WorldWideScience

Sample records for local autonomy, financial autonomy, expenditures autonomy, local budget

  1. LOCAL PUBLIC 0 EXPENDITURE AUTONOMY – MEASURING APPROACH

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    Irina BILAN

    2013-06-01

    Full Text Available The decentralization process was continuous in Romania starting with 1990, generating the implication of local authorities in local public finance, as a result of exclusives, shared and delegate competences and, so, the necessity of ensuring a good management of resources and expenditures. Therefore, the decentralization of competences / responsibilities from State to local governments was a major Romanian political theme and a first rank component of management of local public finance, as main driving instrument for local development. Specific legal framework of local responsibilities is established both to European and national level. Researchers based on regulation and practice have tried to quantify the responsibilities developing different models to measure local revenue and expenditures autonomy. The paper aims is to identify some models for measuring local expenditure autonomy and to apply for Romania. The study is oriented to measure local expenditure autonomy in Romania using Bell, Ebel, Kaiser and Rojchaichainthorn's model.

  2. Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania

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    Dănuţ Vasile JEMNA

    2013-06-01

    Full Text Available Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variables which represent the determinants of the local revenue autonomy. Using empirical evidence from Romanian counties, we analyze the regional distributions for own revenues and for the significant determinants of local revenue autonomy. By means of econometric modeling we will highlight the variables which are statistically significant and explain the variation of the local revenues of Romanian counties, as well as the order of importance of the determinants of local financial autonomy. The empirical results show us that, although, theoretically, the counties have a great administrative and financial autonomy, practically this autonomy is very reduced (an average of under 40% for local revenue. The modeling results show that the degree of local financial autonomy can be increased by increasing economic development, urbanization, the average living area per person and fertility. Unemployment and a high level of demographic dependency contribute to the decrease of local financial autonomy.

  3. Demographic and Socio-Economic Determinants of Local Financial Autonomy in Romania

    OpenAIRE

    Dănuţ Vasile JEMNA; Mihaela ONOFREI; Elena CIGU

    2013-01-01

    Local autonomy is a rarely explored concept in the literature, still holding an increasing importance in the current context of Romania’s development in the European Union. In this paper we attempt to provide an overall survey on the financial dimension of local autonomy, assuming that local autonomy cannot be implemented, unless local authorities have adequate financial resources. In this study we also analyze the possibility to measure the local revenue autonomy and to identify the variable...

  4. Local government financial autonomy in Nigeria: The State Joint Local Government Account

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    Jude Okafor

    2010-07-01

    Full Text Available This paper addresses the statutory financial relations and financial autonomy of local government in Nigeria, and the freedom of local government to generate revenue from its assigned sources without external interference. It focuses particularly on a financial instrument called the State Joint Local Government Account (SJLGA and how its operations have positively or negatively affected the financial autonomy of local government councils and the inter-relations between state and local government in Nigeria.

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

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    Maria Letitia Andronic (Bratulescu

    2016-04-01

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

  6. AN APROACH OF LOCAL FINANCIAL AUTONOMY AND IMPLICATION OVER SUSTAINABLE DEVELOPMENT IN THE KNOWLEDGE SOCIETY

    OpenAIRE

    Elena CIGU

    2014-01-01

    Local governments play an important role in sustainable development processes based on their administrative and financial autonomy. Policies and programs undertaken to assure sustainable development by local governments produce benefits for persistence of the knowledge society. This paper will try to highlight the implication of local financial autonomy over sustainable development of local communities in a knowledge society, based especially on local financial autonomy theory approach.

  7. Measuring local autonomy: A decision-making approach

    NARCIS (Netherlands)

    Fleurke, F.; Willemse, R.

    2006-01-01

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

  8. AN APROACH OF LOCAL FINANCIAL AUTONOMY AND IMPLICATION OVER SUSTAINABLE DEVELOPMENT IN THE KNOWLEDGE SOCIETY

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    Elena CIGU

    2014-12-01

    Full Text Available Local governments play an important role in sustainable development processes based on their administrative and financial autonomy. Policies and programs undertaken to assure sustainable development by local governments produce benefits for persistence of the knowledge society. This paper will try to highlight the implication of local financial autonomy over sustainable development of local communities in a knowledge society, based especially on local financial autonomy theory approach.

  9. SOME CONSIDERATIONS ON LOCAL FINANCIAL AUTONOMY IN THE CONTEXT OF THE CURRENT FINANCIAL CRISIS

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    Vezure Oana Sabina

    2012-03-01

    Full Text Available Financing of local authorities is currently at the Centre of the political discourse is a daily concern. Romania faces, usually with an attempt to offset the need for control and reduction of public spending with greater financial autonomy of local authorities. At the time, it was searched and searches for a path, a means to achieve a fair distribution of financial resources between the various levels of administration, budget reductions to all of them. If strengthening democracy means to strengthen local autonomy, then it means you have created a system for financing local authorities to be efficient, fair and pointing towards the economic needs of States. In other words, decentralization and local financing and the principle of subsidiarity are mutually dependent. Rightly, the decentralisation of financial management is considered to be the "backbone" of the administrative system of decentralisation, the financial resources being those which are operational link between the needs of local communities and the rules necessary to satisfy them. Thus, the lack of financial resources of the local self-government can result in failure to meet the needs of its members, which at the same time failure of administrative decentralization. The decentralisation of financial management can also be seen as the Government of some specific functions on the line of management authority and the tax revenue to the local public authorities.

  10. SOME CONSIDERATIONS REGARDING THE FINANCIAL AUTONOMY OF THE ROMANIAN ADMINISTRATIVETERRITORIAL UNITS

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    MELINDA CENUŞE

    2014-12-01

    Full Text Available In Romania local autonomy is administrative and financial. If local financial resources are not independent from the state budget and they continue to depend on it exclusively and if financial independence remains only a target which has not been materialized in practice, then the administrative autonomy of the communes, towns and counties will not yield the expected results and will still be limited. According to the European Charter of Local Self-Government the financial resources available for the Local Government authorities should be correlated, commensurate with their duties and their decentralized competences. A recent decision of the Romanian Constitutional Court sustains the same idea. Having in mind this CC’s Decision, the provisions of the European Charter of Local Self-Government and the nowadays insolvent Romanian administrative-territorial units, allow me to underline in this paper my opinion that the financial autonomy is the substance of local autonomy.

  11. Decentralization and public expenditure: Does special local autonomy affect regional economic growth?

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    Martapina Anggai

    2018-04-01

    Full Text Available This study examines the relationship between public expenditure within regional autonomy policy and economic growth in West Papua and Papua provinces. We distinguish two kinds of expenditure’s decentralization – operational and capital – and also private expenditures. We use an unbalanced panel data over the period of 2007-2010 to investigate those expenditures, whether they enhance regional economic growth or not. We find that the government’s operating and private expenditures have a positive effect on local economic growth, but there is no relationship between capital expenditure’s decentralization on economic growth. The findings did not conform to a-priori efficiency expectations, which suggest needing to reform regional autonomy and fiscal decentralization policy in both provinces.

  12. Approach to local autonomy in the German and British systems of municipal financing

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    Francisco Javier Durán García

    2017-09-01

    Full Text Available At the European level the recognition of local self-government is a peaceful matter after being approved in the European Charter of Local Autonomy. However, the scope of this local financial autonomy varies according to the model of public finances that each country adopts. In this article we analyze the German and British models of local finance, two opposite examples in the way of organizing their treasure that directly affect the scope of the local autonomy of their municipalities. After a first part where the legal basis of the local autonomy is analyzed, the main sources of municipal financing are studied in each model, and it concludes with an assessment of the financial autonomy of the local entities within the Spanish system in comparison with the exposed models.

  13. Analysis of the Local Budget’s Expenditures Structure at Different Types of Administrative Units in Romania

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    Dan-Constantin Danuletiu

    2016-01-01

    Full Text Available Financial decentralization process affected the expenditure part of the local budgets in Romania by imposing new destinations for own revenues, but also by limiting the decision autonomy because of the equalization system design or the transfer of responsibilities without establishing new sources of revenues. But the effects on the local budgets are not the same for every administrative unit. The article highlights the structure of expenditures of local budgets for different types of administrative unit, for identifying variations in and potential causes of the financial autonomy regarding local expenditures.

  14. Local Autonomy in Action: Beijing’s Hong Kong and Macau Policies

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    Bill Chou

    2013-01-01

    Full Text Available This paper investigates how Beijing governs its two special administrative regions (SARs of Hong Kong and Macau through leverages on their local autonomy. First, a conceptual analysis of local autonomy will be provided. Local autonomy is more than a zero-sum game between the central and local authorities over how much power should be granted or taken from the local authorities; it also concerns the space for cultural expression and the use of local customs in public administration. Second, the degree of local autonomy in Hong Kong and Macau will be critically examined. On paper, both SAR governments are able to freely make decisions on a wide range of policies. In practice, however, Beijing has the absolute authority to override the decisions of Hong Kong and Macau. It is argued that the autonomy in cultural expression can compensate for the institutional constraints on the two SARs’ decision-making power and is thus able to alleviate public discontent – as long as the constraints do not conflict with the people’s core values and ways of life.

  15. [Autonomy for financial management in public and private healthcare facilities in Brazil].

    Science.gov (United States)

    Santos, Maria Angelica Borges dos; Madeira, Fátima Carvalho; Passos, Sonia Regina Lambert; Bakr, Felipe; Oliveira, Klivia Brayner de; Andreazzi, Marco Antonio Ratzsch de

    2014-01-01

    Autonomy in financial management is an advantage in public administration. A 2009 National Healthcare Facility Survey showed that 3.9% of Brazil's 52,055 public healthcare facilities had some degree of financial autonomy. Such autonomy was more common in inpatient facilities (17.8%), those managed by State governments (26.3%), and in Southern Brazil (6.6%). Autonomy was mainly partial (for resources in specific areas, relating to small outlays, consumables and capital goods, and outsourced services or personnel). 74.3% of 2,264 public facilities with any financial autonomy were under direct government administration. Financial autonomy in public healthcare facilities appears to be linked to local political decisions and not necessarily to the facility's specific legal and administrative status. However, legal status displays distinct scopes of autonomy - those under direct government administration tend to be less autonomous, and those under private businesses more autonomous; 85.8% of the 45,394 private healthcare facilities reported that they were financially autonomous.

  16. INSTITUTIONAL AND CONJUNCTURAL FACTORS ACTION ON AUTONOMY IN LOCAL PUBLIC ADMINISTRATION MANAGEMENT

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    SCUTARIU PETRONELA

    2016-02-01

    Full Text Available Component without which the function of local public administration management would be compromised, administrative autonomy manifests under the action of various factors. From such an angle, the space of this article is dedicated to identifying the factors affecting the autonomy in management of local public administration in order to show their actions on its manifestation. By developing the present approach, beyond the incompleteness of the existing explanations relative to this sphere of interest, we have identified and highlighted the action of two sets of factors - institutional and conjunctural. Ensign turned out to be the action that institutional factors exert on autonomy, the latter being the greater, as the local administrative structure is higher, as the number of local public services is higher, when there are legal regulations that warrant it, and vice versa. Then analyzing conjunctural factors, we found that the influence of the economic crisis is, as expected, adverse to autonomy manifestation. Regarding the local development factor, we showed that a local community with a high degree of development functions without the intervention of center, a situation that favors autonomy, as opposed to a less developed community that requires the support of the center, intervention which mitigates the autonomy. By examining the action of political factor, we noticed that, although politicians define public strategies and policies that will be implemented, which gives it a positive connotation, most often autonomy suffers under the politics influence. Finally, the social organization in local collectivities provides favorable ground to the manifestation and functioning of autonomy in the management of local public administration.

  17. Policy regime and policy change: Comparing the phenomenon of local government before and after regional autonomy

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    Kamaludin Kamaludin

    2018-04-01

    Full Text Available This research aims to evaluate the financial performance of four municipalities (Bengkulu City, Rejang Lebong Regency, South Bengkulu Regency, and North Bengkulu Regency in Bengkulu Province, Indonesia. The study also identifies the contribution of several financial variables before and after the implementation of regional autonomy. Theoretically, regional autonomy enables these four municipalities to manage their Local Own-Source Revenue (LOSR or PAD - Pendapatan Asli Daerah better because these municipalities now have to learn to manage their financial resources independently. However, the findings indicate that these four municipalities still exhibit a high financial dependency on the central government or the fiscal balance fund. Consequently, the contribution of LOSR to the total income is still low. Besides, the study finds that these four municipalities exhibit a sufficiently good efficiency ratio but a fluctuating LOSR growth ratio, especially in some municipalities before the proliferation of new municipalities. Further, the main variables of the degree of financial decentralization, local financial autonomy, efficiency, and LOSR growth do not exhibit significant differences between the pre- and post- regional autonomy implementation.

  18. Local government autonomy and development of localities in Nigeria

    African Journals Online (AJOL)

    Other challenges include inadequate finances, weak intergovernmental relations, fledging democracy and grand corruption. These must be adequately tackled for LGs to make more positive impact in the localities. Some pertinent recommendations are as follows. LGs need adequate autonomy, hard work rather than verbal ...

  19. Local government autonomy and development of localities in Nigeria

    African Journals Online (AJOL)

    The paper found that inadequate handling of virtually all the above issues has posed some challenges for LGs' developmental efforts in the localities. Inadequate autonomy has been found to be the independent variable in the challenges. Other challenges include inadequate finances, weak intergovernmental relations, ...

  20. the search for local government autonomy in nigeria

    African Journals Online (AJOL)

    RAYAN_

    autonomous. Keywords: Search, local government, autonomy, pathways and realization .... time. 6 There were, for instance, the Native Authority Ordinance, the Native Revenue .... Construction and maintenance of primary schools; and e.

  1. LOCAL COMMUNITY EMPOWERMENT IN THE SPECIAL AUTONOMY LAW IN PAPUA PROVINCE

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    Usman Pakasi

    2012-08-01

    Full Text Available The establishment of the 2001 Special Autonomy Law in Papua Province is not exempted from economic, political and socio-cultural problems. The law is intended to empower the people by preserving their interests and upholding the basic rights of native Papuans. This research aims at finding out a theoretical understanding on the forms of local community empowerment during the implementation of special autonomy in Papua Province. The study is performed through a qualitative approach with a phenomenological strategy. The research was conducted at a location in Jayapura. Empirical data were obtained using the techniques of observation, in-depth interviews, and other secondary data. The implementation of Special Autonomy in Papua Province has brought forth a fundamental change in the approaches and policies of community development, particularly local community empowerment that includes indigenous communities, women, and religion. Local community empowerment in the economic and socio-cultural aspects represents the effort to improve the welfare and sense of justice within the local community in development.

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

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    Cristi IFTENE

    2009-01-01

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

  3. [Boundaries of the autonomy of local health administration: innovation, creativity and evidence-based decision-making].

    Science.gov (United States)

    Silva, Silvio Fernandes da; Souza, Nathan Mendes; Barreto, Jorge Otávio Maia

    2014-11-01

    The scope of this article was to identify the boundaries of the autonomy of local administration in the context of the federal pact in the Brazilian Unified Health System and the importance and potential for promoting innovation, creativity and evidence-based decision-making by local governments. The methodology used was to ask questions that favored dialogue with the specific literature to identify the influence of centrally-formulated policies in spaces of local autonomy and then to identify strategies to foster innovation, creativity and the systematic use of evidence-based research in health policy implementation. A gradual reduction in municipal decision-making autonomy was detected due to increased financial commitment of the municipalities resulting from responsibilities assumed, albeit with the possibility of reverting this trend in the more recent context. Some determinants and challenges for the dissemination of innovative practices were analyzed and some relevant national and international experiences in this respect were presented. The conclusion drawn is that it is possible to make local decision-making more effective provided that initiatives are consolidated to promote this culture and the formulation and implementation of evidence-based health policies.

  4. New Paradigm for Local Financial Management: A Review of Local Budgeting System

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    Hendra Karianga

    2016-12-01

    Full Text Available Fiscal decentralization gives authority to the head of region and regional parliament to manage the local budget. The outcomes of the research indicate that the Good Financial Governance principle has been subject to frequent study in its understanding as a new paradigm for local financial management. As it turns out in practice, however, it has certain weaknesses, particularly in view of the accountability and legitimacy aspects of its establishment. In fact, the local budget has become a vehicle for corruption by the state administration is in the center of power, local autonomy shift some corruptor from the center to the local. The issue is how to manage the local budget in order to minimize corruption. If the commitment of the management of local budget is based on new principles in the local financial management, it believed that the local budget is governed annually by the local government will lead to the people’s welfare in the region. Based on such view, the Good Financial Governance principles appears to be the ideal approach to be applied in managing the local budgeting system.

  5. Marine Robot Autonomy

    CERN Document Server

    2013-01-01

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

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

    Science.gov (United States)

    Lewis, Jenny M; Marjoribanks, Tim

    2003-01-01

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

  7. THEORETICAL AND PRACTICAL CONSIDERATIONS ON FINANCIAL AUTONOMY AND BALANCE LOCAL BUDGETS IN ROMANIA

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    POPEANGĂ VASILE NICOLAE

    2015-03-01

    Full Text Available In order to meet the needs of local interest, the state is obliged to organize and operate a system of economic and social relations, in cash, whose purpose is the creation and distribution of funds into local financial resources. This set of relationships is known as local finance. "Local Public Finance is the work of local governments in their capacity as user of special techniques, financial, such as the budget, taxes, fees, allowances, expenses, loans etc."

  8. Substate federalism and fracking policies: does state regulatory authority trump local land use autonomy?

    Science.gov (United States)

    Davis, Charles

    2014-01-01

    State officials responsible for the regulation of hydraulic fracturing (fracking) operations used in the production of oil and gas resources will inevitably confront a key policy issue; that is, to what extent can statewide regulations be developed without reducing land use autonomy typically exercised by local officials? Most state regulators have historically recognized the economic importance of industry jobs and favor the adoption of uniform regulatory requirements even if these rules preempt local policymaking authority. Conversely, many local officials seek to preserve land use autonomy to provide a greater measure of protection for public health and environmental quality goals. This paper examines how public officials in three states-Colorado, Pennsylvania, and Texas-address the question of state control versus local autonomy through their efforts to shape fracking policy decisions. While local officials within Texas have succeeded in developing fracking ordinances with relatively little interference from state regulators, Colorado and Pennsylvania have adopted a tougher policy stance favoring the retention of preemptive oil and gas statutes. Key factors that account for between state differences in fracking policy decisions include the strength of home rule provisions, gubernatorial involvement, and the degree of local experience with industrial economic activities.

  9. Senegal : School Autonomy and Accountability

    OpenAIRE

    World Bank

    2012-01-01

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

  10. Institutional Financial Autonomy in Practice

    DEFF Research Database (Denmark)

    Szwebs, Witold

    2016-01-01

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

  11. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

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

  12. DECENTRALIZATION, ELIGIBILITY OF AUTHORITIES AND CONSULTATION OF CITIZENS - EVIDENCE OF THE OCCURRENCE OF AUTONOMY IN LOCAL PUBLIC ADMINISTRATION MANAGEMENT

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    ZAHARIA PETRONELA

    2013-04-01

    Full Text Available Being important for the proper functioning of the management activity conducted at the local public administration level, local autonomy cannot occur without the support coming from other rules of organization and functioning of local administrative system. From this perspective, in this paper we propose to analyze the content of decentralization, eligibility of authorities and consultation of citizens in solving local problems, in order to highlight how each of these principles demonstrates the efficiency of autonomy. Moving power from central public administration authorities to local authorities in the decentralization process, making authorities of administrative-territorial units eligible and the involvement of local community members in solving problems affecting them are clear evidence of the occurrence of autonomy in local public administration management.

  13. Autonomy of the University: A Financial, Academic and Administrational Approach

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    Ali Rıza ERDEM

    2013-01-01

    Full Text Available The concept of “autonomy” is mostly discussed at the institutional level. The term “autonomy” literally refers to “the right of self administration of an institution under its own legal constitution”. It has not only been a subject on which much has been negotiated in the academic world until far and a subject on which has never been reached a full agreement yet but also a subject which has been distinctively interpreted by all sides. To realize their social responsibilities in a best way, universities have to get the opportunity of an autonomous constitution. Moreover, this autonomy essentially depends on the existence of a harmonious financial, academic and administrational system. Today there is no a fully autonomised university but extent of autonomous. For an institution, a financial autonomy is “the state of driving its own expenditures by using freely its own sources”. It is of three dimensions, one of which is preparing its own budget, the other of which is constituting its own financial sources and the last of which is using its own financial sources. Today, in this respect, there is no yet “a fully autonomised university” in the world, because they are not capable of meeting the money which they need for their existence. To all people who have academic titles, “academic autonomy” necessarily refers to a chance of free education and researches free of all kinds of pressure and orientation attempts. According to Turkish constitution, academic freedom is limited to national defense and security & social order. According to a report in the ninth plan of development, released by “High Commission of Academic Education”, there is also not a fully academic autonomy. By the word “Administrational Autonomy” in universities, it is certainly meant that those institutions are driven and inspected by their own democratic organs whose members are necessarily democratically appointed. According to in the ninth plan of

  14. Autonomy and Acceptance of Long-Term Care

    Science.gov (United States)

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

    2009-01-01

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

  15. Autonomy and the principle of respect for autonomy.

    Science.gov (United States)

    Gillon, R

    1985-06-15

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

  16. Standby-battery autonomy versus power quality

    Science.gov (United States)

    Bitterlin, Ian F.

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

  17. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

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

  18. EVOLUTION OF THE LOCAL BUDGET REVENUES AND EXPENSES. CASE STUDY: ORĂȘTIE TOWN HALL, HUNEDOARA COUNTY

    Directory of Open Access Journals (Sweden)

    ILEANA-SORINA (BOCA RAKOS

    2016-12-01

    Full Text Available At present, the elaboration of budgets at any level is a real problem especially due to the need of respecting the budget balance principle, since the need for financial resources is greater than the existing funds necessary for a good development of the economic activites. Consequently, by this work, the authors deal with aspects concerning the general framework and procedures of creation, administration, commission and use of the local public funds, and the responsibilities of the local public authorities and of the public institutions involved in the domain of local public finances. The paper deals, on the level of an administrative-territorial unit with a number of about 20.000 inhabitants, with the aggregate budget revenues and expenses that make up the general budget of the respective unit, after consolidation, by the elimination of the transfers of sums between budgets, reflecting the dimension of the public financial effort, on the level of the year 2016 and its state of balance or imbalance. To analyze the data, the authors realized a case study regarding the evolution of the local budget revenues and expenses, at a public entity of Hunedoara County, the results obtained being analyzed and interpreted under the economic and social aspect. The overall objective of this study refers to the possibility of strengthening the operational and financial autonomy of the administrative-territorial unit and the local budget. Although at the national level, the laws necessary for the budget system operation were elaborated on the principle of local autonomy, however, at the level of administrative units we cannot yet speak of the existence of a real local autonomy, whereas the revenues of the local budgets are not sufficient to cover the expense level. The paper ends with the authors’ conclusions related to the need to increase the financial resources mobilized available to the local public authorities, by means of the local budgets, in order to

  19. The Challenge of University Autonomy

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  20. University Internationalization and University Autonomy

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Gulieva, Valeria

    2016-01-01

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

  1. Financial Autonomy and Challenges to Being a Regionally Responsive Higher Education Institution

    Science.gov (United States)

    Kohtamaki, Vuokko; Lyytinen, Anu

    2004-01-01

    This paper discusses some current problems and challenges of the Finnish AMKs (polytechnic institutions), and whether financial autonomy could contribute to finding solutions for some of these problems. It provides an overview of the current status of financial autonomy of polytechnics in 6 European countries, and finally attempts to find links…

  2. The contribution of fiscal/financial decentralization to the debt expansion of the local financing platform

    Science.gov (United States)

    Huayang, Yin; Di, Zhou; Bing, Cui

    2018-02-01

    Using soft budget theory to explore the formation mechanism and the deep institutional incentive of the local financing platform debt expansion from the perspective of fiscal / financial decentralization, construct theoretical framework which explain the expansion of local debt financing platform and conduct an empirical test, the results showed that the higher the degree of fiscal decentralization, fiscal autonomy as a soft constraint body of local government the stronger, local financing platform debt scale is greater; the higher the degree of financial decentralization, local government and financial institutions have the higher autonomy with respect to the central, local financing platform debt scale is bigger; financial synergy degree is stronger, local government financial mutual supervision prompted the local government debt more transparency, local debt financing platform size is smaller.

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

    Science.gov (United States)

    Atkins, Kim

    2006-10-01

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

  4. The Evolution of Autonomy.

    Science.gov (United States)

    Stammers, Trevor

    2015-01-01

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

  5. Autonomy: Life and Being

    Science.gov (United States)

    Williams, Mary-Anne

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

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

    Science.gov (United States)

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

    2018-01-29

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

  7. University autonomy as sensemaking

    DEFF Research Database (Denmark)

    Lind, Jonas Krog

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

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

    Directory of Open Access Journals (Sweden)

    Marinela Mironiuc

    2010-12-01

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

  9. Respect for rational autonomy.

    Science.gov (United States)

    Walker, Rebecca L

    2009-12-01

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

  10. Professional autonomy.

    Science.gov (United States)

    Aprile, A E

    1998-02-01

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

  11. Autonomy as Aesthetic Practice

    NARCIS (Netherlands)

    Lütticken, S.

    2014-01-01

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

  12. Regimes of Autonomy

    NARCIS (Netherlands)

    Anderson, Joel

    2014-01-01

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

  13. Syntactic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Rocha, L.M.

    1998-12-01

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

  14. Autonomy and hyperthyroidism

    International Nuclear Information System (INIS)

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

    1986-01-01

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

  15. U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization?

    Science.gov (United States)

    Bustamante, Arturo Vargas

    2016-01-01

    For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. PMID:27694684

  16. Negotiating autonomy at the margins of the state

    DEFF Research Database (Denmark)

    Eilenberg, Michael

    2009-01-01

    Recent processes of decentralization have dramatically changed local political configurations and access to resources throughout Indonesia. In particular, the resource-rich regions at the margins of the state have, in the name of regional autonomy, experienced new spaces for manoeuvre in their cl......Recent processes of decentralization have dramatically changed local political configurations and access to resources throughout Indonesia. In particular, the resource-rich regions at the margins of the state have, in the name of regional autonomy, experienced new spaces for manoeuvre...

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

    OpenAIRE

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

    2011-01-01

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

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

    Science.gov (United States)

    Maassen, Peter; Gornitzka, Åse; Fumasoli, Tatiana

    2017-01-01

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

  19. (Re)Discovering University Autonomy

    DEFF Research Database (Denmark)

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

    2016-01-01

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

  20. Tensions across Federalism, Localism, and Professional Autonomy: Social Media and Stakeholder Response to Increased Accountability

    Science.gov (United States)

    Berry, Kimberly Scriven; Herrington, Carolyn D.

    2013-01-01

    Drawing upon research on federalism, localism, and professional autonomy, this article explores how educational stakeholders used social media to discuss and organize against the implementation of Differentiated Accountability in a large Florida school district. The results showed that the stakeholders used social media to engage in sense making…

  1. Law, autonomy and advance directives.

    Science.gov (United States)

    Willmott, Lindy; White, Ben; Mathews, Ben

    2010-12-01

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

  2. Entrepreneurial autonomy and its dynamics

    NARCIS (Netherlands)

    van Gelderen, M.W.

    2016-01-01

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

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

    Science.gov (United States)

    Rigaux, Natalie

    2011-06-01

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

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

    OpenAIRE

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

    2012-01-01

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

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

    Science.gov (United States)

    Fainzang, Sylvie

    2016-12-01

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

  6. Anagogy of autonomy.

    Science.gov (United States)

    Boyd, A L

    2000-07-01

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

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

    OpenAIRE

    Marinela Mironiuc; Mihaela Robu; Ion Robu

    2010-01-01

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

  8. Compulsory Autonomy-Promoting Education

    Science.gov (United States)

    Schinkel, Anders

    2010-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  10. Autonomy of State Agencies

    DEFF Research Database (Denmark)

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

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

  11. Limits to relational autonomy--the Singaporean experience.

    Science.gov (United States)

    Krishna, Lalit Kumar Radha; Watkinson, Deborah S; Beng, Ng Lee

    2015-05-01

    Recognition that the Principle of Respect for Autonomy fails to work in family-centric societies such as Singapore has recently led to the promotion of relational autonomy as a suitable framework within which to place healthcare decision making. However, empirical data, relating to patient and family opinions and the practices of healthcare professionals in Confucian-inspired Singapore, demonstrate clear limitations on the ability of a relational autonomy framework to provide the anticipated compromise between prevailing family decision-making norms and adopted Western led atomistic concepts of autonomy. Evidence suggests that despite a growing infusion of Western influence, there is still little to indicate any major shift to individual decision making, particularly in light of the way society and healthcare are structured. Similarly, the lack of employing a shared decision-making model and data that discredit the notion that the complex psychosocial and cultural factors that affect the decision making may be considered "content neutral" not only prevents the application of relational autonomy but questions the viability of the values behind the Principle of Respect for Autonomy. Taking into account local data and drawing upon a wider concept of personhood that extends beyond prevailing family-centric ideals along with the complex interests that are focused upon the preservation of the unique nature of personhood that arises from the Ring Theory of Personhood, we propose and "operationalize" the employing of an authoritative welfare-based approach, within the confines of best interest decision making, to better meet the current care needs within Singapore. © The Author(s) 2014.

  12. Kinetic examination of the thyroid for an early detection of localized autonomy

    International Nuclear Information System (INIS)

    Das, B.K.; Kissel, H.J.; Schnabel, K.

    1980-01-01

    Early diagnosis of localised thyroid autonomy can in many cases be of high importance for the patient. By manifesting accelerated radioiodine kinetics in suspicious lobes or regions of the thyroid, autonomies of the thyroid can be detected early and definitely. Examination covered 50 euthyroidic patients showing only an asymmetric thyroidal configuration in the scintiscan. Unilateral determining of the radioiodine kinetics at the Auger-camera helped to find out if, and in how many cases, there is really an accelerated iodine metabolism in the thyroids represented asymmetrically. Fire of the examinated patients showed, compared with the opposite side, both increased iodine uptake and accelerated iodine output in the lobes which are seen more clearly in the scintiscan. This might be an indication of a very early stage of thyroidal autonomy. (orig.) [de

  13. Public Health Autonomy: A Critical Reappraisal.

    Science.gov (United States)

    Zimmerman, Frederick J

    2017-11-01

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

  14. Does maternal autonomy influence feeding practices and infant growth in rural India?

    Science.gov (United States)

    Shroff, Monal R; Griffiths, Paula L; Suchindran, Chirayath; Nagalla, Balakrishna; Vazir, Shahnaz; Bentley, Margaret E

    2011-08-01

    The high prevalence of child under-nutrition remains a profound challenge in the developing world. Maternal autonomy was examined as a determinant of breast feeding and infant growth in children 3-5 months of age. Cross-sectional baseline data on 600 mother-infant pairs were collected in 60 villages in rural Andhra Pradesh, India. The mothers were enrolled in a longitudinal randomized behavioral intervention trial. In addition to anthropometric and demographic measures, an autonomy questionnaire was administered to measure different dimensions of autonomy (e.g. decision-making, freedom of movement, financial autonomy, and acceptance of domestic violence). We conducted confirmatory factor analysis on maternal autonomy items and regression analyses on infant breast feeding and growth after adjusting for socioeconomic and demographic variables, and accounting for infant birth weight, infant morbidity, and maternal nutritional status. Results indicated that mothers with higher financial autonomy were more likely to breastfeed 3-5 month old infants. Mothers with higher participation in decision-making in households had infants that were less underweight and less wasted. These results suggest that improving maternal financial and decision-making autonomy could have a positive impact on infant feeding and growth outcomes. Published by Elsevier Ltd.

  15. Autonomy and Financial Sources, Key Factors in the Performance of Health Insurance Scheme: Case of Albania

    Directory of Open Access Journals (Sweden)

    Enkelejda Avdi

    2013-12-01

    Full Text Available Autonomy of public health insurance scheme comprises political, financial, organizational, normative and contractual aspects. The paper analyses the role and position of a health insurance scheme (HIS within the overall healthcare system in Albania, the relationship to all other institutions, stakeholders and actors. By analyesing published literature and collected data through secondary sources, the paper focuses on financial autonomy, which refers first of all to a certain level of budgetary independence regarding source generation and spending on health services. For assuring effective and efficient performance of the single payer for health care services in Albania, need effective changes in the legislation do take into account the various levels of autonomy mentioned above.

  16. Intention, autonomy, and brain events.

    Science.gov (United States)

    Gillett, Grant

    2009-07-01

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

  17. An intercultural nursing perspective on autonomy.

    Science.gov (United States)

    Hanssen, Ingrid

    2004-01-01

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

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

    NARCIS (Netherlands)

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

    2006-01-01

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

  19. TERRITORIAL AND NON-TERRITORIAL AUTONOMY: “ROMANIAN PARADOX”

    Directory of Open Access Journals (Sweden)

    CRISTIAN JURA

    2012-05-01

    Full Text Available Whereas in Romania there are 19 national minorities officially acknowledged by Romanian state, up to present, one did not manage to adopt a special law of national minorities. We identify special disposals related to national minorities in Romanian Constitution, in the law of local public administration, the law of education, the law concerning the election of the Chamber of Deputies and Senate, the law related to political parties, the law for the election of the authorities of local public administration, the law concerning the combating of all forms of discrimination. In the last project of the Law concerning the statute of national minorities in Romania, a new concept is introduced: cultural autonomy of minorities. The cultural autonomy is a form of non-territorial autonomy. Nevertheless, Romania is criticised by some international organisations for the fact that the organisations of national minorities represented in the Parliament of Romania have instituted a monopole, therefore no other organisation of any minority is allowed to participate to the elections.

  20. The economic value of autonomy

    NARCIS (Netherlands)

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

    2003-01-01

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

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

    Science.gov (United States)

    Weiner, Jennie M.; Woulfin, Sarah L.

