios varying from low to high medical seriousness. Quota samples of approximately 290 middle-aged urban residents in Australia, China, Malaysia, India, South Korea, Thailand, and the USA completed an online survey that examined desired levels of FI and identified individual difference predictors in each country. All reliability coefficients were acceptable. Regression models met standard assumptions. The strongest finding across all 7 countries was that those who desired higher self-involvement (SI) in medical decision making also wanted lower FI. On the other hand, respondents who valued relational-interdependence tended to want their families involved - a key finding in 5 of 7 countries. In addition, in 4 of 7 countries, respondents who valued social hierarchy desired higher FI. Other antecedents were less consistent. These results suggest that it is important for health providers to avoid East-West cultural stereotypes. There are meaningful numbers of patients in all 7 countries who want to be individually involved and those individuals tend to prefer lower FI. On the other hand, more interdependent patients are likely to want families involved in many of the countries studied. Thus, individual differences within culture appear to be important in predicting whether a patient desires FI. For this reason, avoiding culture-based assumptions about desired FI during medical decision making is central to providing more effective patient centered care.

Perfect Power Prototype for Illinois Institute of Technology

Energy Technology Data Exchange (ETDEWEB)

Shahidehpour, Mohammad [Illinois Inst. Of Technology, Chicago, IL (United States)

2014-09-30

Starting in October 2008, Illinois Institute of Technology (IIT), in collaboration with over 20 participating members, led an extensive effort to develop, demonstrate, promote, and commercialize a microgrid system and offer supporting technologies that will achieve Perfect Power at the main campus of IIT. A Perfect Power system, as defined by the Galvin Electricity Initiative (GEI), is a system that cannot fail to meet the electric needs of the individual end-user. The Principle Investigator of this Perfect Power project was Dr. Mohammad Shahidehpour, Director of the Robert W. Galvin Center for Electricity Innovation at IIT. There were six overall objectives of the Perfect Power project: (1) Demonstrate the higher reliability introduced by the microgrid system at IIT; (2) Demonstrate the economics of microgrid operations; (3) Allow for a decrease of fifty percent (50%) of grid electricity load; (4) Create a permanent twenty percent (20%) decrease in peak load from 2007 level; (5) Defer planned substation through load reduction; (6) Offer a distribution system design that can be replicated in urban communities.

Individual health insurance within the family : can subsidies promote family coverage?

OpenAIRE

Kanika Kapur; M. Susan Marquis; José J. Escarce

2007-01-01

This paper examines the role of price in health insurance coverage decisions within the family to guide policy in promoting whole family coverage. We analyze the factors that affect individual health insurance coverage among families, and explore family decisions about whom to cover and whom to leave uninsured. The analysis uses household data from California combined with abstracted individual health plan benefit and premium data. We find that premium subsidies for individual insurance would...

Exploring the association between insecure attachment styles and adolescent autonomy in family decision making: a differentiated approach.

Science.gov (United States)

Van Petegem, Stijn; Beyers, Wim; Brenning, Katrijn; Vansteenkiste, Maarten

2013-12-01

The present investigation focuses on the associations between adolescents' insecure attachment styles (i.e., anxiety and avoidance) and their autonomous functioning in family decision making. In line with recent insights in the construct of adolescent autonomy, we combined two perspectives on autonomy, differentiating between the degree of independent versus dependent functioning and the self-endorsed and pressuring motives underlying (in)dependent functioning. A longitudinal sample of 327 adolescents (age range = 13-20 years; 64 % girls) completed questionnaires on attachment to the mother and father and on both autonomy operationalisations on two measurement moments spanning a 1-year interval. Structural equation modeling showed that attachment avoidance generally was unrelated to the degree of independent decision making and the motives underlying independent decision making, but related to more pressuring motives for dependent decision making. Anxiety, on the other hand, was associated with a lower degree of independent decision making as well as with more pressuring motives for both independent and dependent decision making. Cross-lagged paths were generally in line with these findings. Theoretical implications are outlined in the discussion.

Justification of Structural and Technological Solutions on Junction Perfecting on Permyakova and Shirotnaya Streets Intersection in Tyumen

Science.gov (United States)

Sannikov, S. P.; Timohovetz, V. D.; Kuzuek, A. Y.

2017-11-01

This article presents the justification of structurally-technological decisions on a junction perfecting on the intersection of Permyakova and Shirotnaya Streets in Tyumen. The authors made a comparative analysis of typical road junctions. Based on the comparison, the engineering decisions were made for an individual type of transport junctions. Several options of individual design were proposed and analyzed and three most suitable types for the road junctions were offered. On the basis of a multilateral studying and evaluation of the developed transport the article further proposed a transport junction with change-side traffic. The use of this type of intersection will increase the road junction capacity, reduce the number of accidents due to conflicting flows reduction which, in its turn, will increase the speed of cars.

10 CFR 609.16 - Perfection of liens and preservation of collateral.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Perfection of liens and preservation of collateral. 609.16... THAT EMPLOY INNOVATIVE TECHNOLOGIES § 609.16 Perfection of liens and preservation of collateral. (a... to perfect and maintain liens, as applicable, on assets which are pledged as collateral for the...

Scheme for achieving coherent perfect absorption by anisotropic metamaterials

KAUST Repository

Zhang, Xiujuan

2017-02-22

We propose a unified scheme to achieve coherent perfect absorption of electromagnetic waves by anisotropic metamaterials. The scheme describes the condition on perfect absorption and offers an inverse design route based on effective medium theory in conjunction with retrieval method to determine practical metamaterial absorbers. The scheme is scalable to frequencies and applicable to various incident angles. Numerical simulations show that perfect absorption is achieved in the designed absorbers over a wide range of incident angles, verifying the scheme. By integrating these absorbers, we further propose an absorber to absorb energy from two coherent point sources.

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes

Directory of Open Access Journals (Sweden)

Graeme Kohler

2017-11-01

Full Text Available n a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. Methods The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs at decision-making points in primary healthcare (PHC based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. Results The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. Conclusion This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to include value-based (customer driven quality and experience of care perspectives of several important stakeholders including patient advisors. The next step will be to implement the strategy within DMCs, spread the strategy PHC, both locally and provincially with a focus on sustainability.

Indefinite and Continuative Interpretations of the English Present Perfect

Directory of Open Access Journals (Sweden)

Katarina Dea Žetko

2005-06-01

Full Text Available The objective of our paper is to demonstrate that the English present perfect is not by inherent meaning either indefinite or continuative. Notions like indefinite and continuative are contextdependent interpretations of whole constructions and their broader context. However, continuative interpretation can also be triggered by certain adverbials, negative constructions and verbs in the progressive form. But, even these factors do not always guarantee continuative interpretations. Construction, continuative meaning can be cancelled by the context in a broader sense, this fact being a proof that this meaning is merely an implicature. We will demonstrate how different factors interact and trigger either indefinite or continuative interpretations which are not inherent in the present perfect itself. Our paper will attempt to provide sufficient evidence that there is no indefinite/continuative distinction in the English present perfect, the inherent meaning or function of the present perfect is merely to locate the situation somewhere within a period that starts before the time of utterance and leads up to it.

Family planning and family vision in mothers after diagnosis of a child with autism spectrum disorder.

Science.gov (United States)

Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane

2016-07-01

The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with autism spectrum disorder in the United States, by understanding the transformation in family vision before and after the diagnosis. A total of 22 mothers of first born children, diagnosed with autism between 2 and 4 years of age, were interviewed about family vision prior to and after their child's diagnosis. Grounded Theory method was used for data analysis. Findings indicated that coherence of early family vision, maternal cognitive flexibility, and maternal responses to diagnosis were highly influential in future family planning decisions. The decision to have additional children reflected a high level of adaptability built upon a solid internalized family model and a flexible approach to life. Decision to stop childrearing reflected a relatively less coherent family model and more rigid cognitive style followed by ongoing hardship managing life after the diagnosis. This report may be useful for health-care providers in enhancing therapeutic alliance and guiding family planning counseling. © The Author(s) 2015.

Semantic growth of morphological families in English

Directory of Open Access Journals (Sweden)

Henry Regina

2013-01-01

Full Text Available This paper explores the question of when and how morphological families are formed in one’s mental lexicon, by analyzing age-of-acquisition norms to morphological families (e.g., booking, bookshelf, check book and their shared morphemes (book. We demonstrate that the speed of growth and the size of the family depend on how early the shared morpheme is acquired and how many connections the family has at the time a new concept is incorporated in the family. These findings dovetail perfectly with the Semantic Growth model of connectivity in semantic networks by Steyvers and Tenenbaum (2005. We discuss implications of our findings for theories of vocabulary acquisition.

Perfect and Periphrastic Passive Constructions in Danish

DEFF Research Database (Denmark)

Bjerre, Tavs; Bjerre, Anne

2007-01-01

This paper gives an account of the event and argument structure of past participles and the linking between argument structure and valence structure. It further accounts for how participles form perfect and passiv constructions with auxiliaries. We assume that the same participle form is used...... in both types of construction. Our claim is that the valence structure of a past participle is predictable from its semantic type, and that the valence structure predicts with which auciliary a past participle combines in perfect constructions and whether the past participle may occur in passiv...

Perfect 800 Advanced Strategies for Top Students

CERN Document Server

Celenti, Dan

2010-01-01

Getting into the nation's most competitive universities requires more than a good SAT score, it requires a perfect score. Perfect 800: SAT Math gives advanced students the tools needed to master the SAT math test. Covering areas including arithmetic concepts; algebra; geometry; and additional topics such as probability and weighted average, the book offers exposure to a wide range of degrees of difficulty in a holistic approach that allows students to experience the "real thing," including the impact of time constraints on their performance. By emphasizing critical thinking and analytic skills

Family planning decisions for parents of children with a rare genetic condition: A scoping review.

Science.gov (United States)

Gee, Melanie; Piercy, Hilary; Machaczek, Katarzyna

2017-12-01

Expansion of newborn screening programmes increases the complexity around reproductive choices, both in terms of the increased number of parents faced with making reproductive decisions from the earliest days of their affected child's life, and the number of conditions for which such decisions have to be made. We conducted a scoping review to explore: (i) reproductive decision-making among parents of children with recessive genetic conditions; and, (ii) the involvement of healthcare services in facilitating and supporting those decisions. Systematic search processes involved seven bibliographic databases, citation, and grey literature searches. From an initial total of 311 identified articles, seven met the inclusion criteria and were included in the review. The extracted data were organised around three themes: factors influencing reproductive decisions taken by parents, how those factors changed over time, and the involvement of healthcare services in supporting and facilitating reproductive decisions. Most studies focused on attitudes towards, and uptake of, pre-natal diagnosis (PND) and termination. None of the studies considered the wider range of reproductive choices facing all parents, including those of children with conditions for whom PND and termination is not available or where good health outcomes make these options less justifiable. The literature provided little insight into the role of healthcare staff in providing family planning support for these parents. There is a need to better understand the support parents need in their decision-making, and who is best placed to provide that support. Copyright © 2017 Elsevier B.V. All rights reserved.

Bringing Value-Based Perspectives to Care: Including Patient and Family Members in Decision-Making Processes.

Science.gov (United States)

Kohler, Graeme; Sampalli, Tara; Ryer, Ashley; Porter, Judy; Wood, Les; Bedford, Lisa; Higgins-Bowser, Irene; Edwards, Lynn; Christian, Erin; Dunn, Susan; Gibson, Rick; Ryan Carson, Shannon; Vallis, Michael; Zed, Joanna; Tugwell, Barna; Van Zoost, Colin; Canfield, Carolyn; Rivoire, Eleanor

2017-03-06

Recent evidence shows that patient engagement is an important strategy in achieving a high performing healthcare system. While there is considerable evidence of implementation initiatives in direct care context, there is limited investigation of implementation initiatives in decision-making context as it relates to program planning, service delivery and developing policies. Research has also shown a gap in consistent application of system-level strategies that can effectively translate organizational policies around patient and family engagement into practice. The broad objective of this initiative was to develop a system-level implementation strategy to include patient and family advisors (PFAs) at decision-making points in primary healthcare (PHC) based on wellestablished evidence and literature. In this opportunity sponsored by the Canadian Foundation for Healthcare Improvement (CFHI) a co-design methodology, also well-established was applied in identifying and developing a suitable implementation strategy to engage PFAs as members of quality teams in PHC. Diabetes management centres (DMCs) was selected as the pilot site to develop the strategy. Key steps in the process included review of evidence, review of the current state in PHC through engagement of key stakeholders and a co-design approach. The project team included a diverse representation of members from the PHC system including patient advisors, DMC team members, system leads, providers, Public Engagement team members and CFHI improvement coaches. Key outcomes of this 18-month long initiative included development of a working definition of patient and family engagement, development of a Patient and Family Engagement Resource Guide and evaluation of the resource guide. This novel initiative provided us an opportunity to develop a supportive system-wide implementation plan and a strategy to include PFAs in decision-making processes in PHC. The well-established co-design methodology further allowed us to

Exploring the requirements for a decision aid on familial breast cancer in the UK context: a qualitative study with patients referred to a cancer genetics service.

NARCIS (Netherlands)

Iredale, R.; Rapport, F.; Sivell, S.; Jones, W.; Edwards, A.; Gray, J.; Elwyn, G.

2008-01-01

RATIONALE: Patients concerned about a family history of breast cancer can face difficult decisions about screening, prophylactic surgery and genetic testing. Decision aids can facilitate patient decision making and currently include leaflets and computerized tools. These are largely aimed at the

Team decision problems with classical and quantum signals.

Science.gov (United States)

Brandenburger, Adam; La Mura, Pierfrancesco

2016-01-13

We study team decision problems where communication is not possible, but coordination among team members can be realized via signals in a shared environment. We consider a variety of decision problems that differ in what team members know about one another's actions and knowledge. For each type of decision problem, we investigate how different assumptions on the available signals affect team performance. Specifically, we consider the cases of perfectly correlated, i.i.d., and exchangeable classical signals, as well as the case of quantum signals. We find that, whereas in perfect-recall trees (Kuhn 1950 Proc. Natl Acad. Sci. USA 36, 570-576; Kuhn 1953 In Contributions to the theory of games, vol. II (eds H Kuhn, A Tucker), pp. 193-216) no type of signal improves performance, in imperfect-recall trees quantum signals may bring an improvement. Isbell (Isbell 1957 In Contributions to the theory of games, vol. III (eds M Drescher, A Tucker, P Wolfe), pp. 79-96) proved that, in non-Kuhn trees, classical i.i.d. signals may improve performance. We show that further improvement may be possible by use of classical exchangeable or quantum signals. We include an example of the effect of quantum signals in the context of high-frequency trading. © 2015 The Authors.

Perfect 2-colorings of the generalized Petersen graph

Indian Academy of Sciences (India)

There are no perfect 2-colorings of GP(n, 2) with the matrix A3. Proof. Suppose, contrary to our claim, there is a perfect 2-coloring of GP(n, 2) with the matrix A3. By Lemma 3.4, there are 2 vertices ai and bi, for some 0 ≤ i ≤ n−1, such that they are the same color. By symmetry, without loss of generality, we can assume T (a0) ...

The role of patients' families in treatment decision-making among adult cancer patients in the Sultanate of Oman.

Science.gov (United States)

Al-Bahri, A; Al-Moundhri, M; Al-Mandhari, Z; Al-Azri, M

2018-04-17

There are limited numbers of studies available in Middle Eastern Arabic countries regarding participation of family ‎members in cancer treatment decision-making (TDM). The aim of this study was to evaluate the role of family members' ‎in TDM among ‎adult Omani cancer ‎patients. A cross-sectional study was conducted in two main teaching hospitals. All adult Omani patients who were diagnosed with cancer and their nominated family members were invited to ‎participate. A tool developed by Cancer Care Outcomes Research and ‎Surveillance Consortium was used to identify the level of family involvement in TDM. A weighted kappa (k) was significant (p time of diagnosis ‎(OR = 3.10; 95% CI: 1.37-7.03). Oncologists in Oman should be aware of the strong family involvement in TDM to allow a successful cancer treatment. © 2018 John Wiley & Sons Ltd.

A decision support model for improving a multi-family housing complex based on CO2 emission from electricity consumption.

Science.gov (United States)

Hong, Taehoon; Koo, Choongwan; Kim, Hyunjoong

2012-12-15

The number of deteriorated multi-family housing complexes in South Korea continues to rise, and consequently their electricity consumption is also increasing. This needs to be addressed as part of the nation's efforts to reduce energy consumption. The objective of this research was to develop a decision support model for determining the need to improve multi-family housing complexes. In this research, 1664 cases located in Seoul were selected for model development. The research team collected the characteristics and electricity energy consumption data of these projects in 2009-2010. The following were carried out in this research: (i) using the Decision Tree, multi-family housing complexes were clustered based on their electricity energy consumption; (ii) using Case-Based Reasoning, similar cases were retrieved from the same cluster; and (iii) using a combination of Multiple Regression Analysis, Artificial Neural Network, and Genetic Algorithm, the prediction performance of the developed model was improved. The results of this research can be used as follows: (i) as basic research data for continuously managing several energy consumption data of multi-family housing complexes; (ii) as advanced research data for predicting energy consumption based on the project characteristics; (iii) as practical research data for selecting the most optimal multi-family housing complex with the most potential in terms of energy savings; and (iv) as consistent and objective criteria for incentives and penalties. Copyright © 2012 Elsevier Ltd. All rights reserved.

Thermodynamical stability for a perfect fluid

Energy Technology Data Exchange (ETDEWEB)

Fang, Xiongjun; Jing, Jiliang [Hunan Normal University, Department of Physics, Key Laboratory of Low Dimensional Quantum Structures and Quantum Control of Ministry of Education, and Synergetic Innovation Center for Quantum Effects and Applications, Changsha, Hunan (China); He, Xiaokai [Hunan Normal University, Department of Physics, Key Laboratory of Low Dimensional Quantum Structures and Quantum Control of Ministry of Education, and Synergetic Innovation Center for Quantum Effects and Applications, Changsha, Hunan (China); Hunan First Normal University, School of Mathematics and Computational Science, Changsha (China)

2017-12-15

According to the maximum entropy principle, it has been proved that the gravitational field equations could be derived by the extrema of the total entropy for a perfect fluid, which implies that thermodynamic relations contain information as regards gravity. In this manuscript, we obtain a criterion for the thermodynamical stability of an adiabatic, self-gravitating perfect fluid system by the second variation of the total entropy. We show, for Einstein's gravity with spherical symmetry spacetime, that the criterion is consistent with that for the dynamical stability derived by Chandrasekhar and Wald. We also find that the criterion could be applied to cases without spherical symmetry, or under general perturbations. The result further establishes the connection between thermodynamics and gravity. (orig.)

Perfect 3-colorings of the cubic graphs of order 10

Directory of Open Access Journals (Sweden)

Mehdi Alaeiyan

2017-10-01

Full Text Available Perfect coloring is a generalization of the notion of completely regular codes, given by Delsarte. A perfect m-coloring of a graph G with m colors is a partition of the vertex set of G into m parts A_1, A_2, ..., A_m such that, for all $ i,j \\in \\lbrace 1, ... , m \\rbrace $, every vertex of A_i is adjacent to the same number of vertices, namely, a_{ij} vertices, of A_j. The matrix $A=(a_{ij}_{i,j\\in \\lbrace 1,... ,m\\rbrace }$, is called the parameter matrix. We study the perfect 3-colorings (also known as the equitable partitions into three parts of the cubic graphs of order 10. In particular, we classify all the realizable parameter matrices of perfect 3-colorings for the cubic graphs of order 10.

Computing a quasi-perfect equilibrium of a two-player game

DEFF Research Database (Denmark)

Miltersen, Peter Bro; Sørensen, Troels Bjerre

2010-01-01

Refining an algorithm due to Koller, Megiddo and von Stengel, we show how to apply Lemke's algorithm for solving linear complementarity programs to compute a quasi-perfect equilibrium in behavior strategies of a given two-player extensive-form game of perfect recall. A quasi-perfect equilibrium...... of a zero-sum game, we devise variants of the algorithm that rely on linear programming rather than linear complementarity programming and use the simplex algorithm or other algorithms for linear programming rather than Lemke's algorithm. We argue that these latter algorithms are relevant for recent...

A Hypergraph Dictatorship Test with Perfect Completeness

Science.gov (United States)

Chen, Victor

A hypergraph dictatorship test is first introduced by Samorodnitsky and Trevisan and serves as a key component in their unique games based {operatorname{PCP}} construction. Such a test has oracle access to a collection of functions and determines whether all the functions are the same dictatorship, or all their low degree influences are o(1). Their test makes q ≥ 3 queries, has amortized query complexity 1+Oleft(log q/qright), but has an inherent loss of perfect completeness. In this paper we give an (adaptive) hypergraph dictatorship test that achieves both perfect completeness and amortized query complexity 1+Oleft(log q/qright).

Optimization of Perfect Absorbers with Multilayer Structures

Science.gov (United States)

Li Voti, Roberto

2018-02-01

We study wide-angle and broadband perfect absorbers with compact multilayer structures made of a sequence of ITO and TiN layers deposited onto a silver thick layer. An optimization procedure is introduced for searching the optimal thicknesses of the layers so as to design a perfect broadband absorber from 400 nm to 750 nm, for a wide range of angles of incidence from 0{°} to 50{°}, for both polarizations and with a low emissivity in the mid-infrared. We eventually compare the performances of several optimal structures that can be very promising for solar thermal energy harvesting and collectors.

Electromagnetic Detection of a Perfect Invisibility Cloak

International Nuclear Information System (INIS)

Zhang Baile; Wu, Bae-Ian

2009-01-01

A perfect invisibility cloak is commonly believed to be undetectable from electromagnetic (EM) detection because it is equivalent to a curved but empty EM space created from coordinate transformation. Based on the intrinsic asymmetry of coordinate transformation applied to motions of photons and charges, we propose a method to detect this curved EM space by shooting a fast-moving charged particle through it. A broadband radiation generated in this process makes a cloak visible. Our method is the only known EM mechanism so far to detect an ideal perfect cloak (curved EM space) within its working band.

Apnea of prematurity--perfect storm.

Science.gov (United States)

Di Fiore, Juliann M; Martin, Richard J; Gauda, Estelle B

2013-11-01

With increased survival of preterm infants as young as 23 weeks gestation, maintaining adequate respiration and corresponding oxygenation represents a clinical challenge in this unique patient cohort. Respiratory instability characterized by apnea and periodic breathing occurs in premature infants because of immature development of the respiratory network. While short respiratory pauses and apnea may be of minimal consequence if oxygenation is maintained, they can be problematic if accompanied by chronic intermittent hypoxemia. Underdevelopment of the lung and the resultant lung injury that occurs in this population concurrent with respiratory instability creates the perfect storm leading to frequent episodes of profound and recurrent hypoxemia. Chronic intermittent hypoxemia contributes to the immediate and long term co-morbidities that occur in this population. In this review we discuss the pathophysiology leading to the perfect storm, diagnostic assessment of breathing instability in this unique population and therapeutic interventions that aim to stabilize breathing without contributing to tissue injury. Copyright © 2013. Published by Elsevier B.V.

Perfect Liberty or Natural Liberty?

DEFF Research Database (Denmark)

Jacobsen, Stefan Gaarsmand

2012-01-01

The article investigates the concept of natural order as it is used by François Quesnay and Adam Smith in their respective economic writings. While Smith used the concept only after having visited Quesnay and the Physiocrats in France in the 1760s, in The Wealth of Nations he sought to negotiate...... the meaning of what was “natural” about economic life. The Physiocrats believed it possible to identify a model or a perfect regime of natural order – an order that they in fact thought to exist and function in China due to a rigorous system of economic laws. Smith sided with contemporary critics...... of this metaphysical vision of economic perfection (and of Chinese governance), but he suggested that the economic mechanisms of the physiocratic theories would remain intact even with a minimum of control by state laws. However, Smith’s balancing act on these questions remained disputed even by his Scottish...

General exact solution for homogeneous time-dependent self-gravitating perfect fluids

International Nuclear Information System (INIS)

Gaete, P.; Hojman, R.

1988-01-01

A procedure to obtain the general exact solution of Einstein equations for a self-gravitating spherically-symmetric static perfect fluid obeying an arbitrary equation of state, is applied to time-dependent Kantowsky-Sachs line elements (with spherical, planar and hyperbolic symmetry). As in the static case, the solution is generated by an arbitrary function of the independent variable and its first derivative. To illustrate the results, the whole family of (plane-symmetric) solutions with a ''gamma-law'' equation of state is explicity obtained in terms of simple known functions. It is also shown that, while in the static plane-symmtric line elements, every metric is in one to one correspondence with a ''partner-metric'' (both originated from the same generatrix function), in this case every generatrix function univocally determines one metric. (author) [pt

"Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

Science.gov (United States)

Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

2013-09-22

Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for

Holographic perfect fluidity, Cotton energy-momentum duality and transport properties

Energy Technology Data Exchange (ETDEWEB)

Mukhopadhyay, Ayan [Centre de Physique Théorique, Ecole Polytechnique, CNRS UMR 7644,Route de Saclay, 91128 Palaiseau Cedex (France); Institut de Physique Théorique, CEA, CNRS URA 2306,91191 Gif-sur-Yvette (France); Petkou, Anastasios C. [Institute of Theoretical Physics, Department of Physics, Aristotle University of Thessaloniki,54124 Thessaloniki (Greece); Petropoulos, P. Marios; Pozzoli, Valentina [Centre de Physique Théorique, Ecole Polytechnique, CNRS UMR 7644,Route de Saclay, 91128 Palaiseau Cedex (France); Siampos, Konstadinos [Service de Mécanique et Gravitation, Université de Mons, UMONS,20 Place du Parc, 7000 Mons (Belgium)

2014-04-23

We investigate background metrics for 2+1-dimensional holographic theories where the equilibrium solution behaves as a perfect fluid, and admits thus a thermodynamic description. We introduce stationary perfect-Cotton geometries, where the Cotton-York tensor takes the form of the energy-momentum tensor of a perfect fluid, i.e. they are of Petrov type D{sub t}. Fluids in equilibrium in such boundary geometries have non-trivial vorticity. The corresponding bulk can be exactly reconstructed to obtain 3+1-dimensional stationary black-hole solutions with no naked singularities for appropriate values of the black-hole mass. It follows that an infinite number of transport coefficients vanish for holographic fluids. Our results imply an intimate relationship between black-hole uniqueness and holographic perfect equilibrium. They also point towards a Cotton/energy-momentum tensor duality constraining the fluid vorticity, as an intriguing boundary manifestation of the bulk mass/nut duality.

