Browsing by Subject "AUTONOMY"

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  • Jayanti, Anuradha; Neuvonen, Markus; Wearden, Alison; Morris, Julie; Foden, Philip; Brenchley, Paul; Mitra, Sandip; BASIC-HHD Study Grp (2015)
    Background: Medical decision-making is critical to patient survival and well-being. Patients with end stage renal disease (ESRD) are faced with incrementally complex decision-making throughout their treatment journey. The extent to which patients seek involvement in the decision-making process and factors which influence these in ESRD need to be understood. Methods: 535 ESRD patients were enrolled into the cross-sectional study arm and 30 patients who started dialysis were prospectively evaluated. Patients were enrolled into 3 groups-'predialysis' (group A), 'in-centre' haemodialysis (HD) (group B) and self-care HD (93 % at home-group C) from across five tertiary UK renal centres. The Autonomy Preference Index (API) has been employed to study patient preferences for information-seeking (IS) and decision-making (DM). Demographic, psychosocial and neuropsychometric assessments are considered for analyses. Results: 458 complete responses were available. API items have high internal consistency in the study population (Cronbach's alpha > 0.70). Overall and across individual study groups, the scores for information-seeking and decision-making are significantly different indicating that although patients had a strong preference to be well informed, they were more neutral in their preference to participate in DM (p <0.05). In the age, education and study group adjusted multiple linear regression analysis, lower age, female gender, marital status; higher API IS scores and white ethnicity background were significant predictors of preference for decision-making. DM scores were subdivided into tertiles to identify variables associated with high (DM > 70: and low DM ( Conclusion: ESRD patients prefer to receive information, but this does not always imply active involvement in decision-making. By understanding modifiable and non-modifiable factors which affect patient preferences for involvement in healthcare decision-making, health professionals may acknowledge the need to accommodate individual patient preferences to the extent determined by the individual patient factors.
  • Lizotte, Christopher; Nguyen, Nicole (2020)
    In this paper, we make a case for situating the school as a geopolitical site. The geopolitical functions of schools and schooling have long been investigated by geographers: forming national citizens, promoting geostrategic discourses, and disciplining populations, to name a few. However, we advocate an approach that is “outward looking,” examining the school not just as a space where these functions are carried out by the state, but as a site where institutional structure, educators, and students exercise agency in complicating the actual implementation of state geo- political aims. We do this by examining two cases where public schooling has been leveraged by Western states in the service of the post-9/11 securitization of Muslim students in the United Kingdom and France. We argue that these two cases illustrate that schools can be examined not just as containers for state policy, but as explanatory moments in their own right in understanding state geopolitical strategy.