    2017-01-01

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

  2. Clinical guidelines and the fate of medical autonomy in Ontario.

    Science.gov (United States)

    Rappolt, S G

    1997-04-01

    Conceptually, clinical guidelines and professional autonomy have a paradoxical relationship. Despite being the quintessence of medical knowledge at the corporate level, guidelines diminish the clinical autonomy of individual practitioners, and therefore threaten medicine's justification for its autonomy. Theorists have argued that professional autonomy will be retained through elite dominance of practitioners, while comparative research suggests that economic autonomy can be traded off to retain clinical autonomy. Under government pressure to regulate the growth of Ontario physicians' fee-for-service public expenditure, the profession's representative organization, the Ontario Medical Association (OMA), promoted voluntary clinical guidelines, hoping to both constrain costs and preserve professional control over the content of medical care. The OMA collaborated with the Ministry of Health in developing guidelines and establishing a provincial centre for health service research. Ontario's practitioners disregarded the OMA's exhortations to implement clinical guidelines, suggesting that in the absence of external constraints, practitioners can subvert elite dominance. However, practitioners' unchecked clinical and economic autonomy, combined with evidence of wide provincial variations in medical care, served to legitimize the government's increasingly unilateral control over the schedule of insured medical services, and, in 1993, their imposition of a global cap on physicians' fee-for-service income pool. When analysed in the context of ongoing Ministry-OMA relations, the failure of the OMA's guidelines strategy to constrain medical service costs has expedited an overall decline in medical autonomy in Ontario. The emergence and course of Ontario's clinical guidelines movement is consistent with the view that medical autonomy is contingent upon broad class forces, and the conceptualization of professional organizations as instruments for mediated occupational control.

  3. Shared decision-making and patient autonomy.

    Science.gov (United States)

    Sandman, Lars; Munthe, Christian

    2009-01-01

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

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

    Science.gov (United States)

    Liu, Dong; Fu, Ping-ping

    2011-01-01

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

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

    Science.gov (United States)

    Gulosino, Charisse

    2010-01-01

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

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

    Science.gov (United States)

    Lin, Katherine Y

    2014-01-01

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

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

    Science.gov (United States)

    Lin, Katherine Y.

    2013-01-01

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

  8. Understanding nurse practitioner autonomy.

    Science.gov (United States)

    Weiland, Sandra A

    2015-02-01

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

  9. Compulsory autonomy-promoting education

    NARCIS (Netherlands)

    A. Schinkel (Anders)

    2010-01-01

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

  10. Invited Article: Threats to physician autonomy in a performance-based reimbursement system.

    Science.gov (United States)

    Larriviere, Daniel G; Bernat, James L

    2008-06-10

    Physician autonomy is currently threatened by the external application of pay for performance standards and required conformity to practice guidelines. This phenomenon is being driven by concerns over the economic viability of increasing per capita health care expenditures without a concomitant rise in favorable health outcomes and by the unjustified marked variations among physicians' practice patterns. Proponents contend that altering the reimbursement system to encourage physicians to make choices based upon the best available evidence would be one way to ensure better outcomes per health care dollar spent. Although physician autonomy is most easily justified when decisions are made by appealing to the best available evidence, incentivizing decision-making risks sacrificing physician autonomy to political and social forces if the limitations of evidence-based medicine are not respected. Any reimbursement system designed to encourage physicians to utilize the best available evidence by providing financial incentives must recognize physicians who try to play to the numbers as well as physicians who refuse to follow the best available evidence if doing so would conflict with good medicine or patient preferences. By designing, promulgating, and updating evidence-based clinical practice guidelines, medical specialty societies can limit threats to physician autonomy while improving medical practice.

  11. Respect for autonomy and technological risks

    NARCIS (Netherlands)

    Asveld, L.

    2008-01-01

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

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

    Science.gov (United States)

    Gordillo Alvarez-Valdés, Lourdes

    2008-01-01

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

  13. Models, controls, and levels of semiotic autonomy

    Energy Technology Data Exchange (ETDEWEB)

    Joslyn, C.

    1998-12-01

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

  14. Changing professional autonomy?

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh

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

  15. Subsidiary Autonomy and Knowledge Transfer

    DEFF Research Database (Denmark)

    Søberg, Peder Veng; Wæhrens, Brian Vejrum

    2015-01-01

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

  16. Characteristics of Law-Autonomy Foreign Subsidiaries

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; McDonald, Frank; Stephan, Andreas

    2012-01-01

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

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

    OpenAIRE

    NGUYEN THANH, NHAN

    2012-01-01

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

  18. Autonomy and minority rights

    DEFF Research Database (Denmark)

    Barten, Ulrike

    2008-01-01

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

  19. Autonomy, Social Interactions and Culture

    OpenAIRE

    Marini, Annalisa; Navarra, Pietro

    2016-01-01

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

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

    Science.gov (United States)

    Steinberg, Matthew P.; Cox, Amanda Barrett

    2017-01-01

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

  1. Authenticity and autonomy in deep-brain stimulation.

    Science.gov (United States)

    Wardrope, Alistair

    2014-08-01

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

  2. Autonomy in chimpanzees.

    Science.gov (United States)

    Beauchamp, Tom L; Wobber, Victoria

    2014-04-01

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

  3. THE CORRELATION BETWEEN THE AUTONOMY RATIO AND THE RETURN ON EQUITY

    OpenAIRE

    Daniel BRÎNDESCU – OLARIU

    2014-01-01

    Previous studies conducted over companies from the Timis County indicate a negative correlation between the autonomy ratio and the bankruptcy risk. At the same time, high values of the autonomy ratio could have a negative effect on the return on equity. The current study aims to evaluate the relationship between the autonomy ratio and the return on equity. The target population included all the companies from the Timis County that have submitted financial statements to the fiscal authoriti...

  4. The Connotations of Language Teacher Autonomy

    Science.gov (United States)

    Han, Ligang

    2017-01-01

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

  5. Are NHS foundation trusts able and willing to exercise autonomy? 'You can take a horse to water...'.

    Science.gov (United States)

    Exworthy, Mark; Frosini, Francesca; Jones, Lorelei

    2011-10-01

    Foundation trusts (FTs) have been a central part of the government's National Health Service (NHS) reforms in England since 2004. They illustrate the government's claim to decentralization, by granting greater autonomy to high performing organizations. The number of FTs has grown steadily, reaching 131 in September 2010, over 50% of eligible trusts. Despite this growth, and notwithstanding the fact that organizations which initially became FTs were previously high performing, doubts remain about the implementation of the FT policy. This article examines the implementation of FTs in the NHS and focuses on the nature and exercise of autonomy by FTs. It argues that the ability of FTs to exercise autonomy is in place, but the (relatively limited) extent of implementation may be explained by trusts' lack of willingness to exercise such autonomy. Such unwillingness may be because of continued centralization, unclear policy and financial regimes, fear of negative impacts on relations with other local organizations, and awareness of greater risk to the FT, among others. Addressing the tension between FTs' ability and willingness to exercise autonomy will largely explain the extent to which the government's provider side reforms will be implemented.

  6. Autonomy and Firefighting: Perceived Competence and Stress.

    Science.gov (United States)

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

    2016-12-01

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

  7. Indications for treatment of thyroid autonomy

    International Nuclear Information System (INIS)

    Emrich, D.

    1989-01-01

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

  8. Autonomy and the Sources of Political Normativity

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

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

  9. Evaluation of Existing Situation of University Institutional Autonomy in Moldova

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Bugaian, Larisa; Gulieva, Valeria

    2014-01-01

    This chapter introduces four studies in which the current status of university institutional autonomy in Moldova is evaluated. At the same time it discusses the methodology employed in the study, provide a brief introduction to the higher education sector in Moldova and summaries key findings fro...... the evaluation of organizational, financial, HR and academic autonomy in Moldova.......This chapter introduces four studies in which the current status of university institutional autonomy in Moldova is evaluated. At the same time it discusses the methodology employed in the study, provide a brief introduction to the higher education sector in Moldova and summaries key findings from...

  10. Adolescents, Graduated Autonomy, and Genetic Testing

    Directory of Open Access Journals (Sweden)

    Susan Fox

    2012-01-01

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

  11. Autonomy support for autonomous motivation in medical education.

    Science.gov (United States)

    Kusurkar, Rashmi A; Croiset, Gerda

    2015-01-01

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

  12. Maternal autonomy is inversely related to child stunting in Andhra Pradesh, India.

    Science.gov (United States)

    Shroff, Monal; Griffiths, Paula; Adair, Linda; Suchindran, Chirayath; Bentley, Margaret

    2009-01-01

    Child stunting, an outcome of chronic undernutrition, contributes to poor quality of life, morbidity and mortality. In South Asia, the low status of women is thought to be one of the primary determinants of undernutrition across the lifespan. Low female status can result in compromised health outcomes for women, which in turn are related to lower infant birthweight and may affect the quality of infant care and nutrition. Maternal autonomy (defined as a woman's personal power in the household and her ability to influence and change her environment) is likely an important factor influencing child care and ultimately infant and child health outcomes. To examine the relationship between maternal autonomy and child stunting in Andhra Pradesh, India, we analysed data from National Family Health Survey (NFHS)-2. We used cross-sectional demographic, health and anthropometric information for mothers and their oldest child autonomy are presented by four dimensions - decision making, permission to travel, attitude towards domestic violence and financial autonomy - constructed using seven binary variables. Logistic regression models were used to test associations between indicators of female autonomy and the risk of having a stunted child. Women with higher autonomy {indicated by access to money [odds ratio (OR) = 0.731; 95% confidence interval (CI) 0.546, 0.981] and freedom to choose to go to the market [OR = 0.593; 95% CI 0.376, 0.933]} were significantly less likely to have a stunted child, after controlling for household socio-economic status and mother's education. In this south Indian state, two dimensions of female autonomy have an independent effect on child growth, suggesting the need for interventions that increase women's financial and physical autonomy.

  13. Integrated System Health Management (ISHM) and Autonomy

    Science.gov (United States)

    Figueroa, Fernando; Walker, Mark G.

    2018-01-01

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

  14. Autonomy and independence in language learning

    CERN Document Server

    Benson, Phil

    2014-01-01

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

  15. "Women's autonomy and pregnancy care in rural India: a contextual analysis".

    Science.gov (United States)

    Mistry, Ritesh; Galal, Osman; Lu, Michael

    2009-09-01

    Studies in low-income countries have shown that women's autonomy (i.e. the freedom of women to exercise their judgment in order to act for their own interests) influences a number of reproductive and child health outcomes, including the use of pregnancy care services. However, studies have not examined the full spectrum of pregnancy care services needed for safe motherhood and have not accounted for community context. This study analyzed data on women and their villages from the cross-sectional population-based National Family Health Survey-2 (1998-1999) of rural India to investigate whether women's autonomy (measured in the 3 dimensions of decision-making autonomy, permission to go out, and financial autonomy) was associated with the use of adequate prenatal, delivery and postnatal care. The findings indicate women's autonomy was associated with greater use of pregnancy care services, particularly prenatal and postnatal care. The effect of women's autonomy on pregnancy care use varied according to the region of India examined (North, East and South) such that it was most consistently associated with pregnancy care use in south India, which also had the highest level of self-reported women's autonomy. The results regarding village level factors suggest that public investment in rural economic development, primary health care access, social cohesion and basic infrastructure such as electrification and paved roads were associated with pregnancy care use. Improvements in women's autonomy and these village factors may improve healthier child bearing in rural India.

  16. EFFICIENCY FINANCIAL RESOURCES IN VOCATIONAL EDUCATION

    Directory of Open Access Journals (Sweden)

    Nataliia Kovernuk

    2016-11-01

    Full Text Available The purpose of writing is to research and analyze the effectiveness of financial resources in vocational education in Ukraine and develop practical recommendations for their improvement. To research and analyze the practices of formation and use of financial resources in vocational education. Research conducted by the methods of empirical knowledge, analysis, clustering, comparison, observation, synthesis, graphical analysis. The measures effective use of financial resources in vocational education in Ukraine. Methodology is actual work of scientists and researchers. Results are exploring of the practice of planning expenditures of state and local budgets for vocational education concluded that in planning expenditure dominates the normative method of budget planning. This discrepancy established approaches to the development of standards of employee’s vocational institutions and expenditures of staff, on the one hand, and the required planning spending on vocational education. When planning educational grants for training labor to local budgets is determined by the amount of expenditures that are relevant to the intergovernmental transfers, which include, in particular, spending on vocational education. Although the legislation stipulates the independence of local budgets and calculation of expenditures that are relevant to the intergovernmental transfers should be done only to determine the amount of educational grants for training labor, in practice there is a significant limitation of the autonomy of local governments in the planning of local budgets. Thus, the deterioration of the efficiency of spending on vocational education due to increasing labor costs and labor charges. The reason for this was the dynamics as increased wages and a change in the number of employees engaged in technical and vocational education. Value. The analysis of public expenditure planning practices and local budgets for vocational education concluded that in

  17. Autonomy support for autonomous motivation in medical education

    Directory of Open Access Journals (Sweden)

    Rashmi A. Kusurkar

    2015-05-01

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

  18. The Principalship, Autonomy, and After

    Science.gov (United States)

    Eacott, Scott

    2015-01-01

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

  19. WOMEN’S AUTONOMY AND THE FAMILY IN RECENT ROMANIAN POLICY-MAKING

    Directory of Open Access Journals (Sweden)

    ALICE IANCU

    2011-04-01

    Full Text Available In my paper I aim to provide an analysis of the relation between women’s autonomy and the family in Romanian recent policy-making. I will focus primarily on policies developed by the Romanian state after Romania’s integration in the European Union with regards to the family and family-related policy domains. My analysis will focus on several variables: 1. the theoretical instruments available for analyzing women’s autonomy in relation to state policies 2. the understanding of the family in Romanian policy-making 3. the interplay between women’s autonomy and the family and how policy-making influences the relation between the two. The analysis will take into consideration the specific Romanian socio-political context in terms of economic conditions, ideological influences and gender relations. Political theory is no stranger to the issue of individual autonomy. In my paper I will focus on recent feminist political theories on gendered accounts of autonomy. These accounts modify the understanding of autonomy and focus on conditions and aspects of autonomy relevant to women’s lives and experiences. The current financial crisis and recent developments in Romanian policy-making will be analyzed in terms of how they affect women’s autonomy. Since much of Romanian policy-making still avoids including gender and gender relations into its explicit justifications, provisions and evaluation, referring to the family as a basic social unit, the gendered consequences for women’s autonomy of such an approach need to be understood and acknowledged. In my analysis I will use both Romanian and European recent policy papers, as well as recent data obtained through social research.

  20. Protecting autonomy as authenticity using Ulysses contracts.

    Science.gov (United States)

    van Willigenburg, Theo; Delaere, Patrick

    2005-08-01

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

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

    Directory of Open Access Journals (Sweden)

    Sandra Rubin Glass

    1997-01-01

    Full Text Available

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

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

  2. Autonomy, Vulnerability, Recognition, and Justice

    NARCIS (Netherlands)

    Anderson, J.H.; Honneth, A.

    2005-01-01

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

  3. Radioiodine therapy of thyroid autonomy

    Energy Technology Data Exchange (ETDEWEB)

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

    2002-08-01

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

  4. Radioiodine therapy of thyroid autonomy

    International Nuclear Information System (INIS)

    Reiners, Christoph; Schneider, Peter

    2002-01-01

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

  5. The ADEPT Framework for Intelligent Autonomy

    National Research Council Canada - National Science Library

    Ricard, Michael; Kolitz, Stephan

    2003-01-01

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

  6. Rawls: The Problem of Autonomy and Coherentism

    Directory of Open Access Journals (Sweden)

    Elnora Gondim

    2010-12-01

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

  7. Student Perceptions of Their Autonomy at University

    Science.gov (United States)

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

    2018-01-01

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

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

    Science.gov (United States)

    Devisch, Ignaas

    2011-10-01

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

  9. Women's autonomy and experience of physical violence within marriage in rural India: evidence from a prospective study.

    Science.gov (United States)

    Sabarwal, Shagun; Santhya, K G; Jejeebhoy, Shireen J

    2014-01-01

    Evidence regarding the relationship between married women's autonomy and risk of marital violence remains mixed. Moreover, studies examining the contribution of specific aspects of women's autonomy in influencing the risk of marital violence using measures of autonomy that incorporate its dynamic nature are rare. We investigated the relationship between women's autonomy and their experience of marital violence in rural India using prospective data. We used data on 4,904 rural women drawn from two linked studies: the NFHS-2, conducted during 1998-1999 and a follow-up study for a subgroup of women carried out during 2002-2003. Three dimensions of autonomy were used: financial autonomy, freedom of movement, and household decision-making. Marital violence was measured as experience of physical violence in the year prior to the follow-up survey. Findings indicate the protective effects of financial autonomy and freedom of movement in reducing the risk of marital violence in the overall model. Furthermore, region-wise analysis revealed that in the more gender equitable settings of south India, financial autonomy exerted a protective influence on risk of marital violence. However, in the more gender-stratified settings of north India, none of the dimensions of autonomy were found to have any protective effect on women's risk of marital violence. Results argue for an increased focus on strategies aimed at improving women's financial status through livelihood skill-building opportunities, development of a strong savings orientation, and asset-building options.

  10. Autonomy, nudging and post-truth politics.

    Science.gov (United States)

    Keeling, Geoff

    2017-11-16

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

  11. Decision-Making Autonomy and Subsidiary Innovation

    DEFF Research Database (Denmark)

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

    2013-01-01

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

  12. School Autonomy, Leadership and Learning: A Reconceptualisation

    Science.gov (United States)

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

    2016-01-01

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

  13. Issues of promoting learner autonomy in EFL context

    Directory of Open Access Journals (Sweden)

    Pichugova Inna L.

    2016-01-01

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

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

    DEFF Research Database (Denmark)

    Rostbøll, Christian Fogh

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

  15. Buddhism and Autonomy-Facilitating Education

    Science.gov (United States)

    Morgan, Jeffrey

    2013-01-01

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

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

    Energy Technology Data Exchange (ETDEWEB)

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

    2017-05-01

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

  17. Fiscal autonomy of urban councils in Zimbabwe

    African Journals Online (AJOL)

    LAW

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

  18. Perceived autonomy in the first semester of mathematics studies

    OpenAIRE

    Liebendörfer, Michael; Hochmuth, Reinhard

    2015-01-01

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

  19. Patient autonomy in home care: Nurses' relational practices of responsibility.

    Science.gov (United States)

    Jacobs, Gaby

    2018-01-01

    Over the last decade, new healthcare policies are transforming healthcare practices towards independent living and self-care of older people and people with a chronic disease or disability within the community. For professional caregivers in home care, such as nurses, this requires a shift from a caring attitude towards the promotion of patient autonomy. To explore how nurses in home care deal with the transformation towards fostering patient autonomy and self-care. Research design and context: A case study was conducted in a professional development course ('learning circle') for home care nurses, including participant observations and focus groups. The theoretical notion of 'relational agency' and the moral concept of 'practices of responsibility' were used to conduct a narrative analysis on the nurses' stories about autonomy. Eight nurses, two coaches and two university lecturers who participated in the learning circle. Ethical considerations: Informed consent was sought at the start of the course and again, at specific moments during the course of the learning circle. Three main themes were found that expressed the moral demands experienced and negotiated by the nurses: adapting to the person, activating patients' strengths and collaboration with patients and informal caregivers. On a policy and organisational level, the moral discourse on patient autonomy gets intertwined with the instrumental discourse on healthcare budget savings. This is manifested in the ambiguities the nurses face in fostering patient autonomy in their daily home care practice. To support nurses, critical thinking, moral sensitivity and trans-professional working should be part of their professional development. The turn towards autonomy in healthcare raises moral questions about responsibilities for care. Promoting patient autonomy should be a collaborative endeavour and deliberation of patients, professional and informal caregivers together.

  20. Euthyroid goitre with and without functional autonomy: A comparison; Jodmangelstruma mit und ohne funktionelle Autonomie in der euthyreoten Phase: Ein Vergleich

    Energy Technology Data Exchange (ETDEWEB)

    Hillenhinrichs, H.; Emrich, D. [Goettingen Univ. (Germany). Abt. fuer Nuklearmedizin

    1998-05-01

    Analysis of functional autonomy in euthyroid goitre. Methods: In an area of moderate iodine deficiency 163 goitrous patients without and 179 with functional autonomy all clinically euthyroid were compared by sex, age, signs and symptoms, sonographic results, qualitative and quantitative scintigraphy without and with suppression, TRH test, hormone concentrations and iodine excretion in the urine. Results: Age, signs and symptoms, thyroid volume and structure did not contribute sufficiently to diagnosis. To detect functional autonomy quantitative scintigraphy under suppression was superior to the TRH test. Increased hormone concentrations were observed in 15% of patients with functional autonomy. A global {sup 99m}Tc thyroid uptake of {>=}3% under suppression indicates a higher risk of spontaneous hyperthyroidism. It was present in 20% of patients with functional autonomy. Conclusion: to diagnose and treat adequately functional autonomy in euthyroid goitre quantitative scintigraphy, determination of TSH and hormone concentrations are inevitable. (orig.) [Deutsch] Analyse der funktionellen Autonomie in der euthyreoten Phase. Methoden: Es wurden 163 klinisch euthyreote Patienten mit Jodmangelstruma ohne und 179 mit funktioneller Autonomie anhand von Geschlechtsverhaeltnis, Lebensalter, Beschwerden, Symptomen, sonographischem Befund, qualitativer und quantitativer Szintigraphie ohne und mit Suppression, TRH-Test, Hormonkonzentrationen und Jodausscheidung im Urin verglichen. Ergebnisse: Lebensalter, Beschwerden und Symptome, Schilddruesenvolumen und Echomuster lieferten keinen ausreichend sicheren Beitrag zur Diagnose. Die quantitative Szintigraphie war dem TRH-Test ueberlegen. Erhoehte Hormonkonzentrationen ergaben sich bei 15% der Patienten mit funktioneller Autonomie. Als Grenzwert fuer ein erhoehtes spontanes Hyperthyreoserisiko wurde eine globale thyreoidale {sup 99m}Tc-Aufnahme unter Suppression von {>=}3% ermittelt, die in 20% der Patienten mit funktioneller

  1. ASEAN’s Path to Regional Autonomy: Lessons Learned from the European Union

    Science.gov (United States)

    2016-04-04

    ASEAN. ASEAN’s Path to Regional Autonomy 12 Both the 1997 Asian Financial Crisis and ASEAN expansion to Myanmar made it clear that something...From - To) 04/04/2016 Master’s of Military Studies SEP 2015 -APR 2016 4. TITLE AND SUBTITLE Sa. CONTRACT NUMBER ASEAN’s Path to Regional Autonomy ...greater autonomy by enhancing military interoperability, making ASEAN the primary hub for diplomatic arrangements with non-members, transitioning to a

  2. Freedom of Expression, Deliberation, Autonomy and Respect

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2011-01-01

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

  3. The Autonomy Activity Status of Multinational Subsidiaries

    DEFF Research Database (Denmark)

    Dzikowska, Marlena; Gammelgaard, Jens; Jindra, Björn

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

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

    Science.gov (United States)

    Twomey, Mary

    2012-10-01

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

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

    Science.gov (United States)

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

    2014-10-01

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

  6. Personal Autonomy and Rational Suicide.

    Science.gov (United States)

    Webber, May A.; Shulman, Ernest

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

  7. Teacher Autonomy: Power or Control?

    Science.gov (United States)

    Lawson, Tony

    2004-01-01

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

  8. Our experience with radioiodine therapy of thyroid functional autonomies

    International Nuclear Information System (INIS)

    Kraft, Otakar

    2005-01-01

    targeted radiation dose in autonomously functioning tissue. The radioiodine amount administered was based on the volume of thyroid or the nodule, 24-hours radioiodine accumulation, the effective half-life of radioiodine, the absorbed dose of 500 Gy per gram of the nodule (UFA) or 300 Gy per gram of the whole thyroid (in patients with MFA and DFA). Before radioiodine therapy an average serum levels of total thyroxine was 164.6 nmol/l, of free thyroxine 20.8 pmol/l and triiodothyronine 3.2 nmol/l, in all patients TSH was suppressed. Before therapy patient's complaints were cardiovascular in 88% of patients (tachycardia, irregular pulse, palpitation), neurological (nerves, agitation) in 72% of patients, hypermetabolic (loss of weight, intolerance of warm, perspiration) in 68% of patients and local (feeling of neck compression, swallow difficulties) in 30% of patients. After therapy the average serum levels of total thyroxine was 108.8 nmol/l, free thyroxine 12.5 pmol/l and triiodothyronine 2.0 nmol/l and improvement of symptoms in 91%, without improvement in 8.7% and worsening in 0.3% of patients. The suppression of TSH disappeared in 607 of treated patients (76%). A volume reduction of thyroid of 38% was achieved in any type of functional autonomy after radioiodine treatment. Side effects were minimal and in some patients presented as a transient neck pressure or pain and neck swelling as a manifestation of post radiation thyroiditis. Post radiation hypothyroidism was diagnosed in 36 patients (4.5%). The results of this study show that the radioiodine therapy of the thyroid functional autonomies is safe, with low incidence of adverse effects. It is effective and for patients non-demanding. (author)

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

    Science.gov (United States)

    Nelsen, Peter

    2010-01-01

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

  10. The Chains on All My People Are the Chains on Me: Restrictions to Collective Autonomy Undermine the Personal Autonomy and Psychological Well-Being of Group Members.

    Science.gov (United States)

    Kachanoff, Frank J; Taylor, Donald M; Caouette, Julie; Khullar, Thomas H; Wohl, Michael J A

    2018-01-11

    Four studies assessed the potentially detrimental effects that restrictions to collective autonomy (i.e., a group's freedom to determine and practice its own identity) may have for the personal autonomy and psychological well-being of group members. In Study 1, using 3 distinct samples (NSample1a = 123, NSample1b = 129, NSample1c = 370), correlational and cross-cultural evidence indicates that perceived restrictions to the collective autonomy of one's group is directly associated with reduced personal autonomy, and indirectly associated with diminished well-being through personal autonomy. In Study 2 (N = 411), a longitudinal assessment of group members over 3 time-points during a 4-month period found that group members who perceived greater collective autonomy restriction also experienced reduced personal autonomy, and in turn, reduced psychological well-being over time. In Study 3 (N = 255), group members described a time during which their ingroup had (or did not have) its collective autonomy unduly restricted by other groups. Participants who were primed to think that their group lacked collective autonomy reported reduced feelings of personal autonomy, and reduced psychological well-being (compared with those primed to think their group had collective autonomy). In Study 4 (N = 389), collective autonomy was manipulated within the context of an intensive laboratory simulation. Collective autonomy-restricted group members experienced less personal autonomy than those who did not have their collective autonomy restricted. Together these findings suggest that restrictions to a group's collective autonomy may have detrimental consequences for the personal autonomy and psychological well-being of group members. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  11. Autonomy @ Ames

    Science.gov (United States)

    Van Dalsem, William; Krishnakumar, Kalmanje Srinivas

    2016-01-01

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

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

    Science.gov (United States)

    Swaine, Lucas

    2010-01-01

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

  13. Autonomy, recognition and education

    Directory of Open Access Journals (Sweden)

    Angelo Vitório Cenci

    2015-01-01

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

  14. Monetary Autonomy in Select Asian Economies : Role of International Reserves

    OpenAIRE

    Hiroyuki Taguchi; Geethanjali Nataraj; Pravakar Sahoo

    2010-01-01

    This paper examines the trends in monetary autonomy and its interaction with financial integration, currency regime and foreign reserves for the past two decades in select Asian countries viz., Thailand, Korea, Indonesia, Philippines, and India. Our main findings are as follows : First, Thailand, Korea and Indonesia, who experienced the change in currency regime towards a floating regime, have lowered the sensitivities of their interest rates (have raised monetary autonomy) after the regime c...

  15. Volitional Trust, Autonomy Satisfaction, and Engagement at Work.

    Science.gov (United States)

    Heyns, Marita; Rothmann, Sebastiaan

    2018-02-01

    This study tested a structural model that identifies the nature of relationships between trust, autonomy satisfaction, and personal engagement at work. A cross-sectional survey design with a convenience sample ( n = 252) was used. The Behavioral Trust Inventory, Work-Related Basic Need Satisfaction Scale, and Work Engagement Scale were administered. While reliance-based trust did not have a significant influence on engagement, disclosure-based trust in a focal leader was found to predict satisfaction of autonomy needs and employee engagement. Mediation analyses revealed that satisfaction of the need for autonomy facilitates the influence of trust on work outcomes. More specifically, disclosure (a dimension of trust) impacted engagement via autonomy satisfaction. Overall, the model explained 44% of total variance in engagement, to which the variables proportionately contributed as follows: autonomy satisfaction = 79.58%, disclosure = 18.22%, and reliance = 2.20%. The findings provide possible directions for how leaders can leverage trust to facilitate autonomy support and higher levels of engagement.

  16. Teacher Autonomy Perceptions of Iranian and Turkish EFL Teachers

    Directory of Open Access Journals (Sweden)

    Ebrahim KHEZERLOU

    2013-07-01

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

  17. [What is patient autonomy?

    Science.gov (United States)

    Durand, Guillaume

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

  18. Emotional autonomy and depression among Chinese adolescents.

    Science.gov (United States)

    Chou, K L

    2000-06-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  20. Women's autonomy and husbands' involvement in maternal health care in Nepal.

    Science.gov (United States)

    Thapa, Deependra Kaji; Niehof, Anke

    2013-09-01

    Both increasing women's autonomy and increasing husbands' involvement in maternal health care are promising strategies to enhance maternal health care utilization. However, these two may be at odds with each other insofar as autonomous women may not seek their husband's involvement, and involved husbands may limit women's autonomy. This study assessed the relationship between women's autonomy and husbands' involvement in maternal health care. Field work for this study was carried out during September-November 2011 in the Kailali district of Nepal. In-depth interviews and focus group discussions were used to investigate the extent of husbands' involvement in maternal health care. A survey was carried out among 341 randomly selected women who delivered a live baby within one year prior to the survey. The results show that husbands were involved in giving advice, supporting to reduce the household work burden, and making financial and transportation arrangements for the delivery. After adjustment for other covariates, economic autonomy was associated with lower likelihood of discussion with husband during pregnancy, while domestic decision-making autonomy was associated with both lower likelihood of discussion with husband during pregnancy and the husband's presence at antenatal care (ANC) visits. Movement autonomy was associated with lower likelihood of the husband's presence at ANC visits. Intra-spousal communication was associated with higher likelihood of discussing health with the husband during pregnancy, birth preparedness, and the husbands' presence at the health facility delivery. The magnitude and direction of association varied per autonomy dimension. These findings suggest that programs to improve the women's autonomy and at the same time increase the husband's involvement should be carefully planned. Despite the traditional cultural beliefs that go against the involvement of husbands, Nepalese husbands are increasingly entering into the area of maternal

  1. Radioiodine-treatment (RIT) of functional thyroidal autonomy

    International Nuclear Information System (INIS)

    Meller, J.; Sahlmann, C.O.; Becker, W.

    2002-01-01

    Since 1942, therapy with radioiodine (RIT) has gained a major role in the treatment of benign thyroid disorders, notably hyperthyroidism caused by Graves' disease or toxic multinodular goitre (thyroid autonomy). In iodine deficient areas thyroid autonomy accounts for 40-50% of all cases with hyperthyroidism. RIT has become a cost-effective first-line procedure in autonomy-patients with latent or overt hyperthyroidism, especially in the absence of a large goitre, after thyroid surgery and in elderly patients with associated conditions who carry a high intra- or perioperative risk. Decisions concerning the definitive treatment of thyroid autonomy should take into account previous episodes of hyperthyroidism, objective parameters of risk stratification in euthyroid patients as well as concomitant diseases and the probability of iodine exposure in the future. In Central Europe the majority of investigators prefer to estimate the therapeutic activity individually by a radioiodine test. TCTUs (global 99m-Tc-pertechnetate thyroid uptake under suppression) - based dose concepts have been proven to be highly effective in the elimination of autonomy and carry a low (< 10%) risk of postradioiodtherapeutic hypothyroidism. Radioiodine therapy for autonomy has been found to be both effective and safe and without major early or late side effects. The most frequent complication is hypothyroidism requiring lifelong follow-up. (author)

  2. Netherlands: Steady decline in job autonomy

    NARCIS (Netherlands)

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

    2015-01-01

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

  3. Advancing Learner Autonomy in TEFL via Collaborative Learning

    Science.gov (United States)

    Jacobs, George M.; Shan, Tan Hui

    2015-01-01

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

  4. A Reconfigurable Testbed Environment for Spacecraft Autonomy

    Science.gov (United States)

    Biesiadecki, Jeffrey; Jain, Abhinandan

    1996-01-01

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

  5. Finding Autonomy in Birth*

    Science.gov (United States)

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

    2009-01-01

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

  6. See More, Do More, Teach More: Surgical Resident Autonomy and the Transition to Independent Practice.

    Science.gov (United States)

    Hashimoto, Daniel A; Bynum, William E; Lillemoe, Keith D; Sachdeva, Ajit K

    2016-06-01

    The graduate medical education system is tasked with training competent and autonomous health care providers while also improving patient safety, delivering more efficient care, and cutting costs. Concerns about resident autonomy and preparation for independent and safe practice appear to be growing, and the field of surgery faces unique challenges in preparing graduates for independent practice. Multiple factors are contributing to an erosion of resident autonomy and decreased operative experience, including differing views of autonomy, financial forces, duty hours regulations, and diverse community health care needs. Identifying these barriers and developing solutions to overcome them are vital first steps in reversing the trend of diminishing autonomy in surgical residency training. This Commentary highlights the problem of decreasing autonomy, outlines specific threats to resident autonomy, and discusses potential solutions to mitigate their impact on the successful transition to independent practice.

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

    Science.gov (United States)

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

    2017-12-01

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

  8. The Ideal of Moral Autonomy

    Directory of Open Access Journals (Sweden)

    Ricardo Marquisio Aguirre

    2017-10-01

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

  9. How important is Autonomy to Professional Workers?

    Directory of Open Access Journals (Sweden)

    Arne Mastekaasa

    2011-11-01

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

  10. Freedom of Expression, Deliberation, Autonomy and Respect

    OpenAIRE

    Rostbøll, Christian F.