Holographic perfect fluidity, Cotton energy-momentum duality and transport properties

International Nuclear Information System (INIS)

Mukhopadhyay, Ayan; Petkou, Anastasios C.; Petropoulos, P. Marios; Pozzoli, Valentina; Siampos, Konstadinos

2014-01-01

We investigate background metrics for 2+1-dimensional holographic theories where the equilibrium solution behaves as a perfect fluid, and admits thus a thermodynamic description. We introduce stationary perfect-Cotton geometries, where the Cotton-York tensor takes the form of the energy-momentum tensor of a perfect fluid, i.e. they are of Petrov type D t . Fluids in equilibrium in such boundary geometries have non-trivial vorticity. The corresponding bulk can be exactly reconstructed to obtain 3+1-dimensional stationary black-hole solutions with no naked singularities for appropriate values of the black-hole mass. It follows that an infinite number of transport coefficients vanish for holographic fluids. Our results imply an intimate relationship between black-hole uniqueness and holographic perfect equilibrium. They also point towards a Cotton/energy-momentum tensor duality constraining the fluid vorticity, as an intriguing boundary manifestation of the bulk mass/nut duality

An Exploration of Decision-Making Processes on Infant Delivery Site from the Perspective of Pregnant Women, New Mothers, and Their Families in Northern Karnataka, India.

Science.gov (United States)

Blanchard, Andrea Katryn; Bruce, Sharon Gail; Jayanna, Krishnamurthy; Gurav, Kaveri; Mohan, Haranahalli L; Avery, Lisa; Moses, Stephen; Blanchard, James Frederick; Ramesh, Banadakoppa M

2015-09-01

This study was conducted to explore the decision-making processes regarding sites for delivery of infants among women, their husbands, and mothers-in-law in a rural area of northern Karnataka state, south India. Qualitative semi-structured, individual in-depth interviews were conducted in 2010 among 110 pregnant women, new mothers, husbands and mothers-in-law. Interviews were conducted by trained local researchers in participants' languages and then translated into English. Decisions were made relationally, as family members weighed their collective attitudes and experiences towards a home, private or public delivery. Patterns of both concordance and discordance between women and their families' preferences for delivery site were present. The voice of pregnant women and new mothers was not always subordinate to that of other family members. Still, the involvement of husbands and mothers-in-law was important in decision-making, indicating the need to consider the influence of household gender and power dynamics. All respondent types also expressed shifts in social context and cultural attitudes towards increasing preference for hospital delivery. An appreciation of the interdependence of family members' roles in delivery site decision-making, and how they are influenced by the socio-cultural context, must be considered in frameworks used to guide the development of relevant interventions to improve the utilization and quality of maternal, neonatal and child health services.

THE INFLUENCE OF FAMILY RELATIONS ON DECISION MAKING IN FAMILY BUSINESSES

OpenAIRE

Stoilkovska, Aleksandra; Milenkovska , Violeta; Serafimovic , Gordana

2013-01-01

The peculiarity and uniqueness of family businesses set them apart from other businesses in many things. Natural need of man to survive in these harsh circumstances forces him to constantly seek new sources of funding or simply tries to improve the existing. Secure existence is difficult to ensure. The successful family business provides many benefits: reliable operation, to be your own boss, flexible working hours, family members are taken care of, to become successful with your own strength...

Construction of Subgame-Perfect Mixed Strategy Equilibria in Repeated Games

NARCIS (Netherlands)

Berg, Kimmo; Schoenmakers, Gijsbertus

2017-01-01

This paper examines how to construct subgame-perfect mixed-strategy equilibria in discounted repeated games with perfect monitoring.We introduce a relatively simple class of strategy profiles that are easy to compute and may give rise to a large set of equilibrium payoffs. These sets are called

Formative Evaluation of Clinician Experience with Integrating Family History-Based Clinical Decision Support into Clinical Practice

Directory of Open Access Journals (Sweden)

Megan Doerr

2014-03-01

Full Text Available Family health history is a leading predictor of disease risk. Nonetheless, it is underutilized to guide care and, therefore, is ripe for health information technology intervention. To fill the family health history practice gap, Cleveland Clinic has developed a family health history collection and clinical decision support tool, MyFamily. This report describes the impact and process of implementing MyFamily into primary care, cancer survivorship and cancer genetics clinics. Ten providers participated in semi-structured interviews that were analyzed to identify opportunities for process improvement. Participants universally noted positive effects on patient care, including increases in quality, personalization of care and patient engagement. The impact on clinical workflow varied by practice setting, with differences observed in the ease of integration and the use of specific report elements. Tension between the length of the report and desired detail was appreciated. Barriers and facilitators to the process of implementation were noted, dominated by the theme of increased integration with the electronic medical record. These results fed real-time improvement cycles to reinforce clinician use. This model will be applied in future institutional efforts to integrate clinical genomic applications into practice and may be useful for other institutions considering the implementation of tools for personalizing medical management.

“Do your homework…and then hope for the best”: the challenges that medical tourism poses to Canadian family physicians’ support of patients’ informed decision-making

Science.gov (United States)

2013-01-01

Background Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism. Methods Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants’ perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians’ abilities to support medical tourists’ informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Results Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician’s role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician’s reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians’ concerns that treatments sought abroad may not be based on the best available medical evidence on treatment

Perfect quantum multiple-unicast network coding protocol

Science.gov (United States)

Li, Dan-Dan; Gao, Fei; Qin, Su-Juan; Wen, Qiao-Yan

2018-01-01

In order to realize long-distance and large-scale quantum communication, it is natural to utilize quantum repeater. For a general quantum multiple-unicast network, it is still puzzling how to complete communication tasks perfectly with less resources such as registers. In this paper, we solve this problem. By applying quantum repeaters to multiple-unicast communication problem, we give encoding-decoding schemes for source nodes, internal ones and target ones, respectively. Source-target nodes share EPR pairs by using our encoding-decoding schemes over quantum multiple-unicast network. Furthermore, quantum communication can be accomplished perfectly via teleportation. Compared with existed schemes, our schemes can reduce resource consumption and realize long-distance transmission of quantum information.

The influence of multiple ownership interests and decision-making networks on the management of family forest lands: evidence from the United States

Science.gov (United States)

Stephanie A. Snyder; Michael A. Kilgore

2018-01-01

A national assessment of how the number of parcel owners influence family forest land management and use decisions in the US was conducted using a subset of the US Forest Service's National Woodland Owner Survey Dataset. Seventy-two percent of single parcel family forest land ownership respondents of at least 4.05 ha had multiple owners. The extent to which past...

Decision-making in the inductive mode : The role of human behavior

OpenAIRE

Nobel, Johan

2013-01-01

Economists have convulsively maintained the assumption that humans are able to arrive at decisions by perfect deductive rationality, despite the fact empirical evidences are showing otherwise. The contradicting evidences have resulted in a personal view that instead of finding a unified theory about decision-making, a sound approach would be to study how humans in fact are reasoning in specific contexts. The context of interest for this paper is where it could be assumed humans’ persistence o...

Family Planning and Family Vision in Mothers after Diagnosis of a Child with Autism Spectrum Disorder

Science.gov (United States)

Navot, Noa; Jorgenson, Alicia Grattan; Vander Stoep, Ann; Toth, Karen; Webb, Sara Jane

2016-01-01

The diagnosis of a child with autism has short- and long-term impacts on family functioning. With early diagnosis, the diagnostic process is likely to co-occur with family planning decisions, yet little is known about how parents navigate this process. This study explores family planning decision making process among mothers of young children with…

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.

Implementation of a perfect metamaterial absorber into multi-functional sensor applications

Science.gov (United States)

Akgol, O.; Karaaslan, M.; Unal, E.; Sabah, C.

2017-05-01

Perfect metamaterial absorber (MA)-based sensor applications are presented and investigated in the microwave frequency range. It is also experimentally analyzed and tested to verify the behavior of the MA. Suggested perfect MA-based sensor has a simple configuration which introduces flexibility to sense the dielectric properties of a material and the pressure of the medium. The investigated applications include pressure and density sensing. Besides, numerical simulations verify that the suggested sensor achieves good sensing capabilities for both applications. The proposed perfect MA-based sensor variations enable many potential applications in medical or food technologies.

Business intelligence and decision making tools - New trends on romanian market

Directory of Open Access Journals (Sweden)

Ph.D. Silviu Cojocaru

2012-05-01

Full Text Available Despite the limits imposed by the computer’s impossibility to perfectly duplicate the human reasoning, the information systems that assist decision making and the business intelligence components are considered nowadays compulsory instruments of the modern manager; most of the daily decision procedures, the information required by the decision making process together with the information search and retrieval techniques are taken over completely by these systems. Furthermore, their continuous development, doubled the improvement of computers’ performances, offer increased possibilities to take over major parts of some of the most intense reasoning activities performed by humans

A comparative study of factors influencing decisions on desired family size among married men and women in Bokkos, a rural local government area in Plateau state.

Science.gov (United States)

Kahansim, Makshwar L; Hadejia, Idris S; Sambo, Mohammed N

2013-03-01

The total fertility rate of Nigerian women has remained high at 5.7. This is even higher for women in rural areas. Men and women in rural areas desire more children than those in urban areas. This study was aimed at describing and comparing the factors that influence family size decisions among men and women in Bokkos, a rural Local Government Area in Plateau state, Nigeria. A cross sectional descriptive comparative study was used. Data was collected using structured interviewer administered questionnaires. Seventy two percent of women and 83.6% of men who desire to have 1-4 children had at least a secondary school education. Close to seventy percent of both men and women would have fewer children if they are certain of their survival to adulthood. Over 50% of the respondents believe that the husbands should have the final say on family size decisions. Preference for male children influences decisions on family size among men and women in the study population.

Resources, attractiveness, family commitment; reproductive decisions in human mate choice.

Science.gov (United States)

Bereczkei, T; Voros, S; Gal, A; Bernath, L

1997-08-01

This study of reproductive decisions in human mate selection used data from "lonely hearts" advertisements to examine a series of predictions based on the mate preferences of male and females relating to age; physical appearance; financial condition and socioeconomic status; family commitment and personal traits; short- and long-term mating; and marital status and preexisting children. The sample consisted of 1000 personal advertisements (500 male) placed in two daily, national papers between February and October 1994 in Hungary. The research procedure included a pilot study of 150 advertisers (75 male) to refine the categories examined. Analysis was performed using 1) a matrix with one axis referring to offers and the other to demands of males and females separately; 2) a matrix of offers only to derive correlated traits of claims by males and females; and 3) a matrix with columns describing sex, offers, demands, advertiser's age, and required age and a row for each of the 1000 samples. It was found that men preferred younger mates, while women preferred older ones. Men were more likely to seek physical attractiveness, while women were more likely to seek financial resources (ranked 7th) and high status (ranked 6th). Women strongly preferred male domestic virtue and family commitment, and twice as many women as men demanded long-term relationships. Women more frequently declared preexisting children, and men exhibited a reluctance to accept these children. Both males and females employed "trade-off" strategies, making greater demands if they felt they had attractive offers.

Hamiltonian formalism for perfect fluids in general relativity

International Nuclear Information System (INIS)

Demaret, J.; Moncrief, V.

1980-01-01

Schutz's Hamiltonian theory of a relativistic perfect fluid, based on the velocity-potential version of classical perfect fluid hydrodynamics as formulated by Seliger and Whitham, is used to derive, in the framework of the Arnowitt, Deser, and Misner (ADM) method, a general partially reduced Hamiltonian for relativistic systems filled with a perfect fluid. The time coordinate is chosen, as in Lund's treatment of collapsing balls of dust, as minus the only velocity potential different from zero in the case of an irrotational and isentropic fluid. A ''semi-Dirac'' method can be applied to quantize astrophysical and cosmological models in the framework of this partially reduced formalism. If one chooses Taub's adapted comoving coordinate system, it is possible to derive a fully reduced ADM Hamiltonian, which is equal to minus the total baryon number of the fluid, generalizing a result previously obtained by Moncrief in the more particular framework of Taub's variational principle, valid for self-gravitating barotropic relativistic perfect fluids. An unconstrained Hamiltonian density is then explicitly derived for a fluid obeying the equation of state p=(gamma-1)rho (1 < or = γ < or = 2), which can adequately describe the phases of very high density attained in a catastrophic collapse or during the early stages of the Universe. This Hamiltonian density, shown to be equivalent to Moncrief's in the particular case of an isentropic fluid, can be simplified for fluid-filled class-A diagonal Bianchi-type cosmological models and appears as a suitable starting point for the study of the canonical quantization of these models

New care home admission following hospitalisation: How do older people, families and professionals make decisions about discharge destination? A case study narrative analysis.

Science.gov (United States)

Rhynas, Sarah J; Garrido, Azucena Garcia; Burton, Jennifer K; Logan, Gemma; MacArthur, Juliet

2018-03-24

To gain an in-depth understanding of the decision-making processes involved in the discharge of older people admitted to hospital from home and discharged to a care home, as described in the case records. The decision for an older person to move into a care home is significant and life-changing. The discharge planning literature for older people highlights the integral role of nurses in supporting and facilitating effective discharge. However, little research has been undertaken to explore the experiences of those discharged from hospital to a care home or the processes involved in decision-making. A purposive sample of 10 cases was selected from a cohort of 100 individuals admitted to hospital from home and discharged to a care home. Cases were selected to highlight important personal, relational and structural factors thought to affect the decision-making process. Narrative case studies were created and were thematically analysed to explore the perspectives of each stakeholder group and the conceptualisations of risk which influenced decision-making. Care home discharge decision-making is a complex process involving stakeholders with a range of expertise, experience and perspectives. Decisions take time and considerable involvement of families and the multidisciplinary team. There were significant deficits in documentation which limit the understanding of the process and the patient's voice is often absent from case records. The experiences of older people, families and multidisciplinary team members making care home decisions in the hospital setting require further exploration to identify and define best practice. Nurses have a critical role in the involvement of older people making discharge decisions in hospital, improved documentation of the patient's voice is essential. Health and social care systems must allow older people time to make significant decisions about their living arrangements, adapting to changing medical and social needs. © 2018 John Wiley

Perfect transfer of arbitrary states in quantum spin networks

International Nuclear Information System (INIS)

Christandl, Matthias; Kay, Alastair; Datta, Nilanjana; Dorlas, Tony C.; Ekert, Artur; Landahl, Andrew J.

2005-01-01

We propose a class of qubit networks that admit perfect state transfer of any two-dimensional quantum state in a fixed period of time. We further show that such networks can distribute arbitrary entangled states between two distant parties, and can, by using such systems in parallel, transmit the higher-dimensional systems states across the network. Unlike many other schemes for quantum computation and communication, these networks do not require qubit couplings to be switched on and off. When restricted to N-qubit spin networks of identical qubit couplings, we show that 2 log 3 N is the maximal perfect communication distance for hypercube geometries. Moreover, if one allows fixed but different couplings between the qubits then perfect state transfer can be achieved over arbitrarily long distances in a linear chain. This paper expands and extends the work done by Christandl et al., Phys. Rev. Lett. 92, 187902 (2004)

Family members' satisfaction with care and decision-making in intensive care units and post-stay follow-up needs-a cross-sectional survey study.

Science.gov (United States)

Frivold, Gro; Slettebø, Åshild; Heyland, Daren K; Dale, Bjørg

2018-01-01

The aim of this study was to explore family members' satisfaction with care and decision-making during the intensive care units stay and their follow-up needs after the patient's discharge or death. A cross-sectional survey study was conducted. Family members of patients recently treated in an ICU were participating. The questionnaire contented of background variables, the instrument Family Satisfaction in ICU (FS-ICU 24) and questions about follow-up needs. Descriptive and non-parametric statistics and a multiple linear regression were used in the analysis. A total of 123 (47%) relatives returned the questionnaire. Satisfaction with care was higher scored than satisfaction with decision-making. Follow- up needs after the ICU stay was reported by 19 (17%) of the participants. Gender and length of the ICU stay were shown as factors identified to predict follow-up needs.

When the past comes back to haunt you:the enduring influence of upbringing on the work-family balance decisions of professional parents

OpenAIRE

Lupu, Ioana; Spence, Crawford William; Empson, Laura

2017-01-01

Prior research generally presents work–family decisions as an individual’s rational choice between alternatives, downplaying the crucial role that upbringing plays in shaping work and parenting decisions. This article emphasizes how habitus – historically constituted and embodied dispositions – structures perceptions about what is ‘right’ and ‘normal’ for working mothers and fathers. This relational approach explores how the entrenched dispositions of individuals interact dynamically with con...

The Perfect Glass Paradigm: Disordered Hyperuniform Glasses Down to Absolute Zero

Science.gov (United States)

Zhang, G.; Stillinger, F. H.; Torquato, S.

2016-11-01

Rapid cooling of liquids below a certain temperature range can result in a transition to glassy states. The traditional understanding of glasses includes their thermodynamic metastability with respect to crystals. However, here we present specific examples of interactions that eliminate the possibilities of crystalline and quasicrystalline phases, while creating mechanically stable amorphous glasses down to absolute zero temperature. We show that this can be accomplished by introducing a new ideal state of matter called a “perfect glass”. A perfect glass represents a soft-interaction analog of the maximally random jammed (MRJ) packings of hard particles. These latter states can be regarded as the epitome of a glass since they are out of equilibrium, maximally disordered, hyperuniform, mechanically rigid with infinite bulk and shear moduli, and can never crystallize due to configuration-space trapping. Our model perfect glass utilizes two-, three-, and four-body soft interactions while simultaneously retaining the salient attributes of the MRJ state. These models constitute a theoretical proof of concept for perfect glasses and broaden our fundamental understanding of glass physics. A novel feature of equilibrium systems of identical particles interacting with the perfect-glass potential at positive temperature is that they have a non-relativistic speed of sound that is infinite.

[INVITED] Coherent perfect absorption of electromagnetic wave in subwavelength structures

Science.gov (United States)

Yan, Chao; Pu, Mingbo; Luo, Jun; Huang, Yijia; Li, Xiong; Ma, Xiaoliang; Luo, Xiangang

2018-05-01

Electromagnetic (EM) absorption is a common process by which the EM energy is transformed into other kinds of energy in the absorber, for example heat. Perfect absorption of EM with structures at subwavelength scale is important for many practical applications, such as stealth technology, thermal control and sensing. Coherent perfect absorption arises from the interplay of interference and absorption, which can be interpreted as a time-reversed process of lasing or EM emitting. It provides a promising way for complete absorption in both nanophotonics and electromagnetics. In this review, we discuss basic principles and properties of a coherent perfect absorber (CPA). Various subwavelength structures including thin films, metamaterials and waveguide-based structures to realize CPAs are compared. We also discuss the potential applications of CPAs.

People learn other people's preferences through inverse decision-making.

Science.gov (United States)

Jern, Alan; Lucas, Christopher G; Kemp, Charles

2017-11-01

People are capable of learning other people's preferences by observing the choices they make. We propose that this learning relies on inverse decision-making-inverting a decision-making model to infer the preferences that led to an observed choice. In Experiment 1, participants observed 47 choices made by others and ranked them by how strongly each choice suggested that the decision maker had a preference for a specific item. An inverse decision-making model generated predictions that were in accordance with participants' inferences. Experiment 2 replicated and extended a previous study by Newtson (1974) in which participants observed pairs of choices and made judgments about which choice provided stronger evidence for a preference. Inverse decision-making again predicted the results, including a result that previous accounts could not explain. Experiment 3 used the same method as Experiment 2 and found that participants did not expect decision makers to be perfect utility-maximizers. Copyright © 2017 Elsevier B.V. All rights reserved.

Gender Differences in Bladder Cancer Treatment Decision Making.

Science.gov (United States)

Pozzar, Rachel A; Berry, Donna L

2017-03-01

To explore gender differences in bladder cancer treatment decision making.
. Secondary qualitative analysis of interview transcripts.
. One multidisciplinary genitourinary oncology clinic (Dana-Farber Cancer Institute) and two urology clinics (Brigham and Women's Hospital and Beth Israel Deaconess Medical Center) in Boston, MA.
. As part of the original study, 45 men and 15 women with bladder cancer participated in individual interviews. Participants were primarily Caucasian, and most had at least some college education.
. Word frequency reports were used to identify thematic differences between the men's and women's statements. Line-by-line coding of constructs prevalent among women was then performed on all participants in NVivo 9. Coding results were compared between genders using matrix coding queries.
. The role of family in the decision-making process was found to be a dominant theme for women but not for men. Women primarily described family members as facilitators of bladder cancer treatment-related decisions, but men were more likely to describe family in a nonsupportive role.
. The results suggest that influences on the decision-making process are different for men and women with bladder cancer. Family may play a particularly important role for women faced with bladder cancer treatment-related decisions.
. Clinical nurses who care for individuals with bladder cancer should routinely assess patients' support systems and desired level of family participation in decision making. For some people with bladder cancer, family may serve as a stressor. Nurses should support the decision-making processes of all patients and be familiar with resources that can provide support to patients who do not receive it from family.

Explaining evolution via constrained persistent perfect phylogeny

Science.gov (United States)

2014-01-01

Background The perfect phylogeny is an often used model in phylogenetics since it provides an efficient basic procedure for representing the evolution of genomic binary characters in several frameworks, such as for example in haplotype inference. The model, which is conceptually the simplest, is based on the infinite sites assumption, that is no character can mutate more than once in the whole tree. A main open problem regarding the model is finding generalizations that retain the computational tractability of the original model but are more flexible in modeling biological data when the infinite site assumption is violated because of e.g. back mutations. A special case of back mutations that has been considered in the study of the evolution of protein domains (where a domain is acquired and then lost) is persistency, that is the fact that a character is allowed to return back to the ancestral state. In this model characters can be gained and lost at most once. In this paper we consider the computational problem of explaining binary data by the Persistent Perfect Phylogeny model (referred as PPP) and for this purpose we investigate the problem of reconstructing an evolution where some constraints are imposed on the paths of the tree. Results We define a natural generalization of the PPP problem obtained by requiring that for some pairs (character, species), neither the species nor any of its ancestors can have the character. In other words, some characters cannot be persistent for some species. This new problem is called Constrained PPP (CPPP). Based on a graph formulation of the CPPP problem, we are able to provide a polynomial time solution for the CPPP problem for matrices whose conflict graph has no edges. Using this result, we develop a parameterized algorithm for solving the CPPP problem where the parameter is the number of characters. Conclusions A preliminary experimental analysis shows that the constrained persistent perfect phylogeny model allows to

Nonminimal coupling of perfect fluids to curvature

International Nuclear Information System (INIS)

Bertolami, Orfeu; Lobo, Francisco S. N.; Paramos, Jorge

2008-01-01

In this work, we consider different forms of relativistic perfect fluid Lagrangian densities that yield the same gravitational field equations in general relativity (GR). A particularly intriguing example is the case with couplings of the form [1+f 2 (R)]L m , where R is the scalar curvature, which induces an extra force that depends on the form of the Lagrangian density. It has been found that, considering the Lagrangian density L m =p, where p is the pressure, the extra-force vanishes. We argue that this is not the unique choice for the matter Lagrangian density, and that more natural forms for L m do not imply the vanishing of the extra force. Particular attention is paid to the impact on the classical equivalence between different Lagrangian descriptions of a perfect fluid.

Parental Ethnotheories and Family Language Policy in Transnational Adoptive Families

Science.gov (United States)

Fogle, Lyn Wright

2013-01-01

Family language policy refers to explicit and overt decisions parents make about language use and language learning as well as implicit processes that legitimize certain language and literacy practices over others in the home. Studies in family language policy have emphasized the ways in which family-internal processes are shaped by and shape…

Hydrogen can be used as a perfect fuel

International Nuclear Information System (INIS)

Aydin, E.

2005-01-01

At present, hydrogen is one of the new and clean energy production sources. Hydrogen is the perfect partner for electricity, and together they create an integrated energy system based on distributed power generation and use. Hydrogen and electricity are interchangeable using a fuel cell (to convert hydrogen to electricity) or an electrolyzer (for converting electricity to hydrogen). A regenerative fuel cell works either way, converting hydrogen to electricity and vice versa. Hydrogen and electricity are both energy carriers because, unlike naturally occurring hydrocarbon fuels, they must both be produced using a primary energy source. In this study, it will be discussed whether hydrogen is perfect fuel or not

Finding the Perfect Match: Factors That Influence Family Medicine Residency Selection.

