Determining the psychometric properties of the Enhancing Decision-making Assessment in Midwifery (EDAM) measure in a cross cultural context

© 2016 Jefford et al. Background: The ability to act on and justify clinical decisions as autonomous accountable midwifery practitioners, is encompassed within many international regulatory frameworks, yet decision-making within midwifery is poorly defined. Decision-making theories from medicine and nursing may have something to offer, but fail to take into consideration midwifery context and philosophy and the decisional autonomy of women. Using an underpinning qualitative methodology, a decision-making framework was developed, which identified Good Clinical Reasoning and Good Midwifery Practice as two conditions necessary to facilitate optimal midwifery decision-making during 2nd stage labour. This study aims to confirm the robustness of the framework and describe the development of Enhancing Decision-making Assessment in Midwifery (EDAM) as a measurement tool through testing of its factor structure, validity and reliability. Method: A cross-sectional design for instrument development and a 2 (country; Australia/UK) x 2 (Decision-making; optimal/sub-optimal) between-subjects design for instrument evaluation using exploratory and confirmatory factor analysis, internal consistency and known-groups validity. Two 'expert' maternity panels, based in Australia and the UK, comprising of 42 participants assessed 16 midwifery real care episode vignettes using the empirically derived 26 item framework. Each item was answered on a 5 point likert scale based on the level of agreement to which the participant felt each item was present in each of the vignettes. Participants were then asked to rate the overall decision-making (optimal/sub-optimal). Findings: Post factor analysis the framework was reduced to a 19 item EDAM measure, and confirmed as two distinct scales of 'Clinical Reasoning' (CR) and 'Midwifery Practice' (MP). The CR scale comprised of two subscales; 'the clinical reasoning process' and 'integration and intervention'. The MP scale also comprised two subscales; women's relationship with the midwife' and 'general midwifery practice'. Conclusion: EDAM would generally appear to be a robust, valid and reliable psychometric instrument for measuring midwifery decision-making, which performs consistently across differing international contexts. The 'women's relationship with midwife' subscale marginally failed to meet the threshold for determining good instrument reliability, which may be due to its brevity. Further research using larger samples and in a wider international context to confirm the veracity of the instrument's measurement properties and its wider global utility, would be advantageous

Security Policies as Membranes in Systems for Global Computing

We propose a simple global computing framework, whose main concern is code migration. Systems are structured in sites, and each site is divided into two parts: a computing body, and a membrane which regulates the interactions between the computing body and the external environment. More precisely, membranes are filters which control access to the associated site, and they also rely on the well-established notion of trust between sites. We develop a basic theory to express and enforce security policies via membranes. Initially, these only control the actions incoming agents intend to perform locally. We then adapt the basic theory to encompass more sophisticated policies, where the number of actions an agent wants to perform, and also their order, are considered

Scalable Dense Non-rigid Structure-from-Motion: A Grassmannian Perspective

This paper addresses the task of dense non-rigid structure-from-motion (NRSfM) using multiple images. State-of-the-art methods to this problem are often hurdled by scalability, expensive computations, and noisy measurements. Further, recent methods to NRSfM usually either assume a small number of sparse feature points or ignore local non-linearities of shape deformations, and thus cannot reliably model complex non-rigid deformations. To address these issues, in this paper, we propose a new approach for dense NRSfM by modeling the problem on a Grassmann manifold. Specifically, we assume the complex non-rigid deformations lie on a union of local linear subspaces both spatially and temporally. This naturally allows for a compact representation of the complex non-rigid deformation over frames. We provide experimental results on several synthetic and real benchmark datasets. The procured results clearly demonstrate that our method, apart from being scalable and more accurate than state-of-the-art methods, is also more robust to noise and generalizes to highly non-linear deformations.Comment: 10 pages, 7 figure, 4 tables. Accepted for publication in Conference on Computer Vision and Pattern Recognition (CVPR), 2018, typos fixed and acknowledgement adde

Object Action Complexes as an Interface for Planning and Robot Control

Abstract — Much prior work in integrating high-level artificial intelligence planning technology with low-level robotic control has foundered on the significant representational differences between these two areas of research. We discuss a proposed solution to this representational discontinuity in the form of object-action complexes (OACs). The pairing of actions and objects in a single interface representation captures the needs of both reasoning levels, and will enable machine learning of high-level action representations from low-level control representations. I. Introduction and Background The different representations that are effective for continuous control of robotic systems and the discrete symbolic AI presents a significant challenge for integrating AI planning research and robotics. These areas of research should be abl

Towards a complete multiple-mechanism account of predictive language processing [Commentary on Pickering & Garrod]

Although we agree with Pickering & Garrod (P&G) that prediction-by-simulation and prediction-by-association are important mechanisms of anticipatory language processing, this commentary suggests that they: (1) overlook other potential mechanisms that might underlie prediction in language processing, (2) overestimate the importance of prediction-by-association in early childhood, and (3) underestimate the complexity and significance of several factors that might mediate prediction during language processing

An integrated theory of language production and comprehension

Currently, production and comprehension are regarded as quite distinct in accounts of language processing. In rejecting this dichotomy, we instead assert that producing and understanding are interwoven, and that this interweaving is what enables people to predict themselves and each other. We start by noting that production and comprehension are forms of action and action perception. We then consider the evidence for interweaving in action, action perception, and joint action, and explain such evidence in terms of prediction. Specifically, we assume that actors construct forward models of their actions before they execute those actions, and that perceivers of others' actions covertly imitate those actions, then construct forward models of those actions. We use these accounts of action, action perception, and joint action to develop accounts of production, comprehension, and interactive language. Importantly, they incorporate well-defined levels of linguistic representation (such as semantics, syntax, and phonology). We show (a) how speakers and comprehenders use covert imitation and forward modeling to make predictions at these levels of representation, (b) how they interweave production and comprehension processes, and (c) how they use these predictions to monitor the upcoming utterances. We show how these accounts explain a range of behavioral and neuroscientific data on language processing and discuss some of the implications of our proposal