    2011-01-01

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

  11. Review: Local Government in England: Centralisation, Autonomy and Control by Colin Corpus, Mark Roberts, Rachel Wall

    Directory of Open Access Journals (Sweden)

    Jonathan Carr-West

    2018-04-01

    Full Text Available Local Government in England: Centralisation, Autonomy and Control is a serious book and an important contribution to the scholarship around local government. It opens however, with a pleasingly comic tableau as academics from England, Portugal and Poland bicker amiably at a conference and on Twitter about whose country is really the most centralised. The rest of the book is devoted to showing why the English academics were right, why it matters and what should be done about it. The main thrust of the text is an analysis of the impact of the dominant policy narratives around centralism and localism. The argument that Copus, Wall and Roberts put forward could be boiled down to the assertion that the problem with local government in England is that it is neither local nor government. But to make this case they first helpfully unpack several sets of concepts that are all too often elided together.

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

    OpenAIRE

    Rostbøll, Christian F.

    2009-01-01

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

  13. Autonomy and informed consent: a mistaken association?

    Science.gov (United States)

    Kristinsson, Sigurdur

    2007-09-01

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

  14. Epistemic Autonomy: A Criterion for Virtue?

    Science.gov (United States)

    Mudd, Sasha

    2013-01-01

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

  15. Are there limits to respect for autonomy in bioethics?

    Science.gov (United States)

    de Roubaix, Malcolm

    2008-06-01

    I discuss the significance of respect for personal autonomy in bioethics with reference to its practical expression: rational informed patient choice. The question is whether, given the apparent practical limitations to this notion, bioethical autonomy should be seen as an absolute. After a historical review of informed consent and its development, I discuss the requirements for informed consent. Some inherent tensions are evaluated, as is the applicability of the notion that in order to be legitimate, autonomy should do some ethical work. Limits to the notion of informed consent are explored with reference to six examples: the right of women to reproductive autonomy; the autonomy of legally minor Jehovah's Witnesses; autonomy in cosmetic surgery; inappropriate treatment; autonomy and human medical research, and euthanasia and other end-of-life options. The discussion is within a South African framework with reference to other jurisdictions and decisions where appropriate. I conclude that whilst some unusual instances of limitation of bioethical informed consent might be ethically justifiable, the arguments presented point to the opposite: the unfounded limitation of informed consent.

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

    Science.gov (United States)

    Griffiths, P E; West, C

    2015-08-01

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

  17. Women's autonomy and reproductive health care utilisation: empirical evidence from Tajikistan.

    Science.gov (United States)

    Kamiya, Yusuke

    2011-10-01

    Women's autonomy is widely considered to be a key to improving maternal health in developing countries, whereas there is no consistent empirical evidence to support this claim. This paper examines whether or not and how women's autonomy within the household affects the use of reproductive health care, using a household survey data from Tajikistan. Estimation is performed by the bivariate probit model whereby woman's use of health services and the level of women's autonomy are recursively and simultaneously determined. The data is from a sample of women aged 15-49 from the Tajikistan Living Standard Measurement Survey 2007. Women's autonomy as measured by women's decision-making on household financial matters increase the likelihood that a woman receives antenatal and delivery care, whilst it has a negative effect on the probability of attending to four or more antenatal consultations. The hypothesis that women's autonomy and reproductive health care utilisation are independently determined is rejected for most of the estimation specifications, indicating the importance of taking into account the endogenous nature of women's autonomy when assessing its effect on health care use. The empirical results reconfirm the assertion that women's status within the household is closely linked to reproductive health care utilisation in developing countries. Policymakers therefore need not only to implement not only direct health interventions but also to focus on broader social policies which address women's empowerment. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  18. The Autonomy of Deportation

    Directory of Open Access Journals (Sweden)

    Nicholas de Genova

    2017-06-01

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

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

    Science.gov (United States)

    Reddiford, Gordon

    1993-01-01

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

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

    International Nuclear Information System (INIS)

    Hillenhinrichs, H.; Emrich, D.

    1998-01-01

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

  1. Autonomy and Housing Accessibility Among Powered Mobility Device Users

    Science.gov (United States)

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

    2015-01-01

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

  2. English-Medium Instruction and Self-Governance in Higher Education: The Journey of a Vietnamese University through the Institutional Autonomy Regime

    Science.gov (United States)

    Nguyen, Huong Thu; Hamid, M. Obaidul; Moni, Karen

    2016-01-01

    As neoliberal ideals of deregulation, accountability, quality and financial autonomy take hold of education worldwide, higher education institutions (HEIs) in developing economies are adopting strategies to improve educational quality; attract local and international students; enhance institutional ranking and global competitiveness; and, more…

  3. Effective means of planning for and implementing autonomy

    DEFF Research Database (Denmark)

    Rehof, Lars Adam

    1991-01-01

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

  4. Analisis Pengelolaan Keuangan Daerah Di Kota Jayapura Pada Era Otonomi Khusus

    Directory of Open Access Journals (Sweden)

    Halomoan Hutajulu

    2016-06-01

    Full Text Available The implementation of the Special Autonomy (Special Autonomy in accordance with Law No. 21, 2001, is an effort to accelerate the development and distribution of areas in the city of Jayapura. Implementation OTSUS is the equation of regional autonomy of local governments and financial management. The purpose of this study to analyze the financial management aspects of the area in terms of effectiveness, and budget planning after special autonomy, and justice analyze budget allocations. Quantitative analysis of the research approach consisting of a horizontal analysis, vertical analysis, and conversion analysis. The results showed that the effectiveness of the financial management of Jayapura city district in the Special Autonomy less effective, analysis of revenue and revenue growth ratio high of 37.33 percent and lowest 6.07. Ratio highest balanced fund 49.55 percent in 2006. Highest expenditure ratio reached 47.13 percent. The results showed a tendency analyst highest revenue growth in 2009 of Rp45.103 Billion, followed by the highest propensity balanced fund Rp567.980 Billion in 2009, the trend of the highest expenditures Rp451.190 Billion in 2009, the highest real development expenditure Rp208.063 Billion in 2008, the highest absorbed construction Rp147.418 Billion in 2006. Financial planning area is under estimated to PAD, whereas the conversion of the budget shows the budget surplus in 2002 and 2007.

  5. Understanding critical care nurses' autonomy in Jordan.

    Science.gov (United States)

    Maharmeh, Mahmoud

    2017-10-02

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

  6. U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization? Comment on "Decentralisation of Health Services in Fiji: A Decision Space Analysis".

    Science.gov (United States)

    Bustamante, Arturo Vargas

    2016-06-07

    For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form) is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form) is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization. © 2016 by Kerman University of Medical Sciences.

  7. Personal financial incentives in health promotion: where do they fit in an ethic of autonomy?

    Science.gov (United States)

    Ashcroft, Richard E

    2011-06-01

    This paper reviews the ethical controversy concerning the use of monetary incentives in health promotion, focussing specifically on the arguments relating to the impact on personal autonomy of such incentives. Offering people small amounts of money in the context of health promotion and medical care has been attempted in a number of settings in recent years. This use of personal financial incentives has attracted a degree of ethical controversy. One form of criticism is that such schemes interfere with the autonomy of the patient or citizen in an illegitimate way. This paper presents a thematic analysis of the main arguments concerning personal autonomy and the use of monetary incentives in behaviour change. The main moral objections to the uses of incentives are that they may be in general or in specific instances paternalistic, coercive, involve bribery, or undermine the agency of the person. While incentive schemes may engage these problems on occasion, there is no good reason to think that they do so inherently and of necessity. We need better behavioural science evidence to understand how incentives work, in order to evaluate their moral effects in practice. © 2011 Blackwell Publishing Ltd.

  8. PUBLIC EXPENDITURE ON HEALTH IN LOCAL BUDGETS

    Directory of Open Access Journals (Sweden)

    Cristinel ICHIM

    2017-06-01

    Full Text Available This paper entitled "Public expenditure on health in local budgets" aims analysing and deepening major spending categories that public authorities finance at local level, namely health expenditure. In the first part of the article we have specified the content and role of this category of expenditure in local budgets and also made some feedback on decentralization in health. In the second part of the work, based on data available in Statistical Yearbook of Romania, we have carried out an analysis of the dynamics of health spending from local budgets to emphasize their place and role in the health care expenses. The research carried out follows that the evolution and structure of health expenditure financed from local budgets is determined, along with the legislative framework in the field, by several variables that differ from one territorial administrative unit to another: the existence of sanitary units, their type, the involving of local public authorities in their development and modernization, the number and the social structure of the population. The research shows that over the period 1993-2015, the dynamics of the share of health spending in total expenditures of local budgets is sinusoidal, with a minimum threshold in 2000 of only 0.3%.

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

    Science.gov (United States)

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

    2017-11-01

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

  10. Autonomy, Competence and Non-interference

    OpenAIRE

    Roberts, Joseph T.F.

    2017-01-01

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

  11. The Changing Scope of Professional Autonomy

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh; Wrede, Sirpa

    2009-01-01

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

  12. Autonomy and Automation

    Science.gov (United States)

    Shively, Jay

    2017-01-01

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

  13. Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education.

    Science.gov (United States)

    Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

    2016-09-01

    Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students' perceived autonomy and intrinsic motivation.

  14. Patient autonomy and informed consent in critically lll

    Directory of Open Access Journals (Sweden)

    Todorović Zoran M.

    2017-01-01

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

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

    Science.gov (United States)

    Ambrosini, Daniel L; Crocker, Anne G

    2009-01-01

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

  16. Autonomy, Trust, and Respect.

    Science.gov (United States)

    Nys, Thomas

    2016-02-01

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

  17. Emotional autonomy and problem behavior among Chinese adolescents.

    Science.gov (United States)

    Chou, Kee-Lee

    2003-12-01

    The author examined the association between emotional autonomy and problem behavior among Chinese adolescents living in Hong Kong. The respondents were 512 adolescents, 16 to 18 years of age, who were interviewed for a cross-sectional study. Three dimensions of emotional autonomy including individuation, nondependency on parents, and de-idealization of parents were significantly and positively correlated with the amount of problem behavior the participants engaged in during the past 6 months. Using a simple linear multiple regression model, the author found that problem behavior was associated with only one aspect of emotional autonomy-individuation. Results indicated that the relationship between problem behavior and three aspects of emotional autonomy was similar in both individualistic and collectivistic societies.

  18. Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

    Directory of Open Access Journals (Sweden)

    Yu-Kai Chang, Senlin Chen, Kun-Wei Tu, Li-Kang Chi

    2016-09-01

    Full Text Available Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61 or the control group (n = 65 for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation.

  19. Students' autonomy and teacher's interpersonal style in self-determination theory

    Directory of Open Access Journals (Sweden)

    Lalić-Vučetić Nataša

    2009-01-01

    Full Text Available Starting from psychological needs that are considered basic within self-determination theory (autonomy, competence and relatedness, the importance of encouraging students' autonomy in school context is particularly emphasised. Appreciation of students' autonomy has a stimulating effect on school achievement, conceptual understanding, creativity development, strengthening of self-esteem, and students adapt better to school system and demonstrate a larger degree of internalisation of school rules and intrinsic motivation. Teachers' behavioural style largely determines the degree of students' autonomy in school life and work. Self-determination theory implies the necessity of agreement between the developmental need for autonomy in children and the level of adult control and distinguishes between two styles of interpersonal behavior of teachers: (a those who offer support to students' autonomy by their behavior and (b those that are predominantly inclined to control students' behavior. This paper also points out to different strategies that can be applied by teachers in working with students in school, which also contribute to the development of students' autonomy. What is especially encouraging is the fact that it is possible to learn and to develop 'appreciation of students' autonomy' as teacher's interpersonal style.

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

    Directory of Open Access Journals (Sweden)

    Sonia Ingoglia

    2013-08-01

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

  1. A longitudinal research on the development of emotional autonomy during adolescence.

    Science.gov (United States)

    Parra, Agueda; Oliva, Alfredo

    2009-05-01

    The purpose of the present paper was to study the development of emotional autonomy through adolescence analysing its association with family relationships. The development of emotional autonomy involves an increase in adolescents' subjective sense of his or her independence, especially in relation to parents. From some scholars emotional autonomy is a normative manifestation of the detachment process from parents, however, others point out that detachment from parental ties is not the norm, so high level of adolescent emotional autonomy is the consequence of negative family relationships. In our study a sample of 101 adolescents were followed for 5 years, from early to middle adolescence, and completed questionnaires to measure their emotional autonomy and the quality of their family relationships. Our results showed that over the course of adolescence some dimensions of emotional autonomy increase, meanwhile others decrease, so the global level of emotional autonomy global level remains stable. On the other hand, emotional autonomy is associated with negative family relationships, so emotional autonomy, more than a necessary process to become adult, could be indicating an insecure attachment to parents.

  2. The Future of Reproductive Autonomy.

    Science.gov (United States)

    Johnston, Josephine; Zacharias, Rachel L

    2017-12-01

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

  3. U-Form vs. M-Form: How to Understand Decision Autonomy Under Healthcare Decentralization?; Comment on “Decentralisation of Health Services in Fiji: A Decision Space Analysis”

    Directory of Open Access Journals (Sweden)

    Arturo Vargas Bustamante

    2016-09-01

    Full Text Available For more than three decades healthcare decentralization has been promoted in developing countries as a way of improving the financing and delivery of public healthcare. Decision autonomy under healthcare decentralization would determine the role and scope of responsibility of local authorities. Jalal Mohammed, Nicola North, and Toni Ashton analyze decision autonomy within decentralized services in Fiji. They conclude that the narrow decision space allowed to local entities might have limited the benefits of decentralization on users and providers. To discuss the costs and benefits of healthcare decentralization this paper uses the U-form and M-form typology to further illustrate the role of decision autonomy under healthcare decentralization. This paper argues that when evaluating healthcare decentralization, it is important to determine whether the benefits from decentralization are greater than its costs. The U-form and M-form framework is proposed as a useful typology to evaluate different types of institutional arrangements under healthcare decentralization. Under this model, the more decentralized organizational form (M-form is superior if the benefits from flexibility exceed the costs of duplication and the more centralized organizational form (U-form is superior if the savings from economies of scale outweigh the costly decision-making process from the center to the regions. Budgetary and financial autonomy and effective mechanisms to maintain local governments accountable for their spending behavior are key decision autonomy variables that could sway the cost-benefit analysis of healthcare decentralization.

  4. On the Compatibility of Autonomy and Relatedness.

    Science.gov (United States)

    Hodgins, Holley S.; And Others

    1996-01-01

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

  5. 40 CFR 73.86 - State regulatory autonomy.

    Science.gov (United States)

    2010-07-01

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

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

    NARCIS (Netherlands)

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

    2016-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Pavlos Hatzopoulos

    2015-03-01

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

  8. Don’t Always Prefer My Chosen Objects: Low Level of Trait Autonomy and Autonomy Deprivation Decreases Mere Choice Effect

    Science.gov (United States)

    Shang, Zhe; Tao, Tuoxin; Wang, Lei

    2016-01-01

    Choice effect is a robust phenomenon in which even “mere choice” that does not include actual choosing actions could result in more preference for the self-chosen objects over other-chosen objects. In the current research, we proposed that autonomy would impact the mere choice effect. We conducted two studies to examine the hypothesis. The results showed that the mere choice effect measured by Implicit Association Test (IAT) significantly decreased for participants with lower levels of trait autonomy (Study 1) and when participants were primed to experience autonomy deprivation (Study 2). The theoretical and practical implications are discussed. PMID:27148132

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

    Science.gov (United States)

    Chen, Kai-Li; Chen, Ching-Huey

    2014-10-01

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

  10. Patient autonomy: a view from the kitchen.

    Science.gov (United States)

    Struhkamp, Rita M

    2005-01-01

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

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

    Science.gov (United States)

    de Wit, F A

    2012-01-01

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

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

    Science.gov (United States)

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

    2015-01-01

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

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

    Science.gov (United States)

    Finnigan, Kara S.

    2007-01-01

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

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

    Science.gov (United States)

    White, Lucie

    2017-08-11

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

  15. Juridical-Criminal Paternalism, Autonomy and Vulnerability: Legitimation Criteria of Paternalistic Interventions on Individual Autonomy in Criminal Matters

    Directory of Open Access Journals (Sweden)

    Heráclito Mota Barreto Neto

    2015-12-01

    Full Text Available The following paper has as objective questioning the legitimacy of state's paternalistic interventions on individual autonomy by using institutional-criminal instruments. In this path, the paper aims to understand in which cases the State is allowed to interfere in private individual lives under the justification of being promoting a well or avoiding a harm and, as well, in which cases such interference is abusive of individuals self-determination. Into this analysis, the work will study the current concepts of paternalism, the theoretical classifications on paternalistic interventions which will be useful to demonstrate admissible and inadmissible species of paternalism and Joel Feinberg and Gerald Dworkin's anti- paternalistic theories. Following, this subject will be analyzed in association with the implications of juridical-criminal goods involved in conflicts between autonomy, human vulnerabilities and paternalism, specially regarding to the (unavailability of those goods. In the end, the work intends to define legitimation criteria for paternalistic interventions inserted in criminal laws, which superimpose themselves on the individual autonomy, in order to harmonize constitutional values of respect for autonomy, protection of vulnerable individuals and the Criminal Law functions of exclusive protection of juridical goods.

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

    Science.gov (United States)

    Carter, Jean A.

    2011-01-01

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

  17. Stories of Human Autonomy, Law, and Technology

    Science.gov (United States)

    Tranter, Kieran

    2010-01-01

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

  18. What does respect for the patient's autonomy require?

    Science.gov (United States)

    Cheng, Kam-Yuen

    2013-11-01

    Personal autonomy presupposes the notion of rationality. What is not so clear is whether, and how, a compromise of rationality to various degrees will diminish a person's autonomy. In bioethical literature, three major types of threat to the rationality of a patient's medical decision are identified: insufficient information, irrational beliefs/desires, and influence of different framing effects. To overcome the first problem, it is suggested that patients be provided with information about their diseases and treatment choices according to the objective standard. I shall explain how this should be finessed. Regarding the negative impact of irrational beliefs/desires, some philosophers have argued that holding irrational beliefs can still be an expression of autonomy. I reject this argument because the degree of autonomy of a decision depends on the degree of rationality of the beliefs or desires on which the decision is based. Hence, to promote patient autonomy, we need to eliminate irrational beliefs by the provision of evidence and good arguments. Finally, I argue that the way to smooth out the framing effects is to present the same information in different perspectives: it is too often assumed that medical information can always be given in a complete and unadorned manner. This article concludes with a cautionary note that the protection of patient autonomy requires much more time and effort than the current practice usually allows. © 2012 John Wiley & Sons Ltd.

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

    DEFF Research Database (Denmark)

    Rostbøll, Christian F.

    2009-01-01

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

  20. Effect of Autonomy Support on Self-Determined Motivation in Elementary Physical Education

    Science.gov (United States)

    Chang, Yu-Kai; Chen, Senlin; Tu, Kun-Wei; Chi, Li-Kang

    2016-01-01

    Using the quasi-experimental design, this study examined the effect of autonomy support on self-determined motivation in elementary school physical education (PE) students. One hundred and twenty six participants were assigned to either the autonomy support group (n = 61) or the control group (n = 65) for a six-week intervention period. Perceived teacher autonomy, perceived autonomy in PE, and self-determined motivation in PE were pre- and post-tested using validated questionnaires. Significant increases in perceived teacher autonomy and perceived autonomy in PE were observed in the autonomy support group, but not in the control group. Intrinsic motivation was higher in the autonomy support group than that in the control group. From an experimental perspective, these findings suggest that the autonomy support was successfully manipulated in the PE classes, which in turn increased the students’ perceived autonomy and intrinsic motivation. Key points The SDT is a relevant theoretical framework for elementary school physical education. Using the quasi-experimental research design, this study is one of the earlies studies supporting that elementary school PE teachers can manipulate the instructional context using the SDT to increase students’ perceived autonomy and intrinsic motivation. Increasing students’ perceived autonomy may not lead to significant changes in other SDT constructs (i.e., amotivation, external regulation, introjected regulation, and identified regulation). PMID:27803624

  1. Limits of the principle of budgetary stability with respect to the financial autonomy of the Spanish Autonomous Communities

    Directory of Open Access Journals (Sweden)

    Carlo Alberto Ciaralli

    2018-04-01

    Full Text Available The constitutional reform by which in 2011 Spain amended Article 135 of the Constitution is the topic of this article. By such an amendment the principle of financial and budgetary stability as well as a strict control over the budget of public administration and the devolved regional institutions (Comunidades Autonomas has been introduced. All this amounts to severe limitations on the structural deficit. In fact, this reform has brought about a strengthening of the supervisory powers of the State over policies which the Constitution confers to the Comunidades Autonomas as well as clamping down on their financial autonomy. The thrust of the article is to show how, in time of crisis, the “financial constitution” changes its structure to adapt to the inputs coming from European rules and the financial markets.

  2. Architecture for autonomy

    Science.gov (United States)

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

    2006-05-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  4. Threats to Autonomy in Consumer Societies and Their Implications for Education

    Science.gov (United States)

    Schinkel, Anders; de Ruyter, Doret; Steutel, Jan

    2010-01-01

    The development of autonomy in children is a central concern of liberal philosophers of education. We endorse the liberal intuition that autonomy matters and that it is an appropriate aim of education. However, we divert from autonomy liberals, who defend a rather limited and demanding conception of autonomy that is closely connected with skills…

  5. [Autonomy, Trust and Medical Ethics in Onora O'Neill's Work].

    Science.gov (United States)

    Jaramillo, Carlos Alberto López; Lew, Jorge Carlos Holguín

    2013-03-01

    Autonomy has become a key concept in bioethics. Onora O'neill is perhaps the most representative author and researcher in the philosophical and bioethical fields regrding the concept of autonomy. To review the concept of autonomy in Onora O'Neill's work so as to understand its relevance in current bioethics. The concept of bioethics is reviewed in relation to three fundamental quesions: 1) Which are the main limitations of the individualistic conception of autonomy? 2) How to understand the relations between trust and autonomy together with their implications? and 3) Which are the implications of principled autonomy for aspects such as doctor-patient relationship and informed consent. The main works by O'Neill are reviewed, specifically regarding medical bioethics. O'neill's approach is original and relates Kantian autonomy to her own conceptions about trust, and both the individual and social levels of bioethics. The author has developed a Kantian non indvidualistic view of autonomy. Her conceptulization of trust and the crises this concept is currently undergoing complement and strengthen the concept of principled autonomy. The implications of O'Neill's concepts go beyond theoretical discussions and in her work she uses examples and analyzes circumstances which demonstrate the applicability of her proposals. O'Neill's work contributes to dealing with the challenges posed by the socio-political context of cost-efficiency oriented health systems and of the so-called defensive medicine. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

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

    Science.gov (United States)

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

    2017-09-01

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

  7. Direct-to-consumer genomics on the scales of autonomy

    Science.gov (United States)

    Vayena, Effy

    2015-01-01

    Direct-to-consumer (DTC) genetic services have generated enormous controversy from their first emergence. A dramatic recent manifestation of this is the Food and Drug Administration's (FDA) cease and desist order against 23andMe, the leading provider in the market. Critics have argued for the restrictive regulation of such services, and even their prohibition, on the grounds of the harm they pose to consumers. Their advocates, by contrast, defend them as a means of enhancing the autonomy of those same consumers. Autonomy emerges as a key battle-field in this debate, because many of the ‘harm’ arguments can be interpreted as identifying threats to autonomy. This paper assesses whether DTC genomic services are a threat to, or instead, an enhancement of, personal autonomy. It deploys Joseph Raz's account of personal autonomy, with its emphasis on choice from a range of valuable options. It then seeks to counter claims that DTC genomics threatens autonomy because it involves manipulation in contravention of consumers’ independence or because it does not generate valuable options which can be meaningfully engaged with by consumers. It is stressed that the value of the options generated by DTC genomics should not be judged exclusively from the perspective of medical actionability, but should take into consideration plural utilities. Finally, the paper ends by broaching policy recommendations, suggesting that there is a strong autonomy-based argument for permitting DTC genomic services, and that the key question is the nature of the regulatory conditions under which they should be permitted. The discussion of autonomy in this paper helps illuminate some of these conditions. PMID:24797610

  8. Women's decision-making autonomy and children's schooling in rural Mozambique.

    Science.gov (United States)

    Luz, Luciana; Agadjanian, Victor

    2015-03-24

    Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. The results show a positive association of women's decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women's autonomy is net of other women's characteristics typically associated with enrollment and does not mediate the effects of those characteristics. Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters' schooling and may have a greater say in making and implementing decisions regarding daughters' education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women's status on children's educational outcomes.

  9. Scaffolding Learner Autonomy in Online University Courses

    Science.gov (United States)

    Ribbe, Elisa; Bezanilla, María José

    2013-01-01

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

  10. Relativní autonomie kultury v Alexanderově kulturní sociologii

    OpenAIRE

    Skovajsa, Marek

    2012-01-01

    This article offers a critical discussion of the concept of the ‘relative autonomy of culture’ that is central to Jeffrey C. Alexander’s cultural sociology. It shows that, in Alexander’s work, the relative autonomy of culture is conceptualised in two different ways: first, as an analytical autonomy that is part of a multidimensional model of social action, and second, as the formal autonomy of a semiotic system that dominates in the more culturalist strand of Alexander’s work. The author clai...

  11. The Effect of Gender on Resident Autonomy in the Operating room.

    Science.gov (United States)

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

    Discrimination against women training in medicine and surgery has been subjectively described for decades. This study objectively documents gender differences in the degree of autonomy given to thoracic surgery trainees in the operating room. Thoracic surgery residents and faculty underwent frame of reference training on the use of the 4-point Zwisch scale to measure operative autonomy. Residents and faculty then submitted evaluations of their perception of autonomy granted for individual operations as well as operative difficulty on a real-time basis using the "Zwisch Me!!" mobile application. Differences in autonomy given to male and female residents were elucidated using chi-square analysis and ordered logistic regression. Seven academic medical centers with thoracic surgery training programs. Volunteer thoracic surgery residents in both integrated and traditional training pathways and their affiliated cardiothoracic faculty. Residents (n = 33, female 18%) submitted a total of 596 evaluations to faculty (n = 48, female 12%). Faculty gave less autonomy to female residents with only 56 of 184 evaluations (30.3%) showing meaningful autonomy (passive help or supervision only) compared to 107 of 292 evaluations (36.7%) at those levels for male residents (p = 0.02). Resident perceptions of autonomy showed even more pronounced differences with female residents receiving only 38 of 197 evaluations (19.3%) with meaningful autonomy compared to 133 of 399 evaluations (33.3%) for male residents (p autonomy granted to residents. Evaluations of operative autonomy reveal a significant bias against female residents. Faculty education is needed to encourage allowing female residents more operative autonomy. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  12. Local Leader, Liberalism and Autonomy in the Mexican Revolution. Pahuatlán, Puebla, 1911–1914

    Directory of Open Access Journals (Sweden)

    Óscar Fernando López Meraz

    2017-07-01

    Full Text Available The article analyzes the revolutionary process in the municipality of Pahuatlán, located in the Sierra Norte de Puebla (Mexico, from 1911 to 1914. The objective is to understand the particularities of this space to know the impact it had on the daily life of its inhabitants. The questions that led the investigation were: How does the Revolution arrive in Pahuatlán? What motivated the pahuatecos to be part of the revolutionary process? How did your participation in daily life affect you? Likewise, we assume that Pahuateca's participation was due to the attempt of the regional political leaders to execute the mandates of the liberal state in terms that were locally acceptable; That is to say, they elaborated a local agenda that provided political and social stability in the municipality based on the defense of the local autonomy, and not in the necessity of an agrarian claim. From a local perspective, we observe how the specific characteristics acquired by the revolutionary movement in Pahuatlán are closely related to what happened at the national and state levels.

  13. SOCIOTROPY AND AUTONOMY IN EATING DISORDERS

    OpenAIRE

    Radziwiłłowicz, Wioletta; Czarniak, Katarzyna

    2014-01-01

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

  14. The Cascading Development of Autonomy and Relatedness From Adolescence to Adulthood

    Science.gov (United States)

    Oudekerk, Barbara A.; Allen, Joseph P.; Hessel, Elenda T.; Molloy, Lauren E.

    2014-01-01

    We tested a developmental cascade model of autonomy and relatedness in the progression from parent to friend to romantic relationships across ages 13, 18, and 21. Participants included 184 adolescents (53% female, 58% Caucasian, 29% African American) recruited from a public middle school in Virginia. Parental psychological control at age 13 undermined the development of autonomy and relatedness, predicting relative decreases in autonomy and relatedness with friends between ages 13 and 18 and lower levels of autonomy and relatedness with partners at age 18. These cascade effects extended into adult friendships and romantic relationships, with autonomy and relatedness with romantic partners at age 18 being a strong predictor of autonomy and relatedness with both friends and partners at age 21. PMID:25345623

  15. Relational autonomy: moving beyond the limits of isolated individualism.

    Science.gov (United States)

    Walter, Jennifer K; Ross, Lainie Friedman

    2014-02-01

    Although clinicians may value respecting a patient's or surrogate's autonomy in decision-making, it is not always clear how to proceed in clinical practice. The confusion results, in part, from which conception of autonomy is used to guide ethical practice. Reliance on an individualistic conception such as the "in-control agent" model prioritizes self-sufficiency in decision-making and highlights a decision-maker's capacity to have reason transcend one's emotional experience. An alternative model of autonomy, relational autonomy, highlights the social context within which all individuals exist and acknowledges the emotional and embodied aspects of decision-makers. These 2 conceptions of autonomy lead to different interpretations of several aspects of ethical decision-making. The in-control agent model believes patients or surrogates should avoid both the influence of others and emotional persuasion in decision-making. As a result, providers have a limited role to play and are expected to provide medical expertise but not interfere with the individual's decision-making process. In contrast, a relational autonomy approach acknowledges the central role of others in decision-making, including clinicians, who have a responsibility to engage patients' and surrogates' emotional experiences and offer clear guidance when patients are confronting serious illness. In the pediatric setting, in which decision-making is complicated by having a surrogate decision-maker in addition to a patient, these conceptions of autonomy also may influence expectations about the role that adolescents can play in decision-making.

  16. The impact of regional autonomy and monetary crisis on economic growth in Yogyakarta

    Directory of Open Access Journals (Sweden)

    Sarastri Mumpuni Ruchba

    2015-04-01

    Full Text Available This study analyzes the impact of some factors, especially the implementation of autonomy and monetary crisis on economic growth in Yogyakarta Special Province. The independent variables entered into the model are investment, labor force and government spending, as well as two dummy variables, namely the financial crisis and the 1990-2013 regional autonomy implementations. This study uses multiple linear regression analysis with Ordinary Least Square (OLS. This study finds that investment and regional autonomy do not affect the economic growth in Yogyakarta, while labor force and monetary crisis negatively affect economic growth. The study also finds that government spending has a positive influence on economic growth.

  17. The many faces of autonomy.

    Science.gov (United States)

    Gracia, Diego

    2012-02-01

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

  18. Autonomy-based arguments against physician-assisted suicide and euthanasia: a critique.

    Science.gov (United States)

    Sjöstrand, Manne; Helgesson, Gert; Eriksson, Stefan; Juth, Niklas

    2013-05-01

    Respect for autonomy is typically considered a key reason for allowing physician assisted suicide and euthanasia. However, several recent papers have claimed this to be grounded in a misconception of the normative relevance of autonomy. It has been argued that autonomy is properly conceived of as a value, and that this makes assisted suicide as well as euthanasia wrong, since they destroy the autonomy of the patient. This paper evaluates this line of reasoning by investigating the conception of valuable autonomy. Starting off from the current debate in end-of-life care, two different interpretations of how autonomy is valuable is discussed. According to one interpretation, autonomy is a personal prudential value, which may provide a reason why euthanasia and assisted suicide might be against a patient's best interests. According to a second interpretation, inspired by Kantian ethics, being autonomous is unconditionally valuable, which may imply a duty to preserve autonomy. We argue that both lines of reasoning have limitations when it comes to situations relevant for end-of life care. It is concluded that neither way of reasoning can be used to show that assisted suicide or euthanasia always is impermissible.

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

    Science.gov (United States)

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

    2011-04-01

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

  20. Measuring the e-Learning Autonomy of Distance Education Students

    Directory of Open Access Journals (Sweden)

    Mehmet Firat

    2016-08-01

    Full Text Available Previous studies have provided evidence that learner autonomy is an important factor in academic achievement. However, few studies have investigated the autonomy of distance education students in e-learning environments. The purpose of this study is to evaluate the e-learning autonomy of distance education students who are responsible for their own learning. For this purpose, as the first step of the study, an e-learning autonomy scale was developed. Analyses of the validity and reliability of the scale were carried out with the participation of 1,152 distance education students from Anadolu University, Open Education System. The scale has an internal consistency coefficient of α = 0.952 and a single factorial model that explains 66.58% of the total variance. The scale was implemented with 3,293 students from 42 different programs. According to the findings, student autonomy in e-learning environments is directly proportional to level of ICT use but not affected by program or gender.

  1. Becoming Autonomous: Nonideal Theory and Educational Autonomy

    Science.gov (United States)

    Wilson, Terri S.; Ryg, Matthew A.

    2015-01-01

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

  2. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement.

    Science.gov (United States)

    Gabrysch, Sabine; McMahon, Shannon A; Siling, Katja; Kenward, Michael G; Campbell, Oona M R

    2016-03-02

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman's ability to act upon her own preferences. How autonomy should be constructed and measured - namely, as an individual or cluster-level variable - has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman's autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts.

  3. Autonomy dimensions and care seeking for delivery in Zambia; the prevailing importance of cluster-level measurement

    Science.gov (United States)

    Gabrysch, Sabine; McMahon, Shannon A.; Siling, Katja; Kenward, Michael G.; Campbell, Oona M. R.

    2016-01-01

    It is widely held that decisions whether or when to attend health facilities for childbirth are not only influenced by risk awareness and household wealth, but also by factors such as autonomy or a woman’s ability to act upon her own preferences. How autonomy should be constructed and measured – namely, as an individual or cluster-level variable – has been less examined. We drew on household survey data from Zambia to study the effect of several autonomy dimensions (financial, relationship, freedom of movement, health care seeking and violence) on place of delivery for 3200 births across 203 rural clusters (villages). In multilevel logistic regression, two autonomy dimensions (relationship and health care seeking) were strongly associated with facility delivery when measured at the cluster level (OR 1.27 and 1.57, respectively), though not at the individual level. This suggests that power relations and gender norms at the community level may override an individual woman’s autonomy, and cluster-level measurement may prove critical to understanding the interplay between autonomy and care seeking in this and similar contexts. PMID:26931301

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

    Science.gov (United States)

    Corwyn, Robert F.; Bradley, Robert H.