Science.gov (United States)

Wright, Katherine M; Ryan, Elizabeth R; Gatta, John L; Anderson, Lauren; Clements, Deborah S

2016-04-01

Residency program selection is a significant experience for emerging physicians, yet there is limited information about how applicants narrow their list of potential programs. This study examines factors that influence residency program selection among medical students interested in family medicine at the time of application. Medical students with an expressed interest in family medicine were invited to participate in a 37-item, online survey. Students were asked to rate factors that may impact residency selection on a 6-point Likert scale in addition to three open-ended qualitative questions. Mean values were calculated for each survey item and were used to determine a rank order for selection criteria. Logistic regression analysis was performed to identify factors that predict a strong interest in urban, suburban, and rural residency programs. Logistic regression was also used to identify factors that predict a strong interest in academic health center-based residencies, community-based residencies, and community-based residencies with an academic affiliation. A total of 705 medical students from 32 states across the country completed the survey. Location, work/life balance, and program structure (curriculum, schedule) were rated the most important factors for residency selection. Logistic regression analysis was used to refine our understanding of how each factor relates to specific types of residencies. These findings have implications for how to best advise students in selecting a residency, as well as marketing residencies to the right candidates. Refining the recruitment process will ensure a better fit between applicants and potential programs. Limited recruitment resources may be better utilized by focusing on targeted dissemination strategies.

10 CFR 611.108 - Perfection of liens and preservation of collateral.

Science.gov (United States)

2010-01-01

... 10 Energy 4 2010-01-01 2010-01-01 false Perfection of liens and preservation of collateral. 611... of collateral. (a) The Agreement and other documents related thereto shall provide that: (1) DOE and... necessary to perfect and maintain liens, as applicable, on assets which are pledged as collateral for the...

Building the perfect PC

CERN Document Server

Thompson, Robert Bruce

2006-01-01

This popular Build-It-Yourself (BIY) PC book covers everything you want to know about building your own system: Planning and picking out the right components, step-by-step instructions for assembling your perfect PC, and an insightful discussion of why you'd want to do it in the first place. Most big brand computers from HP, Dell and others use lower-quality components so they can meet their aggressive pricing targets. But component manufacturers also make high-quality parts that you can either purchase directly, or obtain through distributors and resellers. Consumers and corporations

Le Perfectionnement en Phonetique (Perfecting Phonetics)

Science.gov (United States)

Laroche-Bouvy, Danielle

1975-01-01

This article describes the programs of the Institut d'Etudes Linguistiques et Phonetiques, located in Paris. The program focuses on perfecting the students' phonetic production of French. Both curriculum and teaching methods are described, as well as a course in phonetics for future teachers of French. (Text is in French.) (CLK)

Do Musicians with Perfect Pitch Have More Autism Traits than Musicians without Perfect Pitch? An Empirical Study

DEFF Research Database (Denmark)

Dohn, Anders; Garza-Villarreal, Eduardo A.; Heaton, Pamela

2012-01-01

Perfect pitch, also known as absolute pitch (AP), refers to the rare ability to identify or produce a musical tone correctly without the benefit of an external reference. AP is often considered to reflect musical giftedness, but it has also been associated with certain disabilities due to increas...

Looking beyond the perfect lens

International Nuclear Information System (INIS)

Wee, W H; Pendry, J B

2010-01-01

The holy grail of imaging is the ability to see through anything. From the conservation of energy, we can easily see that to see through a lossy material would require lenses with gain. The aim of this paper therefore is to propose a simple scheme by which we can construct a general perfect lens, with gain-one that can restore both the phases and amplitudes of near and far fields.

Surrogacy families 10 years on: relationship with the surrogate, decisions over disclosure and children's understanding of their surrogacy origins.

Science.gov (United States)

Jadva, V; Blake, L; Casey, P; Golombok, S

2012-10-01

This study aimed to prospectively examine families created using surrogacy over a 10-year period in the UK with respect to intending parents' and children's relationship with the surrogate mother, parents' decisions over disclosure and children's understanding of the nature of their conception. Semi-structured interviews were administered by trained researchers to intending mothers, intending fathers and children on four occasions over a 10-year period. Forty-two families (19 with a genetic surrogate mother) participated when the child was 1-year old and by age 10 years, 33 families remained in the study. Data were collected on the frequency of contact with the surrogate mother, relationship with the surrogate, disclosure of surrogacy to the child and the child's understanding of their surrogacy birth. Frequency of contact between surrogacy families and their surrogate mother decreased over time, particularly for families whose surrogate was a previously unknown genetic carrier (P Surrogacy families maintained good relationships with the surrogate mother over time. Children felt positive about their surrogate mother and their surrogacy birth. The sample size of this study was small and further, larger investigations are needed before firm conclusions can be drawn.

The Present Perfect in World Englishes

Science.gov (United States)

Yao, Xinyue; Collins, Peter

2012-01-01

This paper reports on a comprehensive corpus-based study of regional and stylistic variation in the distribution of the English present perfect. The data represents ten English varieties of both the Inner Circle and Outer Circle, covering four major text types: conversation, news reportage, academic and fictional writing. The results are discussed…

Dual band metamaterial perfect absorber based on Mie resonances

Energy Technology Data Exchange (ETDEWEB)

Liu, Xiaoming; Lan, Chuwen; Li, Bo; Zhou, Ji, E-mail: zhouji@tsinghua.edu.cn [State Key Laboratory of New Ceramics and Fine Processing, School of Materials Science and Engineering, Tsinghua University, Beijing 100084 (China); Bi, Ke [School of Science, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Zhao, Qian [State Key Lab of Tribology, Department of Precision Instruments and Mechanology, Tsinghua University, Beijing 100084 (China)

2016-08-08

We numerically and experimentally demonstrated a polarization insensitive dual-band metamaterial perfect absorber working in wide incident angles based on the two magnetic Mie resonances of a single dielectric “atom” with simple structure. Two absorption bands with simulated absorptivity of 99% and 96%, experimental absorptivity of 97% and 94% at 8.45 and 11.97 GHz were achieved due to the simultaneous magnetic and electric resonances in dielectric “atom” and copper plate. Mie resonances of dielectric “atom” provide a simple way to design metamaterial perfect absorbers with high symmetry.

FAMILY IDENTITY PECULIARITIES OF WOMEN WHO HAVE MADE THE DECISION TO TERMINATE PREGNANCY AND ARE IN A STATE OF LEGAL OR CIVIL MARRIAGE

Directory of Open Access Journals (Sweden)

Natalya Vladimirovna Lukyanchenko

2013-08-01

Full Text Available In this article we reflect on the relevance of the family identity research of the women who have made the decision to terminate their pregnancy.  Family identity is defined as a specific form of personal and group identity that includes three aspects of family and self -perception as a family member: structural, emotional-evaluative and cognitional. Evaluation research of the women in a state of legal and civil marriage is given.  General and specific peculiarities of their family identity are emphasized. General peculiarities are interpersonal relationships perception in the family as distanced and family image rigidity. Various active-passive positions inside a married couple, common for women in legal or civil marriages, are attributed to specific peculiarities. DOI: http://dx.doi.org/10.12731/2218-7405-2013-7-5

Constructing the "Ideal" Family for Family-Centred Practice: Challenges for Delivery

Science.gov (United States)

Dodd, Jenny; Saggers, Sherry; Wildy, Helen

2009-01-01

Family-centred practice positions families as the key decision-makers, central to and experts in the wants and needs of their child. This paper discusses how families interviewed for a Western Australian study describe their relationships with a range of allied health professionals in the paediatric disability sector. The allied health…

Tunable THz perfect absorber with two absorption peaks based on graphene microribbons

DEFF Research Database (Denmark)

Gu, Mingyue; Xiao, Binggang; Xiao, Sanshui

2018-01-01

Perfect absorption is characterised by the complete suppression of incident and reflected electromagnetic wave, and complete dissipation of the incident energy. A tunable perfect terahertz (THz) absorber with two absorption peaks based on graphene is presented. The proposed structure consists of ...

AN FDTD ALGORITHM WITH PERFECTLY MATCHED LAYERS FOR CONDUCTIVE MEDIA. (R825225)

Science.gov (United States)

We extend Berenger's perfectly matched layers (PML) to conductive media. A finite-difference-time-domain (FDTD) algorithm with PML as an absorbing boundary condition is developed for solutions of Maxwell's equations in inhomogeneous, conductive media. For a perfectly matched laye...

How much do family physicians involve pregnant women in decisions about prenatal screening for Down syndrome?

Science.gov (United States)

Gagnon, Susie; Labrecque, Michel; Njoya, Merlin; Rousseau, François; St-Jacques, Sylvie; Légaré, France

2010-02-01

To assess the extent to which family physicians (FPs) involve women in decisions about prenatal screening for Down syndrome. Based on transcripts of consultations between 41 FPs and 128 women, two raters independently assessed clinician's efforts to involve women in decisions about prenatal screening for Down syndrome using the French-language version of OPTION. Descriptive statistics of OPTION scores were calculated. Construct validity was assessed by performing a principal factor analysis and by measuring association with consultation duration and FPs sociodemograhics. Internal consistency was assessed with Cronbach's alpha and inter-rater reliability with the intraclass correlation coefficient. The overall mean OPTION score was low: 19 +/- 7 (range = 0 [no involvement] to 100 [high involvement]). One factor accounted for 80% of the variance. Both internal consistency and inter-rater reliability were very good (Cronbach's alpha = 0.73; ICC = 0.76). OPTION scores were lower for residents than for licensed FPs (17 +/- 5 vs 21 +/- 4; p = 0.02) and were positively associated with duration of consultation (r = 0.56; p women in decisions about prenatal screening for Down syndrome. (c) 2009 John Wiley & Sons, Ltd.

Rethinking Family Power.

Science.gov (United States)

Kranichfeld, Marion L.

1987-01-01

Men's power is emphasized in the family power literature on marital decision making. Little attention has been paid to women's power, accrued through their deeper embeddedness in intrafamilial roles. Micro-level analysis of family power demonstrates that women's positions in the family power structure rest not on the horizontal marital tie but…

Perfect commuting-operator strategies for linear system games

Science.gov (United States)

Cleve, Richard; Liu, Li; Slofstra, William

2017-01-01

Linear system games are a generalization of Mermin's magic square game introduced by Cleve and Mittal. They show that perfect strategies for linear system games in the tensor-product model of entanglement correspond to finite-dimensional operator solutions of a certain set of non-commutative equations. We investigate linear system games in the commuting-operator model of entanglement, where Alice and Bob's measurement operators act on a joint Hilbert space, and Alice's operators must commute with Bob's operators. We show that perfect strategies in this model correspond to possibly infinite-dimensional operator solutions of the non-commutative equations. The proof is based around a finitely presented group associated with the linear system which arises from the non-commutative equations.

Rationality and Integration in a Family Childrearing Decision.

Science.gov (United States)

Diana, Mark S.

This paper illuminates how concepts of rationality developed by Diesing in l962 are reflected in parents' childrearing decisions. After examining technical (TR), economic (ER), social (SR), legal (LR), and political (PR) rationalities or decision-making styles, consideration is given to integrative effects and the influence of parents' friends and…

Perspectives of Patients, Families, and Health Care Professionals on Decision-Making About Dialysis Modality—The Good, the Bad, and the Misunderstandings!

OpenAIRE

Griva, Konstadina; Li, Zhi Hui; Lai, Alden Yuanhong; Choong, Meng Chan; Foo, Marjorie Wai Yin

2013-01-01

♦ Objectives: This study explored the factors influencing decision-making about dialysis modality, integrating the perspectives of patients, their families, and health care professionals within an Asian population. The study further sought to understand the low penetration rate of peritoneal dialysis (PD) in Singapore.

Robust Secure Authentication and Data Storage with Perfect Secrecy

Directory of Open Access Journals (Sweden)

Sebastian Baur

2018-04-01

Full Text Available We consider an authentication process that makes use of biometric data or the output of a physical unclonable function (PUF, respectively, from an information theoretical point of view. We analyse different definitions of achievability for the authentication model. For the secrecy of the key generated for authentication, these definitions differ in their requirements. In the first work on PUF based authentication, weak secrecy has been used and the corresponding capacity regions have been characterized. The disadvantages of weak secrecy are well known. The ultimate performance criteria for the key are perfect secrecy together with uniform distribution of the key. We derive the corresponding capacity region. We show that, for perfect secrecy and uniform distribution of the key, we can achieve the same rates as for weak secrecy together with a weaker requirement on the distribution of the key. In the classical works on PUF based authentication, it is assumed that the source statistics are known perfectly. This requirement is rarely met in applications. That is why the model is generalized to a compound model, taking into account source uncertainty. We also derive the capacity region for the compound model requiring perfect secrecy. Additionally, we consider results for secure storage using a biometric or PUF source that follow directly from the results for authentication. We also generalize known results for this problem by weakening the assumption concerning the distribution of the data that shall be stored. This allows us to combine source compression and secure storage.

Perfect lensing with phase-conjugating surfaces: toward practical realization

International Nuclear Information System (INIS)

Maslovski, Stanislav; Tretyakov, Sergei

2012-01-01

It is theoretically known that a pair of phase-conjugating surfaces can function as a perfect lens, focusing propagating waves and enhancing evanescent waves. However, the known experimental approaches based on thin sheets of nonlinear materials cannot fully realize the required phase conjugation boundary condition. In this paper, we show that the ideal phase-conjugating surface is, in principle, physically realizable and investigate the necessary properties of nonlinear and nonreciprocal particles which can be used to build a perfect lens system. The physical principle of the lens operation is discussed in detail and directions of possible experimental realizations are outlined. (paper)

Perceived influence, decision-making and access to information in family services as factors of parental empowerment: a cross-sectional study of parents with young children.

Science.gov (United States)

Vuorenmaa, Maaret; Halme, Nina; Perälä, Marja-Leena; Kaunonen, Marja; Åstedt-Kurki, Päivi

2016-06-01

Parental empowerment is known to increase parents' resources and to reduce stress, and therefore to improve family well-being. Professionals working in family services (child health clinics, school health care, day care, preschool and primary school) encounter families in various everyday settings and can significantly support parental empowerment. This study aimed (i) to identify associations between parental empowerment and demographic and family service characteristics (i.e. parents' participation and perceived influence, decision-making and access to information) and (ii) to identify predictors of maternal and paternal empowerment. Study design was cross-sectional. Participants were mothers (n = 571) and fathers (n = 384) of children aged 0-9 who were selected by stratified random sampling in 2009. Associations were analysed by t-test, one-way analysis of variance and multiple linear regression analysis. Sufficient perceived influence and joint decision-making by family and professionals on family service appointments emerged as significant variables of increased parental empowerment. Access to adequate information about municipal services was also associated with high empowerment. These family service characteristics were associated with parents' sense that they were able to manage in everyday life and had influence on specific service situations and family services in general. Mothers with a child aged under 3 or a child in home care or primary school, and fathers with a lower education feel less empowered in family services than other parents. Knowledge about the factors associated with parental empowerment can contribute to further reinforce parental empowerment, help identify parents who need special attention and contribute to the development of family services. © 2015 Nordic College of Caring Science.

A hybrid of monopoly and perfect competition model for hi-tech products

Science.gov (United States)

Yang, P. C.; Wee, H. M.; Pai, S.; Yang, H. J.; Wee, P. K. P.

2010-11-01

For Hi-tech products, the demand rate, the component cost as well as the selling price usually decline significantly with time. In the case of perfect competition, shortages usually result in lost sales; while in a monopoly, shortages will be completely backordered. However, neither perfect competition nor monopoly exists. Therefore, there is a need to develop a replenishment model considering a hybrid of perfect competition and monopoly when the cost, price and demand are decreasing simultaneously. A numerical example and sensitivity analysis are carried out to illustrate this model. The results show that a higher decline-rate in the component cost leads to a smaller service level and a larger replenishment interval. When the component cost decline rate increases and the selling price decline rate decreases simultaneously, the replenishment interval decreases. In perfect competition it is better to have a high service level, while for the case with monopoly, keeping a low service level is better due to complete backordering.

What is anthropological about The Perfect Human?

DEFF Research Database (Denmark)

Thomsen, Line Hassall

2015-01-01

Jørgen Leth has classified The Perfect Human as an anthropological film. But is the film anthropological at all? This article explores Leth’s connections with anthropology and finds that he is more inspired by anthropological framing than he is by anthropological research methods....

Couples' joint decision-making: the construction and validation of a key proxy for understanding gender relations in contemporary families

Directory of Open Access Journals (Sweden)

Maira Covre-Sussai

2014-06-01

Full Text Available Gender relations have become a key dimension in family studies, and understanding gender relations as both determining and resulting from outcome of new family configurations requires the use of specific surveys aimed at the dynamics of couples. Unfortunately, nationally representative surveys of this type are not available for Latin American countries. Nonetheless, the most recent versions of the Demographic and Health Surveys (DHS include a section called "Women's Status and Empowerment", which can provide information about gender relations as well. This study aims at assessing the construct of gender relations in terms of couples' joint decision-making for all five Brazilian geographical regions. To this end, a step-by-step multi-group confirmatory factor analysis (MGCFA was applied in order to verify whether this concept can be compared across Brazilian regions. Results show that the DHS items can be used reliably for measuring couples' joint decision-making and that this construct can be meaningfully compared over the regions. These findings will contribute to further demographic and sociological research on gender relations which can use this concept and other indicators provided by the DHS to identify the causal processes related to it.

Diffraction of love waves by two staggered perfectly weak half-planes

International Nuclear Information System (INIS)

Asghar, S.; Zaman, F.D.; Sajida Asghar

1989-01-01

Love wave travelling in a layer of uniform thickness overlying a half-space is assumed to be incident on two parallel but staggered perfectly weak half-planes lying in the upper layer. The diffracted fields is calculated using the modified Wiener-Hopf technique and contour integration method. The diffracted waves satisfy the dispersion relations appropriate to different regions formed by the perfectly weak half-planes

75 FR 55588 - Family-to-Family Health Information Center Program

Science.gov (United States)

2010-09-13

... resources, financing, related services and parent-to-parent support for families with children and youth... make informed health care decisions, be full partners in decision-making and access needed resources/referrals and financing for those services in the state of Florida. It is also imperative that the center...

Involved, inputting or informing: "Shared" decision making in adult mental health care.

Science.gov (United States)

Bradley, Eleanor; Green, Debra

2018-02-01

A diagnosis of serious mental illness can impact on the whole family. Families informally provide significant amounts of care but are disproportionately at risk of carer burden when compared to those supporting people with other long-term conditions. Shared decision making (SDM) is an ethical model of health communication associated with positive health outcomes; however, there has been little research to evaluate how routinely family is invited to participate in SDM, or what this looks like in practice. This UK study aimed to better understand how the family caregivers of those diagnosed with SMI are currently involved in decision making, particularly decisions about treatment options including prescribed medication. Objectives were to Explore the extent to which family members wish to be involved in decisions about prescribed medication Determine how and when professionals engage family in these decisions Identify barriers and facilitators associated with the engagement of family in decisions about treatment. Open-ended questions were sent to professionals and family members to elicit written responses. Qualitative responses were analysed thematically. Themes included the definition of involvement and "rules of engagement." Staff members are gatekeepers for family involvement, and the process is not democratic. Family and staff ascribe practical, rather than recovery-oriented roles to family, with pre-occupation around notions of adherence. Staff members need support, training and education to apply SDM. Time to exchange information is vital but practically difficult. Negotiated teams, comprising of staff, service users, family, peers as applicable, with ascribed roles and responsibilities could support SDM. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Maxwell's fish-eye lens and the mirage of perfect imaging

International Nuclear Information System (INIS)

Merlin, R

2011-01-01

Recent claims that Maxwell's fish-eye is a perfect lens, capable of providing images with deep subwavelength resolution, are examined. We show that the imaging properties of a dispersionless fish-eye are very similar to those of an ideal spherical cavity. Using this correspondence, we prove that the correct solution to Maxwell equations in the fish-eye gives image sizes that are consistent with the standard diffraction limit. Perfect focusing is an optical illusion that results from placing a time-reversed source at the position of the geometrical image which, when combined with the field due to the primary (object) source, mimics the behavior of a perfect drain. Issues of causality are briefly discussed. We also demonstrate that passive outlets are not a good alternative to time-reversed sources for broadband drain-like behavior and that, even if they were, they could not do a better job than conventional optical systems at providing high resolution

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

Hit by a Perfect Storm? Art & Design in the National Student Survey

Science.gov (United States)

Yorke, Mantz; Orr, Susan; Blair, Bernadette

2014-01-01

There has long been the suspicion amongst staff in Art & Design that the ratings given to their subject disciplines in the UK's National Student Survey are adversely affected by a combination of circumstances--a "perfect storm". The "perfect storm" proposition is tested by comparing ratings for Art & Design with those…

Tie-breaking in games of perfect information

DEFF Research Database (Denmark)

Tranæs, Torben

1998-01-01

The paper suggests that ties in an extensive form game have strategic implications if they represent credible threats or promises. We consider a subset of subgame-perfect Nash equilibria obtained by breaking ties according to their strategic implications, and show that the subset is nonempty for ...

A not-so-short description of the PERFECT platform

International Nuclear Information System (INIS)

Bugat, S.; Zeghadi, A.; Adjanor, G.

2010-01-01

This article describes the building of the so-called 'PERFECT platform', which main issue was to allow the development of the PERFECT end-products dedicated to the prediction of the degradation of material properties due to irradiation. First, the general principles used to build the platform are detailed. Such principles guided the choices of preferential development language, architecture, and operating system. The architecture of the platform is then described. It allows an easy development of the end-products, and a 'black-box' integration of the codes developed during the project. Each end-product can be seen as a sequence of modules, each module representing a physical phenomenon in time and space. The platform is very flexible, so that different methodologies can be tested and compared inside an end-product. The second part is devoted to the description of a classical PERFECT study, defined thanks to the graphical user interface developed in the project. Focus is made in particular on how a selection of modules is done, how the input data can be entered, and how the study execution is fully controlled by the user. A final description of the post-processing facilities on the results is exposed.

Effective high-order solver with thermally perfect gas model for hypersonic heating prediction

International Nuclear Information System (INIS)

Jiang, Zhenhua; Yan, Chao; Yu, Jian; Qu, Feng; Ma, Libin

2016-01-01

Highlights: • Design proper numerical flux for thermally perfect gas. • Line-implicit LUSGS enhances efficiency without extra memory consumption. • Develop unified framework for both second-order MUSCL and fifth-order WENO. • The designed gas model can be applied to much wider temperature range. - Abstract: Effective high-order solver based on the model of thermally perfect gas has been developed for hypersonic heat transfer computation. The technique of polynomial curve fit coupling to thermodynamics equation is suggested to establish the current model and particular attention has been paid to the design of proper numerical flux for thermally perfect gas. We present procedures that unify five-order WENO (Weighted Essentially Non-Oscillatory) scheme in the existing second-order finite volume framework and a line-implicit method that improves the computational efficiency without increasing memory consumption. A variety of hypersonic viscous flows are performed to examine the capability of the resulted high order thermally perfect gas solver. Numerical results demonstrate its superior performance compared to low-order calorically perfect gas method and indicate its potential application to hypersonic heating predictions for real-life problem.

Patient Preferences and Surrogate Decision Making in Neuroscience Intensive Care Units

Science.gov (United States)

Cai, Xuemei; Robinson, Jennifer; Muehlschlegel, Susanne; White, Douglas B.; Holloway, Robert G.; Sheth, Kevin N.; Fraenkel, Liana; Hwang, David Y.

2016-01-01

In the neuroscience intensive care unit (NICU), most patients lack the capacity to make their own preferences known. This fact leads to situations where surrogate decision makers must fill the role of the patient in terms of making preference-based treatment decisions, oftentimes in challenging situations where prognosis is uncertain. The neurointensivist has a large responsibility and role to play in this shared decision making process. This review covers how NICU patient preferences are determined through existing advance care documentation or surrogate decision makers and how the optimum roles of the physician and surrogate decision maker are addressed. We outline the process of reaching a shared decision between family and care team and describe a practice for conducting optimum family meetings based on studies of ICU families in crisis. We review challenges in the decision making process between surrogate decision makers and medical teams in neurocritical care settings, as well as methods to ameliorate conflicts. Ultimately, the goal of shared decision making is to increase knowledge amongst surrogates and care providers, decrease decisional conflict, promote realistic expectations and preference-centered treatment strategies, and lift the emotional burden on families of neurocritical care patients. PMID:25990137

The Perfect Eye A Novel Model for Teaching the Theory of Refraction.

Science.gov (United States)

Kurtz, Daniel

1999-01-01

The Perfect Eye model simplifies solutions to a wide variety of optometry instructional problems by facilitating student understanding of the interaction among lenses, objects, accommodation, and ametropia. The model is based on the premise that inside every eye is a perfect (emmetropic) eye, and that the physiological eye is a combination of the…

On the Contribution of Slovenian Linguistics to the History of the Ancient Greek Perfect

Directory of Open Access Journals (Sweden)

Jerneja Kavčič

2010-12-01

Full Text Available An important contribution to the history of the Ancient Greek perfect is the study of Erika Mihevc-Gabrovec, The Disappearance of the Perfect in Late Greek (La disparition du parfait dans le grec de la basse époque. In terms of theory and content, her study continues the work of Pierre Chantraine, but somewhat diverges from her predecessor’s views on the issue of the merger between the aorist and the perfect, identifying examples of the use of the perfect even in an – according to Pierre Chantraine – relatively late period.  Some years after the publication of Erika Mihevc-Gabrovec’s book, the question of when the aorist and the perfect may have merged was raised again, to be addressed by McKay in a number of articles. Today, the views on the subject are strongly divided.   As argued by the author of this paper, one of the setbacks in examining the merger between the aorist and the perfect concerns the methodology, since researchers have tended to rely exclusively on their sense of language. A possible new approach is offered in the framework of the Slovenian theory of Natural Syntax, which has from the start paid considerable attention to English sentences of the I believe her to be intelligent type. The paper describes similar sentences in New Testament Greek, terming them “sentences of the λέγουσινἀνάστασινμὴεἶναι type”. In New Testament Greek, they display a tendency to use the present infinitive of stative verbs; relatively frequent is also the perfect infinitive (of non-stative verbs, while, as already noted in other studies, these sentences – at least in New Testament Greek – avoid the aorist infinitive. Such sentences thus bear witness to the fact that the aorist and the perfect were not fully interchangeable in New Testament Greek; the status of the aorist and perfect infinitives in sentences of the λέγουσινἀνάστασινμὴεἶναι type should also be taken into

Perfectly Secure Oblivious RAM without Random Oracles

DEFF Research Database (Denmark)

Damgård, Ivan Bjerre; Meldgaard, Sigurd Torkel; Nielsen, Jesper Buus

2011-01-01

We present an algorithm for implementing a secure oblivious RAM where the access pattern is perfectly hidden in the information theoretic sense, without assuming that the CPU has access to a random oracle. In addition we prove a lower bound on the amount of randomness needed for implementing...