    2016-01-01

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

  5. A relational perspective on autonomy for older adults residing in nursing homes.

    Science.gov (United States)

    Sherwin, Susan; Winsby, Meghan

    2011-06-01

    To review critically the traditional concept of autonomy, propose an alternative relational interpretation of autonomy, and discuss how this would operate in identifying and addressing ethical issues that arise in the context of nursing home care for older adults. Respect for patient autonomy has been the cornerstone of clinical bioethics for several decades. Important though this principle is, there is debate on how to interpret the core concept of autonomy. We review the appeal of the traditional approach to autonomy in health care and then identify some of the difficulties with this conception. We use philosophical methods to explain and discuss the traditional and relational conceptions of autonomy and we illuminate our discussion with examples of various contextual applications. We support the relational conception of autonomy as offering a richer, more contextualized understanding of autonomy which attends to the social, political and economic conditions that serve as background to an agent's deliberations. To illuminate these ideas, we discuss the situation of frail older adults who frequently find their autonomy limited not only by their medical conditions but also by cultural prejudices against the aged and by the conditions commonly found within the nursing homes in which many reside. We propose ways of improving the relational autonomy of this population. © 2010 Blackwell Publishing Ltd.

  6. THE USEFULNESS OF THE AUTONOMY RATIO IN THE PREDICTION OF BANKRUPTCY

    Directory of Open Access Journals (Sweden)

    Daniel BRÎNDESCU-OLARIU

    2015-11-01

    Full Text Available The purpose of the current study was to test the potential of the autonomy ratio in the prediction of bankruptcy. The target population included all the active companies from the Timis County with annual sales of over 10,000 lei. The event the research was focused on is represented by the occurence of bankruptcy 2 years after the date of the financial statements of reference. The bankruptcy was defined in accordance with the Romanian law applicable over the period targeted by the study. The tests were performed over a paired-sample that included all the companies from the target population that went bankrupt during the period 2011-2012. The discrimination power of the autonomy ratio was evaluated for different cut-off values recommended by the existing literature. The research proves the utility of the autonomy ratio in the prediction of bankruptcy two years before its occurence.

  7. The cascading development of autonomy and relatedness from adolescence to adulthood.

    Science.gov (United States)

    Oudekerk, Barbara A; Allen, Joseph P; Hessel, Elenda T; Molloy, Lauren E

    2015-01-01

    A developmental cascade model of autonomy and relatedness in the progression from parent to friend to romantic relationships across ages 13, 18, and 21 was examined among 184 adolescents (53% female, 58% Caucasian, 29% African American) recruited from a public middle school in Virginia. Parental psychological control at age 13 undermined the development of autonomy and relatedness, predicting relative decreases in autonomy and relatedness with friends between ages 13 and 18 and lower levels of autonomy and relatedness with partners at age 18. These cascade effects extended into adult friendships and romantic relationships, with autonomy and relatedness with romantic partners at age 18 being a strong predictor of autonomy and relatedness with both friends and partners at age 21. © 2014 The Authors. Child Development © 2014 Society for Research in Child Development, Inc.

  8. How Sex Selection Undermines Reproductive Autonomy.

    Science.gov (United States)

    Browne, Tamara Kayali

    2017-06-01

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

  9. Religious Belonging, Religious Agency, and Women’s Autonomy in Mozambique

    Science.gov (United States)

    Agadjanian, Victor; Yabiku, Scott T.

    2016-01-01

    Women’s autonomy has frequently been linked with women’s opportunities and investments, such as education, employment, and reproductive control. The association between women’s autonomy and religion in the developing world, however, has received less attention, and the few existing studies make comparisons across major religious traditions. In this study, we focus on variations in levels of female decision-making autonomy within a single religious tradition—Christianity. Using unique survey data from a predominantly Christian area in Mozambique, we devise an autonomy scale and apply it to compare women affiliated to different Christian denominations as well as unaffiliated women. In addition to affiliation, we examine the relationship between autonomy and women’s religious agency both within and outside their churches. Multivariate analyses show that women belonging to more liberal religious traditions (such as Catholicism and mainline Protestantism) and tend to have higher autonomy levels, regardless of other factors. These results are situated within the cross-national scholarship on religion and women’s empowerment and are interpreted in the context of gendered religious dynamics in Mozambique and similar developing settings. PMID:26973353

  10. Bankruptcy Prediction Based on the Autonomy Ratio

    Directory of Open Access Journals (Sweden)

    Daniel Brîndescu Olariu

    2016-11-01

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

  11. School nurses' perceptions of empowerment and autonomy.

    Science.gov (United States)

    DeSisto, Marie C; DeSisto, Thomas Patrick

    2004-08-01

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

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

    Science.gov (United States)

    Lynch, Martin F.

    2013-01-01

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

  13. Autonomy and exclusion among Danish prisoners in education

    DEFF Research Database (Denmark)

    Riis, Anita Holm

    2018-01-01

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

  14. Changing Professional autonomy in the Context of Institutional Change

    DEFF Research Database (Denmark)

    Jespersen, Peter Kragh; Houlberg Salomonsen, Heidi

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

  15. Financial Autonomy as a Necessary Condition for the Functioning of Public Institutions of Higher Education in Ukraine

    Directory of Open Access Journals (Sweden)

    Vynogradnya Vita

    2016-11-01

    Full Text Available The article analyzes the main directions of development of financial autonomy of universities. The alternative sources of funding universities in terms of the lack of funding are determined. It has been found out that the proper organization of financial structure and expansion of the areas of fundraising by universities contributes to their competitiveness.

  16. State governance versus dentists' autonomy - the case of Swedish dental care.

    Science.gov (United States)

    Franzén, Cecilia

    2018-03-01

    A trend towards the state governance of healthcare through quality indicators and national clinical guidelines has been observed, and it is argued that this trend can be a challenge to the autonomy of healthcare professionals. In Sweden, these regulatory tools have been implemented in combination with subsidies for adult dental care that are based on guideline recommendations which serve to ensure that dental care is evidence-based and cost-effective. This paper aims to analyse the implications of these changes regarding dentists' autonomy and whether the government's political intentions can be fulfilled. The paper is based on documents from government authorities and professional theories. The financial control over Swedish dental care has been strengthened, and it can be argued that this is a step in the right direction from a societal point of view, as public resources are limited. Dentists' professional autonomy with their patients is not affected, which is appropriate, as patients should be treated according to their individual needs and expectations. This article shows that the state's governance does not directly detail dentists' work, which indicates a balance between state governance and dentists' autonomy. However, further research is required to get knowledge on Swedish dentists' view of the governance.

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

    OpenAIRE

    Kojima, Hideo

    2006-01-01

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

  18. Autonomy and Accountability in Standards-Based Reform

    Directory of Open Access Journals (Sweden)

    Susan Watson

    2001-08-01

    Full Text Available In this article we discuss the effects of one urban school district's efforts to increase the autonomy and accountability of schools and teams of teachers through a standards-based reform known as team- based schooling. Team-based schooling is designed to devolve decision-making authority down to the school level by increasing teachers' autonomy to make decisions. Increased accountability is enacted in the form of a state-level standards-based initiative. Based on our evaluation over a two-year period involving extensive fieldwork and quantitative analysis, we describe the ways that teachers, teams and school administrators responded to the implementation of team-based schooling. What are the effects of increasing school-level autonomy and accountability in the context of standards- based reform? Our analysis highlights several issues: the "lived reality" of teaming as it interacts with the existing culture within schools, the ways that teachers respond to the pressures created by increased internal and external accountability, and the effects of resource constraints on the effectiveness of implementation. We conclude by using our findings to consider more broadly the trade-off between increased autonomy and accountability on which standards-based reforms like team-based schooling are based.

  19. Ny styring af lærernes autonomi?

    DEFF Research Database (Denmark)

    Holm, Claus

    2015-01-01

    Kapitlet ”Ny styring af lærernes autonom?” i bogen Folkeskolen - efter reformen fokuserer på, hvordan en realisering af den vedtagne skolereform og forventningen om en kommende brug af nye forenklede Fælles Mål ud fra en målstyringstænkning ændrer lærernes autonomi til at udøve dømmekraft i...... klasseværelset. Dermed er kapitlets tese, at man ikke – i hvert fald ikke kun – kan tale om et tab af autonomi, men en ændret opfattelse og indhold heraf. Opgaven er derfor at indkredse, hvordan danske læreres autonomi til at udøve professionel dømmekraft forandrer sig, hvis man realiserer idéen om en...... læringsmålstyret undervisning, konkret i form af forenklede Fælles Mål. Og netop spørgsmålet om lærerens autonomi til at udøve professionel dømmekraft bliver i sammenhæng med styring heraf et centralt emne og problematik at afklare. Ikke kun i dansk sammenhæng, men også internationalt....

  20. Mental health as rational autonomy.

    Science.gov (United States)

    Edwards, R B

    1981-08-01

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

  1. Toward a framework for levels of robot autonomy in human-robot interaction.

    Science.gov (United States)

    Beer, Jenay M; Fisk, Arthur D; Rogers, Wendy A

    2014-07-01

    A critical construct related to human-robot interaction (HRI) is autonomy, which varies widely across robot platforms. Levels of robot autonomy (LORA), ranging from teleoperation to fully autonomous systems, influence the way in which humans and robots may interact with one another. Thus, there is a need to understand HRI by identifying variables that influence - and are influenced by - robot autonomy. Our overarching goal is to develop a framework for levels of robot autonomy in HRI. To reach this goal, the framework draws links between HRI and human-automation interaction, a field with a long history of studying and understanding human-related variables. The construct of autonomy is reviewed and redefined within the context of HRI. Additionally, the framework proposes a process for determining a robot's autonomy level, by categorizing autonomy along a 10-point taxonomy. The framework is intended to be treated as guidelines to determine autonomy, categorize the LORA along a qualitative taxonomy, and consider which HRI variables (e.g., acceptance, situation awareness, reliability) may be influenced by the LORA.

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

    Science.gov (United States)

    Fagan, Andrew

    2004-01-01

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

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

    Science.gov (United States)

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

    2017-09-01

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

  4. THE CORRELATION BETWEEN THE AUTONOMY RATIO AND THE RETURN ON EQUITY

    Directory of Open Access Journals (Sweden)

    Daniel BRÎNDESCU – OLARIU

    2014-11-01

    Considering the relationship between the autonomy ratio and the bankruptcy risk as well as the relationship between the autonomy ratio and the return on equity, it is concluded that the optimum value of the autonomy ratio is placed within the interval [50%; 100%].

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

    Science.gov (United States)

    Chiou, Wen-Bin

    2006-01-01

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

  6. Financial – Accounts View on the Governmental Expenses and the Autonomy Administration in the Conditions of the Slovak Republic

    Directory of Open Access Journals (Sweden)

    Marián Kočner

    2014-01-01

    Full Text Available The extension of state activities currently raises the need to fund specific public projects in the area of the infrastructure, ecology, or the entire expenditure programs in the field of education, health and social care and culture. Into the accounts methodology of the national and autonomy administration were introduced the transfers which represent prevalent expenses, capital expenditures, grants, subsidies and contributions. From an accounting perspective views there is an important fact from which the transfer passes, respectively whether the transfer is provided by the founder, the transfer by another entity within the public administration, or the transfer goes from an entity outside of the public administration. Watching transfers is important for the subsequent preparation of consolidated financial statements and summary financial statements of the public administration. The aggregate accounts of government administration in 2012 expanded by another group of accounting entities namely the state enterprises, RSR, Eximbanka and other public entities.

  7. Meta-synthesis on nurse practitioner autonomy and roles in ambulatory care.

    Science.gov (United States)

    Wang-Romjue, Pauline

    2018-04-01

    Many healthcare stakeholders view nurse practitioners (NPs) as an important workforce resource to help fill the anticipated shortage of 20,400 ambulatory care physicians that is expected by 2020. Multiple quantitative studies revealed the attributes of NPs' practice autonomy and roles. However, there is no qualitative meta-synthesis that describes the experiences of NPs' practice autonomy and roles. To describe and understand the experiences of NPs regarding their practice autonomy and roles in various ambulatory settings through the exploration of existing qualitative studies: meta-synthesis. A qualitative meta-synthesis was conducted to gain insight into ambulatory NPs' practice autonomy and roles through content analysis and reciprocal translation. Articles published between 2000 and 2017 were retrieved by searching 7 databases using the following key words: U.S. qualitative studies, advance practice nurses, NP role in ambulatory care, NP autonomy, and outpatient care. Autonomy, NPs' roles and responsibilities, practice relationships, and organizational work environment pressures are the four main themes that emerged from the content analysis of the nine selected qualitative studies. Within and between states, NPs' experiences with autonomy and NPs' roles are multifaceted depending on state regulations, practice relationships, and organizational work environments. © 2017 Wiley Periodicals, Inc.

  8. Maternal Household Decision-Making Autonomy and Adolescent Education in Honduras.

    Science.gov (United States)

    Hendrick, C Emily; Marteleto, Leticia

    2017-06-01

    Maternal decision-making autonomy has been linked to positive outcomes for children's health and well-being early in life in low- and middle-income countries throughout the world. However, there is a dearth of research examining if and how maternal autonomy continues to influence children's outcomes into adolescence and whether it impacts other domains of children's lives beyond health, such as their education. The goal of this study was to determine whether high maternal decision-making was associated with school enrollment for secondary school-aged youth in Honduras. Further, we aimed to assess whether the relationships between maternal autonomy and school enrollment varied by adolescents' environmental contexts and individual characteristics such as gender. Our analytical sample included 6,579 adolescents ages 12-16 living with their mothers from the Honduran Demographic and Health Survey (DHS) 2011-12. We used stepwise logistic regression models to investigate the association between maternal household decision-making autonomy and adolescents' school enrollment. Our findings suggest that adolescents, especially girls, benefit from their mothers' high decision-making autonomy. Findings suggest that maternal decision-making autonomy promotes adolescents' school enrollment above and beyond other maternal, household, and regional influences.

  9. Does autonomy for public hospitals in developing countries increase performance? Evidence-based case studies.

    Science.gov (United States)

    De Geyndt, Willy

    2017-04-01

    Governments in middle and low income countries have sought ways for the past decades to make their public hospitals more performing. The objectives of this assessment are to: (a) synthesize the experience of eleven countries at granting autonomy to their public hospitals and the obstacles encountered; (b) deduce which autonomy policies have or have not been effective documenting successes and failures; and (c) propose evidence-based recommendations to policy makers. Data for five countries are derived from the author's participation in the autonomy process augmented by current updates provided by national colleagues. Data for the other six countries are derived from publications available in the literature. Policies granting autonomy to public hospitals have had limited success. In all cases Boards of Directors have been created. Governance of autonomized hospitals by Boards however is obstructed by the resistance of central level entities to have their authority diminished. The Ministry of Finance tends to maintain control over revenues and expenditures. The Public Service Commission resists abdicating its role to hire, promote, transfer and dismiss government employees. The Ministry of Health attempts to keep its authority to appoint hospital staff, procure medical supplies and equipment; it may do so directly or indirectly by selecting and appointing Board members. Management information systems continue to collect activity measures to be aggregated at the national level for statistical purposes and do not provide financial and clinical data useful for decision making by the Boards and by senior management. Decentralizing decision making to the operational level has had limited success. Stakeholders at the central level devise strategies to maintain their power. Two main obstacles are delegating authority over human resources and finances that are sine qua non conditions for governing and increasing the performance of public hospitals. Copyright © 2017 Elsevier

  10. The moral agency of institutions: effectively using expert nurses to support patient autonomy.

    Science.gov (United States)

    Charles, Sonya

    2017-08-01

    Patient autonomy-with an emphasis on informed consent and the right to refuse treatment-is a cornerstone of modern bioethics. Within discussions about patient autonomy, feminist bioethicists have argued for a relational approach to autonomy. Under a relational framework, we must look beyond the individual moment of choice to include the role relationships and specific contexts can play in supporting or undermining autonomy. Given the day-to-day interactions they have with patients, nurses play a significant role in helping patients understand the nature of their illnesses and make truly informed decisions. However, the skills of expert nurses also support patient autonomy in more subtle ways. Specifically, nurses develop skills of attunement that help them to find subtle ways to support patient autonomy. However, in order to effectively do this, nurses need institutions that support their professional autonomy. In this paper, I look at the ways nurses have been inhibited in their professional autonomy both as a profession and as individual practitioners. I argue that turning our attention to institutions and the role they play in supporting or undermining nurses' autonomy can help promote nurses' professional autonomy and thereby enhance patient autonomy. 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/.

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

    Science.gov (United States)

    Choi, Min; De Gagne, Jennie C

    2016-03-01

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

  12. First- and second-born adolescents' decision-making autonomy throughout adolescence.

    Science.gov (United States)

    Campione-Barr, Nicole; Lindell, Anna K; Short, Stephen D; Greer, Kelly Bassett; Drotar, Scott D

    2015-12-01

    First- and second-born adolescents' and their parents' perceptions of adolescents' decision-making autonomy were compared from ages 12 to 19 in a longitudinal sample of 145 predominantly White, middle class families. Utilizing a multivariate, multilevel modeling approach, differences in perceptions of adolescents' autonomy between parents and each adolescent, as well as by social-cognitive domain were examined. The present study found that when comparing parents' perceptions of their children at the same age, second-borns were granted more autonomy regarding conventional issues than first-borns during early adolescence, but by later adolescence first-borns were granted more autonomy regarding prudential issues than second-borns. However, comparisons between adolescents' and siblings' perceptions showed no differences. Potential reasons for, and implications of, differences in perceptions of adolescent autonomy are discussed. Copyright © 2015 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  13. Patient Autonomy for the Management of Chronic Conditions: A Two-Component Re-conceptualization

    Science.gov (United States)

    Naik, Aanand D.; Dyer, Carmel B.; Kunik, Mark E.; McCullough, Laurence B.

    2010-01-01

    The clinical application of the concept of patient autonomy has centered on the ability to deliberate and make treatment decisions (decisional autonomy) to the virtual exclusion of the capacity to execute the treatment plan (executive autonomy). However, the one-component concept of autonomy is problematic in the context of multiple chronic conditions. Adherence to complex treatments commonly breaks down when patients have functional, educational, and cognitive barriers that impair their capacity to plan, sequence, and carry out tasks associated with chronic care. The purpose of this article is to call for a two-component re-conceptualization of autonomy and to argue that the clinical assessment of capacity for patients with chronic conditions should be expanded to include both autonomous decision making and autonomous execution of the agreed-upon treatment plan. We explain how the concept of autonomy should be expanded to include both decisional and executive autonomy, describe the biopsychosocial correlates of the two-component concept of autonomy, and recommend diagnostic and treatment strategies to support patients with deficits in executive autonomy. PMID:19180389

  14. Autonomy support, basic psychological needs and well-being in Mexican athletes.

    Science.gov (United States)

    López-Walle, Jeanette; Balaguer, Isabel; Castillo, Isabel; Tristán, José

    2012-11-01

    Based on Basic Needs Theory, one of the mini-theories of Self-determination Theory (Ryan & Deci, 2002), the present study had two objectives: (a) to test a model in the Mexican sport context based on the following sequence: perceived coach autonomy support, basic psychological needs satisfaction, and psychological well-being, and b) to analyze the mediational effect of the satisfaction of perceived coach autonomy support on indicators of psychological well-being (satisfaction with life and subjective vitality). Six hundred and sixty-nine young Mexican athletes (Boys = 339; Girls = 330; M(age) = 13.95) filled out a questionnaire assessing the study variables. Structural equations analyses revealed that perceived coach autonomy support predicted satisfaction of the basic psychological needs for autonomy, competence, and relatedness. Furthermore, basic need satisfaction predicted subjective vitality and satisfaction with life. Autonomy, competence and relatedness partially mediated the path from perceived coach autonomy support to psychological well-being in young Mexican athletes.

  15. Students' autonomy and teacher's interpersonal style in self-determination theory

    OpenAIRE

    Lalić-Vučetić Nataša; Đerić Ivana; Đević Rajka

    2009-01-01

    Starting from psychological needs that are considered basic within self-determination theory (autonomy, competence and relatedness), the importance of encouraging students' autonomy in school context is particularly emphasised. Appreciation of students' autonomy has a stimulating effect on school achievement, conceptual understanding, creativity development, strengthening of self-esteem, and students adapt better to school system and demonstrate a larger degree of internalisation of school ru...

  16. A biochemistry laboratory course designed to enhance students autonomy

    Directory of Open Access Journals (Sweden)

    T. Silva

    2015-08-01

    Full Text Available INTRODUCTION: Laboratory sessions are responsible for promoting instrumentation skills desirable in biochemistry and biochemistry related careers. They are traditionally based on experimental protocols that lead to the expected results, and students usually have not autonomy to plan and execute their experiments. GOALS: This work aimed to enhance a traditional biochemistry lab course, applying pre-lab quizzes on protein biochemistry and lab techniques in order to have students better prepared to plan, execute and interpret experiments. This approach also aims to bring the laboratory sessions into an inquiry-based environment capable to improve students’ independent capabilities in 2 autonomy domains: learning and communication. MATERIAL AND METHODS: Online quizzes are delivered one week before each laboratory session, containing questions regarding the experimental techniques and theoretical basis related to them. Laboratory activities are presented in an inquiry-based approach where the first class of each activity is dedicated to plan experiments in order to answer the research questions presented by instructors. Activities are also organized in order to enhance students’ autonomy. The first activity is the simplest and more instructor-controlled and the last one is the most complex and less driven, transferring gradually to students the responsibility for their decisions in laboratory, supporting students’ autonomy. RESULTS: Online quizzes allowed instructors to identify students’ difficulties and to timely intervene. Scientific reports presented by students at the end of each activity showed that they performed better on less driven activities in which autonomy support were more complex than in the instructor controlled activities. CONCLUSIONS: Scientific reports analysis reveals students capabilities related to different scopes of autonomy, such as: discuss different strategies; find multiple solutions to solve problems; make their

  17. Evidence-Responsiveness and the Ongoing Autonomy of Treatment Preferences.

    Science.gov (United States)

    Weimer, Steven

    2017-06-14

    To be an autonomous agent is to determine one's own path in life. However, this cannot plausibly be seen as a one-off affair. An autonomous agent does not merely set herself on a particular course and then lock the steering wheel in place, so to speak, but must maintain some form of ongoing control over her direction in life-must keep her eyes on the road and her hands on the wheel. Circumstances often change in important and unexpected ways, after all, and it is reasonable to think that a crucial part of autonomy consists of the ability and disposition to recognize and properly respond to such changes. This implies, I contend, that a patient whose initial decision to undergo a given treatment satisfied plausible requirements of autonomy, but who is now unable to recognize that available evidence indicates the need to reconsider her medical situation and options has come to lack autonomy with respect to her desire to continue that treatment. However, and despite its importance with respect to both theoretical understandings of autonomy and applications of the concept to clinical ethics, this ongoing aspect of autonomy has received little attention. This paper aims to go some way toward remedying that. I first critically review two of the few theories of autonomy that do address "evidence-responsiveness" so as to identify and elaborate what I take to be the most promising way in which to account for this aspect of autonomy. After considering and responding to a possible objection to the evidence-responsiveness condition I propose, I conclude by discussing its clinical implications. That condition, I argue, is not merely theoretically sound, but can and should be applied to clinical practice.

  18. Enhancing autonomy in paid surrogacy.

    Science.gov (United States)

    Damelio, Jennifer; Sorensen, Kelly

    2008-06-01

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

  19. Free to Lead: Autonomy in Highly Successful Charter Schools. Issue Brief

    Science.gov (United States)

    Ableidinger, Joe; Hassel, Bryan C.

    2010-01-01

    Autonomy is a key component of the charter school concept. By allowing charter schools to have autonomy over decisions concerning finance, personnel, scheduling, curriculum and instruction, states have enabled many of these schools to produce stellar results for their students. This issue brief explores autonomy at five excellent charter schools…

  20. [Physician and autonomy: on time perception and job satisfaction].

    Science.gov (United States)

    Huisman, Frank G

    2015-01-01

    Is it true that haste is sneaking into medicine? In this article, it is argued that it mainly concerns the perception of being rushed, which is caused by a loss of autonomy of the modern physician. In the fifties, physicians were busy as well, but because they enjoyed a greater degree of autonomy compared to their contemporary colleagues, they did not experience this in a negative way. Due to increased bureaucracy and the introduction of market dynamics, the medical profession has lost autonomy, which in turn led to a loss of job satisfaction.

  1. Does Country Context Distance Determine Subsidiary Decision-Making Autonomy?

    DEFF Research Database (Denmark)

    de Jong, Gjalt; Van Vo, Dut; Marek, Philipp

    2015-01-01

    enterprises, highlighting the importance of such intra-firm collaboration. The division of decision-making autonomy is a core issue in the management of headquarters–subsidiary relationships. The main contribution of our paper is that we confront two valid theoretical frameworks – business network theory......We studied an underrepresented area in the international business (IB) literature: the effect of country context distance on the distribution of decision-making autonomy across headquarters and foreign affiliates. Foreign affiliates directly contribute to the competitive advantages of multinational...... approach to the study of subsidiary decision-making autonomy...

  2. The autonomy of grammar and semantic internalism

    Directory of Open Access Journals (Sweden)

    Dobler Tamara

    2014-01-01

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

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

    NARCIS (Netherlands)

    Sleegers, P.; Wesselingh, A.

    1995-01-01

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

  4. the doctrine of party autonomy in international commercial arbitration

    African Journals Online (AJOL)

    RAYAN_

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

  5. Patient Autonomy in a High-Tech Care Context - A Theoretical Framework.

    Science.gov (United States)

    Lindberg, Catharina; Fagerström, Cecilia; Willman, Ania

    2018-06-12

    To synthesise and interpret previous findings with the aim of developing a theoretical framework for patient autonomy in a high-tech care context. Putting the somewhat abstract concept of patient autonomy into practice can prove difficult since when it is highlighted in healthcare literature the patient perspective is often invisible. Autonomy presumes that a person has experience, education, self-discipline and decision-making capacity. Reference to autonomy in relation to patients in high-tech care environments could therefore be considered paradoxical, as in most cases these persons are vulnerable, with impaired physical and/or metacognitive capacity, thus making extended knowledge of patient autonomy for these persons even more important. Theory development. The basic approaches in theory development by Walker and Avant were used to create a theoretical framework through an amalgamation of the results from three qualitative studies conducted previously by the same research group. A theoretical framework - the control-partnership-transition framework - was delineated disclosing different parts co-creating the prerequisites for patient autonomy in high-tech care environments. Assumptions and propositional statements that guide theory development were also outlined, as were guiding principles for use in day-to-day nursing care. Four strategies used by patients were revealed: the strategy of control, the strategy of partnership, the strategy of trust, and the strategy of transition. An extended knowledge base, founded on theoretical reasoning about patient autonomy, could facilitate nursing care that would allow people to remain/become autonomous in the role of patient in high-tech care environments. The control-partnership-transition framework would be of help in supporting and defending patient autonomy when caring for individual patients, as it provides an understanding of the strategies employed by patients to achieve autonomy in high-tech care contexts. The

  6. Om evalueringsforskningens relative autonomi

    DEFF Research Database (Denmark)

    Nørholm, Morten

    2008-01-01

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

  7. Obesity prevention advocacy in Australia: an analysis of policy impact on autonomy.

    Science.gov (United States)

    Haynes, Emily; Hughes, Roger; Reidlinger, Dianne P

    2017-06-01

    To explore obesity policy options recommended by stakeholders and identify their impact on individual autotomy. Qualitative and quantitative methods were used. A content analysis of submissions to the Australian Government's Inquiry into Obesity was conducted. Each recommendation was categorised by its impact on autonomy, according to existing frameworks. Chi-square test for independence was used to explore the association between autonomy and stakeholder support defined as frequency of recommendation. The extent of support for a policy option was significantly associated with impact on autonomy (pautonomy were least frequently recommended in every setting; but more likely in schools (27%) than other settings (autonomy were most widely recommended (46%). Stakeholders advocated policy options that enhance individual autonomy to a greater extent than those that diminish autonomy. Implications for public health: Targeting obesity policy options that enhance rather than diminish autonomy may be more politically acceptable across most settings, with the exception of schools where more restrictive policy options are appropriate. Re-framing options accordingly may improve leadership by government in obesity policy. © 2017 The Authors.

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

    Science.gov (United States)

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

    2017-04-01

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

  9. Building a School Leadership Programme: An American Paradox of Autonomy and Accountability

    Science.gov (United States)

    Reyes-Guerra, Daniel; Russo, Marianne R.; Bogotch, Ira E.; Vásquez-Colina, Maria D.

    2014-01-01

    School districts within the USA face ever-decreasing autonomy in rendering decisions regarding instruction, curriculum and the leading and managing of schools at the local level due to the ever-increasing accountability measures implemented by district, state and federal governments. This study investigates a joint university-school district…

  10. Instructors' Support of Student Autonomy in an Introductory Physics Course

    Science.gov (United States)

    Hall, Nicholas; Webb, David

    2014-12-01

    The role of autonomy in the student experience in a large-enrollment undergraduate introductory physics course was studied from a self-determination theory perspective. A correlational study investigated whether certain aspects of the student experience correlated with how autonomy supportive (versus controlling) students perceived their instructors to be. An autonomy-supportive instructor acknowledges students' perspectives and feelings and provides students with information and opportunities for choice while minimizing external pressures (e.g., incentives or deadlines). It was found that the degree to which students perceived their instructors as autonomy supportive was positively correlated with student interest and enjoyment in learning physics (β =0.31***) and negatively correlated with student anxiety about taking physics (β =-0.23**). It was also positively correlated with how autonomous (versus controlled) students' reasons for studying physics became over the duration of the course (i.e., studying physics more because they wanted to versus had to; β =0.24***). This change in autonomous reasons for studying physics was in turn positively correlated with student performance in the course (β =0.17*). Additionally, the degree to which students perceived their instructors as autonomy supportive was directly correlated with performance for those students entering the course with relatively autonomous reasons for studying physics (β =0.25**). In summary, students who perceived their instructors as more autonomy supportive tended to have a more favorable motivational, affective, and performance experience in the course. The findings of the present study are consistent with experimental studies in other contexts that argue for autonomy-supportive instructor behaviors as the cause of a more favorable student experience.

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

    Directory of Open Access Journals (Sweden)

    Shalini Sisodia

    2013-10-01

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

  12. Patient autonomy in chronic care: solving a paradox

    Directory of Open Access Journals (Sweden)

    Reach G

    2013-12-01

    Full Text Available Gérard Reach Department of Endocrinology, Diabetes, and Metabolic Diseases, Avicenne Hospital AP-HP, and EA 3412, CRNH-IdF, Paris 13 University, Sorbonne Paris Cité, Bobigny, France Abstract: The application of the principle of autonomy, which is considered a cornerstone of contemporary bioethics, is sometimes in obvious contradiction with the principle of beneficence. Indeed, it may happen in chronic care that the preferences of the health care provider (HCP, who is largely focused on the prevention of long term complications of diseases, differ from those, more present oriented, preferences of the patient. The aims of this narrative review are as follows: 1 to show that the exercise of autonomy by the patient is not always possible; 2 where the latter is not possible, to examine how, in the context of the autonomy principle, someone (a HCP can decide what is good (a treatment for someone else (a patient without falling into paternalism. Actually this analysis leads to a paradox: not only is the principle of beneficence sometimes conflicting with the principle of autonomy, but physician's beneficence may enter into conflict with the mere respect of the patient; and 3 to propose a solution to this paradox by revisiting the very concepts of the autonomous person, patient education, and trust in the patient–physician relationship: this article provides an ethical definition of patient education. Keywords: preference, autonomy, person, reflexivity, empathy, sympathy, patient education, trust, respect, care

  13. Ignorance, information and autonomy.

    Science.gov (United States)

    Harris, J; Keywood, K

    2001-09-01

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

  14. Job autonomy and job satisfaction: new evidence

    OpenAIRE

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

    2003-01-01

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

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

    Directory of Open Access Journals (Sweden)

    Laura Cavana

    2011-12-01

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

  16. Epistemic merit, autonomy, and testimony

    Directory of Open Access Journals (Sweden)

    Jesús VEGA ENCABO

    2008-01-01

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

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

    Science.gov (United States)

    Shively, Jay

    2016-01-01

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

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

    OpenAIRE

    Ivanovska, Biljana

    2015-01-01

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

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

    OpenAIRE

    Keller, Heidi

    2016-01-01

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

  20. Regional resources buffer the impact of functional limitations on perceived autonomy in older adults with multiple illnesses.

    Science.gov (United States)

    Schüz, Benjamin; Westland, Josh N; Wurm, Susanne; Tesch-Römer, Clemens; Wolff, Julia K; Warner, Lisa M; Schwarzer, Ralf

    2016-03-01

    Retaining perceptions of autonomy is a key component of successful aging. Perceived autonomy refers to the capacity to make and enact self-directed decisions. These perceptions are often threatened in older adults with multiple illnesses, when functional limitations resulting from these illnesses impede the enactment of self-directed decisions. Regional resources (in Germany specifically at the level of administrative districts) might counteract these impediments of autonomy. Economically stronger districts can provide more-concrete support resources for older adults, buffering the negative effect of functional limitations on self-perceived autonomy. This study assessed participants aged over 65 with 2 or more chronic conditions. In total, N = 287 provided data (Mage = 73.3, SD = 5.07), and n = 97 were women. Gross domestic product (GDP) per capita was used as a proxy measure of administrative district wealth in Germany. Hierarchical multilevel regression analyses with cross-level interactions were conducted. Results suggest that the detrimental effect of functional limitations on perceived autonomy is less pronounced for participants residing in higher GDP districts. Conversely, for participants in lower GDP districts, the effect is exacerbated. This finding suggests that districts with greater financial resources might be better able to invest in supports that promote and facilitate autonomy and, thus, provide a buffer against threats to individual perceived autonomy. (c) 2016 APA, all rights reserved).