Consumer socialization of children in modern family

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Kovač-Žnideršić Ružica

2016-01-01

Full Text Available The research presented in this paper is based on the behavior of a specific segment of consumers - specific for its psychological as well as economic characteristics - segment of kids (children as consumers. Therefore, the kids as consumers and their influence in family decision making process, in the framework of modern ('new' families, are the subject of this research. The aim of the paper is analyising the importance of family as the main driving force of consumer socialization of children in which kids achieve more significant and active participation in making purchasing decisions. Results of empirical research, presented in this paper, are in line with the findings of foreign authors with regards to influence of children in family decision making.

Perfect Fluid Theory and its Extensions

OpenAIRE

Jackiw, R.; Nair, V. P.; Pi, S. -Y.; Polychronakos, A. P.

2004-01-01

We review the canonical theory for perfect fluids, in Eulerian and Lagrangian formulations. The theory is related to a description of extended structures in higher dimensions. Internal symmetry and supersymmetry degrees of freedom are incorporated. Additional miscellaneous subjects that are covered include physical topics concerning quantization, as well as mathematical issues of volume preserving diffeomorphisms and representations of Chern-Simons terms (= vortex or magnetic helicity).

Exercises to improve the decision making of judokas youth of Santiago de Cuba

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Gerardo Antonio Rodríguez-Vázquez

2018-01-01

Full Text Available The weaknesses identified in the EIDE "Captain Orestes Acosta" in Santiago de Cuba in the process of tactical preparation in judo in female youth category motivated the author to develop an investigation with the following scientific problem: How to encourage perfect Offensive making decisions in combating youth team athletes Judo? The objective of this research is the refine of special exercises to promote the development of decision-making in combating youth team athletes Judo. Different theoretical and empirical methods were used to evidence the weaknesses identified. It further emphasizes the novelty of the proposal to use special exercises imbalance, defense, counterattack and combinations favoring decisions in combat.

On the perfect hexagonal packing of rods

International Nuclear Information System (INIS)

Starostin, E L

2006-01-01

In most cases the hexagonal packing of fibrous structures or rods extremizes the energy of interaction between strands. If the strands are not straight, then it is still possible to form a perfect hexatic bundle. Conditions under which the perfect hexagonal packing of curved tubular structures may exist are formulated. Particular attention is given to closed or cycled arrangements of the rods like in the DNA toroids and spools. The closure or return constraints of the bundle result in an allowable group of automorphisms of the cross-sectional hexagonal lattice. The structure of this group is explored. Examples of open helical-like and closed toroidal-like bundles are presented. An expression for the elastic energy of a perfectly packed bundle of thin elastic rods is derived. The energy accounts for both the bending and torsional stiffnesses of the rods. It is shown that equilibria of the bundle correspond to solutions of a variational problem formulated for the curve representing the axis of the bundle. The functional involves a function of the squared curvature under the constraints on the total torsion and the length. The Euler-Lagrange equations are obtained in terms of curvature and torsion and due to the existence of the first integrals the problem is reduced to the quadrature. The three-dimensional shape of the bundle may be readily reconstructed by integration of the Ilyukhin-type equations in special cylindrical coordinates. The results are of universal nature and are applicable to various fibrous structures, in particular, to intramolecular liquid crystals formed by DNA condensed in toroids or packed inside the viral capsids

Does training family physicians in shared decision making promote optimal use of antibiotics for acute respiratory infections? Study protocol of a pilot clustered randomised controlled trial

Directory of Open Access Journals (Sweden)

Côté Luc

2007-11-01

Full Text Available Abstract Background In North America, although it varies according to the specific type of acute respiratory infections (ARI, use of antibiotics is estimated to be well above the expected prevalence of bacterial infections. The objective of this pilot clustered randomized controlled trial (RCT is to assess the feasibility of a larger clustered RCT aiming at evaluating the impact of DECISION+, a continuing professional development (CPD program in shared decision making, on the optimal use of antibiotics in the context of ARI. Methods/design This pilot study is a cluster RCT conducted with family physicians from Family Medicine Groups (FMG in the Quebec City area, Canada. Participating FMG are randomised to an immediate DECISION+ group, a CPD program in shared decision making, (experimental group, or a delayed DECISION+ group (control group. Data collection involves recruiting five patients consulting for ARI per physician from both study groups before (Phase 1 and after (Phase 2 exposure of the experimental group to the DECISION+ program, and after exposure of the control group to the DECISION+ program (Phase 3. The primary outcome measures to assess the feasibility of a larger RCT include: 1 proportion of contacted FMG that agree to participate; 2 proportion of recruited physicians who participate in the DECISION+ program; 3 level of satisfaction of physicians regarding DECISION+; and 4 proportion of missing data in each data collection phase. Levels of agreement of the patient-physician dyad on the Decisional Conflict Scale and physicians' prescription profile for ARI are performed as secondary outcome measures. Discussion This study protocol is informative for researchers and clinicians interested in designing and/or conducting clustered RCT with FMG regarding training of physicians in shared decision making. Trial Registration ClinicalTrials.gov Identifier: NCT00354315

Perfect state of Cryptococcus neoformans, Filobasidiella neoformans, on pigeon manure filtrate agar

Energy Technology Data Exchange (ETDEWEB)

Staib, F.

1981-02-01

To enable studies of the dependence of Cryptococcus neoformans and its perfect and imperfect states upon bird manure as a habitat of this pathogen, a nutrient medium closely resembling natural conditions was prepared. As sole nutrient, the water soluble ingredients of manure from pigeons (Columbia livia) were used. There was no heat sterilization of the manure filtrate. Using a standard pair of C. neoformans strains for mating, it could be demonstrated that the perfect state of the fungus developed on this so called pigeon manure filtrate agar within 48 h at 26 degrees C. This medium is supposed to help in the elucidation of the epidemiological significance of the perfect and imperfect states of this pathogen.

Family Decision-Making Style, Peer Group Affiliation and Prior Academic Achievement as Predictors of the Academic Achievement of African American Students

Science.gov (United States)

Engerman, Kimarie

2006-01-01

A study analyzed family decision-making style, peer group affiliation, and academic achievement in 10th grade as predictors of academic achievement of African American students in 12th grade. Findings indicated that though peer groups were known to influence academic performance, affiliation with learning oriented peers in 10th grade did not…

Family support in cancer survivorship.

Science.gov (United States)

Muhamad, Mazanah; Afshari, Mojgan; Kazilan, Fitrisehara

2011-01-01

This paper raises issues about the role of family members in providing support for breast cancer survivors. Data were collected from 400 breast cancer survivors in Peninsular Malaysia through a custom-designed questionnaire fielded at hospitals and support group meetings. The data were analyzed using descriptive statistics. The analyses show that all family members could be supportive, especially in decision making and help with emotional issues. The spouse was the main support provider among the family members (others were children, parents, siblings and more distant relatives). The results also indicated that a significant percentage practiced collaborative decision-making. Breast cancer survivors needed their family members' support for information on survivorship strategies such as managing emotions, health, life style and dietary practice. The family members' supportive role may be linked to the Malaysian strong family relationship culture. For family members to contribute more adequately to cancer survivorship, it is suggested that appropriate educational intervention also be provided to them.

Hyper-Achievement, Perfection, and College Student Resilience

Science.gov (United States)

Eells, Gregory T.

2017-01-01

Over the past decade, there has been considerable attention given to college students' experience of pressure to pursue perfection through hyper-achievement and the psychological and emotional toll this process takes on them. The popular press has highlighted this phenomenon and raised specific questions about some of the related consequences like…

Generalized magneto-thermoviscoelasticity in a perfectly conducting ...

Indian Academy of Sciences (India)

on the theory of generalized thermoelastic diffusion with one relaxation time. ... cavity is taken to be traction free and subjected to both heating and external constant ... problems on wave propagation in a linear viscoelas- ... Let us consider a perfect electric conductor medium ... The energy equation in the context of general-.

Family-centered end-of-life care in the ICU.

Science.gov (United States)

Wiegand, Debra L; Grant, Marian S; Cheon, Jooyoung; Gergis, Mary A

2013-08-01

Families of older adults are intricately involved in the end-of-life decision-making process for a family member with a serious illness in the intensive care unit (ICU) setting. However, families are not always as involved and as informed as they would like to be. Creating a culture that assesses family needs and supports families is an important component of family-centered care. There are several strategies that nurses and other members of the interdisciplinary team can use to promote family-centered end-of-life care in the ICU. Nurses can get to know the family by spending time talking with them, assessing them, seeking to understand their perspectives on their family member's condition, and discussing previously verbalized patient wishes for care. This article offers strategies nurses can use to help guide the family through the end-of-life decision-making process, support families as difficult and complex decisions are made in collaboration with the health care team, and prepare families for the dying process. Copyright 2013, SLACK Incorporated.

Decision making in family medicine: randomized trial of the effects of the InfoClinique and Trip database search engines.

Science.gov (United States)

Labrecque, Michel; Ratté, Stéphane; Frémont, Pierre; Cauchon, Michel; Ouellet, Jérôme; Hogg, William; McGowan, Jessie; Gagnon, Marie-Pierre; Njoya, Merlin; Légaré, France

2013-10-01

To compare the ability of users of 2 medical search engines, InfoClinique and the Trip database, to provide correct answers to clinical questions and to explore the perceived effects of the tools on the clinical decision-making process. Randomized trial. Three family medicine units of the family medicine program of the Faculty of Medicine at Laval University in Quebec city, Que. Fifteen second-year family medicine residents. Residents generated 30 structured questions about therapy or preventive treatment (2 questions per resident) based on clinical encounters. Using an Internet platform designed for the trial, each resident answered 20 of these questions (their own 2, plus 18 of the questions formulated by other residents, selected randomly) before and after searching for information with 1 of the 2 search engines. For each question, 5 residents were randomly assigned to begin their search with InfoClinique and 5 with the Trip database. The ability of residents to provide correct answers to clinical questions using the search engines, as determined by third-party evaluation. After answering each question, participants completed a questionnaire to assess their perception of the engine's effect on the decision-making process in clinical practice. Of 300 possible pairs of answers (1 answer before and 1 after the initial search), 254 (85%) were produced by 14 residents. Of these, 132 (52%) and 122 (48%) pairs of answers concerned questions that had been assigned an initial search with InfoClinique and the Trip database, respectively. Both engines produced an important and similar absolute increase in the proportion of correct answers after searching (26% to 62% for InfoClinique, for an increase of 36%; 24% to 63% for the Trip database, for an increase of 39%; P = .68). For all 30 clinical questions, at least 1 resident produced the correct answer after searching with either search engine. The mean (SD) time of the initial search for each question was 23.5 (7

Research on AHP decision algorithms based on BP algorithm

Science.gov (United States)

Ma, Ning; Guan, Jianhe

2017-10-01

Decision making is the thinking activity that people choose or judge, and scientific decision-making has always been a hot issue in the field of research. Analytic Hierarchy Process (AHP) is a simple and practical multi-criteria and multi-objective decision-making method that combines quantitative and qualitative and can show and calculate the subjective judgment in digital form. In the process of decision analysis using AHP method, the rationality of the two-dimensional judgment matrix has a great influence on the decision result. However, in dealing with the real problem, the judgment matrix produced by the two-dimensional comparison is often inconsistent, that is, it does not meet the consistency requirements. BP neural network algorithm is an adaptive nonlinear dynamic system. It has powerful collective computing ability and learning ability. It can perfect the data by constantly modifying the weights and thresholds of the network to achieve the goal of minimizing the mean square error. In this paper, the BP algorithm is used to deal with the consistency of the two-dimensional judgment matrix of the AHP.

Breast milk is conditionally perfect.

Science.gov (United States)

Erick, Miriam

2018-02-01

Breast milk is the universal preferred nutrition for the newborn human infant. New mother have been encouraged to exclusively breastfeed by health care professionals and consumer-advocacy forums for years, citing "breast milk is the perfect food". The benefits are numerous and include psychological, convenience, economical, ecological and nutritionally superior. Human milk is a composite of nutritional choices of the mother, commencing in the pre-conceptual era. Events influencing the eventual nutritional profile of breast milk for the neonate start with pre-conceptual dietary habits through pregnancy and finally to postpartum. Food choices do affect the nutritional profile of human breast milk. It is not known who coined the phrase "breast milk is the perfect food" but it is widely prevalent in the literature. While breast milk is highly nutritive, containing important immunological and growth factors, scientific investigation reveals a few short-falls. Overall, human breast milk has been found to be low in certain nutrients in developed countries: vitamin D, iodine, iron, and vitamin K. Additional nutrient deficiencies have been documented in resource-poor countries: vitamin A, vitamin B 12, zinc, and vitamin B 1/thiamin. Given these findings, isn't it more accurate to describe breast milk as "conditionally perfect"? Correcting the impression that breast milk is an inherently, automatically comprehensive enriched product would encourage women who plan to breastfeed an opportunity to concentrate on dietary improvement to optimizes nutrient benefits ultimately to the neonate. The more immediate result would improve pre-conceptual nutritional status. Here, we explore the nutritional status of groups of young women; some of whom will become pregnant and eventually produce breast milk. We will review the available literature profiling vitamin, mineral, protein and caloric content of breast milk. We highlight pre-existing situations needing correction to optimize

On a ''conformal'' perfect fluid in the classical vacuum

International Nuclear Information System (INIS)

Culetu, H.

1993-02-01

A possible existence of a conformal perfect fluid in the classical vacuum is investigated in this letter. It is shown, contrary to Madsen's opinion, that the scalar field stress tensor acquires a perfect fluid form even with a nonminimal coupling (ξ = 1/6) in the Einstein Lagrangian, provided the geometry is the Lorentzian analogue of the Euclidean Hawking wormhole. In addition, our T μν equals (up to a constant factor) the vacuum expectation value of the Fulling stress tensor for a massless scalar field and Visser's one concerning transversible wormholes. On the other side of the light cone, there is a coordinate system (the dimensionally reduced Witten bubble) where the stress tensor becomes diagonal. (author). 13 refs

Individual decision making, group decision making and deliberation

Directory of Open Access Journals (Sweden)

Radovanović Bojana

2012-01-01

Full Text Available Each of us makes a number of decisions, from the less important to those with far-reaching consequences. As members of different groups, we are also actors of group decision making. In order to make a rational decision, a choice-making procedure must satisfy a number of assumptions (conditions of rationality. In addition, when it comes to group decisions, those procedures should also be “fair.” However, it is not possible to define a procedure of choice-making that would transform individual orders of alternatives based on preferences of perfectly rational individuals into a single social order and still meet conditions of rationality and ethics. The theory of deliberative democracy appeared in response to the impossibility of Social Choice theory. The basic assumption of deliberative democracy is that individuals adjust their preferences taking into account interests of the community. They are open for discussion with other group members and are willing to change their attitudes in order to achieve common interests. Ideally, group members come to an agreement during public discussion (deliberation. Still, this concept cannot completely over­come all the difficulties posed by the theory of social choice. Specifically, there is no solution for strategic and manipulative behavior of individuals. Also, the concept of deliberative democracy faces certain problems particular to this approach, such as, to name but a few, problems with the establishment of equality of participants in the debate and their motivation, as well as problems with the organization of public hearings. [Projekat Ministarstva nauke Republike Srbije, br. 47009: Evropske integracije i društveno-ekonomske promene privrede Srbije na putu ka EU i br. 179015: Izazovi i perspektive strukturnih promena u Srbiji: Strateški pravci ekonomskog razvoja i usklađivanje sa zahtevima EU

Inequivalent quantizations and fundamentally perfect spaces

International Nuclear Information System (INIS)

Imbo, T.D.; Sudarshan, E.C.G.

1987-06-01

We investigate the problem of inequivalent quantizations of a physical system with multiply connected configuration space X. For scalar quantum theory on X we show that state vectors must be single-valued if and only if the first homology group H 1 (X) is trivial, or equivalently the fundamental group π 1 (X) is perfect. The θ-structure of quantum gauge and gravitational theories is discussed in light of this result

Zero-dynamics principle for perfect quantum memory in linear networks

International Nuclear Information System (INIS)

Yamamoto, Naoki; James, Matthew R

2014-01-01

In this paper, we study a general linear networked system that contains a tunable memory subsystem; that is, it is decoupled from an optical field for state transportation during the storage process, while it couples to the field during the writing or reading process. The input is given by a single photon state or a coherent state in a pulsed light field. We then completely and explicitly characterize the condition required on the pulse shape achieving the perfect state transfer from the light field to the memory subsystem. The key idea to obtain this result is the use of zero-dynamics principle, which in our case means that, for perfect state transfer, the output field during the writing process must be a vacuum. A useful interpretation of the result in terms of the transfer function is also given. Moreover, a four-node network composed of atomic ensembles is studied as an example, demonstrating how the input field state is transferred to the memory subsystem and what the input pulse shape to be engineered for perfect memory looks like. (paper)

Zero-dynamics principle for perfect quantum memory in linear networks

Science.gov (United States)

Yamamoto, Naoki; James, Matthew R.

2014-07-01

In this paper, we study a general linear networked system that contains a tunable memory subsystem; that is, it is decoupled from an optical field for state transportation during the storage process, while it couples to the field during the writing or reading process. The input is given by a single photon state or a coherent state in a pulsed light field. We then completely and explicitly characterize the condition required on the pulse shape achieving the perfect state transfer from the light field to the memory subsystem. The key idea to obtain this result is the use of zero-dynamics principle, which in our case means that, for perfect state transfer, the output field during the writing process must be a vacuum. A useful interpretation of the result in terms of the transfer function is also given. Moreover, a four-node network composed of atomic ensembles is studied as an example, demonstrating how the input field state is transferred to the memory subsystem and what the input pulse shape to be engineered for perfect memory looks like.

Mechanical Energy Changes in Perfectly Inelastic Collisions

Science.gov (United States)

Mungan, Carl E.

2013-01-01

Suppose a block of mass "m"[subscript 1] traveling at speed "v"[subscript 1] makes a one-dimensional perfectly inelastic collision with another block of mass "m"[subscript 2]. What else does one need to know to calculate the fraction of the mechanical energy that is dissipated in the collision? (Contains 1 figure.)

Maple Explorations, Perfect Numbers, and Mersenne Primes

Science.gov (United States)

Ghusayni, B.

2005-01-01

Some examples from different areas of mathematics are explored to give a working knowledge of the computer algebra system Maple. Perfect numbers and Mersenne primes, which have fascinated people for a very long time and continue to do so, are studied using Maple and some questions are posed that still await answers.

Thermodynamics of perfect fluids from scalar field theory

CERN Document Server

Ballesteros, Guillermo; Pilo, Luigi

2016-01-01

The low-energy dynamics of relativistic continuous media is given by a shift-symmetric effective theory of four scalar fields. These scalars describe the embedding in spacetime of the medium and play the role of Stuckelberg fields for spontaneously broken spatial and time translations. Perfect fluids are selected imposing a stronger symmetry group or reducing the field content to a single scalar. We explore the relation between the field theory description of perfect fluids to thermodynamics. By drawing the correspondence between the allowed operators at leading order in derivatives and the thermodynamic variables, we find that a complete thermodynamic picture requires the four Stuckelberg fields. We show that thermodynamic stability plus the null energy condition imply dynamical stability. We also argue that a consistent thermodynamic interpretation is not possible if any of the shift symmetries is explicitly broken.

Optimization of preparation of skilled wrestlers by perfection of method of the special preparation

Directory of Open Access Journals (Sweden)

Ogar' G.O.

2009-12-01

Full Text Available The author method of the special physical preparation of skilled fighters is presented. A method carries stage-by-stage character. On the first stage effectively to conduct the accented power training. On the second stage - to perfect explosive force. Tasks of the third stage are perfection of speed force and lactate component of energy supply. On the fourth stage the special is perfected speed-power endurance. The fifth stage coincides with beginning of competition period of macrocycle.

On the perfectness of C^{∞,s}-diffeomorphism groups on a foliated manifold

OpenAIRE

Jacek Lech

2008-01-01

The notion of \\(C^{r,s}\\) and \\(C^{\\infty,s}\\)-diffeomorphisms is introduced. It is shown that the identity component of the group of leaf preserving \\(C^{\\infty,s}\\)-diffeomorphisms with compact supports is perfect. This result is a modification of the Mather and Epstein perfectness theorem.

Perfect imaging with positive refraction in three dimensions

International Nuclear Information System (INIS)

Leonhardt, Ulf; Philbin, Thomas G.

2010-01-01

Maxwell's fish eye has been known to be a perfect lens within the validity range of ray optics since 1854. Solving Maxwell's equations, we show that the fish-eye lens in three dimensions has unlimited resolution for electromagnetic waves.

Family history, surgery, and APC mutation are risk factors for desmoid tumors in familial adenomatous polyposis: an international cohort study

DEFF Research Database (Denmark)

Nieuwenhuis, Marry H; Lefevre, Jérémie H; Bülow, Steffen

2011-01-01

Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice.......Ability to identify patients with familial adenomatous polyposis who have a high risk of developing desmoid tumors may affect decisions in clinical practice....

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.

Reshaping the perfect electrical conductor cylinder arbitrarily

International Nuclear Information System (INIS)

Chen Huanyang; Zhang Xiaohe; Luo Xudong; Ma Hongru; Chan Cheting

2008-01-01

A general method is proposed to design a cylindrical cloak, concentrator and superscatterer with an arbitrary cross section. The method is demonstrated by the design of a perfect electrical conductor (PEC) reshaper which is able to reshape a PEC cylinder arbitrarily by combining the concept of cloak, concentrator and superscatterer together. Numerical simulations are performed to demonstrate its properties.

Aversion to ambiguity and willingness to take risks affect therapeutic decisions in managing atrial fibrillation for stroke prevention: results of a pilot study in family physicians

Directory of Open Access Journals (Sweden)

Raptis S

2017-09-01

Full Text Available Stavroula Raptis,1,* Jia Ning Chen,2,* Florencia Saposnik,2 Roman Pelyavskyy,2 Andrew Liuni,3 Gustavo Saposnik2,4 On behalf of the Stroke Outcomes Research Canada Working Group (SORCan- www.sorcan.ca 1Applied Health Research Centre, Li Ka Shing Knowledge Institute, 2Stroke Outcomes and Decision Neuroscience Research Unit, Department of Medicine, St. Michael’s Hospital, University of Toronto, Toronto, 3Medical Department, Boehringer Ingelheim (Canada Ltd., Burlington, ON, Canada; 4Neuroeconomics and Decision Neuroscience, Department of Economics, University of Zurich, Zurich, Switzerland *These authors contributed equally to this work Background: Anticoagulation is the therapeutic paradigm for stroke prevention in patients with atrial fibrillation (AF. It is unknown how physicians make treatment decisions in primary stroke prevention for patients with AF. Objectives: To evaluate the association between family physicians’ risk preferences (aversion risk and ambiguity and therapeutic recommendations (anticoagulation in the management of AF for primary stroke prevention by applying concepts from behavioral economics. Methods: Overall, 73 family physicians participated and completed the study. Our study comprised seven simulated case vignettes, three behavioral experiments, and two validated surveys. Behavioral experiments and surveys incorporated an economic framework to determine risk preferences and biases (e.g., ambiguity aversion, willingness to take risks. The primary outcome was making the correct decision of anticoagulation therapy. Secondary outcomes included medical errors in the management of AF for stroke prevention. Results: Overall, 23.3% (17/73 of the family physicians elected not to escalate the therapy from antiplatelets to anticoagulation when recommended by best practice guidelines. A total of 67.1% of physicians selected the correct therapeutic options in two or more of the three simulated case vignettes. Multivariate

Surrogacy families 10 years on: relationship with the surrogate, decisions over disclosure and children's understanding of their surrogacy origins

Science.gov (United States)

Jadva, V.; Blake, L.; Casey, P.; Golombok, S.

2012-01-01

BACKGROUND This study aimed to prospectively examine families created using surrogacy over a 10-year period in the UK with respect to intending parents' and children's relationship with the surrogate mother, parents' decisions over disclosure and children's understanding of the nature of their conception. METHODS Semi-structured interviews were administered by trained researchers to intending mothers, intending fathers and children on four occasions over a 10-year period. Forty-two families (19 with a genetic surrogate mother) participated when the child was 1-year old and by age 10 years, 33 families remained in the study. Data were collected on the frequency of contact with the surrogate mother, relationship with the surrogate, disclosure of surrogacy to the child and the child's understanding of their surrogacy birth. RESULTS Frequency of contact between surrogacy families and their surrogate mother decreased over time, particularly for families whose surrogate was a previously unknown genetic carrier (P surrogate mother's egg was used to conceive the child). Most families reported harmonious relationships with their surrogate mother. At age 10 years, 19 (90%) children who had been informed of the nature of their conception had a good understanding of this and 13 of the 14 children who were in contact with their surrogate reported that they liked her. CONCLUSIONS Surrogacy families maintained good relationships with the surrogate mother over time. Children felt positive about their surrogate mother and their surrogacy birth. The sample size of this study was small and further, larger investigations are needed before firm conclusions can be drawn. PMID:22814484

Decision-making experiences of family members of older adults with moderate dementia towards community and residential care home services: a grounded theory study protocol.

Science.gov (United States)

Le Low, Lisa Pau; Lam, Lai Wah; Fan, Kim Pong

2017-06-05

Caring and supporting older people with dementia have become a major public health priority. Recent reports have also revealed a diminishing number of family carers to provide dementia care in the future. Carers who are engaged in the caring role are known to bear significant psychological, practical and economic challenges as the disease advances over time. Seemingly, evidence indicates that the burden of care can be relieved by formal services. This study aims to explore decision-making experiences of family members of older adults with moderate dementia towards the use of community support (CS) and residential care home (RCH) services. A large multi-site constructivist grounded theory in a range of non-government organizations and a private aged home will frame this Hong Kong study. Purposive sampling will begin the recruitment of family members, followed by theoretical sampling. It is estimated that more than 100 family members using CS and RCH services will participate in an interview. The process of successive constant comparative analysis will be undertaken. The final product, a theory, will generate an integrated and comprehensive conceptual understanding which will explain the processes associated with decision-making of family members for dementia sufferers. Deeper understanding of issues including, but not exclusive to, service needs, expectations and hopes among family carers for improving service support to serve dementia sufferers in CS and RCH services will also be revealed. Importantly, this study seeks to illustrate the practical and strategic aspects of the theory and how it may be useful to transfer its applicability to various service settings to better support those who deliver formal and informal care to the dementia population.

A perfect storm? Welfare, care, gender and generations in Uruguay.

Science.gov (United States)

Filgueira, Fernando; Gutiérrez, Magdalena; Papadópulos, Jorge

2011-01-01

This article claims that welfare states modelled on a contributory basis and with a system of entitlements that assumes stable two-parent families, a traditional breadwinner model, full formal employment and a relatively young age structure are profoundly flawed in the context of present-day challenges. While this is true for affluent countries modelled on the Bismarckian type of welfare system, the costs of the status quo are even more devastating in middle-income economies with high levels of inequality. A gendered approach to welfare reform that introduces the political economy and the economy of care and unpaid work is becoming critical to confront what may very well become a perfect storm for the welfare of these nations and their peoples. Through an in-depth study of the Uruguayan case, the authors show how the decoupling of risk and protection has torn asunder the efficacy of welfare devices in the country. An ageing society that has seen a radical transformation of its family and labour market landscapes, Uruguay maintained during the 1980s and 1990s a welfare state that was essentially contributory, elderly and male-oriented, and centred on cash entitlements. This contributed to the infantilization of poverty, increased the vulnerability of women and exacerbated fiscal stress for the system as a whole. Furthermore, because of high levels of income and asset inequality, the redistribution of risk between upper- and lower-income groups presented a deeply regressive pattern. The political economy of care and welfare has begun to change in the last decade or so, bringing about mild reforms in the right direction; but these might prove to be too little and too late.

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.

A linear construction of perfect secret sharing schemes

NARCIS (Netherlands)

Dijk, van M.; Santis, De A.

1995-01-01

In this paper, we generalize the vector space construction due to Brickell [5]. This generalization, introduced by Bertilsson [1], leads to perfect secret sharing schemes with rational information rates in which the secret can be computed efficiently by each qualified group. A one to one

Perfect pitch reconsidered.

Science.gov (United States)

Moulton, Calum

2014-10-01

Perfect pitch, or absolute pitch (AP), is defined as the ability to identify or produce the pitch of a sound without need for a reference pitch, and is generally regarded as a valuable asset to the musician. However, there has been no recent review of the literature examining its aetiology and its utility taking into account emerging scientific advances in AP research, notably in functional imaging. This review analyses the key empirical research on AP, focusing on genetic and neuroimaging studies. The review concludes that: AP probably has a genetic predisposition, although this is based on limited evidence; early musical training is almost certainly essential for AP acquisition; and, although there is evidence that it may be relevant to speech processing, AP can interfere with relative pitch, an ability on which humans rely to communicate effectively. The review calls into question the value of AP to musicians and non-musicians alike. © 2014 Royal College of Physicians.

On the Galois cohomology of unipotent groups and extensions of non-perfect fields

International Nuclear Information System (INIS)

Nguyen Duy Tan; Nguyen Quoc Thang

2006-12-01

In this note we discuss, in the case of unipotent groups over non-perfect fields, an analog of Serre's conjectures for unipotent algebraic group schemes, which relates properties of Galois (or flat) cohomology of unipotent group schemes to finite extensions of non-perfect fields, and Russel's defining equations of one-dimensional unipotent groups. (author)

The Influence of Family and Significant Others on Women's Decisions to Obtain an Abortion: A Study of a Northwest Louisiana Abortion Clinic

Science.gov (United States)

Solomon, Bertina Loutrice

2011-01-01

This study researched whether family members and significant others influence a woman's decision to obtain an abortion. Influence is defined by Merriam-Webster (2011) as the power or capacity of causing an effect in indirect or intangible ways; power exerted over the minds or behaviors of others. The theoretical framework that will be used in…

'Practical' resources to support patient and family engagement in healthcare decisions: a scoping review.

Science.gov (United States)

Kovacs Burns, Katharina; Bellows, Mandy; Eigenseher, Carol; Gallivan, Jennifer

2014-04-15

Extensive literature exists on public involvement or engagement, but what actual tools or guides exist that are practical, tested and easy to use specifically for initiating and implementing patient and family engagement, is uncertain. No comprehensive review and synthesis of general international published or grey literature on this specific topic was found. A systematic scoping review of published and grey literature is, therefore, appropriate for searching through the vast general engagement literature to identify 'patient/family engagement' tools and guides applicable in health organization decision-making, such as within Alberta Health Services in Alberta, Canada. This latter organization requested this search and review to inform the contents of a patient engagement resource kit for patients, providers and leaders. Search terms related to 'patient engagement', tools, guides, education and infrastructure or resources, were applied to published literature databases and grey literature search engines. Grey literature also included United States, Australia and Europe where most known public engagement practices exist, and Canada as the location for this study. Inclusion and exclusion criteria were set, and include: English documents referencing 'patient engagement' with specific criteria, and published between 1995 and 2011. For document analysis and synthesis, document analysis worksheets were used by three reviewers for the selected 224 published and 193 grey literature documents. Inter-rater reliability was ensured for the final reviews and syntheses of 76 published and 193 grey documents. Seven key themes emerged from the literature synthesis analysis, and were identified for patient, provider and/or leader groups. Articles/items within each theme were clustered under main topic areas of 'tools', 'education' and 'infrastructure'. The synthesis and findings in the literature include 15 different terms and definitions for 'patient engagement', 17 different

The intersubjectivity of family consumption

DEFF Research Database (Denmark)

Linnet, Jeppe Trolle

identity and family scape, I analyze how family members negotiate purchase decisions, and relate to each other’s preferences and desires, as well as those of other families. I consider how family members' interrelations as consumers and long-term negotiations over symbolic meanings of consumption......This study of everyday consumption is based on an ethnographic fieldwork conducted among four Danish middle-class families in Copenhagen, from which an illustrative example of family car purchase is drawn. By introducing two new concepts to the study of family consumption; intra-family consumer...

The Perfect Storm--Genetic Engineering, Science, and Ethics

Science.gov (United States)

Rollin, Bernard E.

2014-01-01

Uncertainty about ethics has been a major factor in societal rejection of biotechnology. Six factors help create a societal "perfect storm" regarding ethics and biotechnology: Social demand for ethical discussion; societal scientific illiteracy; poor social understanding of ethics; a "Gresham's Law for Ethics;" Scientific…

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

Quantum private query with perfect user privacy against a joint-measurement attack

Energy Technology Data Exchange (ETDEWEB)

Yang, Yu-Guang, E-mail: yangyang7357@bjut.edu.cn [College of Computer Science and Technology, Beijing University of Technology, Beijing 100124 (China); State Key Laboratory of Information Security, Institute of Information Engineering, Chinese Academy of Sciences, Beijing 100093 (China); Liu, Zhi-Chao [College of Computer Science and Technology, Beijing University of Technology, Beijing 100124 (China); Li, Jian [School of Computer, Beijing University of Posts and Telecommunications, Beijing 100876 (China); Chen, Xiu-Bo [Information Security Center, State Key Laboratory of Networking and Switching Technology, Beijing University of Posts and Telecommunications, Beijing, 100876 (China); Zuo, Hui-Juan [College of Mathematics and Information Science, Hebei Normal University, Shijiazhuang 050024 (China); Zhou, Yi-Hua; Shi, Wei-Min [College of Computer Science and Technology, Beijing University of Technology, Beijing 100124 (China)

2016-12-16

The joint-measurement (JM) attack is the most powerful threat to the database security for existing quantum-key-distribution (QKD)-based quantum private query (QPQ) protocols. Wei et al. (2016) [28] proposed a novel QPQ protocol against the JM attack. However, their protocol relies on two-way quantum communication thereby affecting its real implementation and communication efficiency. Moreover, it cannot ensure perfect user privacy. In this paper, we present a new one-way QPQ protocol in which the special way of classical post-processing of oblivious key ensures the security against the JM attack. Furthermore, it realizes perfect user privacy and lower complexity of communication. - Highlights: • A special classical post-processing ensures the security against the JM attack. • It ensures perfect user privacy. • It ensures lower complexity of communication. Alice's conclusive key rate is 1/6.

Quantum private query with perfect user privacy against a joint-measurement attack

International Nuclear Information System (INIS)

Yang, Yu-Guang; Liu, Zhi-Chao; Li, Jian; Chen, Xiu-Bo; Zuo, Hui-Juan; Zhou, Yi-Hua; Shi, Wei-Min

2016-01-01

The joint-measurement (JM) attack is the most powerful threat to the database security for existing quantum-key-distribution (QKD)-based quantum private query (QPQ) protocols. Wei et al. (2016) [28] proposed a novel QPQ protocol against the JM attack. However, their protocol relies on two-way quantum communication thereby affecting its real implementation and communication efficiency. Moreover, it cannot ensure perfect user privacy. In this paper, we present a new one-way QPQ protocol in which the special way of classical post-processing of oblivious key ensures the security against the JM attack. Furthermore, it realizes perfect user privacy and lower complexity of communication. - Highlights: • A special classical post-processing ensures the security against the JM attack. • It ensures perfect user privacy. • It ensures lower complexity of communication. Alice's conclusive key rate is 1/6.

Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

Directory of Open Access Journals (Sweden)

Dennis Drotar

2010-03-01

Full Text Available Dennis Drotar, Peggy Crawford, Margaret BonnerCincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USAAbstract: Collaborative or shared decision-making between health care providers and families can facilitate treatment adherence, health outcomes, and satisfaction with care in the management of pediatric chronic illness, but raises special challenges. Barriers such as authoritarian models of medical care as well as absence of time and opportunity for dialogue limit collaborative decision making and can disrupt treatment adherence. However, models of provider-family communication that emphasize communication and shared goal-setting inform an anticipatory guidance model of collaborative decision-making that can enhance treatment adherence. Salient challenges and strategies involved in implementing collaborative decision-making in pediatric chronic illness care are described. Research is needed to: 1 describe the communication and decision-making process in the management of pediatric chronic illness; and 2 evaluate the impact of interventions that enhance collaborative decision-making on provider-family communication, illness management, and treatment adherence.Keywords: collaborative decision-making, shared decision-making, treatment adherence, pediatric chronic illness

Analysis of experience of feet functions perfection in rhythmic gymnastic exercises

Directory of Open Access Journals (Sweden)

Nesterova T.V.

2009-10-01

Full Text Available Trainers and gymnasts take the problem of the special preparation feet and developments of method of its perfection to the number of the actual. The results of the pedagogical testing are shown that basic (basic, pushed, amortisation and specific (aesthetic, manipulation, integral functions feet have a different degree of display. They will be realized in exercises on all of the stages of long-term preparation of sportswomen. Most dynamic perfection of functions feet gymnasts take place on the stages of initial and preliminary base preparation.

The Decision-Making Process for Families Investing in Higher Education: A Family Systems Perspective

Science.gov (United States)

McHugh, Erin M.

2017-01-01

When families consider investing in their children's education they must weigh the perceived costs against the potential benefits, which becomes increasingly difficult as the cost of higher education continues to rise. Using a family systems approach, this phenomenological study explored the central research question, "How do families…

Spherically symmetric Einstein-aether perfect fluid models

Energy Technology Data Exchange (ETDEWEB)

Coley, Alan A.; Latta, Joey [Department of Mathematics and Statistics, Dalhousie University, Halifax, Nova Scotia, B3H 3J5 (Canada); Leon, Genly [Instituto de Física, Pontificia Universidad Católica de Valparaíso, Casilla 4950, Valparaíso (Chile); Sandin, Patrik, E-mail: aac@mathstat.dal.ca, E-mail: genly.leon@ucv.cl, E-mail: patrik.sandin@aei.mpg.de, E-mail: lattaj@mathstat.dal.ca [Max-Planck-Institut für Gravitationsphysik (Albert-Einstein-Institut), Am Mühlenberg 1, D-14476 Potsdam (Germany)

2015-12-01

We investigate spherically symmetric cosmological models in Einstein-aether theory with a tilted (non-comoving) perfect fluid source. We use a 1+3 frame formalism and adopt the comoving aether gauge to derive the evolution equations, which form a well-posed system of first order partial differential equations in two variables. We then introduce normalized variables. The formalism is particularly well-suited for numerical computations and the study of the qualitative properties of the models, which are also solutions of Horava gravity. We study the local stability of the equilibrium points of the resulting dynamical system corresponding to physically realistic inhomogeneous cosmological models and astrophysical objects with values for the parameters which are consistent with current constraints. In particular, we consider dust models in (β−) normalized variables and derive a reduced (closed) evolution system and we obtain the general evolution equations for the spatially homogeneous Kantowski-Sachs models using appropriate bounded normalized variables. We then analyse these models, with special emphasis on the future asymptotic behaviour for different values of the parameters. Finally, we investigate static models for a mixture of a (necessarily non-tilted) perfect fluid with a barotropic equations of state and a scalar field.

Identifying and Managing Undue Influence From Family Members in End-of-Life Decisions for Patients With Advanced Cancer.

Science.gov (United States)

Baker, Francis X; Gallagher, Colleen M

2017-10-01

Undue influence from family members of patients with advanced cancer remains a serious ethical problem in end-of-life decision making. Despite the wealth of articles discussing the problem of undue influence, little has been written by way of practical guidance to help clinicians identify and effectively manage situations of undue influence. This article briefly lays out how to identify and manage situations of undue influence sensitively and effectively. We explain how undue influence may present itself in the clinic and distinguish it from ethically permissible expressions of relational autonomy. In addition, we lay out a process by which any clinician suspecting undue influence may gather additional information and, if necessary, conduct a family meeting to address the undue influence. It is our hope that by providing clinicians at all levels of patient care with such guidance, they will feel empowered to respond to cases of undue influence when they arise.

Multi-mode competition in an FEL oscillator at perfect synchronism of an optical cavity

CERN Document Server

Dong, Z W; Kii, T; Yamazaki, T; Yoshikawa, K

2002-01-01

The sustained saturation in a short pulse free electron laser (FEL) oscillator at perfect synchronism of an optical cavity has been observed recently by Japan Atomic Energy Research Institute (JAERI) FEL group by using their super-conducting linac (Phys. Rev. Lett., in preparation). The experiments have clearly shown that FEL efficiency becomes maximum at perfect synchronism, although it has been considered that only a transient state exists at perfect synchronism due to the lethargy effect. Through careful analyses of the experimental condition of JAERI FEL, we found that, in spite of the short length of the electron micro-bunch, the saturation appears due to the following features, which were different from other FEL experiments: (1) very large ratio of the small signal gain to losses, (2) very long electron macro-bunch which can tolerate a slow start up. The saturation and high efficiency at perfect synchronism were benefited from the contribution of the weak sideband instability. In order to analyse these...

Scheme for achieving coherent perfect absorption by anisotropic metamaterials

KAUST Repository

Zhang, Xiujuan; Wu, Ying

2017-01-01

in conjunction with retrieval method to determine practical metamaterial absorbers. The scheme is scalable to frequencies and applicable to various incident angles. Numerical simulations show that perfect absorption is achieved in the designed absorbers over a

Family Health and Financial Literacy--Forging the Connection

Science.gov (United States)

Braun, Bonnie; Kim, Jinhee; Anderson, Elaine A.

2009-01-01

Families are at-risk of or experiencing a diminished quality of living and life in current economic times and difficult decisions are required. Health and financial literacy are the basis for wise personal and public decision making. Family and consumer sciences (FCS) professionals can forge connections between health and financial literacy to…

Decision making analysis of walnut seedling production on a small ...

African Journals Online (AJOL)

The decision has to be made between those three alternatives aiming at achievement of optimal/best economic result for the family farm. Summarizing results obtained from the decision tree, simulation and sensitivity analysis, the optimal solution for the family farm should be to continue production of walnut seedlings with ...

Perfect fluid cosmology with geodesic world lines

International Nuclear Information System (INIS)

Raychaudhuri, A.K.; Maity, S.R.

1978-01-01

It is shown that for a perfect fluid with an equation of state p = p (rho), if the world lines are geodesics, then they are hypersurface orthogonal and the scalars p, rho, sigma 2 , and theta 2 are all constants over these hypersurfaces, irrespective of any spatial-homogeneity assumption. However, an examination of some simple cases does not reveal any spatially nonhomogeneous solution with these properties

Another Class of Perfect Nonlinear Polynomial Functions

Directory of Open Access Journals (Sweden)

Menglong Su

2013-01-01

Full Text Available Perfect nonlinear (PN functions have been an interesting subject of study for a long time and have applications in coding theory, cryptography, combinatorial designs, and so on. In this paper, the planarity of the trinomials xpk+1+ux2+vx2pk over GF(p2k are presented. This class of PN functions are all EA-equivalent to x2.

INVESTIGATION OF MICROPROCESSOR CURRENT PROTECTION LINES WITH IMPROVED INDICES OF TECHNICAL PERFECTION

Directory of Open Access Journals (Sweden)

E. V. Buloichyk

2014-01-01

Full Text Available Technical perfection improvement of microprocessor current protection of distribution networks lines is provided by introduction of asymmetrical fault mode determination and fault location functions in the algorithm of its functioning. As a result of computing experiment the basic indices of the technical perfection of current protection have been obtained in the paper. The paper proves high efficiency of the proposed methods that ensure selective and proper operation in the different modes of the controlled line.

Physicians Perceptions of Shared Decision-Making in Neonatal and Pediatric Critical Care.

Science.gov (United States)

Richards, Claire A; Starks, Helene; O'Connor, M Rebecca; Bourget, Erica; Hays, Ross M; Doorenbos, Ardith Z

2018-04-01

Most children die in neonatal and pediatric intensive care units after decisions are made to withhold or withdraw life-sustaining treatments. These decisions can be challenging when there are different views about the child's best interest and when there is a lack of clarity about how best to also consider the interests of the family. To understand how neonatal and pediatric critical care physicians balance and integrate the interests of the child and family in decisions about life-sustaining treatments. Semistructured interviews were conducted with 22 physicians from neonatal, pediatric, and cardiothoracic intensive care units in a single quaternary care pediatric hospital. Transcribed interviews were analyzed using content and thematic analysis. We identified 3 main themes: (1) beliefs about child and family interests; (2) disagreement about the child's best interest; and (3) decision-making strategies, including limiting options, being directive, staying neutral, and allowing parents to come to their own conclusions. Physicians described challenges to implementing shared decision-making including unequal power and authority, clinical uncertainty, and complexity of balancing child and family interests. They acknowledged determining the level of engagement in shared decision-making with parents (vs routine engagement) based on their perceptions of the best interests of the child and parent. Due to power imbalances, families' values and preferences may not be integrated in decisions or families may be excluded from discussions about goals of care. We suggest that a systematic approach to identify parental preferences and needs for decisional roles and information may reduce variability in parental involvement.

Family Versus Public Solidarity : Theory and Experiment

NARCIS (Netherlands)

Güth, W.; Sutter, M.; Verbon, H.A.A.; Weck-Hannemann, H.

2001-01-01

We present an overlapping generations model with two families who can guarantee old age support either by intra-family transfers from child to parent or via a tax-financed public pension system encompassing both families.We derive the individually and family-specific optimal decisions and present

Is family planning an economic decision?

Science.gov (United States)

Wunderink, S R

1995-09-01

This study examines economic models of household choice and the role of economic factors in determining the timing of births. A static economic model is presented and tested with data from the Netherlands. After the availability of contraceptives, the family size variable shifted from being an exogenous to an endogenous one, because births could be regulated. Costs of childbearing were construed to have maintenance costs for parents and society, attendance costs of care, and intangible costs such as anxiety or personal freedom. Benefits were intangible ones, such as joy and happiness; income; public benefits; and attendance benefits. Intangible benefits enlarged the utility of children, but maintenance costs diminished resources available for consumption. Child quality was a product of market goods purchased by parents and others and household labor. Household time allocation varied with child's age. Private responsibility for children varied by country. Quality of child care varied between countries and over time. Quality was dependent upon economies of scale, variable costs by the age of the child, variable time commitments by age of the child, and market substitutes for private child care. Higher income families spent more money but less time on children. It is pointed out that Becker's model explained number of children, but not timing of births. Postponement of birth was unlikely for those with a limited education, an unpleasant job, and low wages. When the advantages and disadvantages of having a baby were positive, spouses or single women with a high subjective preference were expected to bear a child as soon as possible. Government policy can affect the average family size by increasing or decreasing the financial and/or time burden of children. Postponement may be chosen based on long term analysis of a couple's future, the formation and use of capital, and/or high subjective time preference. Before and after first birth are different frames of reference

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.

Key beliefs related to decisions for physical activity engagement among first-in-family students transitioning to university.

Science.gov (United States)

Cowie, Eloise; Hamilton, Kyra

2014-08-01

The current study investigated key beliefs related to decisions for physical activity (PA) engagement among first-in-family (FIF) students transitioning to university. FIF students (n = 157) completed an online questionnaire assessing standard theory of planned behaviour constructs and belief-based items. One week later, participants completed a follow-up questionnaire assessing self-reported PA during the previous week. Results identified a range of behavioural, normative, and control beliefs that were significantly correlated with both PA intention and behaviour. Various key beliefs were also identified in relation to FIF students' decisions to be regularly physically active, with behavioural beliefs such as "take up too much time", normative beliefs including "friends outside of university", and control beliefs such as "cost", identified. Finally, frequencies of those who strongly or fully accepted these beliefs were analysed, demonstrating that typically, a large number of FIF students did not hold the beliefs, and as such, these are relevant to target in resultant interventions. The current study effectively highlights a number of key beliefs that can be targeted in programs aimed at encouraging FIF students' PA. Further, the study addresses a gap in the literature of targeting FIF students, a cohort at risk for inactivity, and utilises a sound theoretical framework to identify the unique set of beliefs guiding decisions for PA for this at-risk community group.

Simulation of MILD combustion using Perfectly Stirred Reactor model

KAUST Repository

Chen, Z.; Vanteru, Mahendra Reddy; Ruan, S.; Doan, N. A K; Roberts, William L.; Swaminathan, N.

2016-01-01

A simple model based on a Perfectly Stirred Reactor (PSR) is proposed for moderate or intense low-oxygen dilution (MILD) combustion. The PSR calculation is performed covering the entire flammability range and the tabulated chemistry approach is used

Abundance and Characterization of Perfect Microsatellites on the Cattle Y Chromosome.

Science.gov (United States)

Ma, Zhi-Jie

2017-07-03

Microsatellites or simple sequence repeats (SSRs) are found in most organisms and play an important role in genomic organization and function. To characterize the abundance of SSRs (1-6 base-pairs [bp]) on the cattle Y chromsome, the relative frequency and density of perfect or uninterrupted SSRs based on the published Y chromosome sequence were examined. A total of 17,273 perfect SSRs were found, with total length of 324.78 kb, indicating that approximately 0.75% of the cattle Y chromosome sequence (43.30 Mb) comprises perfect SSRs, with an average length of 18.80 bp. The relative frequency and density were 398.92 loci/Mb and 7500.62 bp/Mb, respectively. The proportions of the six classes of perfect SSRs were highly variable on the cattle Y chromosome. Mononucleotide repeats had a total number of 8073 (46.74%) and an average length of 15.45 bp, and were the most abundant SSRs class, while the percentages of di-, tetra-, tri-, penta-, and hexa-nucleotide repeats were 22.86%, 11.98%, 11.58%, 6.65%, and 0.19%, respectively. Different classes of SSRs varied in their repeat number, with the highest being 42 for dinucleotides. Results reveal that repeat categories A, AC, AT, AAC, AGC, GTTT, CTTT, ATTT, and AACTG predominate on the Y chromosome. This study provides insight into the organization of cattle Y chromosome repetitive DNA, as well as information useful for developing more polymorphic cattle Y-chromosome-specific SSRs.