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

    Science.gov (United States)

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

    2017-11-01

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

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

    Science.gov (United States)

    Kohan, Shahnaz; Talebian, Ferdos; Ehsanpour, Soheila

    2014-01-01

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

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

    Science.gov (United States)

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

    2015-11-01

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

  4. Autonomy, positive relationships, and IL-6: evidence for gender-specific effects.

    Science.gov (United States)

    Eisenlohr-Moul, Tory; Segerstrom, Suzanne

    2013-05-01

    A body of evidence indicates that women value relationship-centred aspects of well-being more than men do, while men value autonomy-centred aspects of well-being more than women do. The current study examined whether gender moderates relations between autonomy and positive relationships and interleukin-6 (IL-6), a cytokine associated with inflammatory processes. Aspects of well-being consistent with gender-linked values were expected to be most health protective such that positive relationships would predict lower IL-6 only or more strongly in women, and autonomy would predict lower IL-6 only or more strongly in men. In the first study, a sample of 119 older adults (55% female) living in Kentucky were visited in their homes for interviews and blood draws. In the second study, a sample of 1,028 adults (45% female) living across the United States underwent a telephone interview followed by a visit to a research centre for blood draws. In the Kentucky sample, autonomy was quadratically related to IL-6 such that moderate autonomy predicted higher IL-6; this effect was stronger in men. In the US national sample, more positive relationships were associated with lower IL-6 in women only. When the national sample was restricted to match the Kentucky sample, moderate autonomy was again associated with higher IL-6 in men only. Results provide preliminary evidence for gender-specific effects of positive relationships and autonomy on IL-6. Further work is needed to establish the generalizability of these effects to different ages, cultures, and health statuses. What is already known on this subject? A host of previous work indicates that women value relationship-centred aspects of well-being more than men, while men value autonomy-centred aspects of well-being more than women. Further, there is some evidence suggesting that well-being consistent with gender-linked values is more health protective, such that relationships are more protective for women than for men, while

  5. What Happened to Autonomy? Visual art practices in the creative industries Era

    NARCIS (Netherlands)

    A.M. van Dillen (Anna)

    2014-01-01

    markdownabstractThis thesis concerns the autonomy of visual artists in an era of a booming creative economy and simultaneously declining governmental support for the arts and culture. The research is particularly directed toward the concept of autonomy. On the one hand, there is social autonomy,

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

    NARCIS (Netherlands)

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

    2013-01-01

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

  7. Documenting Different Domains of Promotion of Autonomy in Families

    Science.gov (United States)

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

    2012-01-01

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

  8. Capturing Requirements for Autonomous Spacecraft with Autonomy Requirements Engineering

    Science.gov (United States)

    Vassev, Emil; Hinchey, Mike

    2014-08-01

    The Autonomy Requirements Engineering (ARE) approach has been developed by Lero - the Irish Software Engineering Research Center within the mandate of a joint project with ESA, the European Space Agency. The approach is intended to help engineers develop missions for unmanned exploration, often with limited or no human control. Such robotics space missions rely on the most recent advances in automation and robotic technologies where autonomy and autonomic computing principles drive the design and implementation of unmanned spacecraft [1]. To tackle the integration and promotion of autonomy in software-intensive systems, ARE combines generic autonomy requirements (GAR) with goal-oriented requirements engineering (GORE). Using this approach, software engineers can determine what autonomic features to develop for a particular system (e.g., a space mission) as well as what artifacts that process might generate (e.g., goals models, requirements specification, etc.). The inputs required by this approach are the mission goals and the domain-specific GAR reflecting specifics of the mission class (e.g., interplanetary missions).

  9. Radioiodine therapy of benign thyroid disorders: functional thyroid autonomy

    International Nuclear Information System (INIS)

    Dunkelmann, S.

    2005-01-01

    In the last 15 years, several concepts have been developed to further improve the outcome of radioiodine therapy in functional thyroid autonomy. Results of radioiodine therapy in functional autonomy are considerably better than in Graves' disease. All of the currently-applied concepts offer healing rates of 75-100%, but they differ considerably in the hypothyreosis rates attained. The target volume can be precisely determined by sonography only in unifocal autonomy. In the case of multifocal and disseminated autonomy, the entire thyroid is taken as the target volume and the focal dose is reduced ('dosimetric compromise'). TcTUs-based dose concepts calculate the functionally autonomous volume from the TcTUs and replace the target volume by sonography, in the TcTUs-adapted dose concepts, sonographic target volume is left and the focal dose varied in dependence of the suppression uptake. The objective is to attain a high rate of success with a low rate of hypothyreosis. (orig.)

  10. Solomon Islands School Autonomy and Accountability : SABER Country Report 2013

    OpenAIRE

    World Bank

    2013-01-01

    Education in the Solomon Islands is highly decentralized. While education policy is the sole responsibility of the Ministry of education, school boards are responsible for delivery. The entire organization of the school system is based on checks and balances to ensure accountability. Budgetary autonomy is established. The school board controls the school budget, with input from parents. Pe...

  11. Impact of financial incentives on clinical autonomy and internal motivation in primary care: ethnographic study.

    Science.gov (United States)

    McDonald, Ruth; Harrison, Stephen; Checkland, Kath; Campbell, Stephen M; Roland, Martin

    2007-06-30

    To explore the impact of financial incentives for quality of care on practice organisation, clinical autonomy, and internal motivation of doctors and nurses working in primary care. Ethnographic case study. Two English general practices. 12 general practitioners, nine nurses, four healthcare assistants, and four administrative staff. Observation of practices over a five month period after the introduction of financial incentives for quality of care introduced in the 2004 general practitioner contract. After the introduction of the quality and outcomes framework there was an increase in the use of templates to collect data on quality of care. New regimens of surveillance were adopted, with clinicians seen as "chasers" or the "chased," depending on their individual responsibility for delivering quality targets. Attitudes towards the contract were largely positive, although discontent was higher in the practice with a more intensive surveillance regimen. Nurses expressed more concern than doctors about changes to their clinical practice but also appreciated being given responsibility for delivering on targets in particular disease areas. Most doctors did not question the quality targets that existed at the time or the implications of the targets for their own clinical autonomy. Implementation of financial incentives for quality of care did not seem to have damaged the internal motivation of the general practitioners studied, although more concern was expressed by nurses.

  12. African communal basis for autonomy and life choices.

    Science.gov (United States)

    Ikuenobe, Polycarp

    2017-09-05

    I argue that the metaphysical capacity of autonomy is not intrinsically valuable; it is valuable only when used in relation to a community's values and instrumentally for making the proper choices that will promote one's own and the community's well-being. I use the example of the choice to take one's life by suicide to illuminate this view. I articulate a plausible African conception of personhood as a basis for the idea of relational autonomy. I argue that this conception is better understood as a social-moral thesis, and not a metaphysical thesis. A metaphysical thesis gives an account of the abstract nature of an atomic individual, his agency, and rational choice. The social-moral thesis indicates that personhood and autonomy are positive and relational to the life plans, well-being, material conditions, and the best means for achieving them that are made available and possible by harmonious living in a community. This idea of autonomy is not just having the capacity of freewill; it also involves how such freewill is used, in terms of how an individual's choices are guided by internalized communal values. © 2017 John Wiley & Sons Ltd.

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

    Science.gov (United States)

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

    2004-12-01

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

  14. Women's Autonomy and Skilled Attendance During Pregnancy and Delivery in Nepal.

    Science.gov (United States)

    Kc, Situ; Neupane, Subas

    2016-06-01

    Objectives This study aims to explore the association between women's autonomy and skilled attendance during pregnancy and delivery in Nepal. Methods We adopt data from the Nepal Demographic and Health Survey (NDHS, 2011). We include only married women who gave birth in the 5 years preceding the survey (N = 4148). Women's autonomy was assessed on the basis of four indicators of decision making: healthcare, visiting friends or relatives, household purchases and spending earned money. Each indicator was dichotomized (yes/no) and then summarized into a single variable to measure overall autonomy. Next, we measured health attendance (skilled vs. unskilled) during antenatal and delivery care. The association between women's autonomy and skilled attendance was analysed using a logistic regression model. Results Most women had a medium (40 %) and high (35 %) level of overall autonomy. The proportion of women accessing skilled providers during antenatal and delivery care was 51 and 36 %. Women with autonomy in healthcare, visiting friends or relatives, making household purchases and spending money earned were associated with a higher likelihood of receiving care from skilled providers during antenatal care and delivery. An elevated probability of access to skilled attendance during antenatal (aOR 1.33; 95 % CI 1.10-1.59) and delivery care (aOR 1.38; 95 % CI 1.12-1.70) was reported among women with higher levels of overall autonomy. Conclusion Women's autonomy was significantly associated with the maternal health care utilization by skilled attendants. This study will provide insights for policy makers to develop strategies in improving maternal health.

  15. Principals' Self-Efficacy: Relations with Job Autonomy, Job Satisfaction, and Contextual Constraints

    Science.gov (United States)

    Federici, Roger A.

    2013-01-01

    The purpose of the present study was to explore relations between principals' self-efficacy, perceived job autonomy, job satisfaction, and perceived contextual constraints to autonomy. Principal self-efficacy was measured by a multidimensional scale called the Norwegian Principal Self-Efficacy Scale. Job autonomy, job satisfaction, and contextual…

  16. Rights and care for the protection of nonhuman animal’s practical autonomy

    Directory of Open Access Journals (Sweden)

    Maria Alice da Silva

    2015-07-01

    Full Text Available The aim of this paper is to present Steven Wise’s concept of practical autonomy and how it is distinguished from the traditional and modern Kantian notion of autonomy. This is justified in order to emphasize the importance of this concept of autonomy for the recognition of legal rights to nonhuman animals, and the protection of its particular way of life through care practices and responsibility in the relations between human and nonhuman animals. By the aid of bibliographical research and theoretical analysis, we foremost present Wise’s main conceptual distinctions and, secondly, indicate the application of the concept of practical autonomy in the legal context, aiming to recognize rights for animals. Finally, we show how the concept of practical autonomy requires more than legal rights. It also implies moral obligations by individual agents and by the State to ensure appropriate conditions for autonomy and freedom of nonhuman animals.

  17. Multiculturalism and legal autonomy for cultural minorities

    Directory of Open Access Journals (Sweden)

    Morten Ebbe Juul Nielsen

    2013-11-01

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

  18. Autonomy and couples' joint decision-making in healthcare.

    Science.gov (United States)

    Osamor, Pauline E; Grady, Christine

    2018-01-11

    Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making. We discuss the concept of autonomy as it applies to persons and to actions, human interdependency and gender roles in decision-making, the dynamics and outcomes of couples' joint decision-making, and the ethics of couples' joint decision-making. We believe that the extent to which couples' joint decision-making might be deemed ethically acceptable will vary depending on the context. Given that in many traditional marriages the woman is the less dominant partner, we consider a spectrum of scenarios of couples' joint decision-making about a woman's own health care that move from those that are acceptably autonomous to those that are not consistent with respecting the woman's autonomous decision-making. To the extent that there is evidence that both members of a couple understand a decision, intend it, and that neither completely controls the other, couples' joint decision-making should be viewed as consistent with the principle of respect for the woman's autonomy. At the other end of the spectrum are decisions made by the man without the woman's input, representing domination of one partner by the other. We recommend viewing the dynamics of couples' joint decision-making as existing on a continuum of degrees of autonomy. This continuum-based perspective implies that couples' joint decision-making should not be taken at face value but should be assessed against

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

    Science.gov (United States)

    Newdick, Christopher

    2017-10-01

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

  20. A cross-cultural comparison of the coexistence and domain superiority of individuating and relating autonomy.

    Science.gov (United States)

    Yeh, Kuang-Hui; Bedford, Olwen; Yang, Yung-Jui

    2009-06-01

    The consensus definition of autonomy in the psychological literature emphasizes self-governance through free volition, not separation or independence from others. Since the concept of self may differ cross-culturally, several researchers have tried to incorporate types of self into the notion of autonomy; however, only the dual model of autonomy has been able to do this while retaining an emphasis on volition. The dual model describes two distinct forms of autonomy-individuating and relating-each with superior function in a specific domain of individual functioning. Individuating autonomy represents a volitional capacity to act against social constraints and offers a route to achieve an independent self-identity by expressing individualistic attributes and distinctions. Relating autonomy represents a volitional capacity to act by emphasizing the harmony of self-in-relation-to-others, the quality of interpersonal relationships, and self-transcendence. These two forms of autonomy have been shown to coexist at the individual level in a Taiwanese sample. This study takes the next step, with a cross-cultural test of the coexistence and domain superiority hypotheses of individuating and relating autonomy. Participants included 306 college students from Taiwan and 183 college students from the United States. Structural equation modelling by multigroup analyses confirmed the cross-cultural equivalence of the two-factor individuating autonomy and relating autonomy measurement model. Across both samples the two forms of autonomy were shown to be mutually inclusive and not exclusive or independent. The domain-superior function of each form of autonomy was also confirmed cross-culturally; each form of autonomy has a dominant, but not necessarily exclusive, domain of functioning. Specifically, individuating autonomy was more associated with intrapersonal than interpersonal domain dependent variables, while relating autonomy was more associated with interpersonal than

  1. [Autonomy and practical identity. Cornerstones to ethical physician behavior].

    Science.gov (United States)

    Colt, Henri

    2006-01-01

    Three frequent problems of daily medical practice are analyzed: (1) a physician's perceived obligation to provide medical services regardless of whether one's health care institution provides monetary compensation for the medical act, (2) increasing pressures to obtain informed consent in a national context where paternalistic physician-patient interactions have been customary, and (3) a physician's professional responsibility to offer internationally recognized standard of care even if this means allocating expensive tertiary healthcare resources to a small number of patients in spite of one's knowledge that national governments are unable to provide primary care to millions of their citizens. These problems are discussed from the point of view of the ethical principle of respect for patient autonomy. Potential limiting factors (cultural, financial, religious or disease-related influences) on autonomy of patients and doctors are identified. The functions of patient autonomy in the framework of four different patient-doctor interaction models (paternalist, informative, interpretative and deliberatibe) are described. Physician leaders, health care institutions, and professional organizations are responsible for creating an environment in which doctors can discuss ethical issues as comfortably and as frequently as they discuss biological matters. Health care providers should do their best to recover the human side of medical practice which, undoubtedly, would create a greater likelihood that appropriate decisions will be made when facing complex ethical dilemmas.

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

    Science.gov (United States)

    Saarivirta, Toni; Kumpulainen, Kristiina

    2016-01-01

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

  3. The Impact of Autonomy on Women’s Agency

    Directory of Open Access Journals (Sweden)

    Jeyle Ortiz-Rodríguez

    2017-01-01

    Full Text Available Kabeer’s simple and illustrative definition of empowerment is “the expansion in people’s ability to make strategic life choices in a context where this ability was previously denied to them” (Kabeer, 1999: 437. Women’s empowerment, then, is conceptualized as an increase in agency over time. Little is it known about the importance of the effect of ‘self directed motivations and desires’ and autonomy on women’s agency. The purpose of this paper is to analyze the relationships among women’s autonomy and labor force participation along with their effects on women’s agency in Nuevo Leon, Mexico. For this, we use the structural equation modeling approach. Our results reveal that women’s autonomy and participation in the labor market positively influence their agency levels.

  4. Chinese and US Middle-School Science Teachers' Autonomy, Motivation, and Instructional Practices

    Science.gov (United States)

    Robertson, Laura; Jones, M. Gail

    2013-06-01

    This study examined Chinese and US middle-school science teachers' perceptions of autonomy support. Previous research has documented the link between teachers' perceptions of autonomy and the use of student-oriented teaching practices for US teachers. But is not clear how the perception of autonomy may differ for teachers from different cultures or more specifically how motivation factors differ across cultures. The survey measured teachers' motivation, perceptions of constraints at work, perceptions of students' motivation, and level of autonomy support for students. Exploratory factor analysis of responses for the combined teacher sample (n = 201) was carried out for each of the survey assessments. Significance testing for Chinese (n = 107) and US (n = 94) teachers revealed significant differences in teachers' motivation and perceptions of constraints at work and no significant differences for perceptions of students' motivation or their level of autonomy support for students. Chinese teachers' perceptions of constraints at work, work motivation, and perceptions of student motivation were found to significantly predict teachers' autonomy support. For the US teachers, teacher motivation was the only significant predictor of teachers' autonomy support. A sub-sample of teachers (n = 19) was interviewed and results showed that teachers in both countries reported that autonomy was important to their motivation and the quality of science instruction they provided to students. The primary constraints on teaching reported by the US teachers related to materials and laboratory space while the Chinese teachers reported constraints related to the science curriculum and standards.

  5. Women’s decision-making autonomy and children’s schooling in rural Mozambique

    Science.gov (United States)

    Luz, Luciana; Agadjanian, Victor

    2015-01-01

    BACKGROUND Women’s decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women’s autonomy and children’s schooling. OBJECTIVE To examine the relationship between rural women’s decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child’s gender. METHODS The analysis uses data from a 2009 survey of rural households in four districts of Gaza province in southern Mozambique. Multilevel logistic models predict the probability of being in school for children between 6 and 14 years old. RESULTS The results show a positive association of women’s decision-making autonomy with the probability of being enrolled in primary school for daughters, but not for sons. The effect of women’s autonomy is net of other women’s characteristics typically associated with enrollment and does not mediate the effects of those characteristics. CONCLUSIONS Based on the results, we argue that women with higher levels of decision-making autonomy may have a stronger preference for daughters’ schooling and may have a greater say in making and implementing decisions regarding daughters’ education, compared to women with lower autonomy levels. Results also illustrate a need for considering a broader set of autonomy-related characteristics when examining the effects of women’s status on children’s educational outcomes. PMID:26491400

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

    Science.gov (United States)

    Van Brussel, Leen

    2014-06-01

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

  7. The appearance of Kant's deontology in contemporary Kantianism: concepts of patient autonomy in bioethics.

    Science.gov (United States)

    Secker, B

    1999-02-01

    Kant's concept of autonomy and the Kantian notion of autonomy are often conflated in bioethics. However, the contemporary Kantian notion has very little at all to do with Kant's original. In order to further bioethics discourse on autonomy, I critically distinguish the contemporary Kantian notion from Kant's original concept of moral autonomy. I then evaluate the practical relevance of both concepts of autonomy for use in bioethics. I argue that it is not appropriate to appeal to either concept toward assessing which patients we ought to respect as autonomous. Finally, I sketch criteria for what I take to be a more promising concept of autonomy for patients.

  8. Development of emotional autonomy from adolescence to young adulthood in Spain.

    Science.gov (United States)

    Parra, Agueda; Oliva, Alfredo; Sánchez-Queija, Inmaculada

    2015-01-01

    The main objective of this study was to learn whether emotional autonomy is truly part of a developmental stage for Spanish adolescents and young adults or if it is an indicator of difficult family relationships. Using a longitudinal design, a sample of ninety young people was followed for ten years, from their initial adolescence until their first years of adulthood. At four observation points, the participants completed various questionnaires to evaluate their emotional autonomy, the cohesion in their family relationships and their life satisfaction. There were no gender differences in the development of emotional autonomy. Family cohesion and life satisfaction showed significant negative associations with emotional autonomy and these associations became more pronounced as participants moved from adolescence into adulthood. Based on our results, emotional autonomy from parents does not seem to be a developmental stage taking place during adolescence, but rather, an indicator of difficult family relationships. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  9. Collective autonomy and absenteeism within work teams: a team motivation approach.

    Science.gov (United States)

    Rousseau, Vincent; Aubé, Caroline

    2013-01-01

    This study investigates the role of collective autonomy in regard to team absenteeism by considering team potency as a motivational mediator and task routineness as a moderator. The sample consists of 90 work teams (327 members and 90 immediate superiors) drawn from a public safety organization. Results of structural equation modeling indicate that the relationships between collective autonomy and two indicators of team absenteeism (i.e., absence frequency and time lost) are mediated by team potency. Specifically, collective autonomy is positively related to team potency which in turn is negatively related to team absenteeism. Furthermore, results of hierarchical regression analyses show that task routineness moderates the relationships between collective autonomy and the two indicators of team absenteeism such that these relationships are stronger when the level of task routineness is low. On the whole, this study points out that collective autonomy may exercise a motivational effect on attendance at work within teams, but this effect is contingent on task routineness.

  10. Dignity, dependence and relational autonomy for older people living in nursing homes

    DEFF Research Database (Denmark)

    Tolo Heggestad, Anne Kari; Høy, Bente; Wilhelm Rehnsfeldt, Arne

    2015-01-01

    Dignity is a core concept in nursing care . In earlier theories on dignity, close links have been drawn between dignity and autonomy, and autonomy has been closely related to independence . These traditional understandings of dignity and autonomy may be challenged when an individual moves...... into a nursing home . Our findings show that negative views about dependence, institutional frames and structures in the nursing home, and the attitudes and actions of healthcare personnel may diminish independence and lead to a lack of autonomy . Each of these areas can be experienced as a serious threat...

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

    Science.gov (United States)

    Keller, Heidi

    2016-01-19

    The definition of self and others can be regarded as embodying the two dimensions of autonomy and relatedness. Autonomy and relatedness are two basic human needs and cultural constructs at the same time. This implies that they may be differently defined yet remain equally important. The respective understanding of autonomy and relatedness is socialized during the everyday experiences of daily life routines from birth on. In this paper, two developmental pathways are portrayed that emphasize different conceptions of autonomy and relatedness that are adaptive in two different environmental contexts with very different affordances and constraints. Western middle-class children are socialized towards psychological autonomy, i.e. the primacy of own intentions, wishes, individual preferences and emotions affording a definition of relatedness as psychological negotiable construct. Non-Western subsistence farmer children are socialized towards hierarchical relatedness, i.e. positioning oneself into the hierarchical structure of a communal system affording a definition of autonomy as action oriented, based on responsibility and obligations. Infancy can be regarded as a cultural lens through which to study the different socialization agendas. Parenting strategies that aim at supporting these different socialization goals in German and Euro-American parents on the one hand and Nso farmers from North Western Cameroon on the other hand are described. It is concluded that different pathways need to be considered in order to understand human psychology from a global perspective. © 2015 The Author(s).

  12. Driven by expertise and insulation?: the autonomy of European regulatory agencies

    OpenAIRE

    Ossege, Christoph

    2015-01-01

    Expertise and autonomy are cornerstones to the effective operation and legitimacy of European Regulatory Agencies (ERAs). Yet, we know little about ERAs' actual autonomy, nor about factors shaping it. This article studies ERAs' actual autonomy from public and private actors, emphasising two crucial explanatory factors: expertise and rulemaking competences. The lack of insights on expertise is particularly striking, as expertise -the "raison d'être" and main resource of expert bodies- provides...

  13. A Study of Autonomy English Learning on the Internet

    Science.gov (United States)

    Zhong, Yunsheng

    2008-01-01

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

  14. The importance of supporting autonomy and perceived competence in facilitating long-term tobacco abstinence.

    Science.gov (United States)

    Williams, Geoffrey C; Niemiec, Christopher P; Patrick, Heather; Ryan, Richard M; Deci, Edward L

    2009-06-01

    The Public Health Service (PHS) Guideline for Treating Tobacco Use and Dependence (Fiore et al. 2000) recommends supporting autonomy and perceived competence to facilitate tobacco abstinence. The aim of the study was to evaluate the effectiveness of an intensive tobacco-dependence intervention based on self-determination theory (SDT) and intended to support autonomy and perceived competence in facilitating long-term tobacco abstinence. One thousand and six adult smokers were recruited into a randomized cessation-induction trial. Community care participants received cessation pamphlets and information on local treatment programs. Intervention participants received the same materials and were asked to meet four times with counselors over 6 months to discuss their health in a manner intended to support autonomy and perceived competence. The primary outcome was 24-month prolonged abstinence from tobacco. The secondary outcome was 7-day point prevalence tobacco abstinence at 24 months postintervention. Smokers in the intervention were more likely to attain both tobacco abstinence outcomes and these effects were partially mediated by change in both autonomous self-regulation and perceived competence from baseline to 6 months. Structural equation modeling confirmed the SDT model of health-behavior change in facilitating long-term tobacco abstinence. An intervention based on SDT and consistent with the PHS Guideline, which was intended to support autonomy and perceived competence, facilitated long-term tobacco abstinence.

  15. Autonomy and structure can enhance motivation of volunteers in sport organizations.

    Science.gov (United States)

    Hsu, Wei Ting; Wu, Kou Hsien; Wang, Yi Ching; Hsiao, Chia Huei; Wu, Hui Chin

    2013-12-01

    The goal was better understanding of the motivational factors of volunteers in non-profit sport organizations. The roles of two factors provided by supervisors to their subordinates were examined: autonomy support, i.e., the encouragement of self-initiation and emphasis on choice rather than control, and structure, i.e., the introduction of order, definite procedures, and rules. 489 sport volunteers (289 men, 200 women; M age = 31.2 yr., SD = 7.4) were administered questionnaires assessing their perceived autonomy support, structure, and motivation. Regression analysis indicated that perceived autonomy support predicted motivation. Structure also mediated the effect of perceived autonomy support on motivation. Supervisors of sport organizations should provide adequate structure for their volunteers.

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

    Science.gov (United States)

    Iliopoulou, Katerina K; While, Alison E

    2010-11-01

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

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

    Science.gov (United States)

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

    2017-12-01

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

  18. The impact of motivation and teachers' autonomy support on children's executive functions.

    Science.gov (United States)

    Sosic-Vasic, Zrinka; Keis, Oliver; Lau, Maren; Spitzer, Manfred; Streb, Judith

    2015-01-01

    The present study investigates the interplay of executive functions, motivation, and teacher's autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student's motivation and their teachers' autonomy support on student's executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher's autonomy support and student's intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach.

  19. The Social Perspective on the Renewable Energy Autonomy of Geographically Isolated Communities: Evidence from a Mediterranean Island

    Directory of Open Access Journals (Sweden)

    Fontina Petrakopoulou

    2017-02-01

    Full Text Available The use of renewable energy sources can provide a path toward sustainable development and regional energy independence. In particular, renewable-based energy autonomy constitutes a viable option in remote areas. This work presents a survey on the use of renewable energy as part of an energy autonomy plan on a Mediterranean island. The study also included personal communications with residents and local community leaders. The results show an overall positive attitude toward renewable energy applications. The majority of the respondents support the implementation of renewable-based, small-scale projects corresponding to local energy autonomy scenarios. They are, furthermore, convinced that a wider use of renewable technologies can reduce the environmental impact of conventional fuels. However, although people are aware of technologies widely used on the island, they are much less so when it comes to less prominent technologies (wave energy, fuel cells, etc.. People tend to be more open to installations of solar, wind and geothermal energy, while generally they dislike nuclear and coal power plants. Lastly, the majority of the respondents believe that local policies on energy issues should change, while they also perceive the lack of political will as one of the most important obstacles to the implementation of renewable technologies.

  20. Driven by Expertise and Insulation? The Autonomy of European Regulatory Agencies

    Directory of Open Access Journals (Sweden)

    Christoph Ossege

    2015-03-01

    Full Text Available Expertise and autonomy are cornerstones to the effective operation and legitimacy of European Regulatory Agencies (ERAs. Yet, we know little about ERAs’ actual autonomy, nor about factors shaping it. This article studies ERAs’ actual autonomy from public and private actors, emphasising two crucial explanatory factors: expertise and rulemaking competences. The lack of insights on expertise is particularly striking, as expertise—the “raison d’être” and main resource of expert bodies—provides ERAs with a potentially powerful means to increase autonomy. Relying on a rational institutionalist framework within which ERAs enjoy substantive discretion to pursue their goals, the study empirically compares three powerful ERAs—the European Medicines Agency, the European Chemicals Agency, and the European Food Safety Authority. Based on the analysis of 39 semi-structured expert interviews, findings show that expertise is a crucial explanation for ERAs’ substantive autonomy from the Commission. Towards research intensive private stakeholders, the role of expertise becomes less pronounced. Instead, ERAs are more successful in protecting their autonomy by engaging in the risk-averse interpretation of the regulatory framework and by adapting rules over time to adapt their needs: they engage in “procedural insulation”. Political salience provides a scope condition for ERAs to use expert knowledge and rulemaking competences more strategically—potentially undermining scientific quality.

  1. On the Relations between Parents' Ideals and Children's Autonomy

    Science.gov (United States)

    de Ruyter, Doret J.; Schinkel, Anders

    2013-01-01

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

  2. Teachers' Autonomy in Today's Educational Climate: Current Perceptions from an Acceptable Instrument

    Science.gov (United States)

    Strong, Luman E. G.; Yoshida, Roland K.

    2014-01-01

    This research evaluated the psychometric properties of Friedman's (1999) Teacher Work-Autonomy Scale (TWA) to determine whether it was an acceptable instrument to measure U.S. teacher autonomy in the present educational context. A second purpose was to ascertain the current status of teachers' perceptions of their autonomy from a sample of U.S.…

  3. Intramitochondrial autonomy in rat tissues

    International Nuclear Information System (INIS)

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

    1974-01-01

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

  4. Beyond a Western Bioethics in Asia and Its Implication on Autonomy.

    Science.gov (United States)

    Tan Kiak Min, Mark

    2017-07-01

    Despite flourishing as a multidisciplinary subject, the predominant view in bioethics today is based on Anglo-American thought. This has serious implications for a global bioethics that needs to be contextualized to local cultures and circumstances in order to be relevant. Being the largest continent on the earth, Asia is home to a variety of cultures, religions and countries of different economic statuses. While the practice of medicine in the East and West may be similar, its ethical practices do differ. Thus, the Western understanding of autonomy may not be wholly applicable in the Asian setting, especially in the setting of breaking bad news, giving consent, determining best interests and deciding on end-of-life care. This article explores these topics in depth, attempting to find shared integrating factors, but at the same time arguing for a modified ethical application of autonomy, based on Asian beliefs.

  5. How training and experience affect the benefits of autonomy in a dirty-bomb experiment

    Energy Technology Data Exchange (ETDEWEB)

    David J. Bruemmer; Curtis W. Nielsen; David I. Gertman

    2008-03-01

    A dirty-bomb experiment conducted at the INL is used to evaluate the effectiveness and suitability of three different modes of robot control. The experiment uses three distinct user groups to understand how participants’ background and training affect the way in which they use and benefit from autonomy. The results show that the target mode, which involves automated mapping and plume tracing together with a point and click tasking tool, provides the best performance for each group. This is true for objective performance such as source detection and localization accuracy as well as subjective measures such as perceived workload, frustration and preference. The best overall performance is achieved by the Explosive Ordinance Disposal group which has experience in both robot teleoperation and dirty bomb response. The user group that benefits least from autonomy is the Nuclear Engineers that have no experience with either robot operation or dirty bomb response. The group that benefits most from autonomy is the Weapons of Mass Destruction Civil Response Team that has extensive experience related to the task, but no robot training.

  6. Early and Middle Adolescents’ Autonomy Development: Impact of Maternal HIV/AIDS

    OpenAIRE

    Murphy, Debra A.; Greenwell, Lisa; Resell, Judith; Brecht, Mary-Lynn; Schuster, Mark A.

    2008-01-01

    Progression toward autonomy is considered of central importance during the adolescent period. For young adolescents with an HIV-infected parent, there may be additional challenges. This study investigated current autonomy among early and middle adolescents affected by maternal HIV (N = 108), as well as examined longitudinally the children’s responsibility taking when they were younger (age 6 - 11; N = 81) in response to their mother’s illness and their current autonomy as early/middle adolesc...

  7. LEARNER AUTONOMY IN THE INDONESIAN EFL SETTINGS

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    Nenden Sri Lengkanawati

    2017-01-01

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

  8. Maternal autonomy and child health care utilization in India: results from the National Family Health Survey.

    Science.gov (United States)

    Malhotra, Chetna; Malhotra, Rahul; Østbye, Truls; Subramanian, S V

    2014-07-01

    The objective of this study was to examine the association of maternal autonomy with preventive and curative child health care utilization in India. Data from the National Family Health Survey 2005-2006 were used to ascertain association of maternal autonomy (in 3 dimensions: decision making, access to financial resources, freedom of movement) with child's primary immunization status (indicative of preventive health care use) and treatment seeking for child's acute respiratory infection (indicative of curative health care use). Low maternal freedom of movement was associated with higher odds of incomplete primary immunization of the child and for not seeking treatment for the child's acute respiratory infection. Low maternal financial access was associated with increased odds for incomplete primary immunization of the child. The findings show that improvement in autonomy of Indian mothers, especially their freedom of movement, may help improve utilization of health care for their children. © 2012 APJPH.

  9. Autonomy and performance in the public sector: the experience of English NHS hospitals.

    Science.gov (United States)

    Verzulli, Rossella; Jacobs, Rowena; Goddard, Maria

    2018-05-01

    Since 2004, English NHS hospitals have been given the opportunity to acquire a more autonomous status known as a Foundation Trust (FT), whereby regulations and restrictions over financial, management, and organizational matters were reduced in order to create incentives to deliver higher-quality services in the most efficient way. Using difference-in-difference models, we test whether achieving greater autonomy (FT status) improved hospital performance, as proxied by measures of financial management, quality of care, and staff satisfaction. Results provide little evidence that the FT policy per se has made any difference to the performance of hospitals in most of these domains. Our findings have implications for health policy and inform the trend towards granting greater autonomy to public-sector organizations.

  10. Intergenerational Perspectives on Autonomy Following a Transition to a Continuing Care Retirement Community.

    Science.gov (United States)

    Ayalon, Liat

    2016-02-01

    The study evaluated the concept of autonomy from the perspective of older adults and their adult children following a transition of the older adult to a continuing care retirement community (CCRC). Overall, 70 interviews (with older adults and their adult children; 34 dyads) were analyzed, using a line-by-line open coding, followed by dyadic analysis. Autonomy was not portrayed as a uniform, homogenous construct, but rather encompassed four different domains: (a) the focus of one's attention or concerns: on others, on self, or not at all; (b) the ability to exercise decisions and make independent choices; (c) the degree of physical functioning and ability of the older adult; and (d) the financial ability of the older adult. The duality in the relationships between older adults and their adult children is discussed in relation to the give and take of autonomy that occur following a transition to a CCRC. © The Author(s) 2015.