Understanding A.M. Iqbal’s Vision on Perfect Man

Directory of Open Access Journals (Sweden)

Imam Bahroni

2013-12-01

Full Text Available This article tries to elucidate A.M Iqbal’s vision on the concept of perfectman. Its significance is at the point that Man can transform both his being andhis surroundings according to his own desires and aspirations. He actually makesimprovements upon what is created by God. God created night, he inventedthe lamp; God created clay, and from it he made the cup; God created deserts,mountains, forests, orchards, gardens, and groves. He makes glass out of stoneand turns poison into an antidote. God created the world, but he made it morebeautiful.Iqbal’s reasoning amply justifies belief in the ascendancy of man overthe universe and his predicted perfection. The perfect man is the ultimate endof the revolutionary process, and he is developed out of the present man, justas the full moon is developed from the crescent.

Diamagnetic expansions for perfect quantum gases

DEFF Research Database (Denmark)

Briet, Philippe; Cornean, Horia; Louis, Delphine

2006-01-01

In this work we study the diamagnetic properties of a perfect quantum gas in the presence of a constant magnetic field of intensity B. We investigate the Gibbs semigroup associated with the one particle operator at finite volume, and study its Taylor series with respect to the field parameter ome......:=eB/c in different topologies. This allows us to prove the existence of the thermodynamic limit for the pressure and for all its derivatives with respect to omega (the so-called generalized susceptibilities)....

Simulation of a perfect CVD diamond Schottky diode steep forward current–voltage characteristic

Energy Technology Data Exchange (ETDEWEB)

Kukushkin, V.A., E-mail: vakuk@appl.sci-nnov.ru [Institute of Applied Physics of the Russian Academy of Science, 46 Ulyanov St., 603950 Nizhny Novgorod (Russian Federation); Nizhny Novgorod State University named after N.I. Lobachevsky, 23 Gagarin pr., 603950 Nizhny Novgorod (Russian Federation)

2016-10-01

The kinetic equation approach to the simulation of the perfect CVD diamond Schottky diode current–voltage characteristic is considered. In result it is shown that the latter has a significantly steeper forward branch than that of perfect devices of such a type on usual semiconductors. It means that CVD diamond-based Schottky diodes have an important potential advantage over analogous devices on conventional materials.

Bereaved relatives' decision about deceased organ donation: An integrated psycho-social study conducted in Spain.

Science.gov (United States)

López, Jorge S; Martínez, José M; Soria-Oliver, María; Aramayona, Begoña; García-Sánchez, Rubén; Martín, María J; Almendros, Carmen

2018-05-01

Family refusal to organ donation of a deceased relative represents one of the most important barriers to organ transplantation. Although a large literature about family decisions has amassed, the existing evidence needs further integration and structuring. This study seeks to analyse relationships between bereaved relatives' decisions and a wide range of factors that converge in the family decision process, including interactions and complex relationship patterns, and taking psychosocial theoretical frameworks as reference to conceptualize empirical findings. This observational study examined 16 Spanish hospitals during a 36-month period. Transplant coordination teams collected data of 421 cases of family decision processes about donation (338 donations/83 refusals) through a previously validated instrument. Indicators of the following factors were collected: deceased's characteristics; circumstances of death; bereaved relatives' characteristics, beliefs, and expressions; behaviour of health and coordination staff; and family's emotional responses. Three global hypotheses related to bivariate and multivariate relations of factors with family decisions and relationships/interactions among factors were tested. Relatives' beliefs about the deceased's wishes concerning donation are the strongest predictor of family decisions. However, family decisions are also related to the deceased's characteristics, relatives' characteristics, satisfaction with medical attention, satisfaction with personal treatment and relatives' emotional responses, and other factors. Relatives' emotional reactions are related to satisfaction with health-staff interventions and condition family decision, even if deceased's will concerning donation is known and positive. Relatives' beliefs about deceased's wishes concerning donation vary as a function of deceased's characteristics and according to relatives' characteristics. Understanding of family decisions underlying organ donation may greatly

Perfect coupling of light to a periodic dielectric/metal/dielectric structure

Science.gov (United States)

Wang, Zhengling; Li, Shiqiang; Chang, R. P. H.; Ketterson, John B.

2014-07-01

Using the finite difference time domain method, it is demonstrated that perfect coupling can be achieved between normally incident light and a periodic dielectric/metal/dielectric structure. The structure serves as a diffraction grating that excites modes related to the long range surface plasmon and short range surface plasmon modes that propagate on continuous metallic films. By optimizing the structural dimensions, perfect coupling is achieved between the incident light and these modes. A high Q of 697 and an accompanying ultrasharp linewidth of 0.8 nm are predicted for a 10 nm silver film for optimal conditions.

Agreement on Child Maltreatment Decisions: A Nonrandomized Study on the Effects of Structured Decision-Making

Science.gov (United States)

Bartelink, C.; van Yperen, T. A.; ten Berge, I. J.; de Kwaadsteniet, L.; Witteman, C. L. M.

2014-01-01

Background: Practitioners investigating cases of suspected child maltreatment often disagree whether a child is subject to or at risk of abuse or neglect in the family and, if so, what to do about such abuse or neglect. Structured decision-making is considered to be a solution to the problem of subjective judgments and decisions. Objective: This…

Perfect 2-colorings of the generalized Petersen graph

Indian Academy of Sciences (India)

It is obvious that GP(n, k) is a 3-regular connected graph. DEFINITION 2.2 ... vertex of color i, the number of its neighbors of color j is equal to aij . ... By the given conditions, we can see that a parameter matrix of a perfect 2-coloring of. GP(n, k) ...

Confronting School: Immigrant Families, Hope, Education

Science.gov (United States)

Amigó, María Florencia

2017-01-01

While children remain at the center of families' decisions to emigrate, the global contexts and technologies that allow diasporas to remain connected to their cultures have influenced families' aspirations in relation to their children's education. This article presents data from a qualitative study on how immigrant families negotiate the…

Who should make the decision on the use of GPS for people with dementia?

Science.gov (United States)

Landau, Ruth; Auslander, Gail K; Werner, Shirli; Shoval, Noam; Heinik, Jeremia

2011-01-01

In recent years advanced technologies, such as Global Positioning Systems (GPS), allow for tracking of human spatial activity and provide the ability to intervene to manage that activity. The purpose of this study is to examine the issue of who should decide about the use of electronic tracking using GPS for people with dementia. Based on quantitative data collected from 296 participants comprising cognitively intact elderly, family caregivers of people with dementia, social workers, other professionals, and social work students, study participants were asked to rate nine different potential decision-makers to make this decision. The results show that figures inside the family, particularly the spouse or the most involved family caregiver, were perceived more important in the decision-making process than figures outside the family, whereas the person with dementia was ranked third in the order of the figures. Since the decision to use GPS for tracking raises the ethical dilemma of personal safety versus autonomy and privacy of people with dementia, the findings seem to indicate that the reluctance of professional caregivers to assist family caregivers to make this decision is experienced as frustrating. The findings imply that in order to reach a balance between the wishes and interests of both people with dementia and their family caregivers, there is a need for more active involvement of the professional caregivers to facilitate the family decision-making process.

Exogenous empirical-evidence equilibria in perfect-monitoring repeated games yield correlated equilibria

KAUST Repository

Dudebout, Nicolas; Shamma, Jeff S.

2014-01-01

This paper proves that exogenous empirical-evidence equilibria (xEEEs) in perfect-monitoring repeated games induce correlated equilibria of the associated one-shot game. An empirical-evidence equilibrium (EEE) is a solution concept for stochastic games. At equilibrium, agents' strategies are optimal with respect to models of their opponents. These models satisfy a consistency condition with respect to the actual behavior of the opponents. As such, EEEs replace the full-rationality requirement of Nash equilibria by a consistency-based bounded-rationality one. In this paper, the framework of empirical evidence is summarized, with an emphasis on perfect-monitoring repeated games. A less constraining notion of consistency is introduced. The fact that an xEEE in a perfect-monitoring repeated game induces a correlated equilibrium on the underlying one-shot game is proven. This result and the new notion of consistency are illustrated on the hawk-dove game. Finally, a method to build specific correlated equilibria from xEEEs is derived.

Exogenous empirical-evidence equilibria in perfect-monitoring repeated games yield correlated equilibria

KAUST Repository

Dudebout, Nicolas

2014-12-15

This paper proves that exogenous empirical-evidence equilibria (xEEEs) in perfect-monitoring repeated games induce correlated equilibria of the associated one-shot game. An empirical-evidence equilibrium (EEE) is a solution concept for stochastic games. At equilibrium, agents\\' strategies are optimal with respect to models of their opponents. These models satisfy a consistency condition with respect to the actual behavior of the opponents. As such, EEEs replace the full-rationality requirement of Nash equilibria by a consistency-based bounded-rationality one. In this paper, the framework of empirical evidence is summarized, with an emphasis on perfect-monitoring repeated games. A less constraining notion of consistency is introduced. The fact that an xEEE in a perfect-monitoring repeated game induces a correlated equilibrium on the underlying one-shot game is proven. This result and the new notion of consistency are illustrated on the hawk-dove game. Finally, a method to build specific correlated equilibria from xEEEs is derived.

Metamaterials for perfect absorption

CERN Document Server

Lee, Young Pak; Yoo, Young Joon; Kim, Ki Won

2016-01-01

This book provides a comprehensive overview of the theory and practical development of metamaterial-based perfect absorbers (MMPAs). It begins with a brief history of MMPAs which reviews the various theoretical and experimental milestones in their development. The theoretical background and fundamental working principles of MMPAs are then discussed, providing the necessary background on how MMPAs work and are constructed. There then follows a section describing how different MMPAs are designed and built according to the operating frequency of the electromagnetic wave, and how their behavior is changed. Methods of fabricating and characterizing MMPAs are then presented. The book elaborates on the performance and characteristics of MMPAs, including electromagnetically-induced transparency (EIT). It also covers recent advances in MMPAs and their applications, including multi-band, broadband, tunability, polarization independence and incidence independence. Suitable for graduate students in optical sciences and e...

[Patient expectations about decision-making for various health problems].

Science.gov (United States)

Delgado, Ana; López-Fernández, Luis Andrés; de Dios Luna, Juan; Saletti Cuesta, Lorena; Gil Garrido, Natalia; Puga González, Almudena

2010-01-01

To identify patient expectations of clinical decision-making at consultations with their general practitioners for distinct health problems and to determine the patient and general practitioner characteristics related to these expectations, with special focus on gender. We performed a multicenter cross-sectional study in 360 patients who were interviewed at home. Data on patients' sociodemographic, clinical characteristics and satisfaction were gathered. General practitioners supplied information on their gender and postgraduate training in family medicine. A questionnaire was used to collect data on patients' expectations that their general practitioner account of their opinion and on expectations of clinical decision making> at consultations with their general practitioner for five problems or hypothetical clinical scenarios (strong chest pain/cold with fever/abnormal discharge/depression or sadness/severe family problem). Patients were asked to indicate their preference that decisions on diagnosis and treatment be taken by: a) the general practitioner alone; b) the general practitioner, taking account of the patient's opinion; c) the patient, taking account of the general practitioner's opinion and d) the patient alone. A logistic regression was performed for clinical decision-making. The response rate was 90%. The mean age was 47.3 + or - 16.5 years and 51% were female. Patients' expectations that their general practitioner listen, explain and take account of their opinions were higher than their expectations of participating in decision-making, depending on the problem in question: 32% wished to participate in chest pain and 49% in family problems. Women had lower expectations of participating in depression and family problems. Patients with female general practitioners had higher expectations of participating in family problems and colds. Most patients wished to be listened to, informed and taken into account by their general practitioners and, to a lesser

Scalar-metric quantum cosmology with Chaplygin gas and perfect fluid

Energy Technology Data Exchange (ETDEWEB)

Ghosh, Saumya; Panigrahi, Prasanta K. [Indian Institute of Science Education and Research Kolkata, Nadia, West Bengal (India); Gangopadhyay, Sunandan [Indian Institute of Science Education and Research Kolkata, Nadia, West Bengal (India); S.N. Bose National Centre for Basic Sciences, Kolkata (India)

2018-01-15

In this paper we consider the flat FRW cosmology with a scalar field coupled with the metric along with generalized Chaplygin gas and perfect fluid comprising the matter sector. We use the Schutz's formalism to deal with the generalized Chaplygin gas sector. The full theory is then quantized canonically using the Wheeler-DeWitt Hamiltonian formalism. We then solve the WD equation with appropriate boundary conditions. Then by defining a proper completeness relation for the self-adjointness of the WD equation we arrive at the wave packet for the universe. It is observed that the peak in the probability density gets affected due to both fluids in the matter sector, namely, the Chaplygin gas and perfect fluid. (orig.)

Tunable enhanced optical absorption of graphene using plasmonic perfect absorbers

Energy Technology Data Exchange (ETDEWEB)

Cai, Yijun [Institute of Optoelectronic Technology, Department of Electronic Engineering, Xiamen University, Xiamen 361005 (China); Institute of Electromagnetics and Acoustics, Department of Electronic Science, Xiamen University, Xiamen 361005 (China); Zhu, Jinfeng, E-mail: nanoantenna@hotmail.com [Institute of Electromagnetics and Acoustics, Department of Electronic Science, Xiamen University, Xiamen 361005 (China); Liu, Qing Huo [Department of Electrical and Computer Engineering, Duke University, Durham, North Carolina 27708 (United States)

2015-01-26

Enhancement and manipulation of light absorption in graphene is a significant issue for applications of graphene-based optoelectronic devices. In order to achieve this purpose in the visible region, we demonstrate a design of a graphene optical absorber inspired by metal-dielectric-metal metamaterial for perfect absorption of electromagnetic waves. The optical absorbance ratios of single and three atomic layer graphene are enhanced up to 37.5% and 64.8%, respectively. The graphene absorber shows polarization-dependence and tolerates a wide range of incident angles. Furthermore, the peak position and bandwidth of graphene absorption spectra are tunable in a wide wavelength range through a specific structural configuration. These results imply that graphene in combination with plasmonic perfect absorbers have a promising potential for developing advanced nanophotonic devices.

The Perfect Storm—Genetic Engineering, Science, and Ethics

Science.gov (United States)

Rollin, Bernard E.

2014-02-01

Uncertainty about ethics has been a major factor in societal rejection of biotechnology. Six factors help create a societal "perfect storm" regarding ethics and biotechnology: Social demand for ethical discussion; societal scientific illiteracy; poor social understanding of ethics; a "Gresham's Law for Ethics;" Scientific Ideology; vested interests dominating ethical discussion. How this can be remedied is discussed.

A Lightweight Anonymous Authentication Protocol with Perfect Forward Secrecy for Wireless Sensor Networks

Directory of Open Access Journals (Sweden)

Ling Xiong

2017-11-01

Full Text Available Due to their frequent use in unattended and hostile deployment environments, the security in wireless sensor networks (WSNs has attracted much interest in the past two decades. However, it remains a challenge to design a lightweight authentication protocol for WSNs because the designers are confronted with a series of desirable security requirements, e.g., user anonymity, perfect forward secrecy, resistance to de-synchronization attack. Recently, the authors presented two authentication schemes that attempt to provide user anonymity and to resist various known attacks. Unfortunately, in this work we shall show that user anonymity of the two schemes is achieved at the price of an impractical search operation—the gateway node may search for every possible value. Besides this defect, they are also prone to smart card loss attacks and have no provision for perfect forward secrecy. As our main contribution, a lightweight anonymous authentication scheme with perfect forward secrecy is designed, and what we believe the most interesting feature is that user anonymity, perfect forward secrecy, and resistance to de-synchronization attack can be achieved at the same time. As far as we know, it is extremely difficult to meet these security features simultaneously only using the lightweight operations, such as symmetric encryption/decryption and hash functions.

A Lightweight Anonymous Authentication Protocol with Perfect Forward Secrecy for Wireless Sensor Networks.

Science.gov (United States)

Xiong, Ling; Peng, Daiyuan; Peng, Tu; Liang, Hongbin; Liu, Zhicai

2017-11-21

Due to their frequent use in unattended and hostile deployment environments, the security in wireless sensor networks (WSNs) has attracted much interest in the past two decades. However, it remains a challenge to design a lightweight authentication protocol for WSNs because the designers are confronted with a series of desirable security requirements, e.g., user anonymity, perfect forward secrecy, resistance to de-synchronization attack. Recently, the authors presented two authentication schemes that attempt to provide user anonymity and to resist various known attacks. Unfortunately, in this work we shall show that user anonymity of the two schemes is achieved at the price of an impractical search operation-the gateway node may search for every possible value. Besides this defect, they are also prone to smart card loss attacks and have no provision for perfect forward secrecy. As our main contribution, a lightweight anonymous authentication scheme with perfect forward secrecy is designed, and what we believe the most interesting feature is that user anonymity, perfect forward secrecy, and resistance to de-synchronization attack can be achieved at the same time. As far as we know, it is extremely difficult to meet these security features simultaneously only using the lightweight operations, such as symmetric encryption/decryption and hash functions.

Recurrent network models for perfect temporal integration of fluctuating correlated inputs.

Directory of Open Access Journals (Sweden)

Hiroshi Okamoto

2009-06-01

Full Text Available Temporal integration of input is essential to the accumulation of information in various cognitive and behavioral processes, and gradually increasing neuronal activity, typically occurring within a range of seconds, is considered to reflect such computation by the brain. Some psychological evidence suggests that temporal integration by the brain is nearly perfect, that is, the integration is non-leaky, and the output of a neural integrator is accurately proportional to the strength of input. Neural mechanisms of perfect temporal integration, however, remain largely unknown. Here, we propose a recurrent network model of cortical neurons that perfectly integrates partially correlated, irregular input spike trains. We demonstrate that the rate of this temporal integration changes proportionately to the probability of spike coincidences in synaptic inputs. We analytically prove that this highly accurate integration of synaptic inputs emerges from integration of the variance of the fluctuating synaptic inputs, when their mean component is kept constant. Highly irregular neuronal firing and spike coincidences are the major features of cortical activity, but they have been separately addressed so far. Our results suggest that the efficient protocol of information integration by cortical networks essentially requires both features and hence is heterotic.

Methodic of perfection of higher pedagogical educational establishments girl students’ rhythm

Directory of Open Access Journals (Sweden)

A.N. Kolumbet

2016-06-01

Full Text Available Purpose: to study influence of methodic of rhythm perfection on girl students’ coordination abilities. Material: in the research 264 girl students participated. We assessed individual and collective rhythm, internal and external motor rhythm; rhythm in exercises with musical accompaniment. Results: we have determined that creative motor tasks require variable conditions for their realization. We have proved demand in appropriate criteria for their assessment. It is noted that there is a demand in development of rhythm, considering its main kinds and manifestations, which are formed with some peculiarities. Individual rhythm is determined by activation of attention and its level. It is perfected more successfully rather with stimulated development than with natural. It was found that with age the character of natural progressing of rhythm preserves. Conclusions: it is recommended to develop rhythm in compliance with its kinds and manifestations. Progressing and perfection of rhythm is a long lasted process and shall be realized during all period of girl students’ studying. Such approach forms girl students’ demand in finding of purposeful motor rhythm in all their new motor actions. It ensures optimality of their fulfillment.

Perfectly Reasonable in a Practical World: Understanding Chemistry Teacher Responses to a Change Proposal

Science.gov (United States)

Westbroek, Hanna; Janssen, Fred; Doyle, Walter

2017-12-01

Curriculum ideals often get compromised as a curriculum moves through its various levels of representation. Across the different science reforms, this process of slippage is clearly present. Research shows that teacher subject matter knowledge, PCK, beliefs and context factors all influence implementation. Professional development arrangements focus on fixing deficiencies in teachers' knowledge, beliefs or work context. This approach has not solved the problem of slippage, as we still do not understand what mechanisms operate when teachers make decisions about change proposals. In this study, we unpacked the decision mechanisms of three highly qualified chemistry teachers who subsequently adapted an innovative context-based chemistry unit. In spite of a state of the art professional development arrangement and the teachers being highly qualified, slippage occurred. The teachers' goal systems were used to interpret their reasoning. A goal system is a context-dependent, within-person mental construct that consists of a hierarchy of a person's goals and means in pursuit of a task. We showed that all three teachers adopted or redesigned elements of the change proposals to meet their core goals, i.e., goals that had multiple connections with other goals. This indicated that the adaptations teachers made were perfectly reasonable ways to serve their professional goals. For change to happen, we contend that one should begin with ways to connect teachers' core goals with the lesson or unit goal demands of a proposed innovation. Change emerges from the adaptions teachers make in the service of their core goals.

A corrugated perfect magnetic conductor surface supporting spoof surface magnon polaritons.

Science.gov (United States)

Liu, Liang-liang; Li, Zhuo; Gu, Chang-qing; Ning, Ping-ping; Xu, Bing-zheng; Niu, Zhen-yi; Zhao, Yong-jiu

2014-05-05

In this paper, we demonstrate that spoof surface magnon polaritons (SSMPs) can propagate along a corrugated perfect magnetic conductor (PMC) surface. From duality theorem, the existence of surface electromagnetic modes on corrugated PMC surfaces are manifest to be transverse electric (TE) mode compared with the transverse magnetic (TM) mode of spoof surface plasmon plaritons (SSPPs) excited on corrugated perfect electric conductor surfaces. Theoretical deduction through modal expansion method and simulation results clearly verify that SSMPs share the same dispersion relationship with the SSPPs. It is worth noting that this metamaterial will have more similar properties and potential applications as the SSPPs in large number of areas.

Family Influences on College Students' Occupational Identity

Science.gov (United States)

Berrios-Allison, Ana C.

2005-01-01

The occupational identity statuses of 232 college students were analyzed by examining their family emotional environment and the identity control processes that drive career decision making. Results of multivariate analysis showed that each family differentiation construct, family tolerance for connectedness, and separateness explained significant…

Shared Decision-Making for Cancer Care Among Racial and Ethnic Minorities: A Systematic Review

Science.gov (United States)

Mead, Erin L.; Doorenbos, Ardith Z.; Javid, Sara H.; Haozous, Emily A.; Alvord, Lori Arviso; Flum, David R.

2013-01-01

To assess decision-making for cancer treatment among racial/ethnic minority patients, we systematically reviewed and synthesized evidence from studies of “shared decision-making,” “cancer,” and “minority groups,” using PubMed, PsycInfo, CINAHL, and EMBASE. We identified significant themes that we compared across studies, refined, and organized into a conceptual model. Five major themes emerged: treatment decision-making, patient factors, family and important others, community, and provider factors. Thematic data overlapped categories, indicating that individuals’ preferences for medical decision-making cannot be authentically examined outside the context of family and community. The shared decision-making model should be expanded beyond the traditional patient–physician dyad to include other important stakeholders in the cancer treatment decision process, such as family or community leaders. PMID:24134353

A brief history of decision making.

Science.gov (United States)

Buchanan, Leigh; O'Connell, Andrew

2006-01-01

Sometime around the middle of the past century, telephone executive Chester Barnard imported the term decision making from public administration into the business world. There it began to replace narrower terms, like "resource allocation" and "policy making," shifting the way managers thought about their role from continuous, Hamlet-like deliberation toward a crisp series of conclusions reached and actions taken. Yet, decision making is, of course, a broad and ancient human pursuit, flowing back to a time when people sought guidance from the stars. From those earliest days, we have strived to invent better tools for the purpose, from the Hindu-Arabic systems for numbering and algebra, to Aristotle's systematic empiricism, to friar Occam's advances in logic, to Francis Bacon's inductive reasoning, to Descartes's application of the scientific method. A growing sophistication with managing risk, along with a nuanced understanding of human behavior and advances in technology that support and mimic cognitive processes, has improved decision making in many situations. Even so, the history of decision-making strategies--captured in this time line and examined in the four accompanying essays on risk, group dynamics, technology, and instinct--has not marched steadily toward perfect rationalism. Twentieth-century theorists showed that the costs of acquiring information lead executives to make do with only good-enough decisions. Worse, people decide against their own economic interests even when they know better. And in the absence of emotion, it's impossible to make any decisions at all. Erroneous framing, bounded awareness, excessive optimism: The debunking of Descartes's rational man threatens to swamp our confidence in our choices. Is it really surprising, then, that even as technology dramatically increases our access to information, Malcolm Gladwell extols the virtues of gut decisions made, literally, in the blink of an eye?

Intelligent Information System to support decision making.

Directory of Open Access Journals (Sweden)

Kathrin Rodríguez Llanes

2010-06-01

Full Text Available Making decisions is complicated in a generalized way, the materials and humans resources of the entity we belong to depends on it, such as the fulfillment of its goals. But when the situations are complex, making decisions turns into a very difficult work, due to the great amount of aspects to consider when making the right choice. To make this efficiently the administration must to consult an important volume of information, which generally, is scattered and in any different formats. That’s why appears the need of developing software that crowd together all that information and be capable of, by using powerful search engines and process algorithms improve the good decisions making process. Considering previous explanation, a complete freeware developed product is proposed, this constitutes a generic and multi-platform solution, that using artificial intelligence techniques, specifically the cases based reasoning, gives the possibility to leaders of any institution or organism of making the right choice in any situation.With client-server architecture, this system is consumed from web as a service and it can be perfectly integrated with a management system or the geographic information system to facilitate the business process.

Construction of Subgame-Perfect Mixed-Strategy Equilibria in Repeated Games

Directory of Open Access Journals (Sweden)

Kimmo Berg

2017-11-01

Full Text Available This paper examines how to construct subgame-perfect mixed-strategy equilibria in discounted repeated games with perfect monitoring. We introduce a relatively simple class of strategy profiles that are easy to compute and may give rise to a large set of equilibrium payoffs. These sets are called self-supporting sets, since the set itself provides the continuation payoffs that are required to support the equilibrium strategies. Moreover, the corresponding strategies are simple as the players face the same augmented game on each round but they play different mixed actions after each realized pure-action profile. We find that certain payoffs can be obtained in equilibrium with much lower discount factor values compared to pure strategies. The theory and the concepts are illustrated in 2 × 2 games.