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

    Science.gov (United States)

    Kekewich, Michael A

    2014-03-01

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

  12. Privatization, convergence, and institutional autonomy

    NARCIS (Netherlands)

    Rooijen, van M.

    2011-01-01

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

  13. Does Greater Autonomy Improve School Performance? Evidence from a Regression Discontinuity Analysis in Chicago

    Science.gov (United States)

    Steinberg, Matthew P.

    2014-01-01

    School districts throughout the United States are increasingly providing greater autonomy to local public (non-charter) school principals. In 2005-06, Chicago Public Schools initiated the Autonomous Management and Performance Schools program, granting academic, programmatic, and operational freedoms to select principals. This paper provides…

  14. ARMD Strategic Thrust 6: Assured Autonomy for Aviation Transformation

    Science.gov (United States)

    Ballin, Mark; Holbrook, Jon; Sharma, Shivanjli

    2016-01-01

    In collaboration with the external community and other government agencies, NASA will develop enabling technologies, standards, and design guidelines to support cost-effective applications of automation and limited autonomy for individual components of aviation systems. NASA will also provide foundational knowledge and methods to support the next epoch. Research will address issues of verification and validation, operational evaluation, national policy, and societal cost-benefit. Two research and development approaches to aviation autonomy will advance in parallel. The Increasing Autonomy (IA) approach will seek to advance knowledge and technology through incremental increases in machine-based support of existing human-centered tasks, leading to long-term reallocation of functions between humans and machines. The Autonomy as a New Technology (ANT) approach seeks advances by developing technology to achieve goals that are not currently possible using human-centered concepts of operation. IA applications are mission-enhancing, and their selection will be based on benefits achievable relative to existing operations. ANT applications are mission-enabling, and their value will be assessed based on societal benefit resulting from a new capability. The expected demand for small autonomous unmanned aircraft systems (UAS) provides an opportunity for development of ANT applications. Supervisory autonomy may be implemented as an expansion of the number of functions or systems that may be controlled by an individual human operator. Convergent technology approaches, such as the use of electronic flight bags and existing network servers, will be leveraged to the maximum extent possible.

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

    Science.gov (United States)

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

    2018-05-03

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

  16. Perspectives on autonomy.

    Science.gov (United States)

    Keys, Yolanda

    2009-09-01

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

  17. Maximing Learning Strategies to Promote Learner Autonomy

    Directory of Open Access Journals (Sweden)

    Junaidi Mistar

    2001-01-01

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

  18. Autonomy, Automation, and Systems

    Science.gov (United States)

    Turner, Philip R.

    1987-02-01

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

  19. Undermining Adolescent Autonomy With Parents and Peers: The Enduring Implications of Psychologically Controlling Parenting

    Science.gov (United States)

    Hare, Amanda L.; Szwedo, David E.; Schad, Megan M.; Allen, Joseph P.

    2014-01-01

    This study used a longitudinal, multi-method design to examine whether teens’ perceptions of maternal psychological control predicted lower levels of adolescent autonomy displayed with their mothers and peers over time. Significant predictions from teens’ perceptions of maternal psychological control to teens’ displays of autonomy in maternal and peer relationships were found at age 16 after accounting for adolescent displays of autonomy with mothers and peers at age 13, indicating relative changes in teens’ autonomy displayed with their mother and a close peer over time. Results suggest that the ability to assert one’s autonomy in mid-adolescence may be influenced by maternal behavior early in adolescence, highlighting the importance of parents minimizing psychological control to facilitate autonomy development for teens. PMID:26788023

  20. Undermining Adolescent Autonomy With Parents and Peers: The Enduring Implications of Psychologically Controlling Parenting.

    Science.gov (United States)

    Hare, Amanda L; Szwedo, David E; Schad, Megan M; Allen, Joseph P

    2015-12-01

    This study used a longitudinal, multi-method design to examine whether teens' perceptions of maternal psychological control predicted lower levels of adolescent autonomy displayed with their mothers and peers over time. Significant predictions from teens' perceptions of maternal psychological control to teens' displays of autonomy in maternal and peer relationships were found at age 16 after accounting for adolescent displays of autonomy with mothers and peers at age 13, indicating relative changes in teens' autonomy displayed with their mother and a close peer over time. Results suggest that the ability to assert one's autonomy in mid-adolescence may be influenced by maternal behavior early in adolescence, highlighting the importance of parents minimizing psychological control to facilitate autonomy development for teens.

  1. Performance of the Public Expenditure Management at Local Level in Romania

    Directory of Open Access Journals (Sweden)

    Ani MATEI

    2008-06-01

    Full Text Available The current paper aims to analyze the performance of the public expenditure management based on the decrease of the administrative costs. The paper is grounded on the following premises: (1 Romania as an EU Member State is under a continuous process to harmonize its legislation with the EU legislation. (2 The integration of Romania in EU in 2007 has determined a significant change in the administrative expenditure amount. (3 Strengthening local autonomy through the decentralization and the devolution processes emphasizes clearer the need for improving the performance of the expenditure management at local level. (4 Internal order, flows of communication and transfer, synergy of the governance system assume administrative expenditure that can be determined. (5 The performance of public organizations in managing local governance issues depends directly also on the administrative expenditure level**. [** Paper accepted to be presented at the Fourth TransAtlantic Dialogue “The Status of Inter-Governmental Relations and Multi-Level Governance in Europe and the US”, Workshop 5: “Performance measurement and accountability in IGR-MLG”.

  2. Full autonomy; Autarkie im Komplettpaket

    Energy Technology Data Exchange (ETDEWEB)

    Augsten, Eva

    2011-05-31

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

  3. Do job autonomy and negotiation self-efficacy improve employment relationships?

    Directory of Open Access Journals (Sweden)

    Peter R A Oeij

    2006-10-01

    Full Text Available This study investigated whether improving the employment relationship does more depend on negotiation selfefficacy or on task outonomy for a sample of employees from a Dutch telecom company. Multiple regression analyses were conducted to examine the effects of negotiation self-efficacy and task autonomy on integrative negotiation and the effect of integrative negotiation on psychological contract breach. Results indicate that employees negotiate more integratively when they have higher negotiation self-efficacy, compared to employees with more task autonomy. Empirical support was found for the prediction that higher negotiation self-efficacy and task autonomy correlates with less psychological contract breach.

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

    Science.gov (United States)

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

    2014-08-01

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

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

    Science.gov (United States)

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

    2009-02-01

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

  6. Female autonomy and reported abortion-seeking in Ghana, West Africa.

    Science.gov (United States)

    Rominski, Sarah D; Gupta, Mira; Aborigo, Raymond; Adongo, Phillip; Engman, Cyril; Hodgson, Abraham; Moyer, Cheryl

    2014-09-01

    To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision. In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior. Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. A cybernetic theory of morality and moral autonomy.

    Science.gov (United States)

    Chambers, J

    2001-04-01

    Human morality may be thought of as a negative feedback control system in which moral rules are reference values, and moral disapproval, blame, and punishment are forms of negative feedback given for violations of the moral rules. In such a system, if moral agents held each other accountable, moral norms would be enforced effectively. However, even a properly functioning social negative feedback system could not explain acts in which individual agents uphold moral rules in the face of contrary social pressure. Dr. Frances Kelsey, who withheld FDA approval for thalidomide against intense social pressure, is an example of the degree of individual moral autonomy possible in a hostile environment. Such extreme moral autonomy is possible only if there is internal, psychological negative feedback, in addition to external, social feedback. Such a cybernetic model of morality and moral autonomy is consistent with certain aspects of classical ethical theories.

  8. Teaching quality: High school students' autonomy and competence.

    Science.gov (United States)

    León, Jaime; Medina-Garrido, Elena; Ortega, Miriam

    2018-05-01

    How teachers manage class learning and interact with students affects students’ motivation and engagement. However, it could be that the effect of students’ representation of teaching quality on the students’ motivation varies between classes. Students from 90 classes participated in the study. We used multilevel random structural equation modeling to analyze whether the relationship of the students’ perception of teaching quality (as an indicator of the students’ mental representation) and students’ motivation varies between classes, and if this variability depends on the class assessment of teaching quality (as an indicator of teaching quality). The effect of teachers’ structure on the regression slope of student perception of student competence was .127. The effect of teachers’ autonomy support on the regression slope of student perception of student autonomy was .066. With this study we contribute a more detailed description of the relationship between teaching quality, competence and autonomy.

  9. Autonomy and dignity of patients with dementia: Perceptions of multicultural caretakers.

    Science.gov (United States)

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

    2018-02-01

    A key message in the World Health Organization's report on dementia emphasizes the need to improve public and professional attitudes to dementia and its understanding, while acknowledging the fact that the workforce in dementia care is becoming increasingly diverse culturally. To explore possible differences among formal caretakers from varied cultural background in their attitudes toward the autonomy and human dignity of patients with dementia. Semi-structured interviews and content analysis, utilizing two fictional vignettes for eliciting caretakers' attitudes toward dignity and autonomy of their patients. Participants and context: A total of 20 formal caretakers of patients with dementia from three different cultural groups in Israel ("Sabras," "Arabs," and "Russians"), working in nursing homes and a hospital. Ethical consideration: Approvals of relevant research ethics committees were obtained and followed. In comparison with the other groups, most Arab caretakers offer markedly richer perceptions of human dignity and autonomy. Their human dignity's conceptualization emphasizes "person-centered approach," and their perception of patients' autonomy includes provision of explanations and preservation and encouragement of independence. The differences found in the attitudes toward the meaning of autonomy and human dignity between the Arab caretakers and the other caretakers stand in contrast to previous studies regarding human dignity, emphasizing the common nature of these attitudes. Offering a linkage (theoretical and empirical) between the Arab perceptions of dignity and autonomy, the study strengthen and further the importance attributed in existing literature to person-centered care in enhancing the quality of care for patients with dementia. The conceptualization of human dignity may vary among different cultural groups. It may also influence the extent to which the caretaker holds a full-fledged perception of the patients' autonomy.

  10. Autonomy, Positive Relationships, and IL-6: Evidence for Gender-Specific Effects

    Science.gov (United States)

    Eisenlohr-Moul, Tory A.; Segerstrom, Suzanne C.

    2014-01-01

    Objectives A body of evidence indicates that women value relationship-centered aspects of well-being more than men do, while men value autonomy-centered aspects of well-being more than women do. The current study examined whether gender moderates relations between autonomy and positive relationships and interleukin-6 (IL-6), a cytokine associated with inflammatory processes. Aspects of well-being consistent with gender-linked values were expected to be most health-protective such that positive relationships would predict lower IL-6 only or more strongly in women, and autonomy would predict lower IL-6 only or more strongly in men. Methods In the first study, a sample of 119 older adults (55% female) living in Kentucky were visited in their homes for interviews and blood draws. In the second study, a sample of 1,028 adults (45% female) living across the United States (U.S.) underwent a telephone interview followed by a visit to a research center for blood draws. Results In the Kentucky sample, autonomy was quadratically related to IL-6 such that average autonomy predicted higher IL-6; this effect was stronger in men, providing support for our hypothesis only at above average levels of IL-6. In the U.S. national sample, more positive relationships were associated with lower IL-6 in women only. When the national sample was restricted to match the Kentucky sample, higher autonomy was associated with lower IL-6 in men only. Conclusions Results provide preliminary evidence for gender-specific effects of positive relationships and autonomy on IL-6. Further work is needed to establish the generalizability of these effects to different ages, cultures, and health statuses. PMID:22908985

  11. Abusive supervision, psychosomatic symptoms, and deviance: Can job autonomy make a difference?

    Science.gov (United States)

    Velez, Maria João; Neves, Pedro

    2016-07-01

    Recently, interest in abusive supervision has grown (Tepper, 2000). However, little is still known about organizational factors that can reduce its adverse effects on employee behavior. Based on the Job Demands-Resources Model (Demerouti, Bakker, Nachreiner, & Schaufeli, 2001), we predict that job autonomy acts as a buffer of the positive relationship between abusive supervision, psychosomatic symptoms and deviance. Therefore, when job autonomy is low, a higher level of abusive supervision should be accompanied by increased psychosomatic symptoms and thus lead to higher production deviance. When job autonomy is high, abusive supervision should fail to produce increased psychosomatic symptoms and thus should not lead to higher production deviance. Our model was explored among a sample of 170 supervisor-subordinate dyads from 4 organizations. The results of the moderated mediation analysis supported our hypotheses. That is, abusive supervision was significantly related to production deviance via psychosomatic symptoms when job autonomy was low, but not when job autonomy was high. These findings suggest that job autonomy buffers the impact of abusive supervision perceptions on psychosomatic symptoms, with consequences for production deviance. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  12. Development of Autonomy as a Precondition of Adolescents’ Orientation in Moral Sphere

    Directory of Open Access Journals (Sweden)

    Molchanov S.V.,

    2016-01-01

    Full Text Available The paper discusses the outcomes of a research on the relationship between developmental levels of autonomy and features of moral orientation in adolescents determined by the priority of the value of justice or care within the cognitive (J. Piaget, L. Kohlberg and empathy approach (C. Gillian, N. Eisenberg. The research proved that high levels of autonomy in the cognitive component correlate with the adolescent’s high estimation of moral qualities in various communicative contexts. Low level of emotional autonomy correlates with orientation towards the value of care, while high level correlates with orientation towards the value of justice. Levels of autonomy also correlate with moral judgments. Adolescents with low levels of autonomy reveal greater dependence on the opinion of other people and a stronger desire to appear a better person in the eyes of others. Adolescents with heterochrony of autonomy structure are more oriented towards the stage of the conventional level, i.e. the opinion of other people, a strong desire to appear a better person in the eyes of others, the significance of social rules and order, and the reflective empathic position that affirms the idea of self-sacrifice and defending the rights of others.

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

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

    NARCIS (Netherlands)

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

    2017-01-01

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

  17. Developing child autonomy in pediatric healthcare: towards an ethical model.

    Science.gov (United States)

    Martakis, Kyriakos; Brand, Helmut; Schröder-Bäck, Peter

    2018-06-01

    The changes initiated by the new National Civil and Commercial Code in Argentina underline the pediatric task to empower children's and adolescents' developing autonomy. In this paper, we have framed a model describing autonomy in child healthcare. We carried out a literature review focusing on i) the concept of autonomy referring to the absolute value of the autonomous individual, and ii) the age-driven process of competent decisionmaking development. We summarized our findings developing a conceptual model that includes the child, the pediatrician and the parents. The pediatricianchild relationship is based on different forms of guidance and cooperation, resulting in varying levels of activity and passivity. Parental authority influences the extent of autonomy, based on the level of respect of the child's moral equality. Contextual, existential, conceptual, and socialethical conditions shall be considered when applying the model to facilitate dialogue between pediatricians, children, parents and other actors. Sociedad Argentina de Pediatría.

  18. Women’s decision-making autonomy and children’s schooling in rural Mozambique

    OpenAIRE

    Luciana Luz; Victor Agadjanian

    2015-01-01

    Background: Women's decision-making autonomy in developing settings has been shown to improve child survival and health outcomes. However, little research has addressed possible connections between women's autonomy and children's schooling. Objective: To examine the relationship between rural women's decision-making autonomy and enrollment status of primary school-age children living in their households and how this relationship differs by child's gender. Methods: The analysis uses data...

  19. [Euthanasia and the paradoxes of autonomy].

    Science.gov (United States)

    Siqueira-Batista, Rodrigo; Schramm, Fermin Roland

    2008-01-01

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

  20. Building up Autonomy Through Reading Strategies

    Directory of Open Access Journals (Sweden)

    Alexander Izquierdo Castillo

    2014-10-01

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

  1. Factors Contributing to Learners’ Autonomy in EFL Reading

    OpenAIRE

    Sri Endah Tabiati

    2016-01-01

    Abstract: This study aims to discover factors that assist learners develop their autonomy in EFL reading. The approach employed is qualitative involving EFL learners in an English Department of the Faculty of Cultural Studies, Brawijaya University Malang. There are two stages in the study: the subject selection stage intended to gain potential subjects and the main study intended to find the answer of the research questions. The findings of the study show that the autonomy of EFL learners in ...

  2. The problems and development potential of revenue autonomy in Estonian municipalities. Kohalike omavalitsuste tuluautonoomia probleemid ja arenguvõimalused Eestis

    Directory of Open Access Journals (Sweden)

    Janno Reiljan

    2013-01-01

    Full Text Available In a regionally heterogeneous country like Estonia, it is a difficult task to create a local government revenue structure that guarantees even supply of public services across the entire country and, at the same time, revenue autonomy for the municipalities. In the theoretical part of the current article the suitability of different sources of own revenues are analysed in the context of Estonian municipalities. The empirical part of the article compares the financing principles of Estonian municipalities with other EU countries. Finally, the proportions of different own sources of revenues in the budgets of Estonian local governments are examined and suggestions are made for changing the current system

  3. Managing the accountability-autonomy tensions in university research commercialisation

    OpenAIRE

    Narayan, Anil K.; Northcott, Deryl; Parker, Lee D.

    2017-01-01

    This article investigates organisational responses to emerging concerns about how accountability–autonomy tensions can be managed within the context of university research commercialisation. The findings suggest that changed expectations of university research practices, which result from the introduction of a commercialisation logic, can be managed via the homogenisation of research goals and strategies. The successful management of accountability–autonomy tensions also depends on utilising ...

  4. Between Autonomy and Vulnerability : the Space of Movement

    OpenAIRE

    Kevin McDonald

    2011-01-01

    Analyses of the contemporary alterglobalization movement increasingly emphasize dimensions of autonomy, whose ultimate origins lie in theories of agency understood as sovereignty. This paper argues that critical dimensions of the alterglobalization movement involve practices of embodied action and forms of responsibility that point beyond autonomy, to a paradigm of relational vulnerability. Recognising this is central to understanding ethics, agency, and subjectivity and to understanding move...

  5. Exploring the Concept of Learner Autonomy in Cross-Cultural Research

    Directory of Open Access Journals (Sweden)

    Nga Thanh Nguyen

    2014-09-01

    Full Text Available This research explores how the concept of learner autonomy is understood and used in Vietnamese higher educational settings. Data were collected through interviews in Vietnamese with four university lecturers in Hanoi, Vietnam and then reported in an English language thesis. The problems confronted by the lecturers were in understanding the concept of learner autonomy, the complexities of translation equivalence for the concept from one language to another, and the impact of culture in interpreting the concept of learner autonomy. The paper concludes with recommendations for educators to be sensitive to cultural and linguistic considerations when transferring concepts from one culture to another.

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

    Science.gov (United States)

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

    2013-01-01

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

  7. University Autonomy in the Context of University-Society, State and Market/Capital Relations

    Directory of Open Access Journals (Sweden)

    Dicle ÖZCAN

    2016-05-01

    Full Text Available This study focuses on how the concept university autonomy which constitutes one of the most tangible indicators of academic freedom is positioned in the context of university's relations with state, society and market and concentrates on the possibility of university autonomy. From the emergence of universities in the Middle Age to the modern universities of the present, the concepts of university autonomy and academic freedom have been maintaining their actuality with a growing interest. In the light of studies in Turkey, the purpose of this study is to discuss the change of university autonomy in the historical process and where it can be positioned in the context of building blocks of university autonomy concept and the recent relationship between universities and market-industry-business world.

  8. Women's autonomy in household decision-making: a demographic study in Nepal.

    Science.gov (United States)

    Acharya, Dev R; Bell, Jacqueline S; Simkhada, Padam; van Teijlingen, Edwin R; Regmi, Pramod R

    2010-07-15

    How socio-demographic factors influence women's autonomy in decision making on health care including purchasing goods and visiting family and relatives are very poorly studied in Nepal. This study aims to explore the links between women's household position and their autonomy in decision making. We used Nepal Demographic Health Survey (NDHS) 2006, which provided data on ever married women aged 15-49 years (n = 8257). The data consists of women's four types of household decision making; own health care, making major household purchases, making purchase for daily household needs and visits to her family or relatives. A number of socio-demographic variables were used in multivariable logistic regression to examine the relationship of these variables to all four types of decision making. Women's autonomy in decision making is positively associated with their age, employment and number of living children. Women from rural area and Terai region have less autonomy in decision making in all four types of outcome measure. There is a mixed variation in women's autonomy in the development region across all outcome measures. Western women are more likely to make decision in own health care (1.2-1.6), while they are less likely to purchase daily household needs (0.6-0.9). Women's increased education is positively associated with autonomy in own health care decision making (p make decision in own healthcare. Women from rural area and Terai region needs specific empowerment programme to enable them to be more autonomous in the household decision making. Women's autonomy by education, wealth quintile and development region needs a further social science investigation to observe the variations within each stratum. A more comprehensive strategy can enable women to access community resources, to challenge traditional norms and to access economic resources. This will lead the women to be more autonomous in decision making in the due course.

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

    Science.gov (United States)

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

    2009-07-01

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

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

    Science.gov (United States)

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

    2016-01-01

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

  11. Effective Autonomy, Organisational Relationships and Skilled Jobs in Subsidiaries

    DEFF Research Database (Denmark)

    Gammelgaard, Jens; McDonald, Frank; Tüselmann, Heinz

    2011-01-01

    Purpose – The purpose of this paper is to explore how the proportion of skilled jobs in subsidiaries is influenced by resource gaps created by subsidiary development. Design/methodology/approach – This paper develops a range of propositions that connect the constructs of effective autonomy...... implications – The conceptual model can help parent company managers assess the likely effects of developments in effective autonomy and organisational relationships in their subsidiaries. Subsidiary managers can assess the possible impact of such factors as development of entrepreneurial activities......, specialization within the multinational corporation supply chain and enhancement of absorptive capacity on the proportion of skilled jobs. Originality/value – This paper is the first to describe subsidiary development from a skilled job perspective. It further develops the concept of autonomy and introduces...

  12. Quelles aides les formations hybrides en langues proposent-elles à l'apprenant pour favoriser son autonomie ? What kind of assistance do blended language learning courses provide to learners in order to foster their autonomy?

    Directory of Open Access Journals (Sweden)

    Elke Nissen

    2007-11-01

    Full Text Available L'apprenant qui suit une formation hybride en langues travaille partiellement à distance, ce qui lui demande une certaine autonomie. La question alors est de savoir si ces formations soutiennent l'apprenant dans le développement de son autonomie et si oui, comment. Les réponses des concepteurs de huit formations hybrides à un questionnaire auto-administré montrent que les nécessaires développement et soutien de l'autonomie sont toujours respectés ; ainsi, ces huit formations proposent des aides pour favoriser l'autonomie dans les domaines technique, méthodologique, social et, bien sûr, langagier. Développer ces autonomies semble donc être devenu un standard dans le cadre des formations observées. En revanche, les autonomies de type psycho-affectif, informationnel, cognitif et métacognitif ne sont pas prises en considération dans toutes les formations.When taking a blended learning course, a learner works partially at a distance, which requires some autonomy. The aim of this study is to find out whether blended learning courses sustain the development of learner autonomy and if they do so, how they do it. The statements that 8 course designers made in a questionnaire show that their courses always help the learners to become or to be autonomous. All 8 courses provide assistance (advice, information and activities in order to foster technical, methodological, social and, of course, language autonomy. Consequently, sustaining these four types of autonomy seems to have become a standard in blended learning courses. But, on the contrary, assistance for other types of autonomy is not systematically provided: only several of these courses help the learners to develop psycho affective, informational, cognitive and metacognive autonomy.

  13. Parent-adolescent dyads: association of parental autonomy support and parent-adolescent shared diabetes care responsibility.

    Science.gov (United States)

    Hanna, K M; Dashiff, C J; Stump, T E; Weaver, M T

    2013-09-01

    Parent-adolescent shared responsibility for diabetes care is advocated by experts to achieve beneficial diabetes and psychosocial outcomes for adolescents with type 1 diabetes. Parental autonomy support may be a way to facilitate this sharing. In this dyadic study, we examined parental diabetes-specific autonomy support experienced by adolescents with type 1 diabetes and their parents (n = 89 dyads), and its association with their experience of shared diabetes care responsibility. Path analysis was used to test an Actor-Partner Interdependence Model for parental autonomy support effects on shared responsibility. This was a secondary analysis of data from 89 parent-early/mid-adolescent dyads. Actor effects were identified. Parents' and adolescents' perceptions of parental autonomy support were associated with their respective reports of shared diabetes care responsibility. One partner effect was identified. Adolescents' reports of parental autonomy support were associated with parents' reports of shared responsibility. Parents and adolescents held similar views of autonomy support but discrepant views of shared responsibility. Older adolescents perceived less parental autonomy support. Increasing parental autonomy support may facilitate parent-adolescent sharing of diabetes care responsibility. Adolescent and parent perceptions influence each other and need to be considered when working with them to strengthen parental autonomy support. © 2012 John Wiley & Sons Ltd.

  14. Resource allocation in health care and the role of personal autonomy.

    Science.gov (United States)

    Gandjour, A

    2015-03-01

    Resource allocation decisions in health care require the consideration of ethical values. Major ethical theories include Amartya Sen's capability approach, Norman Daniels's theory of justice for health, and preference utilitarian theory. This paper argues that while only preference utilitarian theory explicitly considers the impact of an individual's actions on others, all 3 theories agree in terms of providing individual autonomy. Furthermore, it shows that all 3 theories emphasise the role of informed preferences in securing individual autonomy. Still, stressing personal autonomy has limited direct implications for priority setting. 2 priority rules for resource allocation could be identified: 1) to give priority to patients with mental disability (over those with pure physical disability); and 2) to give priority to patients with a large expected loss of autonomy without treatment. © Georg Thieme Verlag KG Stuttgart · New York.

  15. Autonomy and relatedness in psychopathology and treatment: a cross-cultural formulation.

    Science.gov (United States)

    Sato, T

    2001-02-01

    A cross-cultural view of psychopathology is proposed, contending that there are two basic systems of self-organization. These two systems of self-organization, labeled autonomy and relatedness, are essential to a person's well-being regardless of the culture or society to which the person belongs. The degree of autonomy and relatedness required to maintain mental health in a specific society is affected by cultural mores. People in collectivistic (primarily non-Western) cultures require high levels of relatedness and moderate levels of autonomy to maintain mental health. People in individualistic (primarily Western) cultures require high levels of autonomy and moderate levels of relatedness to maintain mental health. This view, based on a review of past work in various areas of psychology, is discussed in the context of various forms of psychotherapy existing in individualistic and collectivistic cultures.

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

    Science.gov (United States)

    Basaran Acil, Seher; Dinç, Leyla

    2018-04-14

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

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

    Science.gov (United States)

    Xia, Jiangang; Gao, Xingyuan; Shen, Jianping

    2017-01-01

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

  18. Introducing local property tax for fiscal decentralization and local authority autonomy

    Science.gov (United States)

    Dimopoulos, Thomas; Labropoulos, Tassos; Hadjimitsis, Diafantos G.

    2015-06-01

    Charles Tiebout (1956), in his work "A Pure Theory of Local Expenditures", provides a vision of the workings of the local public sector, acknowledging many similarities to the features of a competitive market, however omitting any references to local taxation. Contrary to other researchers' claim that the Tiebout model and the theory of fiscal decentralization are by no means synonymous, this paper aims to expand Tiebout's theory, by adding the local property tax in the context, introducing a fair, ad valorem property taxation system based on the automated assessment of the value of real estate properties within the boundaries of local authorities. Computer Assisted Mass Appraisal methodology integrated with Remote Sensing technology and GIS analysis is applied to local authorities' property registries and cadastral data, building a spatial relational database and providing data to be statistically processed through Multiple Regression Analysis modeling. The proposed scheme accomplishes economy of scale using CAMA procedures on one hand, but also succeeds in making local authorities self-sufficient through a decentralized, fair, locally calibrated property taxation model, providing rational income administration.

  19. Autopoiesis: Autology, Autotranscendence and Autonomy

    DEFF Research Database (Denmark)

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

  20. Autonomy, Competence and Non-interference.

    Science.gov (United States)

    Roberts, Joseph T F

    2017-12-30

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

  1. Autonomy and the akratic patient.

    Science.gov (United States)

    McKnight, C J

    1993-01-01

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

  2. Local variability in long-term care services: local autonomy, exogenous influences and policy spillovers.

    Science.gov (United States)

    Fernandez, José-Luis; Forder, Julien

    2015-03-01

    In many countries, public responsibility over the funding and provision of long-term care services is held at the local level. In such systems, long-term care provision is often characterised by significant local variability. Using a panel dataset of local authorities over the period 2002-2012, the paper investigates the underlying causes of variation in gross social care expenditure for older people in England. The analysis distinguishes between factors outside the direct control of policy makers, local preferences and local policy spillovers. The results indicate that local demand and supply factors, and to a much lesser extent local political preferences and spatial policy spillovers, explain a large majority of the observed variation in expenditure. Copyright © 2015 John Wiley & Sons, Ltd.

  3. Cooperative autonomy and low. Point for the improvement of their dynamics in Cuba

    Directory of Open Access Journals (Sweden)

    Orestes Rodríguez Musa

    2015-06-01

    Full Text Available The objective of this work is to value the current legal implementation of the cooperative autonomy in Cuba, opinions that can contribute to its improvement. For that reason it begins explaining the origin and the transcendency of the formal declaration of the ACI about the principle of autonomy and independence. In a second moment, some juridical elements are systematized starting from which the Right must modulate the autonomy of the figure. To conclude, a critical-constructive approach to the implementation of the cooperative autonomy in the Cuban socialist legal system is carried out.

  4. Better Nurse Autonomy Decreases the Odds of 30-Day Mortality and Failure to Rescue

    Science.gov (United States)

    Rao, Aditi D.; Kumar, Aparna; McHugh, Matthew

    2017-01-01

    Research Purpose Autonomy is essential to professional nursing practice and is a core component of good nurse work environments. The primary objective of this study was to examine the relationship between nurse autonomy and 30-day mortality and failure to rescue (FTR) in a hospitalized surgical population. Study Design This study was a secondary analysis of cross-sectional data. It included data from three sources: patient discharge data from state administrative databases, a survey of nurses from four states, and the American Hospital Association annual survey from 2006–2007. Methods Survey responses from 20,684 staff nurses across 570 hospitals were aggregated to the hospital level to assess autonomy measured by a standardized scale. Logistic regression models were used to estimate the relationship between nurse autonomy and 30-day mortality and FTR. Patient comorbidities, surgery type, and other hospital characteristics were included as controls. Findings Greater nurse autonomy at the hospital level was significantly associated with lower odds of 30-day mortality and FTR for surgical patients even after accounting for patient risk and structural hospital characteristics. Each additional point on the nurse autonomy scale was associated with approximately 19% lower odds of 30-day mortality (p autonomy place their surgical patients at an increased risk for mortality and FTR. Clinical Relevance Patients receiving care within institutions that promote high levels of nurse autonomy have a lower risk for death within 30 days and complications leading to death within 30 days. Hospitals can actively take steps to encourage nurse autonomy to positively influence patient outcomes. PMID:28094907

  5. Trust and management : Explaining cross-national differences in work autonomy

    NARCIS (Netherlands)

    van Hoorn, A.A.J.

    2013-01-01

    We open the black box of what goes on in firms in terms of management of their operations. Work autonomy is a key aspect of firm organization and we test the hypothesis that societal trust affects the level of autonomy that firms grant to their employees. Analysis of up to 189,213 individuals from

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

    OpenAIRE

    Strube, Miriam

    2004-01-01

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

  7. Authenticity-Sensitive Preferentism and Educating for Well-Being and Autonomy

    Science.gov (United States)

    Haji, Ishtiyaque; Cuypers, Stefaan E.

    2008-01-01

    An overarching aim of education is the promotion of children's personal well-being. Liberal educationalists also support the promotion of children's personal autonomy as a central educational aim. On some views, such as John White's, these two goals--furthering well-being and cultivating autonomy--can come apart. Our primary aim in this paper is…

  8. Evaluations of Conflicts Between Latino Values and Autonomy Desires Among Puerto Rican Adolescents.

    Science.gov (United States)

    Villalobos Solís, Myriam; Smetana, Judith G; Tasopoulos-Chan, Marina

    2017-09-01

    Puerto Rican adolescents (N = 105; M age  = 15.97 years, SD = 1.40) evaluated hypothetical situations describing conflicts between Latino values (family obligations and respeto) and autonomy desires regarding personal, friendship, and dating activities. Adolescents judged that peers should prioritize Latino values over autonomy, which led to greater feelings of pride than happiness. However, they believed that teens would prioritize autonomy over Latino values, which led to greater feelings of happiness than pride. Adolescents reasoned about autonomy desires as personal issues, whereas reasoning about Latino values was multifaceted, including references to conventions and concerns for others. Furthermore, judgments and reasoning depended on the type of autonomy desire and Latino value and sometimes, by participants' age and sex. © 2016 The Authors. Child Development © 2016 Society for Research in Child Development, Inc.

  9. The Impact of Motivation and Teachers’ Autonomy Support on Children’s Executive Functions

    Directory of Open Access Journals (Sweden)

    Zrinka eSosic-Vasic

    2015-02-01

    Full Text Available The present study investigates the interplay of executive functions, motivation and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teachers’ autonomy support on student’s executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher’s autonomy support and student’s intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach.