Perfect Worlds : Utopian Fiction in China and the West

NARCIS (Netherlands)

Fokkema, Douwe

2011-01-01

Perfect Worlds biedt een uitgebreide historische analyse van utopische verhalen in de Chinese en Euro-Amerikaanse traditie. Aan bod komen onder meer de kritiek van Thomas More op Plato, de Europese oriëntalistische speurtocht naar utopieën in China en Chinese schrijvers die hun confucianistische

Perfect Worlds : Utopian Fiction in China and the West

NARCIS (Netherlands)

Fokkema, Douwe

2011-01-01

Perfect Worlds biedt een uitgebreide historische analyse van utopische verhalen in de Chinese en Euro-Amerikaanse traditie. Verschillende hoofdstukken gaan onder meer in op de kritiek van Thomas More op Plato, de Europese oriëntalistische speurtocht naar utopieën in China, Dostoevsky’s reactie op

The periphrastic perfect of Old Persian revisited (slides) [Dataset

NARCIS (Netherlands)

Bavant, M.J.J.

2011-01-01

The voice of the periphrastic perfect of Old Persian has long been a controversial issue. This document is a slide set to present the matter. It illustrates the contents of an article on the same theme: "Retour sur le parfait périphrastique du vieux perse".

Aversion to ambiguity and willingness to take risks affect therapeutic decisions in managing atrial fibrillation for stroke prevention: results of a pilot study in family physicians.

Science.gov (United States)

Raptis, Stavroula; Chen, Jia Ning; Saposnik, Florencia; Pelyavskyy, Roman; Liuni, Andrew; Saposnik, Gustavo

2017-01-01

Anticoagulation is the therapeutic paradigm for stroke prevention in patients with atrial fibrillation (AF). It is unknown how physicians make treatment decisions in primary stroke prevention for patients with AF. To evaluate the association between family physicians' risk preferences (aversion risk and ambiguity) and therapeutic recommendations (anticoagulation) in the management of AF for primary stroke prevention by applying concepts from behavioral economics. Overall, 73 family physicians participated and completed the study. Our study comprised seven simulated case vignettes, three behavioral experiments, and two validated surveys. Behavioral experiments and surveys incorporated an economic framework to determine risk preferences and biases (e.g., ambiguity aversion, willingness to take risks). The primary outcome was making the correct decision of anticoagulation therapy. Secondary outcomes included medical errors in the management of AF for stroke prevention. Overall, 23.3% (17/73) of the family physicians elected not to escalate the therapy from antiplatelets to anticoagulation when recommended by best practice guidelines. A total of 67.1% of physicians selected the correct therapeutic options in two or more of the three simulated case vignettes. Multivariate analysis showed that aversion to ambiguity was associated with appropriate change to anticoagulation therapy in the management of AF (OR 5.48, 95% CI 1.08-27.85). Physicians' willingness to take individual risk in multiple domains was associated with lower errors (OR 0.16, 95% CI 0.03-0.86). Physicians' aversion to ambiguity and willingness to take risks are associated with appropriate therapeutic decisions in the management of AF for primary stroke prevention. Further large scale studies are needed.

Impact of the World Health Organization's Decision-Making Tool for Family Planning Clients and Providers on the quality of family planning services in Iran.

Science.gov (United States)

Farrokh-Eslamlou, Hamidreza; Aghlmand, Siamak; Eslami, Mohammad; Homer, Caroline S E

2014-04-01

We investigated whether use of the World Health Organization's (WHO's) Decision-Making Tool (DMT) for Family Planning Clients and Providers would improve the process and outcome quality indicators of family planning (FP) services in Iran. The DMT was adapted for the Iranian setting. The study evaluated 24 FP quality key indicators grouped into two main areas, namely process and outcome. The tool was implemented in 52 urban and rural public health facilities in four selected and representative provinces of Iran. A pre-post methodology was undertaken to examine whether use of the tool improved the quality of FP services and client satisfaction with the services. Quantitative data were collected through observations of counselling and exit interviews with clients using structured questionnaires. Different numbers of FP clients were recruited during the baseline and the post-intervention rounds (n=448 vs 547, respectively). The DMT improved many client-provider interaction indicators, including verbal and non-verbal communication (p<0.05). The tool also impacted positively on the client's choice of contraceptive method, providers' technical competence, and quality of information provided to clients (p<0.05). Use of the tool improved the clients' satisfaction with FP services (from 72% to 99%; p<0.05). The adapted WHO's DMT has the potential to improve the quality of FP services.

Work, family, and happiness : essays on interdependencies within families, life events, and time allocation decisions

NARCIS (Netherlands)

Pouwels, B.

2011-01-01

In this thesis we investigate how today’s work and family life influence people’s happiness – or the lack thereof. We contribute to the research agenda by focusing on three underexplored issues in the literature, namely i) interdependencies within families, ii) life events, and iii) time allocation

Community Bioethics: The Health Decisions Community Council.

Science.gov (United States)

Gallegos, Tom; Mrgudic, Kate

1993-01-01

Sees health care decision making posing variety of complex issues for individuals, families, and providers. Describes Health Decisions Community Council (HDCC), community-based bioethics committee established to offer noninstitutional forum for discussion of health care dilemmas. Notes that social work skills and values for autonomy and…

Gauge freedom in perfect fluid spatially homogeneous spacetimes

International Nuclear Information System (INIS)

Jantzen, R.T.

1983-01-01

The class of reference systems compatible with the symmetry of a spatially homogeneous perfect fluid spacetime is discussed together with the associated class of symmetry adapted comoving ADM frames (or computational frames). The fluid equations of motion are related to the four functions on the space of fluid flow lines discovered by Taub and which characterize an isentropic flow. (Auth.)

Comment on 'Perfect imaging without negative refraction'

Science.gov (United States)

Blaikie, R. J.

2010-05-01

The prediction of 'perfect' imaging without negative refraction for Maxwell's fish-eye lens (Leonhardt U 2009 New J. Phys. 11 093040) is a consequence of imposing an active localized 'drain' at the image point rather than being a general property of the lens. This work then becomes analogous to other work using time-reversal symmetry and/or structured antennae to achieve super-resolution, which can be applied to many types of imaging system beyond the fish-eye lens.

Comment on 'Perfect imaging without negative refraction'

International Nuclear Information System (INIS)

Blaikie, R J

2010-01-01

The prediction of 'perfect' imaging without negative refraction for Maxwell's fish-eye lens (Leonhardt U 2009 New J. Phys. 11 093040) is a consequence of imposing an active localized 'drain' at the image point rather than being a general property of the lens. This work then becomes analogous to other work using time-reversal symmetry and/or structured antennae to achieve super-resolution, which can be applied to many types of imaging system beyond the fish-eye lens.

The TRIO Framework: Conceptual insights into family caregiver involvement and influence throughout cancer treatment decision-making.

Science.gov (United States)

Laidsaar-Powell, Rebekah; Butow, Phyllis; Charles, Cathy; Gafni, Amiram; Entwistle, Vikki; Epstein, Ronald; Juraskova, Ilona

2017-11-01

Family caregivers are regularly involved in cancer consultations and treatment decision-making (DM). Yet there is limited conceptual description of caregiver influence/involvement in DM. To address this, an empirically-grounded conceptual framework of triadic DM (TRIO Framework) and corresponding graphical aid (TRIO Triangle) were developed. Jabareen's model for conceptual framework development informed multiple phases of development/validation, incorporation of empirical research and theory, and iterative revisions by an expert advisory group. Findings coalesced into six empirically-grounded conceptual insights: i) Caregiver influence over a decision is variable amongst different groups; ii) Caregiver influence is variable within the one triad over time; iii) Caregivers are involved in various ways in the wider DM process; iv) DM is not only amongst three, but can occur among wider social networks; v) Many factors may affect the form and extent of caregiver involvement in DM; vi) Caregiver influence over, and involvement in, DM is linked to their everyday involvement in illness care/management. The TRIO Framework/Triangle may serve as a useful guide for future empirical, ethical and/or theoretical work. This Framework can deepen clinicians's and researcher's understanding of the diverse and varying scope of caregiver involvement and influence in DM. Copyright © 2017 Elsevier B.V. All rights reserved.

Male Involvement in Family Planning Decision Making in Ile-Ife ...

African Journals Online (AJOL)

Erah

ORIGINAL RESEARCH ARTICLE. Male Involvement ... However, fertility and family planning research and .... design, employing both quantitative and qualitative research .... Table 2: Types of family planning methods known to male residents ...

Enrolling adolescents in asthma research: adolescent, parent, and physician influence in the decision-making process.

Science.gov (United States)

Brody, Janet L; Annett, Robert D; Scherer, David G; Turner, Charles; Dalen, Jeanne

2009-06-01

The factors influencing family decisions to participate in adolescent asthma research are not well understood. Legal and ethical imperatives require adolescent research participation to be voluntary. While parents and adolescents often agree about research decisions, disagreements may also occur with relative frequency. Physician recommendations are also known to influence research participation decisions. Little attention has been given to how these dynamics may affect adolescents' involvement in decisions to participate in research. To examine the influence of family and physician-investigator relationships and recommendations on adolescent asthma clinical research participation decisions. A statewide community sample of 111 adolescents 11 to 17 years of age, with a diagnosis of asthma, and their parents participated in this study. Adolescents received a medical evaluation from an asthma specialist and then the family was offered participation in a hypothetical asthma clinical trial. By random assignment, the research study was presented by either the same or an unknown asthma specialist, and half the families in each group also received affirmative recommendations from the asthma specialist to participate in the hypothetical asthma clinical trial. Parents and adolescents made initial private decisions about participating in the trial. Then, following a family discussion of the clinical trial, a final research participation decision was made. Thirty-three percent of parents and adolescents initially disagreed about the research participation decision. When disagreements occurred, final decisions followed the parents' initial views except when the physician-investigator was known and a recommendation was made. Families with initial disagreement about participating were less likely to enroll when the investigator was unknown or when no recommendation was made. Adolescents who initially disagreed with parents' views were less likely to concur with the final research

FINANCIAL MANAGEMENT IN THE FAMILY AND NON-FAMILY SME´S IN THE TEXTILE INDUSTRY IN MEXICO

OpenAIRE

Martha Isabel Bojorquez Zapata; Antonio Emmanuel Perez Brito; Jorge Humberto Basulto Triay

2014-01-01

In this paper, we analyze differences in financial management practices between family and non-family Small and Medium Enterprises (SMEs) in the textile industry. We hypothesize that family SMEs use different sources of funding for new investments, tend to have less debt, are more profitable and use less financial and accounting information for decision making than non-family SMEs. We survey 24 textile SMEs located in Yucatan, Mexico. The results show that family SMEs rely more heavily on int...

Overemphasis on Perfectly Competitive Markets in Microeconomics Principles Textbooks

Science.gov (United States)

Hill, Roderick; Myatt, Anthony

2007-01-01

Microeconomic principles courses focus on perfectly competitive markets far more than other market structures. The authors examine five possible reasons for this but find none of them sufficiently compelling. They conclude that textbook authors should place more emphasis on how economists select appropriate models and test models' predictions…

Hypersurface-homogeneous Universe filled with perfect fluid in f ( R ...

Indian Academy of Sciences (India)

homogeneous Universe filled with perfect fluid in the framework of f ( R , T ) theory of gravity (Harko et al, \\emph{Phys. Rev.} D 84, 024020 (2011)) is derived. The physical behaviour of the cosmological model is studied.

Generation and characterization of a perfect vortex beam with a large topological charge through a digital micromirror device.

Science.gov (United States)

Chen, Yue; Fang, Zhao-Xiang; Ren, Yu-Xuan; Gong, Lei; Lu, Rong-De

2015-09-20

Optical vortices are associated with a spatial phase singularity. Such a beam with a vortex is valuable in optical microscopy, hyper-entanglement, and optical levitation. In these applications, vortex beams with a perfect circle shape and a large topological charge are highly desirable. But the generation of perfect vortices with high topological charges is challenging. We present a novel method to create perfect vortex beams with large topological charges using a digital micromirror device (DMD) through binary amplitude modulation and a narrow Gaussian approximation. The DMD with binary holograms encoding both the spatial amplitude and the phase could generate fast switchable, reconfigurable optical vortex beams with significantly high quality and fidelity. With either the binary Lee hologram or the superpixel binary encoding technique, we were able to generate the corresponding hologram with high fidelity and create a perfect vortex with topological charge as large as 90. The physical properties of the perfect vortex beam produced were characterized through measurements of propagation dynamics and the focusing fields. The measurements show good consistency with the theoretical simulation. The perfect vortex beam produced satisfies high-demand utilization in optical manipulation and control, momentum transfer, quantum computing, and biophotonics.

Accuracy of family history of cancer : clinical genetic implications

NARCIS (Netherlands)

Sijmons, RH; Boonstra, AE; Reefhuis, J; Hordijk-Hos, JM; de Walle, HEK; Oosterwijk, JC; Cornel, MC

Family medical history is the cornerstone of clinical genetic diagnosis and management in cases of familial cancer. The soundness of medical decisions can be compromised if reports by the family on affected relatives are inaccurate. Although very time consuming, family medical histories are

[Life lessons of eight families donating organs of deceased family members].

Science.gov (United States)

Avilés R, Lissette; Rivera M, M Soledad; Catoni S, María Isabel

2014-06-01

Most organ donors are already death. Therefore family members become an essential link in the final decision for organ donation. To get acquainted about the life lessons of people who accepted donating an organ of a deceased family member. Qualitative research, in depth interviews to eight families that accepted donating an organ of a deceased family member. The interviews were analyzed using the method proposed by Streubert et al and modified by Rivera. The life lessons are described in six comprehensive categories. The painful experience changed towards the feeling that the loved one remains alive. This sensation generated a sense of pride in family members and sensitized them towards the painful experience of other people. Therefore, a desire to help and improve as humans beings was awakened. A compassionate approach towards families donating organs with improve organ donation and humanize the process.

The Ideology of the Perfect Dictionary: How Efficient Can a ...

African Journals Online (AJOL)

friendly material which will improve both their fluency in and understanding of the target language, and embed acquired lexis in their long-term memory. Lexicographers, in their search for perfection and in compliance with users' wishes, are ...

Cognitive Learning Styles: Can You Engineer a "Perfect" Match?

Science.gov (United States)

Khuzzan, Sharifah Mazlina Syed; Goulding, Jack Steven

2016-01-01

Education and training is widely acknowledged as being one of the key factors for leveraging organisational success. However, it is equally acknowledged that skills development and the acquisition of learning through managed cognitive approaches has yet to provide a "perfect" match. Whilst it is argued that an ideal learning scenario…

Perfect and imperfect states

Directory of Open Access Journals (Sweden)

Nikitović Aleksandar

2013-01-01

Full Text Available Early Greek ethics embodied in Cretan and Spartan mores, served as a model for Plato`s political theory. Plato theorized the contents of early Greek ethics, aspiring to justify and revitalize the fundamental principles of a traditional view of the world. However, according to Plato`s new insight, deed is further from the truth than a thought i.e. theory. The dorian model had to renounce its position to the perfect prototype of a righteous state, which is a result of the inner logic of philosophical theorizing in early Greek ethics. Prototype and model of philosophical reflection, in comparison to philosophical theory, becomes minor and deficient. Philosophical theorizing of early Greek ethics philosophically formatted Greek heritage, initiating substantial changes to the content of traditional ethics. Replacement of the myth with ontology, as a new foundation of politics, transformed early Greek ethics in various relevant ways. [Projekat Ministarstva nauke Republike Srbije, br. 179049

Novel beam bunching methods by perfect crystals and electromagnetic means

International Nuclear Information System (INIS)

Rauch, H.

1985-01-01

The use of perfect crystals for installing new neutron small-angle scattering cameras provides advantages for measurements in the small Q-range and for real-time experiments. A neutron resonator is proposed which is based on the combination of perfect crystal back-reflections in Zeman energy splitting. The neutron magnetic resonance system in combination with gated crystals can act as a pumping unit for neutrons and as a new pulse-shaping unit. It is shown how travelling magnetic waves can act as powerful neutron bunching units. The achievable velocity changes are around 5 m/s and, therefore, by a factor of 100 larger than in the case of neutron magnetic resonance systems. The advantage of expanding potentials for focusing neutrons from a source with a long pulse duration becomes obvious. Real gain factors higher than 10 are expected for properly designed systems. (author)

Ultra-broadband and wide-angle perfect absorber based on composite metal-semiconductor grating

Science.gov (United States)

Li, Xu; Wang, Zongpeng; Hou, Yumin

2018-01-01

In this letter, we present an ultra-broadband and wide-angle perfect absorber based on composite Ge-Ni grating. Near perfect absorption above 90% is achieved in a wide frequency range from 150 nm to 4200 nm, which covers almost the full spectrum of solar radiation. The absorption keeps robust in a wide range of incident angle from 0º to 60º. The upper triangle Ge grating works as an antireflection coating. The lower Ni grating works as a reflector and an effective energy trapper. The guided modes inside Ge grating are excited due to reflection of the lower Ni grating surface. In longer wavelength band, gap surface plasmons (GSPs) in the Ni grating are excited and couple with the guided modes inside the Ge grating. The coupled modes extend the perfect absorption band to the near-infrared region (150 nm-4200 nm). This design has potential application in photovoltaic devices and thermal emitters.

The Gaze of the Perfect Search Engine: Google as an Infrastructure of Dataveillance

Science.gov (United States)

Zimmer, M.

Web search engines have emerged as a ubiquitous and vital tool for the successful navigation of the growing online informational sphere. The goal of the world's largest search engine, Google, is to "organize the world's information and make it universally accessible and useful" and to create the "perfect search engine" that provides only intuitive, personalized, and relevant results. While intended to enhance intellectual mobility in the online sphere, this chapter reveals that the quest for the perfect search engine requires the widespread monitoring and aggregation of a users' online personal and intellectual activities, threatening the values the perfect search engines were designed to sustain. It argues that these search-based infrastructures of dataveillance contribute to a rapidly emerging "soft cage" of everyday digital surveillance, where they, like other dataveillance technologies before them, contribute to the curtailing of individual freedom, affect users' sense of self, and present issues of deep discrimination and social justice.

Economic decision-models for climate adaptation: a survey; Ekonomiska verktyg som beslutsstoed i klimatanpassningsarbetet: en metodoeversikt

Energy Technology Data Exchange (ETDEWEB)

Kaagebro, Elin; Vredin Johansson, Maria

2008-05-15

Several of the adaptations to the climate change we are about to experience will occur successively and voluntarily in response to the climate change experienced. In many cases these adaptations will work perfectly but, for investments and activities with relatively long life-times (say more than 25 years) and for investments and activities that are sensitive to climate extremes, climate change requires increased planning and foresight. In these situations economic decision models can aid the decision-makers through providing well-founded bases for the decisions, as well as tools for prioritizations. In this report we describe the most common economic decision-models: cost-benefit analysis (CBA), cost-effectiveness analysis (CEA) and multi-criteria analysis (MCA). The descriptions will form a foundation for the continuing work on generating tools that can be useful for local decision-makers in their pursuit of coping with climate change within the Climatools programme

Quantum Type Indeterminacy in Dynamic Decision-Making: Self-Control through Identity Management

Directory of Open Access Journals (Sweden)

Jerome Busemeyer

2012-05-01

Full Text Available The Type Indeterminacy model is a theoretical framework that uses some elements of quantum formalism to model the constructive preference perspective suggested by Kahneman and Tversky. In a dynamic decision context, type indeterminacy induces a game with multiple selves associated with a state transition process. We define a Markov perfect equilibrium among the selves with individual identity (preferences as the state variable. The approach allows to characterize generic personality types and derive some comparative static results.

Perspectives of Korean Patients, Families, Physicians and Nurses on Advance Directives

Directory of Open Access Journals (Sweden)

Jia Lee, PhD, RN

2010-12-01

Conclusions: There were many differences in the perspectives of patients, families, physicians and nurses on advance directives. End-of-life care decisions should take the wishes of patients into account, and that such decisions should therefore be made before the patients lose the capacity to make them. To make well-informed decisions regarding future care, patients and families must be fully educated about advance directives and expected outcomes.

Structured decision making for managing pneumonia epizootics in bighorn sheep

Science.gov (United States)

Sells, Sarah N.; Mitchell, Michael S.; Edwards, Victoria L.; Gude, Justin A.; Anderson, Neil J.

2016-01-01

Good decision-making is essential to conserving wildlife populations. Although there may be multiple ways to address a problem, perfect solutions rarely exist. Managers are therefore tasked with identifying decisions that will best achieve desired outcomes. Structured decision making (SDM) is a method of decision analysis used to identify the most effective, efficient, and realistic decisions while accounting for values and priorities of the decision maker. The stepwise process includes identifying the management problem, defining objectives for solving the problem, developing alternative approaches to achieve the objectives, and formally evaluating which alternative is most likely to accomplish the objectives. The SDM process can be more effective than informal decision-making because it provides a transparent way to quantitatively evaluate decisions for addressing multiple management objectives while incorporating science, uncertainty, and risk tolerance. To illustrate the application of this process to a management need, we present an SDM-based decision tool developed to identify optimal decisions for proactively managing risk of pneumonia epizootics in bighorn sheep (Ovis canadensis) in Montana. Pneumonia epizootics are a major challenge for managers due to long-term impacts to herds, epistemic uncertainty in timing and location of future epizootics, and consequent difficulty knowing how or when to manage risk. The decision tool facilitates analysis of alternative decisions for how to manage herds based on predictions from a risk model, herd-specific objectives, and predicted costs and benefits of each alternative. Decision analyses for 2 example herds revealed that meeting management objectives necessitates specific approaches unique to each herd. The analyses showed how and under what circumstances the alternatives are optimal compared to other approaches and current management. Managers can be confident that these decisions are effective, efficient, and

Family Over Rules? An Ethical Analysis of Allowing Families to Overrule Donation Intentions.

Science.gov (United States)

Shaw, David; Georgieva, Denie; Haase, Bernadette; Gardiner, Dale; Lewis, Penney; Jansen, Nichon; Wind, Tineke; Samuel, Undine; McDonald, Maryon; Ploeg, Rutger

2017-03-01

Millions of people want to donate their organs after they die for transplantation, and many of them have registered their wish to do so or told their family and friends about their decision. For most of them, however, this wish is unlikely to be fulfilled, as only a small number of deaths (1% in the United Kingdom) occur in circumstances where the opportunity to donate organs is possible. Even for those who do die in the "right" way and have recorded their wishes or live in a jurisdiction with a "presumed consent" system, donation often does not go ahead because of another issue: their families refuse to allow donation to proceed. In some jurisdictions, the rate of "family overrule" is over 10%. In this article, we provide a systematic ethical analysis of the family overrule of donation of solid organs by deceased patients, and examine arguments both in favor of and against allowing relatives to "veto" the potential donor's intentions. First, we provide a brief review of the different consent systems in various European countries, and the ramifications for family overrule. Next, we describe and discuss the arguments in favor of permitting donation intentions to be overruled, and then the arguments against doing so. The "pro" arguments are: overrule minimises family distress and staff stress; families need to cooperate for donation to take place; families might have evidence regarding refusal; and failure to permit overrules could weaken trust in the donation system. The "con" arguments are: overrule violates the patient's wishes; the family is too distressed and will regret the decision; overruling harms other patients; and regulations prohibit overrule. We conclude with a general discussion and recommendations for dealing with families who wish to overrule donation. Overall, overrule should only rarely be permitted.

Are groups more rational than individuals? A review of interactive decision making in groups.

Science.gov (United States)

Kugler, Tamar; Kausel, Edgar E; Kocher, Martin G

2012-07-01

Many decisions are interactive; the outcome of one party depends not only on its decisions or on acts of nature but also on the decisions of others. Standard game theory assumes that individuals are rational, self-interested decision makers-that is, decision makers are selfish, perfect calculators, and flawless executors of their strategies. A myriad of studies shows that these assumptions are problematic, at least when examining decisions made by individuals. In this article, we review the literature of the last 25 years on decision making by groups. Researchers have compared the strategic behavior of groups and individuals in many games: prisoner's dilemma, dictator, ultimatum, trust, centipede and principal-agent games, among others. Our review suggests that results are quite consistent in revealing that group decisions are closer to the game-theoretic assumption of rationality than individual decisions. Given that many real-world decisions are made by groups, it is possible to argue that standard game theory is a better descriptive model than previously believed by experimental researchers. We conclude by discussing future research avenues in this area. WIREs Cogn Sci 2012, 3:471-482. doi: 10.1002/wcs.1184 For further resources related to this article, please visit the WIREs website. Copyright © 2012 John Wiley & Sons, Ltd.