  10. The impact of motivation and teachers’ autonomy support on children’s executive functions

    Science.gov (United States)

    Sosic-Vasic, Zrinka; Keis, Oliver; Lau, Maren; Spitzer, Manfred; Streb, Judith

    2015-01-01

    The present study investigates the interplay of executive functions, motivation, and teacher’s autonomy support in school context. In a cross-sectional study design 208 students from different school types completed a standardized motivation questionnaire and processed two executive function tasks. All teachers who teach these students were asked about their autonomy supporting behavior by a standardized test. Multilevel analyses assessed the effects of the student’s motivation and their teachers’ autonomy support on student’s executive functions. Our results show considerable relationships between these variables: high executive function capacities came along with teacher’s autonomy support and student’s intrinsic motivation styles, whereas low executive function capacities were related to external regulation styles. The results indicate the importance of autonomy support in school instruction and disclose the need to popularize the self-regulation approach. PMID:25762958

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

    Science.gov (United States)

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

    2017-08-01

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

  12. THE ISSUEOFSTRENGTHENING BUDGET CAPACITY FOR ENSURING THE FINANCIALINDEPENDENCE OFLOCALAUTHORITIES

    Directory of Open Access Journals (Sweden)

    Dmytriy V. Nekhaychuk

    2018-05-01

    Full Text Available The paper deals with the issues on strengthening local governments’ budget capacity in the face of modern challenges. It shows the conceptual in-depth study of local budgets foundations, income and practical recommendations focusing on stability and capacity. The author proves that the revenues of local budgets play a crucial role in ensuring the full and effective performance of the functions and local authorities’ tasks. The paper shows the scientific analysis of modern economists’ views on the local authorities’ financial autonomy and the local budgets’ role in the process. The paper also shows the retrospective comparative analysis of methods, used by local and foreign scientists for the formation of local budgets’ revenues. It considers the economic nature of income in local budgets as a source of finance, ensures the efficient operation of local authorities. It has been found out that the organization of the process of forming local budgets’ revenues is influenced by the organizational and legal forms of management, type of ownership and specifics of enterprises. Taxes are the dominant source of local budgets’ incomes, the financial regulator of production, means of ensuring socio-economic development of the separate administrative and territorial units and the state as a whole. The authors also analyze different types of revenues, including tax, in the revenue part of local budgets. The authors propose to expand the list of local taxes and fees due to the introduction of tax with targeted use of received funds. The conceptual basis of financial independence of local self-government lies in in the optimal interests of the population, local government, state and business structures. The increase of own revenues in the share of local budgets becomes a strategic issue of the financial autonomy and the corresponding administrative and territorial units.

  13. Relations of Behavioral Autonomy to Health Outcomes Among Emerging Adults With and Without Type 1 Diabetes

    Science.gov (United States)

    Reynolds, Kerry A.; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    Objective To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. Methods High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. Results There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Conclusions Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. PMID:25157070

  14. Beyond Expectations: Autonomy and the Iranian Postgraduate Students in Malaysian Public Universities

    Directory of Open Access Journals (Sweden)

    Sina Neissi

    2017-10-01

    Full Text Available Iranian learners at all levels of education (primary, secondary and tertiary face a number of constraints in their studies due to restriction of educational system, cultures, upbringing and expectations of society. Based on this premise the researchers would like to explore the degrees of autonomy as practiced by selected Iranian postgraduate students studying at three premier public universities in Malaysia. Data were gathered using the Learner Autonomy Profile (LAP developed by Confessore & Confessore (1992.  The findings reveal that these Iranian postgraduate students do practice autonomy and know how to apply positive coping strategies in their studies; thus indicating positive contradiction from the normal expectations of Iranian learners’ performance in relation to autonomy. The paper concludes with the impacts and implications of the findings.

  15. Woolf’s Weighty Gifts: The Measure of Modernist Autonomy

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    Rebecca Colesworthy

    2017-07-01

    Full Text Available This paper argues that Virginia Woolf’s A Room of One’s Own (1929 provides a critical counterpoint to a cluster of recent discourses on the gift, autonomy, and the changing nature of labor in the contemporary creative economy. From Lewis Hyde’s best-selling The Gift to neo-Marxist accounts of post-Fordism, these discourses routinely adopt modernist notions of autonomy in order to characterize creative labor today. Woolf’s feminist vision of autonomy in A Room of One’s Own at once dovetails with and complicates these discourses. In suggesting that feminine creative power, or “gifts,” both are and are not measurable by a monetary standard, she reinforces a familiar tension between gifts and commodities. But in her attentiveness to the material conditions of creativity, she also refuses to let the ideal of autonomy become an alibi for precarity, as is so often the case with feminized labor in our own creative economy. Ultimately, I argue that A Room of One’s Own reads as notes toward the possibility of a measure of the value of the gift as a gift—a measure that need not come at the expense of economic equality.

  16. Autonomy, religious values, and refusal of lifesaving medical treatment.

    Science.gov (United States)

    Wreen, M J

    1991-09-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assigned it by strong anti-paternalists. This weight is sufficient, in their estimation, to justify honouring the patient's refusal. There is thus a tension between the strong anti-paternalist's commitment to the sufficiency of autonomy and our intuitions respecting such cases. Attempts can be made to relieve this tension, such as arguing that patients aren't really rational in the circumstances envisaged, or that other values, such as privacy or bodily integrity, if added to autonomy, are sufficient to justify an anti-paternalistic stance. All such attempts fail, however. But what does not fail is the addition of religious freedom, freedom respecting a patient's religious beliefs and values. Why religious freedom reduces the tension is then explained, and the specialness of religious beliefs and values examined.

  17. Assessment of Parent Orientation towards Autonomy vs. Control in Promoting Children's Healthy Eating and Exercise.

    Science.gov (United States)

    Chiang, Evelyn S; Padilla, Miguel A

    2012-07-01

    Self-determination theory has been widely applied to understanding individuals' health-related behaviors such as eating healthy foods and exercising. Different reasons for engagement are associated with varying levels of personal agency or autonomy. Authority figures in the environment can be supportive of autonomy or, in contrast, controlling. Although researchers have assessed individuals' perceptions of the autonomy-support in their environments, studies have not directly examined the authority figures' orientations to autonomy with respect to health contexts. A new scale, Parent Orientations to Health, was created to investigate parent orientation to autonomy and control with respect to healthy eating and exercise in children. One hundred and forty-three parents of elementary school-aged children responded to the scale. Scale validation and reliability results indicate that the scale successfully assessed parent orientation towards autonomy for children in health contexts. Furthermore, parent autonomy orientation varied according to child weight status and the healthiness of the child's diet. Parent orientation towards autonomy can be evaluated through the use of the Parent Orientations to Health scale. In addition, parent autonomy orientation is associated with both the healthiness of the child's diet (as perceived by the parent) and the child's body mass index. © 2012 The Authors. Applied Psychology: Health and Well-Being © 2012 The International Association of Applied Psychology.

  18. Child Schooling in Ethiopia: The Role of Maternal Autonomy.

    Science.gov (United States)

    Gebremedhin, Tesfaye Alemayehu; Mohanty, Itismita

    2016-01-01

    This paper examines the effects of maternal autonomy on child schooling outcomes in Ethiopia using a nationally representative Ethiopian Demographic and Health survey for 2011. The empirical strategy uses a Hurdle Negative Binomial Regression model to estimate years of schooling. An ordered probit model is also estimated to examine age grade distortion using a trichotomous dependent variable that captures three states of child schooling. The large sample size and the range of questions available in this dataset allow us to explore the influence of individual and household level social, economic and cultural factors on child schooling. The analysis finds statistically significant effects of maternal autonomy variables on child schooling in Ethiopia. The roles of maternal autonomy and other household-level factors on child schooling are important issues in Ethiopia, where health and education outcomes are poor for large segments of the population.

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

    Science.gov (United States)

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

    2015-06-01

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

  20. Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study.

    Science.gov (United States)

    Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen

    2016-01-01

    Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals.

  1. Contextual factors affecting autonomy for patients in Iranian hospitals: A qualitative study

    Science.gov (United States)

    Ebrahimi, Hossein; Sadeghian, Efat; Seyedfatemi, Naeimeh; Mohammadi, Eesa; Crowley, Maureen

    2016-01-01

    Background: Consideration of patient autonomy is an essential element in individualized, patient-centered, ethical care. Internal and external factors associated with patient autonomy are related to culture and it is not clear what they are in Iran. The aim of this study was to explore contextual factors affecting the autonomy of patients in Iranian hospitals. Materials and Methods: This was a qualitative study using conventional content analysis methods. Thirty-four participants (23 patients, 9 nurses, and 2 doctors) from three Iranian teaching hospitals, selected using purposive sampling, participated in semi-structured interviews. Unstructured observation and filed notes were other methods for data collection. The data were subjected to qualitative content analysis and analyzed using the MAXQDA-10 software. Results: Five categories and sixteen subcategories were identified. The five main categories related to patient autonomy were: Intrapersonal factors, physical health status, supportive family and friends, communication style, and organizational constraints. Conclusions: In summary, this study uncovered contextual factors that the care team, managers, and planners in the health field should target in order to improve patient autonomy in Iranian hospitals. PMID:27186203

  2. Teacher autonomy in the era of New Public Management

    OpenAIRE

    Lundström, Ulf

    2015-01-01

    This article examines how upper secondary school teachers perceive and respond to the consequences for their professional autonomy of recent school reforms and restructurings. Based on empirical material from interviews of 119 teachers in three studies conducted between 2002 and 2014, the findings indicate that teacher autonomy has been reduced by school reforms and restructurings since the late 1980s. Regardless of their individual aims, these reforms have collectively created a power struct...

  3. Between Autonomy and Vulnerability : the Space of Movement

    Directory of Open Access Journals (Sweden)

    Kevin McDonald

    2011-03-01

    Full Text Available Analyses of the contemporary alterglobalization movement increasingly emphasize dimensions of autonomy, whose ultimate origins lie in theories of agency understood as sovereignty. This paper argues that critical dimensions of the alterglobalization movement involve practices of embodied action and forms of responsibility that point beyond autonomy, to a paradigm of relational vulnerability. Recognising this is central to understanding ethics, agency, and subjectivity and to understanding movements as a space of experience.

  4. Supervisor Expertise: Resolving the Dilemma between Bureaucratic Control and Teacher Autonomy.

    Science.gov (United States)

    Street, Mary Sue; Licata, Joseph W.

    1989-01-01

    Ideally, teacher confidence in the principal's instructional or supervisory expertise can overcome concerns about professional autonomy and bureaucratic control. This study focuses on elementary teachers' perceptions of the relationships among the principal's supervisory expertise, teacher sense of autonomy, and the robustness of school climate.…

  5. Recentralization within decentralization: County hospital autonomy under devolution in Kenya

    Science.gov (United States)

    Manyara, Anthony M.; Molyneux, Sassy; Tsofa, Benjamin

    2017-01-01

    Background In 2013, Kenya transitioned into a devolved system of government with a central government and 47 semi-autonomous county governments. In this paper, we report early experiences of devolution in the Kenyan health sector, with a focus on public county hospitals. Specifically, we examine changes in hospital autonomy as a result of devolution, and how these have affected hospital functioning. Methods We used a qualitative case study approach to examine the level of autonomy that hospitals had over key management functions and how this had affected hospital functioning in three county hospitals in coastal Kenya. We collected data by in-depth interviews of county health managers and hospital managers in the case study hospitals (n = 21). We adopted the framework proposed by Chawla et al (1995) to examine the autonomy that hospitals had over five management domains (strategic management, finance, procurement, human resource, and administration), and how these influenced hospital functioning. Findings Devolution had resulted in a substantial reduction in the autonomy of county hospitals over the five key functions examined. This resulted in weakened hospital management and leadership, reduced community participation in hospital affairs, compromised quality of services, reduced motivation among hospital staff, non-alignment of county and hospital priorities, staff insubordination, and compromised quality of care. Conclusion Increasing the autonomy of county hospitals in Kenya will improve their functioning. County governments should develop legislation that give hospitals greater control over resources and key management functions. PMID:28771558

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

    Science.gov (United States)

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

    2015-10-01

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

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

    Science.gov (United States)

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

    2017-11-24

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

  8. Autonomy and control in dyads: effects on interaction quality and joint creative performance.

    Science.gov (United States)

    Weinstein, Netta; Hodgins, Holley S; Ryan, Richard M

    2010-12-01

    Two studies examined interaction quality and joint performance on two creative tasks in unacquainted dyads primed for autonomy or control orientations. It was hypothesized that autonomy-primed dyads would interact more constructively, experience more positive mood, and engage the task more readily, and as a result these dyads would perform better. To test this, Study 1 primed orientation and explored verbal creative performance on the Remote Associates Task (RAT). In Study 2, dyads were primed with autonomy and control orientation and videotaped during two joint creative tasks, one verbal (RAT) and one nonverbal (charades). Videotapes were coded for behavioral indicators of closeness and task engagement. Results showed that autonomy-primed dyads felt closer, were more emotionally and cognitively attuned, provided empathy and encouragement to partners, and performed more effectively. The effects of primed autonomy on creative performance were mediated by interpersonal quality, mood, and joint engagement.

  9. Independent State of Samoa School Autonomy and Accountability : SABER Country Report 2013

    OpenAIRE

    World Bank

    2013-01-01

    Education in the Samoa is highly decentralized. While education policy is the sole responsibility of the Ministry of education, school boards are responsible for delivery. The entire organization of the school system is based on checks and balances to ensure accountability. Budgetary autonomy is established. The school board controls the school budget, with input from parents. Personnel ma...

  10. The Exercise of Learner Autonomy in a Virtual EFL Course in Colombia

    Directory of Open Access Journals (Sweden)

    Paula Andrea Bedoya

    2014-04-01

    Full Text Available This case study explores how a group of graduate students manifest autonomy in an English as a Foreign Language virtual course at a Colombian university. Analysis of questionnaires, forums, and interviews showed that students manifested attitudes that led to autonomy such as motivation and commitment at the beginning of the course, but they also manifested high levels of dependence and lack of self-confidence. Later, they became more confident and performed more independently, two attitudes closely-related to autonomy. Furthermore, the results show that factors such as course design, the platform, and the teacher’s role influenced the students’ exercise of autonomy. Finally, the need for designing virtual English as a Foreign Language courses that promote autonomous learning and the teachers’ and the students’ roles in virtual environments are discussed.

  11. The importance of supporting adolescents' autonomy in promoting physical-sport exercise.

    Science.gov (United States)

    Moreno-Murcia, Juan Antonio; Hernández, Elisa Huéscar

    2013-01-01

    This study was conducted toward the objective of analyzing certain factors that influence physical activity in Spanish adolescent students using self-determination theory (Deci & Ryan, 1985; 2000) as a framework. Participants included 698 physical education students whose perception of the autonomy support provided by their teachers was assessed in and out of the class context. Also assessed were social goals of responsibility and relationship with others, basic psychological needs, and intrinsic motivation, which is part of self-determination theory (SDT). Finally, the "intention" factor posited by the theory of planned behavior (TPB) and students' rate of exercise in the last twelve months were considered. The results of structural equations modeling suggest autonomy education, autonomy support, and social goals positively predicted certain psychological mediators, which in turn positively predicted students' intrinsic motivation, which was a positive predictor of intention, and that of rate of exercise. The results also highlight the benefit of promoting autonomy to enhance students' physical exercise practice.

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

    Science.gov (United States)

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

    2015-11-01

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

  13. Women's autonomy in health care decision-making in developing countries: a synthesis of the literature.

    Science.gov (United States)

    Osamor, Pauline E; Grady, Christine

    2016-01-01

    Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women's autonomy in developing countries describe the relationship between women's autonomy and their health care decision-making, and identify sociodemographic factors that influence women's autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus) was performed. Inclusion criteria were 1) publication in English; 2) original articles; 3) investigations on women's decision-making autonomy for health and health care utilization; and 4) developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries' national health surveys. Most studies examined women's autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women's health care decision-making autonomy. Gaps in existing literature regarding women's autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the use of qualitative studies to provide context and nuance.

  14. Autonomy and the Student Experience in Introductory Physics

    Science.gov (United States)

    Hall, Nicholas Ron

    The role of autonomy in the student experience in a large-enrollment undergraduate introductory physics course was studied from a Self-Determination Theory perspective with two studies. Study I, a correlational study, investigated whether certain aspects of the student experience correlated with how autonomy supportive (vs. controlling) students perceived their instructors to be. An autonomy supportive instructor acknowledges students' perspectives, feelings, and perceptions and provides students with information and opportunities for choice, while minimizing external pressures. It was found that the degree to which students perceived their instructors as autonomy supportive was positively correlated with student interest and enjoyment in learning physics (beta=0.31***) and negatively correlated with student anxiety about taking physics (beta=-0.23**). It was also positively correlated with how autonomous (vs. controlled) students' reasons for studying physics became over the duration of the course (i.e., studying physics more because they wanted to vs. had to; beta=0.24***). This change in autonomous reasons for studying physics was in turn positively correlated with student performance in the course (beta=0.17*). Additionally, the degree to which students perceived their instructors as autonomy supportive was directly correlated with performance for those students entering the course with relatively autonomous reasons for studying physics (beta=0.25**). In summary, students who perceived their instructors as more autonomy supportive tended to have a more favorable experience in the course. If greater autonomy support was in fact the cause of a more favorable student experience, as suggested by Self-determination Theory and experimental studies in other contexts, these results would have implications for instruction and instructor professional development in similar contexts. I discuss these implications. Study II, an experimental study, investigated the effect

  15. AUTONOMY AND RELATEDNESS IN MOTHER-TEEN INTERACTIONS AS PREDICTORS OF INVOLVEMENT IN ADOLESCENT DATING AGGRESSION.

    Science.gov (United States)

    Niolon, Phyllis Holditch; Kuperminc, Gabriel P; Allen, Joseph P

    2015-04-01

    This multi-method, longitudinal study examines the negotiation of autonomy and relatedness between teens and their mothers as etiologic predictors of perpetration and victimization of dating aggression two years later. Observations of 88 mid-adolescents and their mothers discussing a topic of disagreement were coded for each individual's demonstrations of autonomy and relatedness using a validated coding system. Adolescents self-reported on perpetration and victimization of physical and psychological dating aggression two years later. We hypothesized that mother's and adolescents' behaviors supporting autonomy and relatedness would longitudinally predict lower reporting of dating aggression, and that their behaviors inhibiting autonomy and relatedness would predict higher reporting of dating aggression. Hypotheses were not supported; main findings were characterized by interactions of sex and risk status with autonomy. Maternal behaviors supporting autonomy predicted higher reports of perpetration and victimization of physical dating aggression for girls, but not for boys. Adolescent behaviors supporting autonomy predicted higher reports of perpetration of physical dating aggression for high-risk adolescents, but not for low-risk adolescents. Results indicate that autonomy is a dynamic developmental process, operating differently as a function of social contexts in predicting dating aggression. Examination of these and other developmental processes within parent-child relationships is important in predicting dating aggression, but may depend on social context.

  16. Nurses' autonomy in end-of-life situations in intensive care units.

    Science.gov (United States)

    Paganini, Maria Cristina; Bousso, Regina Szylit

    2015-11-01

    The intensive care unit environment focuses on interventions and support therapies that prolong life. The exercise by nurses of their autonomy impacts on perception of the role they assume in the multidisciplinary team and on their function in the intensive care unit context. There is much international research relating to nurses' involvement in end-of-life situations; however, there is a paucity of research in this area in Brazil. In the Brazilian medical scenario, life support limitation generated a certain reluctance of a legal nature, which has now become unjustifiable with the publication of a resolution by the Federal Medical Council. In Brazil, the lack of medical commitments to end-of-life care is evident. To understand the process by which nurses exercise autonomy in making end-of-life decisions in intensive care units. Symbolic Interactionism and Corbin and Strauss theory methodology were used for this study. Data were collected through single audio-recorded qualitative interviews with 14 critical care nurses. The comparative analysis of the data has permitted the understanding of the meaning of nurse's experience in exercising autonomy relating to end-of-life decision-making. Institutional ethics approval was obtained for data collection. Participants gave informed consent. All data were anonymized. The results revealed that nurses experience the need to exercise autonomy in intensive care units on a daily basis. Their experience expressed by the process of increase opportunities to exercise autonomy is conditioned by the pressure of the intensive care unit environment, in which nurses can grow, feel empowered, and exercise their autonomy or else can continuously depend on the decisions made by other professionals. Nurses exercise their autonomy through care. They work to create new spaces at the same time that they acquire new knowledge and make decisions. Because of the complexity of the end-of-life situation, nurses must adopt a proactive attitude

  17. Relations of behavioral autonomy to health outcomes among emerging adults with and without type 1 diabetes.

    Science.gov (United States)

    Helgeson, Vicki S; Reynolds, Kerry A; Becker, Dorothy; Escobar, Oscar; Siminerio, Linda

    2014-01-01

    To examine the relation of behavioral autonomy to psychological, behavioral, and physical health among emerging adults with and without type 1 diabetes. High school seniors with (n = 118) and without type 1 diabetes (n = 122) completed online questionnaires for three consecutive years. Behavioral autonomy, psychological health, risk behaviors, and diabetes outcomes were assessed. Regression analyses were conducted to predict Time 2 and 3 outcomes, controlling for Time 1 outcomes. There were no group differences in behavioral autonomy. Behavioral autonomy predicted better psychological health but only for emerging adults without diabetes. Behavioral autonomy was related to increased risk behavior for both groups. Behavioral autonomy was unrelated to self-care but predicted better glycemic control for females. Behavioral autonomy may be beneficial for psychological health, but is related to increased risk behavior. The implications of behavioral autonomy for emerging adults with type 1 diabetes require careful consideration. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Parental Psychological Control and Autonomy Granting: Distinctions and Associations with Child and Family Functioning

    Science.gov (United States)

    Kunz, Jennifer Hauser; Grych, John H.

    2012-01-01

    Objective This study utilized an observational coding scheme to identify parenting behavior reflecting psychological control and autonomy granting and examined relations between these parenting dimensions and indices of child and family functioning. Design A community sample of 90 preadolescents (aged 10.5 to 12 years) and both of their parents engaged in a triadic interaction that was coded for parental psychological control and autonomy granting. Participants also completed measures of child adjustment, interparental conflict, and triangulation. Results Factor analyses indicated that a two-factor model better fit the data than a one-factor model, suggesting that psychological control and autonomy granting are best conceptualized as independent but related constructs. Parental psychological control and autonomy granting exhibited some shared and some unique correlates with indices of child and family functioning. Hierarchical regressions revealed significant interactions between these dimensions, suggesting that the strength of some associations between parents’ use of psychological control and youth adjustment problems depends on the level of autonomy granting exhibited by the parent. Conclusions By examining psychological control and autonomy granting simultaneously as unique constructs, this study identifies patterns of psychological control and autonomy granting that undermine youth adjustment. Findings inform targeted intervention efforts for families of preadolescent youth. PMID:23418403

  19. Exploring the relationship between university internationalization and university autonomy

    DEFF Research Database (Denmark)

    Turcan, Romeo V.; Gullieva, Valeria

    This paper explores a research gap at the intersection of university internationalization and university autonomy. A process model of university internationalization is put forward whereby the process of university internationalization is mediated by university internationalization capacity...... and moderated by target country institutional autonomy and globalization; and entry modes, timing and pace, as well as product mix of internationalization define university’s internationalization pattern. A systematic review is conducted to identify empirical studies at this intersection. One of the questions...

  20. An agent-based Model of Energy Autonomy in Germany

    OpenAIRE

    Huijie, Li; Pfenning, Uwe

    2014-01-01

    Ein kurzer sozio-techischer Einblick in dasw Verständnis und die damit verbundenen Risiken von Energie-Autonomie. Auf lokaler Ebene mündet das Bestreben nach Autonomie in einer systemischen Anomie, auf regionaler Ebene finden sich Synergieeffekte, auf nationaler Ebene sind Energiekooperationen sinnvoll und effektiv. Die Risiken liegen in einer Schaffung von Überkapazitäten und erhöhten Kosten. Die Chancen liegen in Kooperation und Synergien für ein funktionierendes, sicheres EE-EVS.

  1. Autonomy, religious values, and refusal of lifesaving medical treatment.

    OpenAIRE

    Wreen, M J

    1991-01-01

    The principal question of this paper is: Why are religious values special in refusal of lifesaving medical treatment? This question is approached through a critical examination of a common kind of refusal of treatment case, one involving a rational adult. The central value cited in defence of honouring such a patient's refusal is autonomy. Once autonomy is isolated from other justificatory factors, however, possible cases can be imagined which cast doubt on the great valuational weight assign...

  2. Cognitive Architectures and Autonomy: A Comparative Review

    Science.gov (United States)

    Thórisson, Kristinn; Helgasson, Helgi

    2012-05-01

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

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

    Science.gov (United States)

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

    2017-11-13

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

  4. Power to Do...What? Department Heads' Decision Autonomy and Strategic Priorities

    Science.gov (United States)

    Bozeman, Barry; Fay, Daniel; Gaughan, Monica

    2013-01-01

    Using questionnaire data from the 2010 Survey of Academic Chairs, the study focuses on decision autonomy, a component of the power wielded by science, technology, engineering and mathematics (STEM) department chairs in U.S. research extensive universities. A "power index" is developed to measure chairs' decision autonomy, specifically their…

  5. Clinical significance of endogenously labelled thyroid hormones in the diagnosis of thyroidal autonomy

    International Nuclear Information System (INIS)

    Waters, W.; Kutzim, H.

    1983-01-01

    The clinical value of the determination of 123 I concentration in serum 48 hrs after tracer administration ( 123 I) 48 is investigated with special regard to thyroidal autonomy. Serum radioiodine concentration, thyroid radioiodide uptake at 4 and at 48 hrs were measured in 74 healthy subjects and patients with simple goiter, in 36 patients with thyroidal autonomy (diagnosis by thyroid suppression test), and in 20 hyperthyroid patients. 83% of the patients with elevated radioiodine concentration belonged to the group of thyroidal autonomy. The product of radioiodine concentration and thyroid radioiodide uptake is a much better parameter. 95% of the patients in which this product was elevated, belonged to the autonomy group (5% diagnostic error). Also in the control group the diagnostic error was 5%. The combination of ( 123 I) 48 with the result of the TRH-test is very useful in excluding thyroidal autonomy, if ( 123 I) 48 is normal and the TRH-test is positive (100% of the patients have regulated thyroid glands.) 94% of the patients having elevated ( 123 I) 48 and a negative TRH-test belonged to the group of thyroidal autonomy. A very useful combination for the diagnosis of borderline hyperthyroidism is the determination of the product of ( 123 I) 48 and the uptake together with the pulse rate or fine tremor of the fingers (or TRH-test). The results suggest that the determination of ( 123 I) 48 is a very good parameter of thyroidal autonomy beside the thyroid suppression test. It may be used alone for the diagnosis of thyroidal autonomy if the suppression test is contraindicated. In the diagnosis of borderline hyperthyroidism its determination makes the suppression test unnecessary in many instances. (orig.) [de

  6. Care, Autonomy, and Gender in Nursing Practice: A Historical Study of Nurses' Experiences.

    Science.gov (United States)

    Galbany-Estragués, Paola; Comas-d'Argemir, Dolors

    2017-10-01

    Care is the essence of the nursing role and is closely related to the concept of professional autonomy. Autonomy is implicated in power relations between doctors and nurses and between men and women. These relationships are closely linked to care practices and the inequality of nursing and medicine. The aim of this study was to analyze nursing discourse regarding the concept of care and its relationship to the concept of autonomy and gender. This is a historical study based on oral interviews that took place between November 2008 and February 2011. We interviewed 19 nursing professionals who currently worked at the Hospital of the Holy Spirit (near Barcelona) or had worked there between 1961 and 2010. Semistructured interviews were recorded, transcribed, and analyzed. We highlight four main themes: "a real nurse"; "more technology, less care"; "the fragility of autonomy"; and "the invisibility of nursing work." These themes show the contradictions in the nursing profession that are based on the concept of care. However, in daily practice, the concept of care varies. Time pressure distances the nursing practice from its theoretical context. Changes in the concept of care are related to transformations in the health system and nursing work. Changes related to the autonomy of nursing are related to changes in the concept of care. In practice, care has a biomedical orientation. Care has become technologized and bureaucratized, which reduces the time that is spent with the patient. In a context in which medical authority predominates, nursing's struggle for autonomy is based on the recognition of the value of care. When care becomes invisible, the autonomy of nursing as a profession is threatened. This conclusion allows reflections about shifts in the concept of care and how they affect clinical practice and the autonomy of the nursing profession.

  7. Predictors of Enteral Autonomy in Children with Intestinal Failure: A Multicenter Cohort Study.

    Science.gov (United States)

    Khan, Faraz A; Squires, Robert H; Litman, Heather J; Balint, Jane; Carter, Beth A; Fisher, Jeremy G; Horslen, Simon P; Jaksic, Tom; Kocoshis, Samuel; Martinez, J Andres; Mercer, David; Rhee, Susan; Rudolph, Jeffrey A; Soden, Jason; Sudan, Debra; Superina, Riccardo A; Teitelbaum, Daniel H; Venick, Robert; Wales, Paul W; Duggan, Christopher

    2015-07-01

    In a large cohort of children with intestinal failure (IF), we sought to determine the cumulative incidence of achieving enteral autonomy and identify patient and institutional characteristics associated with enteral autonomy. A multicenter, retrospective cohort analysis from the Pediatric Intestinal Failure Consortium was performed. IF was defined as severe congenital or acquired gastrointestinal diseases during infancy with dependence on parenteral nutrition (PN) >60 days. Enteral autonomy was defined as PN discontinuation >3 months. A total of 272 infants were followed for a median (IQR) of 33.5 (16.2-51.5) months. Enteral autonomy was achieved in 118 (43%); 36 (13%) remained PN dependent and 118 (43%) patients died or underwent transplantation. Multivariable analysis identified necrotizing enterocolitis (NEC; OR 2.42, 95% CI 1.33-4.47), care at an IF site without an associated intestinal transplantation program (OR 2.73, 95% CI 1.56-4.78), and an intact ileocecal valve (OR 2.80, 95% CI 1.63-4.83) as independent risk factors for enteral autonomy. A second model (n = 144) that included only patients with intraoperatively measured residual small bowel length found NEC (OR 3.44, 95% CI 1.36-8.71), care at a nonintestinal transplantation center (OR 6.56, 95% CI 2.53-16.98), and residual small bowel length (OR 1.04 cm, 95% CI 1.02-1.06 cm) to be independently associated with enteral autonomy. A substantial proportion of infants with IF can achieve enteral autonomy. Underlying NEC, preserved ileocecal valve, and longer bowel length are associated with achieving enteral autonomy. It is likely that variations in institutional practices and referral patterns also affect outcomes in children with IF. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. New local energy supply as a communal task. Solar statutes between local autonomy and global climatic and resources protection; Neue oertliche Energieversorgung als kommunale Aufgabe. Solarsatzungen zwischen gemeindlicher Selbstverwaltung und globalem Klima- und Ressourcenschutz

    Energy Technology Data Exchange (ETDEWEB)

    Longo, Fabio

    2010-07-01

    Cities and communities have a constitutionally secured autonomy. What means this within the range of the protection of climate and resources? May communities take over global tasks, or are these limited in their local sphere of activity? In the meantime, in most German city halls something is done for the employment of renewable energies. Under this aspect, the author of the contribution under consideration reports at first on a comprehensive jurisprudential answer on the fundamental question which local tasks are entitled to the cities and communities and how this affects the range of climate protection and resources protection. Moreover, up-to-date particularly disputed local solar statutes are evaluated legally.

  9. Monetary autonomy under different exchange rate regimes in the long-run: the case of seven new EU countries

    Directory of Open Access Journals (Sweden)

    Yu HSING

    2013-05-01

    Full Text Available This paper finds that except for Poland, the other six countries possess moderate or significant monetary autonomy in the long run as their interest rates make partial or small adjustments to a change in the Euro area interest rate. Except for the Czech Republic and Poland, the findings support the hypothesis that countries under more flexible exchange rate regimes possess more monetary autonomy than countries under less flexible exchange rate regimes because local interest rates under more flexible exchange rate regimes are less sensitive to a change in the euro area interest rate.

  10. The Role of Teachers in Promoting Learner Autonomy in Secondary Schools in Saudi Arabia

    Science.gov (United States)

    Alonazi, Saleema M.

    2017-01-01

    Today, learner autonomy is considered as a desirable goal in language education. The movement towards learner-centered approaches has resulted in more emphasis on the benefits of learner autonomy in the success of language education. The objective of the study was to investigate the roles of the teachers in promoting learner autonomy in Saudi EFL…

  11. Cognitive autonomy among adolescents with and without hearing loss: Associations with perceived social support.

    Science.gov (United States)

    Michael, Rinat; Attias, Joseph

    2016-04-01

    Cognitive autonomy is a skill which may help adolescents prepare for important decisions in adulthood. The current study examined the associations between cognitive autonomy and perceived social support among adolescents with and without hearing loss. Participants were 177 students: 55 were deaf and hard of hearing (dhh) and 122 were hearing. They completed the Cognitive Autonomy and Self-Evaluation Inventory, the Multidimensional Scale of Perceived Social Support, and a demographic questionnaire. Significant positive correlations were found between some of the cognitive autonomy variables and some of the perceived social support variables. However, among the dhh group, they were fewer and weaker. Family support was found to be a significant predictor of three out of the five cognitive autonomy variables. In addition, significant differences were found between the dhh and hearing participants in some of the cognitive autonomy variables, but not in perceived social support. Implications for theory and practice are discussed. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  12. Beyond individualism: Is there a place for relational autonomy in clinical practice and research?

    Science.gov (United States)

    Dove, Edward S; Kelly, Susan E; Lucivero, Federica; Machirori, Mavis; Dheensa, Sandi; Prainsack, Barbara

    2017-09-01

    The dominant, individualistic understanding of autonomy that features in clinical practice and research is underpinned by the idea that people are, in their ideal form, independent, self-interested and rational gain-maximising decision-makers. In recent decades, this paradigm has been challenged from various disciplinary and intellectual directions. Proponents of 'relational autonomy' in particular have argued that people's identities, needs, interests - and indeed autonomy - are always also shaped by their relations to others. Yet, despite the pronounced and nuanced critique directed at an individualistic understanding of autonomy, this critique has had very little effect on ethical and legal instruments in clinical practice and research so far. In this article, we use four case studies to explore to what extent, if at all, relational autonomy can provide solutions to ethical and practical problems in clinical practice and research. We conclude that certain forms of relational autonomy can have a tangible and positive impact on clinical practice and research. These solutions leave the ultimate decision to the person most affected, but encourage and facilitate the consideration of this person's care and responsibility for connected others.

  13. Autonomy and Reproductive Rights of Married Ikwerre Women in Rivers State, Nigeria.

    Science.gov (United States)

    Princewill, Chitu Womehoma; Jegede, Ayodele Samuel; Wangmo, Tenzin; Riecher-Rössler, Anita; Elger, Bernice Simone

    2017-06-01

    A woman's lack of or limited reproductive autonomy could lead to adverse health effects, feeling of being inferior, and above all being unable to adequately care for her children. Little is known about the reproductive autonomy of married Ikwerre women of Rivers State, Nigeria. This study demonstrates how Ikwerre women understand the terms autonomy and reproductive rights and what affects the exercise of these rights. An exploratory research design was employed for this study. A semi-structured interview schedule was used to conduct thirty-four in-depth interviews and six focus group discussions with purposively sampled educated, semi-educated, and uneducated Ikwerre women in monogamous or polygynous marriages. The collected data was analysed qualitatively with MAXQDA 11 using open and axial coding. The interviews and focus group responses reveal a low level of awareness of autonomy and reproductive rights amongst the Ikwerre women in Nigeria. While some educated women were aware of their reproductive rights, cultural practices were reported to limit the exercise of these rights. Participants reported that Ikwerre culture is a patriarchal one where married women are expected to submit and obey their husbands in all matters; and a good married woman according to Ikwerre standard is one who complies with this culture. Women's refusal of sexual advances from their husbands is described as not being acceptable in this culture; and hence rape in marriage is not recognized in Ikwerre culture. Education and awareness creation on the importance of women's reproductive autonomy could improve their reproductive rights and autonomy in marital settings. Overcoming the patriarchal aspects of Ikwerre culture-for example, the greater value placed on male children than female children and treating women as incompetent individuals-is necessary to promote gender equality as well as help improve women's reproductive autonomy.

  14. Making a difference: incorporating theories of autonomy into models of informed consent.

    Science.gov (United States)

    Delany, C

    2008-09-01

    Obtaining patients' informed consent is an ethical and legal obligation in healthcare practice. Whilst the law provides prescriptive rules and guidelines, ethical theories of autonomy provide moral foundations. Models of practice of consent, have been developed in the bioethical literature to assist in understanding and integrating the ethical theory of autonomy and legal obligations into the clinical process of obtaining a patient's informed consent to treatment. To review four models of consent and analyse the way each model incorporates the ethical meaning of autonomy and how, as a consequence, they might change the actual communicative process of obtaining informed consent within clinical contexts. An iceberg framework of consent is used to conceptualise how ethical theories of autonomy are positioned and underpin the above surface, and visible clinical communication, including associated legal guidelines and ethical rules. Each model of consent is critically reviewed from the perspective of how it might shape the process of informed consent. All four models would alter the process of obtaining consent. Two models provide structure and guidelines for the content and timing of obtaining patients' consent. The two other models rely on an attitudinal shift in clinicians. They provide ideas for consent by focusing on underlying values, attitudes and meaning associated with the ethical meaning of autonomy. The paper concludes that models of practice that explicitly incorporate the underlying ethical meaning of autonomy as their basis, provide less prescriptive, but more theoretically rich guidance for healthcare communicative practices.

  15. The Effects of Autonomy Support on Student Engagement in Peer Assessment

    Science.gov (United States)

    Yuan, Jiangmei; Kim, ChanMin

    2018-01-01

    Although peer assessment is widely implemented in higher education, not all students are highly engaged in it. To enhance student engagement in peer assessment, we designed and developed a web-based tool, autonomy-supportive peer assessment (ASPA), to support students' need for autonomy when they conducted peer assessment. Students' sense of…

  16. Women's autonomy in health care decision-making in developing countries: a synthesis of the literature

    Directory of Open Access Journals (Sweden)

    Osamor PE

    2016-06-01

    Full Text Available Pauline E Osamor, Christine Grady Department of Bioethics, Clinical Center, National Institutes of Health, Bethesda, MD, USA Abstract: Autonomy is considered essential for decision-making in a range of health care situations, from health care seeking and utilization to choosing among treatment options. Evidence suggests that women in developing or low-income countries often have limited autonomy and control over their health decisions. A review of the published empirical literature to identify definitions and methods used to measure women’s autonomy in developing countries describe the relationship between women’s autonomy and their health care decision-making, and identify sociodemographic factors that influence women’s autonomy and decision-making regarding health care was carried out. An integrated literature review using two databases (PubMed and Scopus was performed. Inclusion criteria were 1 publication in English; 2 original articles; 3 investigations on women’s decision-making autonomy for health and health care utilization; and 4 developing country context. Seventeen articles met inclusion criteria, including eleven from South Asia, five from Africa, and one from Central Asia. Most studies used a definition of autonomy that included independence for women to make their own choices and decisions. Study methods differed in that many used study-specific measures, while others used a set of standardized questions from their countries’ national health surveys. Most studies examined women’s autonomy in the context of reproductive health, while neglecting other types of health care utilized by women. Several studies found that factors, including age, education, and income, affect women’s health care decision-making autonomy. Gaps in existing literature regarding women’s autonomy and health care utilization include gaps in the areas of health care that have been measured, the influence of sex roles and social support, and the

  17. University Autonomy: Two Fault-Lines

    Science.gov (United States)

    Evans, G. R.

    2010-01-01

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

  18. [The meaning of autonomy in Chinese culture: obtaining informed consent for operation].

    Science.gov (United States)

    Lin, Mei-Ling; Wu, Jo Yung-Wei; Huang, Mei-Chih

    2008-10-01

    The purpose of gaining the patient's informed consent is ethical, lying in respect for his or her autonomy, and such consent forms the foundation for the performance of clinical medical treatment. In order to respect the patient's autonomy, for example, during decisions about operations, doctors have the obligation to clearly explain that patient's medical condition to him/her. A thorough briefing should be given prior to the obtaining of the patients' consent. In fulfillment of their duties as medical professionals, both doctors and nurses should be involved in clinically informing patients as well as in obtaining their signature for operation and anesthesia. Although informing patients about their physical state is not the responsibility of nurses, it remains absolutely necessary for nurses to understand how people in Asian cultures understand autonomy. This paper begins with a discussion of autonomy in ethics, and then outlines the differences between the Eastern and Western concepts of autonomy, before discussing the obtaining of the signature of consent, a process performed by the nursing staff during clinical treatment, and resulting in the provision of such signatures by patients with the legal capacity to provide them.

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

    Science.gov (United States)

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

    2016-06-01

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

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

    Science.gov (United States)

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

    2015-08-30

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

  1. [The issue of autonomy in medical ethics: philosophy of Karol Wojtyła].

    Science.gov (United States)

    Niebrój, Lesław T; Olejniczak, Marek; Kruźlak, Agnieszka

    2007-01-01

    The issue of autonomy seems to play a very central and fundamental role in contemporary medical ethics. However, it should be emphasized, that there is no agreement on how the concept of autonomy ought to be understood. Although as the main intellectual framework to describe the meaning of "autonomy" is the use of philosophical system of John St. Mill or Immanuel Kant, one could identify the tendency to redefine the concept under study. The aim of this article was to find out if the philosophy of Karol Wojtyla could provide--interesting from the bioethical point of view--insights into understanding of the idea of autonomy. The Wojtyla's critique of Kant's and Mill's understanding of autonomy was shortly described and the main elements of Wojtyla's concept of autonomy were analyzed. On the basis of these considerations it was assumed that philosophical background of Wojtyla is so different from those which are used in the contemporary, especially so called Anglo-American, bioethics that introducing it "elements" of his thinking would lead to misunderstandings and indeed even serious errors. On the other hand, however, philosophical works of Wojtyla seems to be very influential in developing 'personalistic' bioethics. But this bioethics could be accepted only by people who share Wojtyla's ontological and probably also theological or religious assumptions.

  2. Effect of Women's Decision-Making Autonomy on Infant's Birth Weight in Rural Bangladesh

    Science.gov (United States)

    Sharma, Arpana

    2013-01-01

    Background. Low birth weight (LBW), an outcome of maternal undernutrition, is a major public health concern in Bangladesh where the problem is most prominent. Women's decision-making autonomy is likely an important factor influencing maternal and child health outcomes. The aim of the study was to assess the effect of women's decision-making autonomy on infant's birth weight (BW). Methods. The study included data of 2175 enrolled women (14–45 years of age) from the Maternal and Infant Nutritional Intervention in Matlab (MINIMat-study) in Bangladesh. Pearson's chi-square test, analysis of covariance (ANCOVA), and logistic regression analysis were applied at the collected data. Results. Women with lowest decision-making autonomy were significantly more likely to have a low birth weight (LBW) child, after controlling for maternal age, education (woman's and her husband's), socioeconomic status (SES) (odds ratio (OR) = 1.4; 95% confidence interval (CI) 1.0, 1.8). BW was decreased significantly among women with lowest decision making autonomy after adjusting for all confounders. Conclusion. Women's decision-making autonomy has an independent effect on BW and LBW outcome. In addition, there is a need for further exploration to identify sociocultural attributes and gender related determinants of women decision-making autonomy in this study setting. PMID:24575305

  3. Seeking Moral Autonomy in a Chinese Context: A Study of Elementary Moral Education Standards

    Science.gov (United States)

    Lee, Lena; Misco, Thomas

    2016-01-01

    In this article, we explored Chinese moral education standards for grades one and two by using the heuristic of moral autonomy and by employing a typology of moral autonomy, one based on Kantian and Deweyan ideas about moral autonomy and agency. Given the larger charge for all of schooling to develop independence, problem-solving, and creativity…

  4. Agency is Distinct from Autonomy

    Directory of Open Access Journals (Sweden)

    Fred Cummins

    2014-11-01

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

  5. Prediction of sport adherence through the influence of autonomy-supportive coaching among spanish adolescent athletes.

    Science.gov (United States)

    Almagro, Bartolomé J; Sáenz-López, Pedro; Moreno, Juan A

    2010-01-01

    The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years) completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key pointsImportance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes.Interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation.Intrinsic motivation predicted the intention to be physically active in the future.

  6. THE RELATIONSHIP BETWEEN PERCEPTION OF AUTONOMY SUPPORT AND PERCEPTION OF INTERPERSONAL, PROCEDURAL JUSTICE

    OpenAIRE

    Devani Laksmi Indyastuti

    2018-01-01

    Previous studies have a little attention on the impact of perceived autonomy support on the justice. This study examines the impact of perceived autonomy support from supervisor and from environment toward perceived procedural justice and interpersonal justice. Based on self interest model and basic need theory, this study hypothesized that individual’s perception of autonomy supported both from supervisor and work environment would affect his/ her perception of procedural. Based on need fulf...

  7. PREDICTION OF SPORT ADHERENCE THROUGH THE INFLUENCE OF AUTONOMY-SUPPORTIVE COACHING AMONG SPANISH ADOLESCENT ATHLETES

    Directory of Open Access Journals (Sweden)

    Bartolomé J. Almagro

    2010-03-01

    Full Text Available The purpose of this study was to test a motivational model of the coach-athlete relationship, based on self-determination theory and on the hierarchical model of intrinsic and extrinsic motivation. The sample comprised of 608 athletes (ages of 12-17 years completed the following measures: interest in athlete's input, praise for autonomous behavior, perceived autonomy, intrinsic motivation, and the intention to be physically active. Structural equation modeling results demonstrated that interest in athletes' input and praise for autonomous behavior predicted perceived autonomy, and perceived autonomy positively predicted intrinsic motivation. Finally, intrinsic motivation predicted the intention to be physically active in the future. The results are discussed in relation to the importance of the climate of autonomy support created by the coach on intrinsic motivation and adherence to sport by adolescent athletes. Further, the results provide information related to the possible objectives of future interventions for the education of coaches, with the goal of providing them with tools and strategies to favor the development of intrinsic motivation among their athletes. In conclusion, the climate of autonomy support created by the coach can predict the autonomy perceived by the athletes which predicts the intrinsic motivation experienced by the athletes, and therefore, their adherence to athletic practice. Key words: Autonomy support, perceived autonomy, intrinsic motivation, sport adherence

  8. AUTONOMY AND RELATEDNESS IN MOTHER-TEEN INTERACTIONS AS PREDICTORS OF INVOLVEMENT IN ADOLESCENT DATING AGGRESSION

    Science.gov (United States)

    Niolon, Phyllis Holditch; Kuperminc, Gabriel P.; Allen, Joseph P.

    2015-01-01

    Objective This multi-method, longitudinal study examines the negotiation of autonomy and relatedness between teens and their mothers as etiologic predictors of perpetration and victimization of dating aggression two years later. Method Observations of 88 mid-adolescents and their mothers discussing a topic of disagreement were coded for each individual’s demonstrations of autonomy and relatedness using a validated coding system. Adolescents self-reported on perpetration and victimization of physical and psychological dating aggression two years later. We hypothesized that mother’s and adolescents’ behaviors supporting autonomy and relatedness would longitudinally predict lower reporting of dating aggression, and that their behaviors inhibiting autonomy and relatedness would predict higher reporting of dating aggression. Results Hypotheses were not supported; main findings were characterized by interactions of sex and risk status with autonomy. Maternal behaviors supporting autonomy predicted higher reports of perpetration and victimization of physical dating aggression for girls, but not for boys. Adolescent behaviors supporting autonomy predicted higher reports of perpetration of physical dating aggression for high-risk adolescents, but not for low-risk adolescents. Conclusions Results indicate that autonomy is a dynamic developmental process, operating differently as a function of social contexts in predicting dating aggression. Examination of these and other developmental processes within parent-child relationships is important in predicting dating aggression, but may depend on social context. PMID:25914852

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

    Science.gov (United States)

    Stiglbauer, Barbara; Kovacs, Carrie

    2017-12-28

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

  10. Autonomie du groupe restreint et performance

    Directory of Open Access Journals (Sweden)

    Elke Nissen

    2005-09-01

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

  11. [Is autonomy a universal value principle? The study of concrete clinical cases in perinatology].

    Science.gov (United States)

    Tilmans-Cabiax, Chantal

    2007-09-01

    Certain perinatalogy situations make one confront cultural differences and, in particular, the relative importance of the value of female autonomy. This leads to the following question: should autonomy have as much weight everywhere as it is given in Western health ethics? The passionate, philosophical and historical work by J.B. Schneewind, The Invention of Autonomy: A History of Modern Moral Philosophy, is used to assist in the understanding of the important cultural evolutions which have interacted to support the idea of moral autonomy in the West. This return to our roots brings us, not to question moral autonomy through its claim to universality, but to dare to relativize the modalities according to cultural contexts. And especially to rehabilitate other values--for example caring for one another--prominent in other more community orientated societies in which the West can be inspired.

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

    Science.gov (United States)

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

    2015-01-01

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

  13. On autonomy and participation in rehabilitation.

    NARCIS (Netherlands)

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

    2002-01-01

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

  14. Autonomy, consent and responsability. Part 1: limitations of the principle of autonomy as a foundation of informed consent.

    Science.gov (United States)

    Mellado, J M

    2016-01-01

    Legal recognition of patient's rights aspired to change clinical relationship and medical lex artis. However, its implementation has been hampered by the scarcity of resources and the abundance of regulations. For several years, autonomy, consent, and responsibility have formed one of the backbones of the medical profession. However, they have sparked controversy and professional discomfort. In the first part of this article, we examine the conceptual and regulatory limitations of the principle of autonomy as the basis of informed consent. We approach the subject from philosophical, historical, legal, bioethical, deontological, and professional standpoints. In the second part, we cover the viability of informed consent in health care and its relationship with legal responsibility. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

  15. Development of a non-contextual model for determining the autonomy level of intelligent unmanned systems

    Science.gov (United States)

    Durst, Phillip J.; Gray, Wendell; Trentini, Michael

    2013-05-01

    A simple, quantitative measure for encapsulating the autonomous capabilities of unmanned systems (UMS) has yet to be established. Current models for measuring a UMS's autonomy level require extensive, operational level testing, and provide a means for assessing the autonomy level for a specific mission/task and operational environment. A more elegant technique for quantifying autonomy using component level testing of the robot platform alone, outside of mission and environment contexts, is desirable. Using a high level framework for UMS architectures, such a model for determining a level of autonomy has been developed. The model uses a combination of developmental and component level testing for each aspect of the UMS architecture to define a non-contextual autonomous potential (NCAP). The NCAP provides an autonomy level, ranging from fully non- autonomous to fully autonomous, in the form of a single numeric parameter describing the UMS's performance capabilities when operating at that level of autonomy.

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

    Science.gov (United States)

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

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

  17. The role of observed autonomy support, reciprocity, and need satisfaction in adolescent disclosure about friends.

    Science.gov (United States)

    Wuyts, Dorien; Soenens, Bart; Vansteenkiste, Maarten; Van Petegem, Stijn

    2018-06-01

    Although research increasingly addresses the role of parenting in fostering adolescent disclosure, most research relied on self-report measures of parenting and did not address the role of autonomy support. In the present observational study (conducted in Belgium), with 62 mother-adolescent dyads (mean age mothers = 44 years; mean age adolescents = 14 years; 77% of adolescents female), we rated mothers' provision of autonomy support during a 10-minute conversation about friendships. We found that observed maternal autonomy support was related positively to adolescents' degree of and volitional reasons for disclosure about friends. These associations were mediated by observed non-verbal reciprocity during the conversation and by adolescent satisfaction of their needs for autonomy and relatedness. Mothers' autonomy-support and mother-adolescent reciprocity also predicted mothers' own psychological need satisfaction and conversation pleasure. The relevance of the findings for adolescent autonomy and disclosure are discussed. Copyright © 2018. Published by Elsevier Ltd.

  18. "Girl Power!": The Relationship between Women's Autonomy and Children's Immunization Coverage in Ethiopia.

    Science.gov (United States)

    Ebot, Jane O

    2015-09-18

    Although immunizations are efficient and cost effective methods of reducing child mortality, worldwide, approximately 2 million children die yearly of vaccine-preventable diseases. Researchers and health organizations have detailed information on the positive relationship between women's autonomy and children's health outcomes in developing countries. This study investigates the links between women's household autonomy and children's immunization status using data from a nationally representative sample of children aged 12-30 months (N = 2941) from the 2011 Ethiopia Demographic and Health Survey. The results showed that women's socioeconomic status and household autonomy were significantly associated with children's immunization status. Overall, the implications of this study align with those of the Millennium Development Goal #3: improvements in women's household autonomy are linked to more positive child health outcomes.

  19. The Effect of Online Dictionaries Usage on EFL Undergraduate Students' Autonomy

    Science.gov (United States)

    Tananuraksakul, Noparat

    2015-01-01

    Due to EFL undergraduate students' ineffective learning strategies, which mirror lack of autonomy, this paper is a pilot study into how use of Cambridge Dictionaries Online can affect undergraduate students' autonomy or self-reliance in a Thai EFL context. The link was selectively integrated in a writing classroom as a tool to improve their…

  20. A Literature Review on Relationship between Learner Autonomy and Learning Motivation

    Institute of Scientific and Technical Information of China (English)

    LI Lu-lu

    2014-01-01

    This paper sets out to review the relationship of learner autonomy and motivation in English learning based on previ-ous theoretical and empirical studies. This study can be of great help for learners to realize the great importance of learner autono-my and learning motivation, making them more autonomous, motivated and successful in English learning.

  1. Mothers' and fathers' support for child autonomy and early school achievement.

    Science.gov (United States)

    2008-07-01

    Data were analyzed from 641 children and their families in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development to test the hypotheses that in the early school years, mothers' and fathers' sensitive support for autonomy in observed parent-child interactions would each make unique predictions to children's reading and math achievement at Grade 3 (controlling for demographic variables), children's reading and math abilities at 54 months, and children's level of effortful control at 54 months and that these associations would be mediated by the level of and changes over time in children's observed self-reliance in the classroom from Grades 1 through 3. The authors found that mothers' and fathers' support for autonomy were significantly and uniquely associated with children's Grade 3 reading and math achievement with the above controls, but only for boys. For boys, the effect of mothers' support for child autonomy was mediated by higher self-reliance at Grade 1 and of fathers' support for child autonomy by greater increases in self-reliance from Grades 1 through 3.

  2. Factors Contributing to Learners’ Autonomy in EFL Reading

    Directory of Open Access Journals (Sweden)

    Sri Endah Tabiati

    2016-08-01

    Full Text Available Abstract: This study aims to discover factors that assist learners develop their autonomy in EFL reading. The approach employed is qualitative involving EFL learners in an English Department of the Faculty of Cultural Studies, Brawijaya University Malang. There are two stages in the study: the subject selection stage intended to gain potential subjects and the main study intended to find the answer of the research questions. The findings of the study show that the autonomy of EFL learners in reading is influenced by 14 internal and 14 external factors.These factors appear to happen naturally. It seemed that autonomy in reading is subconscious and has been gained by the subjects gradually since childhood. Moreover, autonomy in EFL reading is presumed to be universal as it is found in a collectivist culture such as the one in Indonesia. Based on the findings, suggestions are proposed and addressed to Reading lecturers, parents and the faculty representing the goverment. Because the factors seem to occur before they study at a university, the suggestions are also addressed to teachers and schools. Key Words: internal factors, external factors, contribution, learners’ autonomy, EFL reading Abstrak: Penelitian ini bertujuan untuk menemukan faktor yang membantu mahasiswa dalam mengembangkan kemampuannya secara otonom pada kemampuan membaca EFL. Penelitian ini menggunakan desain kualitative dengan melibatkan mahasiswa kategori EFL Fakultas Ilmu Budaya Universitas Brawijaya Malang. Terdapat dua thapa dalam penelitian ini. Tahap pertama merupakan pemilihan subyek yang bertujuan untuk mencari subyek yang berpotensi dan setelah itu penelitian dilakukan untuk menjawab rumusan masalah. Hasil penelitian ini menunjukan bahwa sikap otonom mahasiswa EFL dalam kemampuan membaca dipengaruhi oleh 14 faktor internal dan 14 faktor eksternal. Faktor-faktor tersebut muncul secara natural. Terlihat bahwa sikap otonom dalam kemampuan membaca merupakah hal yang terjadi

  3. School Autonomy and Accountability in Thailand: Does the Gap between Policy Intent and Implementation Matter?

    Science.gov (United States)

    Patrinos, Harry Anthony; Arcia, Gustavo; Macdonald, Kevin

    2015-01-01

    This article contrasts policy intent and policy implementation in school autonomy and accountability. The analysis uses a conceptual framework based on the interaction between school autonomy, student assessment, and accountability as elements of a closed system. The article analyzes the implementation of school autonomy and accountability policy,…

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

    Directory of Open Access Journals (Sweden)

    Carley Zeal

    2018-03-01

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

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

    Science.gov (United States)

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

    2018-01-01

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

  6. Autonomi og informeret samtykke i sygeplejepraksis

    DEFF Research Database (Denmark)

    Mathar, Helle; Morville, Annette

    2006-01-01

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

  7. "I Want Her to Make Correct Decisions on Her Own:" Former Soviet Union Mothers' Beliefs about Autonomy Development.

    Science.gov (United States)

    Komolova, Masha; Lipnitsky, Jane Y

    2017-01-01

    This qualitative study examined Former Soviet Union (FSU) mothers' explicit and implicit attitudes and parenting practices around adolescents' autonomy development. Interviews were conducted with 10 mothers who had immigrated from the FSU to the US between 10 and 25 years ago, and who had daughters between the ages of 13 and 17 years. Mothers predominantly defined autonomy in terms of adolescents' ability to carry out instrumental tasks, make correct decisions, and financially provide for themselves, but rarely mentioned psychological or emotional independence. Mothers reflected on the various aspects of autonomy emphasized in their country of origin and America, and balancing the two sets of cultural values in their parenting. Although mothers discussed attempts to adopt a less authoritarian approach to parenting than they themselves experienced as children, some mothers' controlling attitudes were revealed through a close analysis of their language. The findings provide important insights into the parenting experiences of FSU immigrant mothers, and the way in which autonomy-related processes may vary cross-culturally. Implications for parenting and clinical practice are also discussed.

  8. Respect for autonomy in the healthcare context: observations from a qualitative study of young adults with cerebral palsy.

    Science.gov (United States)

    Racine, E; Larivière-Bastien, D; Bell, E; Majnemer, A; Shevell, M

    2013-11-01

    Respect for patient autonomy is a cornerstone of contemporary medical ethics and clinical practice. In its different shapes and forms (e.g. being informed, being engaged in discussions and decisions about medical care and being supported in developing healthcare preferences and choices), patient autonomy has been fostered by both paediatric and adult professional societies. The transition from paediatric to adult care creates a complex situation where autonomy for medical decisions shifts to the developing adolescent. More specific challenges to respect for autonomy may be experienced by young adults with cerebral palsy in the transition period where, for example, language and motor impairments may affect communication skills and this may be conflated with cognitive disability. To characterize perspectives towards autonomy in the healthcare context for young adults with cerebral palsy. We carried out semi-structured interviews with 14 young adults (aged 18-25) with cerebral palsy. The audiotaped interviews were transcribed verbatim and analysed using a conventional thematic qualitative content analysis. Participants displayed a range of attitudes towards autonomy, suggesting that the value of autonomy is considered in light of competing values and of context. Testimonials from participants demonstrated that both contextual (e.g. ill-adapted health care, lack of specialized public transport) and relational (e.g. attitudes towards parental involvement in decision making) factors negatively or positively impact autonomy. We observed that there were four key elements interwoven in participants' characterization of autonomy: the coupling of decisional and physical autonomy, the influences of family and society on autonomy, the influence of healthcare professionals on autonomy and the need for preparation for autonomy. © 2012 John Wiley & Sons Ltd.

  9. Who Makes the Choice? Rethinking the Role of Autonomy and Relatedness in Chinese Children's Motivation

    Science.gov (United States)

    Bao, Xue-Hua; Lam, Shui-Fong

    2008-01-01

    The importance of autonomy for children's motivation in collectivistic cultures has been debated hotly. With the understanding that autonomy is not equivalent to freedom of choice, 4 studies addressed this debate by investigating how socioemotional relatedness, choice, and autonomy were related to Chinese children's motivation. Study 1 (N = 56,…

  10. School Autonomy and Government Control: School Leaders' Views on a Changing Policy Landscape in England

    Science.gov (United States)

    Higham, Rob; Earley, Peter

    2013-01-01

    The Conservative-Liberal Democrat Coalition government elected in 2010 has argued contemporary reform will increase the autonomy of schools in England. Given the complexities that exist, however, in the balance between autonomy and control, we explore how school leaders view autonomy as it exists within the wider policy framework. The article…

  11. Autonomy and dependence--experiences of home abortion, contraception and prevention.

    Science.gov (United States)

    Makenzius, Marlene; Tydén, Tanja; Darj, Elisabeth; Larsson, Margareta

    2013-09-01

    Few studies have explored experiences and needs in relation to an induced medical abortion with the final treatment at home. To explore women's and men's experiences and needs related to care in the context of a home abortion as well as to elicit their views on contraception and prevention of unwanted pregnancies. Qualitative interviews were carried out with 24 women and 13 men who had experienced a home abortion; they took place in Sweden during 2009/10. Two overarching themes were identified: Autonomy--the decision to undergo an abortion and the choice of method were well considered by the woman, supported by the partner. The home environment increased their privacy and control, which helped them freely express and share their emotions. They were motivated to avoid a subsequent abortion and considered it an individual responsibility; however, contraceptive follow-up visits were rare. Dependence--a desire to be treated with empathy and respect by care providers and to receive adequate information. In the prevention of unwanted pregnancies, financial resources, improved communication/education and subsidized contraceptives were considered important. Home abortion increases autonomy, and women and partners demonstrate self-care ability. This autonomy, however, is related to dependence: a desire to be treated with empathy and respect on equal terms and to receive adequate information tailored to their self-care needs. Routines in abortion care should be continuously evaluated to ensure care satisfaction, safety and security as well as contraceptive adherence. © 2012 The Authors. Scandinavian Journal of Caring Sciences © 2012 Nordic College of Caring Science.

  12. Emotional Autonomy versus Detachment: Revisiting the Vicissitudes of Adolescence and Young Adulthood.

    Science.gov (United States)

    Ryan, Richard M.; Lynch, John H.

    1989-01-01

    Emotional autonomy was examined in three studies of adolescents and young adults. Subjects of the studies were 148 seventh graders, 213 high school students, and 104 undergraduates, respectively. Discussion concerns the conceptualization of attachment versus detachment, dependence, and autonomy in theories of adolescence. (RJC)

  13. Collectivists' Contingency and Autonomy as Predictors of Buffet Preferences among Taiwanese Adolescents

    Science.gov (United States)

    Chiou, Wen-Bin

    2006-01-01

    In a culture or society with high collectivism, contingent orientation and constrained autonomy are the prominent characteristics of adolescents' self-construal. This article examined whether Taiwanese adolescents' contingency and autonomy were associated with their prevalent preferences for buffet consumption. Findings in a panel survey indicated…

  14. Self-Determination Theory: The Importance of Autonomy to Well-Being across Cultures

    Science.gov (United States)

    Wichmann, Sonia Secher

    2011-01-01

    According to proponents of self-determination theory, autonomous regulation is a universal psychological human need. Researchers have found autonomy (defined as acting in accordance with one's values) related to well-being across cultures. Encouraging client autonomy is therefore fundamental to the practice of humanistic counseling.

  15. Journalistic Autonomy as a Professional Value and Element of Journalism Culture: The European Perspective

    OpenAIRE

    Lauk, Epp; Harro-Loit, Halliki

    2017-01-01

    The current combination of economic recession and info-technological revolution is drastically affecting the working environment of journalists and challenging their autonomy more than ever. This article focuses on how journalists in specific European countries perceive professional autonomy and analyzes the various factors that affect such autonomy. Continuity and discontinuity in journalism cultures are factors that can help us to understand the barriers to media independence...

  16. Autonomy and why you can "Never Let Me Go".

    Science.gov (United States)

    Bowyer, Lynne

    2014-06-01

    Kazuo Ishiguro's book Never Let Me Go is a thoughtful and provocative exploration of what it means to be human. Drawing on insights from the hermeneutic-phenomenology of Martin Heidegger, I argue that the movement of Ishiguro's story can be understood in terms of actualising the human potential for autonomous action. Liberal theories take autonomy to be concerned with analytically and ethically isolatable social units directing their lives in accordance with self-interested preferences, arrived at by means of rational calculation. However, I argue that such theories are simplistic abstractions from our human-life world, distorting the fundamental embodied, embedded, and relational nature of autonomy. When we attend closely to our concrete, lived existence we see instead that autonomy is about responding appropriately to others with whom we share a world. As we follow the path of Ishiguro's central character Kathy H., we are shown how an awareness and acceptance of our existential finitude as precarious and fallible creatures is necessary for guiding such appropriate interactions. As Kathy grows and is affirmed into her life-world, which grounds and supports her Being, she moves from heteronomy to autonomy; from being moved by external laws to embodying those laws, thereby becoming autonomous. This is exemplified by her appropriation of the carer role, through which she responds in a fitting way to those with whom she shares her world, bearing the weight of and dwelling responsibly within our human condition.

  17. Anxiety, depression and autonomy-connectedness: The mediating role of alexithymia and assertiveness.

    Science.gov (United States)

    Rutten, Elisabeth A P; Bachrach, Nathan; van Balkom, Anton J L M; Braeken, Johan; Ouwens, Machteld A; Bekker, Marrie H J

    2016-12-01

    Autonomy-connectedness (self-awareness, sensitivity to others, and capacity for managing new situations) reflects the capacity for self-governance, including in social relationships. Evidence showed that autonomy-connectedness is related to anxiety and depression. Little is known about the underlying mechanisms. We hypothesized that alexithymia and assertiveness would mediate the relationships between autonomy-connectedness and anxiety and depression. Relationships among the variables were investigated in 100 patients with a mean age of 42.2 suffering from anxiety and/or depression using a cross-sectional design. The relationship between self-awareness and both anxiety and depression was mediated by alexithymia. For anxiety, there was also a direct effect of sensitivity to others that was not explained by either alexithymia or assertiveness. Assertiveness did not have any mediational effect. The results indicate that particularly alexithymia explains the association of autonomy-connectedness with anxiety and depression. The study confirmed the relevance of autonomy-connectedness in anxiety and depression. In treating symptoms of anxiety, it is advisable to give attention to normalizing the patient's sensitivity to others. Treatment of patients with symptoms of anxiety and depression should include assessment of emotional awareness and, in the case of impaired emotional awareness, should be tailored as to promote increased awareness. © 2015 The British Psychological Society.

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

    DEFF Research Database (Denmark)

    Andresen, Mette; Puggaard, Lis

    2008-01-01

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

  19. Education and Reproductive Autonomy: The Case of Married Nigerian Women.

    Science.gov (United States)

    Princewill, Chitu Womehoma; De Clercq, Eva; Riecher-Rössler, Anita; Jegede, Ayodele Samuel; Wangmo, Tenzin; Elger, Bernice Simone

    2017-01-01

    In this article, we examine the influence of education on the exercise of married women's reproductive autonomy. We carried out 34 in-depth interviews (IDIs) with purposively sampled married Ikwerre women in Rivers State, Nigeria. The participants were between the ages of 22 and 60, had different educational backgrounds, and were in monogamous and polygynous marriages. Data were analyzed using MAXQDA 11 software. We found that although formal education enhanced women's ability to exercise reproductive autonomy, the culture of demanding absolute respect for men remains a major barrier. Formal education provides women with the knowledge that they need in order to access adequate health services for themselves and their children. Participants also believed that educating men was critical for the exercise of women's reproductive autonomy. The cultural aspects that promote female subordination and patriarchy should be addressed more openly in Nigeria.

  20. Women's household decision-making autonomy and contraceptive behavior among Bangladeshi women.

    Science.gov (United States)

    Rahman, Md Mosfequr; Mostofa, Md Golam; Hoque, Md Aminul

    2014-03-01

    Women's autonomy is a potentially important but less studied indicator of using contraception among women as well as ability to control their fertility. This study explores women's decision-making autonomy as a potential indicator of the use of contraception in Bangladesh. This cross-sectional study utilizes data from the Bangladesh Demographic Health Survey (BDHS) 2007. Information of 8456 currently married and non-pregnant women aged 15-40 years are analyzed to meet up the objective of this study. The mean age of the respondents is 27.19 years and majority of the respondents are from rural areas (62.7%) and also Muslim (90.2%). A large number of women (26.1%) and their husbands (29.0%) have no education and 27.2% respondents were working at the time of interview. The mean number of living children is 2.14. 48.9% of the respondents are currently using a modern method of contraception. More than one-third women are not involved in their household decision-making. Results of this study indicate that household decision-making autonomy is significantly associated with current use of modern contraception, future intention to use contraception and discuss contraception with husband. This measure of women's autonomy provides additional independent explanatory power of contraceptive behavior net of some other socio-demographic variables. This study argues in favor of increasing women's autonomy to increase contraception using rate in this population. Copyright © 2013 Elsevier B.V. All rights reserved.