A simple route to scalable fabrication of perfectly ordered ZnO nanorod arrays

International Nuclear Information System (INIS)

Liu, D F; Xiang, Y J; Liao, Q; Zhang, J P; Wu, X C; Zhang, Z X; Liu, L F; Ma, W J; Shen, J; Zhou, W Y; Xie, S S

2007-01-01

ZnO nanorod arrays with perfect order and uniformity were prepared using a simple, low-cost, commonly available and scalable nanosphere lithography for patterning gold catalyst particles and a successive bottom-up growth technique in a tube furnace chemical vapor deposition system. Each rod in the arrays had perfect surface facets, sharp edges and uniform size. For all of the rods, their sides were oriented the same. This bottom-up assembly method may accelerate the use of ZnO nanorods in real device applications

Couples' fertility decision-making

Directory of Open Access Journals (Sweden)

Petra Stein

2014-06-01

Full Text Available Background: The decision about whether to start a family within a partnership can be viewed as a result of an interaction process. The influence of each of the partners in a couple differs depending on their individual preferences and intentions towards having children. Both of the partners additionally influence each other's fertility intentions and preferences. Objective: We specify, estimate, and test a model that examines the decision about whether to have a child as a choice that is made jointly by the two partners. The transition to the birth of a (further child is investigated with the explicit consideration of both the female partner and the male partner in the partnership context. Methods: An approach for modelling the interactive influences of the two actors in the decision-making process was proposed. A trivariate distribution consisting of both the female and the male partners' fertility intentions, as well as the joint generative decision, was modelled. A multivariate non-linear probit model was chosen and the problem of identification in estimating the relative effects of the actors was resolved. These parameters were used to assess the relative importance of each of the partners' intentions in the decision. We carried out the analysis with MPLUS. Data from the panel of intimate relationships and family dynamics (pairfam was used to estimate the model. Results: The biographical context of each of the partners in relation to their own as well as to their partner's fertility intentions was found to be of considerable importance. Of the significant individual and partner effects, the male partner was shown to have the greater influence. But the female partner was found to have stronger parameters overall and she ultimately has a veto power in the couple's final decision.

Polytropic solutions of a perfect fluid in spatial n-dimensions

International Nuclear Information System (INIS)

Luiz, Fabricio Casarejos Lopes; Rocha, Jaime F. Villas da

2005-01-01

We found all the solutions of a polytropic state equation for a n-dimensional metric associated to a perfect fluid. Some of them represent gravitational collapse with black hole or naked singularity formation. We found also an accelerating cosmological model. (author)

An improved perfectly matched layer in the eigenmode expansion technique

DEFF Research Database (Denmark)

Gregersen, Niels; Mørk, Jesper

2008-01-01

When employing the eigenmode expansion technique (EET), parasitic reflections at the boundary of the computational domain can be suppressed by introducing a perfectly matched layer (PML). However, the traditional PML, suffers from an artificial field divergence limiting its usefulness. We propose...

Comparison among perfect-C®, zero-P®, and plates with a cage in single-level cervical degenerative disc disease.

Science.gov (United States)

Noh, Sung Hyun; Zhang, Ho Yeol

2018-01-25

We intended to analyze the efficacy of a new integrated cage and plate device called Perfect-C for anterior cervical discectomy and fusion (ACDF) to cure single-level cervical degenerative disc disease. We enrolled 148 patients who were subjected to single-level ACDF with one of the following three surgical devices: a Perfect-C implant (41 patients), a Zero-P implant (36 patients), or a titanium plate with a polyetheretherketone (PEEK) cage (71 patients). We conducted a retrospective study to compare the clinical and radiological results among the three groups. The length of the operation, intraoperative blood loss, and duration of hospitalization were significantly lower in the Perfect-C group than in the Zero-P and plate-with-cage groups (P Zero-P groups but was noted in 21 cases (30%) in the plate-with-cage group. The cephalad and caudal plate-to-disc distance (PDD) and the cephalad and caudal PDD/anterior body height (ABH) were significantly greater in the Perfect-C and Zero-P groups than in the plate-with-cage group (P Zero-P group, and in 15 cases (21%) in the plate-with-cage group. Fusion occurred in 37 cases (90%) in the Perfect-C group, in 31 cases (86%) in the Zero-P group, and in 68 cases (95%) in the plate-with-cage group. The Perfect-C, Zero-P, and plate-with-cage devices are effective for treating single-level cervical degenerative disc disease. However, the Perfect-C implant has many advantages over both the Zero-P implant and conventional plate-cage treatments. The Perfect-C implant was associated with shorter operation times and hospitalization durations, less blood loss, and lower subsidence rates compared with the Zero-P implant or the titanium plate with a PEEK cage.

Free education in Sri Lanka. Does it eliminate the family effect?

NARCIS (Netherlands)

Hartog, J.; Ranasinghe, A.

2002-01-01

Using the human capital theory we modelled and estimated the school enrolment and the length of schooling decisions of Sri Lankans. Our results show a very clear positive association between family background and the education decision. Children of affluent families seem to derive more benefits from

Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitative study.

Directory of Open Access Journals (Sweden)

Madeleine J Murtagh

Full Text Available Stroke is a leading cause of disability. Early treatment of acute ischaemic stroke with rtPA reduces the risk of longer term dependency but carries an increased risk of causing immediate bleeding complications. To understand the challenges of knowledge translation and decision making about treatment with rtPA in hyperacute stroke and hence to inform development of appropriate decision support we interviewed patients, their family and health professionals. The emergency setting and the symptomatic effects of hyper-acute stroke shaped the form, content and manner of knowledge translation to support decision making. Decision making about rtPA in hyperacute stroke presented three conundrums for patients, family and clinicians. 1 How to allow time for reflection in a severely time-limited setting. 2 How to facilitate knowledge translation regarding important treatment risks and benefits when patient and family capacity is blunted by the effects and shock of stroke. 3 How to ensure patient and family views are taken into account when the situation produces reliance on the expertise of clinicians. Strategies adopted to meet these conundrums were fourfold: face to face communication; shaping decisions; incremental provision of information; and communication tailored to the individual patient. Relational forms of interaction were understood to engender trust and allay anxiety. Shaping decisions with patients was understood as an expression of confidence by clinicians that helped alleviate anxiety and offered hope and reassurance to patients and their family experiencing the shock of the stroke event. Neutral presentations of information and treatment options promoted uncertainty and contributed to anxiety. 'Drip feeding' information created moments for reflection: clinicians literally made time. Tailoring information to the particular patient and family situation allowed clinicians to account for social and emotional contexts. The principal responses to

Situationally-sensitive knowledge translation and relational decision making in hyperacute stroke: a qualitative study.

Science.gov (United States)

Murtagh, Madeleine J; Burges Watson, Duika L; Jenkings, K Neil; Lie, Mabel L S; Mackintosh, Joan E; Ford, Gary A; Thomson, Richard G

2012-01-01

Stroke is a leading cause of disability. Early treatment of acute ischaemic stroke with rtPA reduces the risk of longer term dependency but carries an increased risk of causing immediate bleeding complications. To understand the challenges of knowledge translation and decision making about treatment with rtPA in hyperacute stroke and hence to inform development of appropriate decision support we interviewed patients, their family and health professionals. The emergency setting and the symptomatic effects of hyper-acute stroke shaped the form, content and manner of knowledge translation to support decision making. Decision making about rtPA in hyperacute stroke presented three conundrums for patients, family and clinicians. 1) How to allow time for reflection in a severely time-limited setting. 2) How to facilitate knowledge translation regarding important treatment risks and benefits when patient and family capacity is blunted by the effects and shock of stroke. 3) How to ensure patient and family views are taken into account when the situation produces reliance on the expertise of clinicians. Strategies adopted to meet these conundrums were fourfold: face to face communication; shaping decisions; incremental provision of information; and communication tailored to the individual patient. Relational forms of interaction were understood to engender trust and allay anxiety. Shaping decisions with patients was understood as an expression of confidence by clinicians that helped alleviate anxiety and offered hope and reassurance to patients and their family experiencing the shock of the stroke event. Neutral presentations of information and treatment options promoted uncertainty and contributed to anxiety. 'Drip feeding' information created moments for reflection: clinicians literally made time. Tailoring information to the particular patient and family situation allowed clinicians to account for social and emotional contexts. The principal responses to the challenges of

Incapacitated decision making power, over emphasized obedience and its exclusionary effects on children

Directory of Open Access Journals (Sweden)

Asad Ullah

2016-12-01

Full Text Available The aim of this paper is limited to the exclusionary effects of poor decision making power on children. A total of 500 children from both genders were selected by systematic sampling technique and interviewed, from seven shopping streets and seven high schools of the District Peshawar. Likert scale was used as measurement tool besides, using Chi-square test and Kendall’s Tau-b tests to check the strength and direction of association between social exclusion and decision making power. Relationship of social exclusion was significant and negative with feeling one’s self influential in molding family level decision, having membership of any organization, liberty in choice of sport, liberty in choice of dress/shoes and people listen to child’s views. At multivariate level the association of social exclusion in male and female children varied by means of power of decision making. Likewise, results of groups based on religious affiliations indicated a spurious relationship between power of making decision in children and their social exclusion. However, result of groups based on joint and nuclear family affiliation indicated a non-spurious relationship between power of making decision in children and their social exclusion; conversely, single parent family group had a spurious relationship with above two groups. Contrariwise, result of groups based on sufficiency of family income indicated a non-spurious relationship between power of making decision in children and their social exclusion. A welfare state while safeguarding employment to all income segments, ensuring child’s constructive social participation at family and community level activities, reintegration of family role in child’s physical, social and psychological care and socialization, and overcoming gender and religion based disparities in the society were some of the policy recommendations in light of the study.

Pityriasis Rotunda: A Case Report of Familial Disease in an American-Born Black Patient

Directory of Open Access Journals (Sweden)

Emily G. Lefkowitz

2016-03-01

Full Text Available Pityriasis rotunda is an uncommon dermatosis with an unusual geographic and racial distribution. The skin disorder is characterized by sharply defined, perfectly circular, scaly patches with no inflammatory changes. Notably, it may be associated with underlying malignancy or chronic infection. We report an uncommon familial case in an American-born female.

A Monte-Carlo game theoretic approach for Multi-Criteria Decision Making under uncertainty

Science.gov (United States)

Madani, Kaveh; Lund, Jay R.

2011-05-01

Game theory provides a useful framework for studying Multi-Criteria Decision Making problems. This paper suggests modeling Multi-Criteria Decision Making problems as strategic games and solving them using non-cooperative game theory concepts. The suggested method can be used to prescribe non-dominated solutions and also can be used as a method to predict the outcome of a decision making problem. Non-cooperative stability definitions for solving the games allow consideration of non-cooperative behaviors, often neglected by other methods which assume perfect cooperation among decision makers. To deal with the uncertainty in input variables a Monte-Carlo Game Theory (MCGT) approach is suggested which maps the stochastic problem into many deterministic strategic games. The games are solved using non-cooperative stability definitions and the results include possible effects of uncertainty in input variables on outcomes. The method can handle multi-criteria multi-decision-maker problems with uncertainty. The suggested method does not require criteria weighting, developing a compound decision objective, and accurate quantitative (cardinal) information as it simplifies the decision analysis by solving problems based on qualitative (ordinal) information, reducing the computational burden substantially. The MCGT method is applied to analyze California's Sacramento-San Joaquin Delta problem. The suggested method provides insights, identifies non-dominated alternatives, and predicts likely decision outcomes.

Policy implications for familial searching.

Science.gov (United States)

Kim, Joyce; Mammo, Danny; Siegel, Marni B; Katsanis, Sara H

2011-11-01

In the United States, several states have made policy decisions regarding whether and how to use familial searching of the Combined DNA Index System (CODIS) database in criminal investigations. Familial searching pushes DNA typing beyond merely identifying individuals to detecting genetic relatedness, an application previously reserved for missing persons identifications and custody battles. The intentional search of CODIS for partial matches to an item of evidence offers law enforcement agencies a powerful tool for developing investigative leads, apprehending criminals, revitalizing cold cases and exonerating wrongfully convicted individuals. As familial searching involves a range of logistical, social, ethical and legal considerations, states are now grappling with policy options for implementing familial searching to balance crime fighting with its potential impact on society. When developing policies for familial searching, legislators should take into account the impact of familial searching on select populations and the need to minimize personal intrusion on relatives of individuals in the DNA database. This review describes the approaches used to narrow a suspect pool from a partial match search of CODIS and summarizes the economic, ethical, logistical and political challenges of implementing familial searching. We examine particular US state policies and the policy options adopted to address these issues. The aim of this review is to provide objective background information on the controversial approach of familial searching to inform policy decisions in this area. Herein we highlight key policy options and recommendations regarding effective utilization of familial searching that minimize harm to and afford maximum protection of US citizens.

A quantitative comparison of corrective and perfective maintenance

Science.gov (United States)

Henry, Joel; Cain, James

1994-01-01

This paper presents a quantitative comparison of corrective and perfective software maintenance activities. The comparison utilizes basic data collected throughout the maintenance process. The data collected are extensive and allow the impact of both types of maintenance to be quantitatively evaluated and compared. Basic statistical techniques test relationships between and among process and product data. The results show interesting similarities and important differences in both process and product characteristics.

16 CFR 23.12 - Misuse of the words “flawless,” “perfect,” etc.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the words âflawless,â âperfect,â... GUIDES FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.12 Misuse of the words “flawless,” “perfect,” etc. (a) It is unfair or deceptive to use the word “flawless” to describe any diamond that...

16 CFR 23.26 - Misuse of the words “flawless,” “perfect,” etc.

Science.gov (United States)

2010-01-01

... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Misuse of the words âflawless,â âperfect,â... GUIDES FOR THE JEWELRY, PRECIOUS METALS, AND PEWTER INDUSTRIES § 23.26 Misuse of the words “flawless,” “perfect,” etc. (a) It is unfair or deceptive to use the word “flawless” as a quality description of any...

Caring Decisions: The Development of a Written Resource for Parents Facing End-of-Life Decisions

OpenAIRE

Xafis, Vicki; Gillam, Lynn; Hynson, Jenny; Sullivan, Jane; Cossich, Mary; Wilkinson, Dominic

2015-01-01

Background: Written resources in adult intensive care have been shown to benefit families facing end of life (EoL) decisions. There are few resources for parents making EoL decisions for their child and no existing resources addressing ethical issues. TheCaring Decisionshandbook and website were developed to fill these gaps. Aim: We discuss the development of the resources, modification after reviewer feedback and findings from initial pilot implementation. Design: A targeted...

The Relationship between Life Skills and Family Performance in Addicted Women

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Saeed Komasi

2010-05-01

Full Text Available Aim: Among ingredients of success of family and decreasing mental and social damages are be some skills in the family. This study was aimed The Relationship between life skills (self awareness, interpersonal relationships, and decision making and, family performance in addicted women of Kermanshah city. Methods: The research design of current study was correlation method. Research population was all addicted women who were referred to Methadone therapy centers of Kermanshah city in summer of 1390. First 15 centers selected randomly and among 82 referred women 22 women discarded because of illiteracy, old age, or lack of cooperating. Thus, Sample of this study was 60 women. Bloom family performance and Ghiasi’s life skills questionnaires were administered among selected sample. Results: The results showed there is significant correlation between family performance and decision making skill in addicted women, but there is not significant correlation between family performance and self awareness and interpersonal relationships. Conclusion: Existing some of special skills in family such as decision making skill can be impressing on the level of family performance and incidence of social damages such as addiction.

Internationalization of Family Businesses

DEFF Research Database (Denmark)

Boyd, Britta; Hollensen, Svend; Goto, Toshio

2010-01-01

This article focuses on the international joint venture formation process of family businesses. The reasoning behind Danfoss’ decision to cooperate with two competing family businesses in Japan and China as well as two nonfamily businesses in Canada and Britain will be analysed. In......-depth qualitative interviews reveal the driving forces on both sides and show how the psychic distance can be reduced between the different parent firms including the joint venture (JV) child. The purpose of this study is to compare equal split or equity joint ventures of non-family and family firms regarding...... the formation process including competences and cultures. The study indicates what core competences of a family business matter when cooperating in equal split joint ventures. Implications for family business owners and ideas for future research are discussed....

Decision making on organ donation: the dilemmas of relatives of potential brain dead donors.

Science.gov (United States)

de Groot, Jack; van Hoek, Maria; Hoedemaekers, Cornelia; Hoitsma, Andries; Smeets, Wim; Vernooij-Dassen, Myrra; van Leeuwen, Evert

2015-09-17

This article is part of a study to gain insight into the decision-making process by looking at the views of the relatives of potential brain dead donors. Alongside a literature review, focus interviews were held with healthcare professionals about their role in the request and decision-making process when post-mortal donation is at stake. This article describes the perspectives of the relatives. A content-analysis of 22 semi-structured in-depth interviews with relatives involved in an organ donation decision. Three themes were identified: 'conditions', 'ethical considerations' and 'look back'. Conditions were: 'sense of urgency', 'incompetence to decide' and 'agreement between relatives'. Ethical considerations result in a dilemma for non-donor families: aiding people or protecting the deceased's body, especially when they do not know his/her preference. Donor families respect the deceased's last will, generally confirmed in the National Donor Register. Looking back, the majority of non-donor families resolved their dilemma by justifying their decision with external arguments (lack of time, information etc.). Some non-donor families would like to be supported during decision-making. The discrepancy between general willingness to donate and the actual refusal of a donation request can be explained by multiple factors, with a cumulative effect. Firstly, half of the participants (most non-donor families) stated that they felt that they were not competent to decide in such a crisis and they seem to struggle with utilitarian considerations against their wish to protect the body. Secondly, non-donor families refused telling that they did not know the deceased's wishes or contesting posthumous autonomy of the eligible. Thirdly, the findings emphasise the importance of Donor Registration, because it seems to prevent dilemmas in decision-making, at least for donor families. Discrepancies between willingness to consent to donate and refusal at the bedside can be attributed

Strategies needed to involve men, other family members.

Science.gov (United States)

Barnett, B

1998-01-01

Women typically do not make decisions about contraceptive use and family planning on their own, and many women often have little, if any, decision-making power in the home. Strategies are therefore needed to empower women, educate family members, and involve men in reproductive health programs. Policymakers should expand the range of male services and encourage the greater use of male contraceptive methods. Furthermore, health programs should include counseling to help men and women improve their communications skills and conduct education campaigns to inform men about the roles they can play in family planning. Men should also learn about the side effects of both male and female methods, since concern over method side effects can frustrate their support of family planning. Appropriate strategies can be tailored to meet individual group needs. Programs in Madagascar, Bangladesh, Honduras, and Nepal are described as examples of how the support of family members can positively affect family planning use and reproductive health.

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

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Yew Kong Lee

Full Text Available To explore the views of Malaysian healthcare professionals (HCPs on stakeholders' decision making roles in localized prostate cancer (PCa treatment.Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically.The participants comprised private urologists (n = 4, government urologists (n = 6, urology trainees (n = 6, government policy maker (n = 1 and oncologists (n = 3. HCP perceptions of the roles of the three parties involved (HCPs, patients, family included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture.A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

To Share or Not to Share: Malaysian Healthcare Professionals' Views on Localized Prostate Cancer Treatment Decision Making Roles.

Science.gov (United States)

Lee, Yew Kong; Lee, Ping Yein; Cheong, Ai Theng; Ng, Chirk Jenn; Abdullah, Khatijah Lim; Ong, Teng Aik; Razack, Azad Hassan Abdul

2015-01-01

To explore the views of Malaysian healthcare professionals (HCPs) on stakeholders' decision making roles in localized prostate cancer (PCa) treatment. Qualitative interviews and focus groups were conducted with HCPs treating PCa. Data was analysed using a thematic approach. Four in-depth interviews and three focus group discussions were conducted between December 2012 and March 2013 using a topic guide. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. The participants comprised private urologists (n = 4), government urologists (n = 6), urology trainees (n = 6), government policy maker (n = 1) and oncologists (n = 3). HCP perceptions of the roles of the three parties involved (HCPs, patients, family) included: HCP as the main decision maker, HCP as a guide to patients' decision making, HCP as a facilitator to family involvement, patients as main decision maker and patient prefers HCP to decide. HCPs preferred to share the decision with patients due to equipoise between prostate treatment options. Family culture was important as family members often decided on the patient's treatment due to Malaysia's close-knit family culture. A range of decision making roles were reported by HCPs. It is thus important that stakeholder roles are clarified during PCa treatment decisions. HCPs need to cultivate an awareness of sociocultural norms and family dynamics when supporting non-Western patients in making decisions about PCa.

The Family in Value Orientations

Science.gov (United States)

Lezhnina, Iu. P.

2011-01-01

Russia's declining birth rate is linked to a delay in a family's decision to have children and to uncertainty about the place of children in a couple's relationship. Despite the rise of individualism and the importance of career and self-realization, however, the family retains a very important place in Russian society. (Contains 1 table, 1…

Which factors influence women in the decision to breastfeed?

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Cândida Canicali Primo

Full Text Available Objective.Identify the factors that influence women in the decision to breastfeed. Methods. Integrative review. Information was gathered from original articles, case studies, theoretical studies, consensus and systematic reviews published between 2007-2013 in Spanish, Portuguese and English and recovered in the databases MEDLINE and LILACS. The descriptors used in this study were: breastfeeding, maternal behavior, risk factors, lactation and newborn. Results. Were included 30 articles, grouped into five categories. Factors influencing the decision of the breastfeeding woman are a convergence of breastfeeding's advantages, benefits and justifications, family, social and professional support, sociodemographic and clinical characteristics of women, personal experience and family tradition and personal choice. Conclusion. The decision to breastfeed by women is influenced by a convergence of factors. It is essential the role of nursing to encourage women in the decision to initiate and maintain breastfeeding her child.

The impact of DECISION+2 on patient intention to engage in shared decision making: secondary analysis of a multicentre clustered randomized trial.

Science.gov (United States)

Couët, Nicolas; Labrecque, Michel; Robitaille, Hubert; Turcotte, Stéphane; Légaré, France

2015-12-01

Training health professionals in shared decision making (SDM) may influence their patients' intention to engage in SDM. To assess the impact of DECISION+2, a SDM training programme for family physicians about the use of antibiotics to treat acute respiratory infections (ARIs), on their patients' intention to engage in SDM in future consultations. Secondary analysis of a multicentre clustered randomized trial. Three hundred and fifty-nine patients consulting family physicians about an ARI in nine family practice teaching units (FPTUs). DECISION+2 (two-hour online tutorial, two-hour workshop, and decision support tools) was offered in the experimental group (five FPTUs, 162 physicians, 181 patients). Usual care was provided in the control group (four FPTUs, 108 physicians, 178 patients). Change in patients' intention scores (range -3 to +3) between pre- and post-consultation. The mean ± SD [median] scores of intention to engage in SDM were high in both study groups before consultation (DECISION+2 group: 1.4 ± 1.0 [1.7]; control group: 1.5 ± 1.1 [1.7]) and increased in both groups after consultation (DECISION+2 group: 2.1 ± 1.1 [2.7]; control group: 1.9 ± 1.2 [2.3]). Change of intention, classified as either increased, stable or decreased, was not statistically associated with the exposure to the DECISION+2 programme after adjusting for the cluster design (proportional odds ratio = 1.5; 95% confidence interval = 0.8-3.0). DECISION+2 had no significant impact on patients' intention to engage in SDM for choosing to use antibiotics or not to treat an ARI in future consultations. Patient-targeted interventions may be necessary to achieve this purpose. © 2014 John Wiley & Sons Ltd.

Perfect independent sets with respect to infinitely many relations

Czech Academy of Sciences Publication Activity Database

Doležal, Martin; Kubiś, Wieslaw

2016-01-01

Roč. 55, č. 7 (2016), s. 847-856 ISSN 0933-5846 R&D Projects: GA ČR(CZ) GA14-07880S Institutional support: RVO:67985840 Keywords : perfect clique * free subgroup * open relation Subject RIV: BA - General Mathematics Impact factor: 0.394, year: 2016 http://link.springer.com/article/10.1007%2Fs00153-016-0498-3

Taking stock of work-family initiatives: How announcements of "family-friendly" human resource decisions affect shareholder value.

OpenAIRE

Michelle M. Arthur; Alison Cook

2004-01-01

This study examines share price reactions to 231 work-family human resource policies adopted by Fortune 500 companies and announced in the Wall Street Journal between 1971 and 1996. Consistent with past research, the results suggest that firm announcements of work-family initiatives positively affected shareholder return. The authors also empirically test three hypotheses concerning how the timing of work-family initiatives influences shareholder reaction. They find that a pioneering company ...

The role of economic evaluation in the decision-making process of family physicians: design and methods of a qualitative embedded multiple-case study

Science.gov (United States)

Lessard, Chantale; Contandriopoulos, André-Pierre; Beaulieu, Marie-Dominique

2009-01-01

Background A considerable amount of resource allocation decisions take place daily at the point of the clinical encounter; especially in primary care, where 80 percent of health problems are managed. Ignoring economic evaluation evidence in individual clinical decision-making may have a broad impact on the efficiency of health services. To date, almost all studies on the use of economic evaluation in decision-making used a quantitative approach, and few investigated decision-making at the clinical level. An important question is whether economic evaluations affect clinical practice. The project is an intervention research study designed to understand the role of economic evaluation in the decision-making process of family physicians (FPs). The contributions of the project will be from the perspective of Pierre Bourdieu's sociological theory. Methods/design A qualitative research strategy is proposed. We will conduct an embedded multiple-case study design. Ten case studies will be performed. The FPs will be the unit of analysis. The sampling strategies will be directed towards theoretical generalization. The 10 selected cases will be intended to reflect a diversity of FPs. There will be two embedded units of analysis: FPs (micro-level of analysis) and field of family medicine (macro-level of analysis). The division of the determinants of practice/behaviour into two groups, corresponding to the macro-structural level and the micro-individual level, is the basis for Bourdieu's mode of analysis. The sources of data collection for the micro-level analysis will be 10 life history interviews with FPs, documents and observational evidence. The sources of data collection for the macro-level analysis will be documents and 9 open-ended, focused interviews with key informants from medical associations and academic institutions. The analytic induction approach to data analysis will be used. A list of codes will be generated based on both the original framework and new themes