Complex home care: challenges arising from the blurring of boundaries between family and professional care

Over the last 50 years, increasingly complex care (such as tracheostomy management, dialysis or enteral feeding) has shifted from hospital to home, with a concomitant rise in patient self-management and care given by family members. Recognition of the importance of the contribution of family care to the health system is also growing. This article reports the findings of a New Zealand study which explored the experiences of family carers who manage technical health procedures at home. It then draws attention to some broader issues raised by shifting complex care from professional management in hospital settings to family care at home, namely the ways in which complex home care blurs the boundaries between professional and family care (creating the ambiguous position of the expert carer) and questions of safety and responsibility in family care. We also discuss the implications for policy around family caregiving in New Zealand. Given the potential physical and mental health impacts of caring, it is time for renewed consideration of what family carers should be expected or allowed to manage and how the health system can support them in their important role.     

The Conversational Model and Child and Family Counselling: Treating Chronic Complex Trauma in a Systemic Framework

Child and Family Counselling Teams in NSW Community Health Services are expected to provide therapeutic services to children who have experienced complex trauma. However, parental trauma is often overlooked or referred elsewhere. A systemic perspective informed by attachment theory and trauma theory provides the basis for addressing parental trauma in Child and Family Counselling Teams, thereby improving parenting. The Conversational Model is an evidence‐based intervention for chronic complex trauma. The foundations of the Conversational Model and its brief component, Short Term Intensive Psychodynamic Psychotherapy, are outlined and a case study is given to illustrate the usefulness of the intervention in Child and Family Counselling. Highlighted is the importance of addressing systemic trauma through parenting to improve attachment quality, family relationships, and children's function.     

Incentives in a Stage‐Gate Process

Many large organizations use a stage‐gate process to manage new product development projects. In a typical stage‐gate process project managers learn about potential ideas from research and exert effort in development while senior executives make intervening go/no‐go decisions. This decentralized decision making results in an agency problem because the idea quality in early stages is unknown to the executive and the project manager must exert unobservable development effort in later stages. In light of these challenges, how should the firm structure incentives to ensure that project managers reveal relevant information and invest the appropriate effort to create value? In this study, we develop a model of adverse selection in research and moral hazard in development with a go/no‐go decision at the intervening gate. Our results show that the principal's uncertainty regarding early‐stage idea quality—a term we refer to as idea risk—alters the effect of late‐stage development risk. The presence of idea risk can alter the incentives offered to the agent and may lead the principal to reject projects that otherwise seem favorable in terms of positive net present value. A simulation of early‐stage ideas, found through search on a complex landscape, shows that the firm can mitigate the negative effects of idea risk by encouraging breadth of search and high tolerance for failure.     

基于复杂网络理论的股票指标关联性实证分析

复杂网络理论是研究股票市场内在结构和功能的有力工具,股票指标的关联性已成为研究股票市场的一个新视角。基于复杂网络理论对深沪300指数(2011年7月28至2012年2月28)构建网络拓扑结构。利用DFA进行数据筛选,计算筛选后数据的股票指标的绝对相关系数。根据股票指标的绝对相关系数概率分布确定阈值,构建网络拓扑结构,计算股票指标的网络统计特征指标,分析收益率、成交量、市盈率的网络结构。研究结果表明,股票收益率和成交量指标的具有较强的关联性,具有小世界性质;市盈率指标具有较弱的关联性,不具有小世界性质,是随机网络且受外界影响较大、效率低下,风险比较大。     

复杂系统质量生存决策的模型研究

在复杂经济系统的生存决策模型的基础上加入期望约束,提出并建立了一个基于资源、惯性和期望约束的质量生存决策的三维基本模型.由于决策系统的质量生存性由质量生存核维持,但在一般情况下得不到质量生存核的解析解,因此对其大小、形状、位置进行了理论分析,并根据理论分析结果,按照不同质量生存特性将三维决策空间进行了定性区域划分,最后用一个仿真实例进行了简单验证.     

智能体建模和资本市场复杂性

以复杂适应系统的思想和智能体建模的方法研究资本市场复杂性是新兴的有价值的研究领域,阐述了资本市场作为复杂适应系统的动力机制,介绍了这一领域一个重要模型———少数派博弈(minority game,MG)模型.仿真发现,处于拥挤阶段的MG具有和实际市场相近的收益率分布.进一步扩展标准MG,提出了快速适应的少数派博弈模型,仿真结果显示,新的模型有着和真实市场相同的特征:收益率分布的尖峰和肥尾现象,揭示了资本市场复杂性的内部动力学机理.     

基于复杂网络的电动汽车充电桩众筹市场信用风险建模与分析

因其经济优势及环境友好特性,电动汽车（EV）保有量持续攀升。而当前中国充电设施建设明显滞后于电动汽车的扩张速度,成为制约电动车发展潜力的主要瓶颈。由于充电设施具有高正外部性,同时投资回收期较长,难以吸引到传统融资,而基于互联网的众筹作为新型融资方式则受到了广泛关注。但由于缺乏强制性的信息披露制度及相关法律法规,众筹融资过程中的信息不对称问题相较传统融资方式更为严重,由此导致的高违约率也进一步削弱了投资者信心。本文利用复杂网络对电动汽车充电桩众筹融资市场进行建模,刻画了众筹投资者决策过程中的羊群效应,基于信息不对称使用多Agent模型对信用风险的产生、影响及针对性政策效果进行了模拟分析。结果表明,众筹投资者在决策过程中易受到社交网络中负面信息的影响,使得筹资人违约行为的不利影响进一步扩散。而严格的罚款机制可以在不影响融资市场均衡的情况下,使违约行为的恶性循环得到遏制。     

Schulentwicklung — ein kritischer Blick auf ein aktuelles Phänomen

School developmement, a critical perspective Today, everything dealing with school becomes subsumed under the keyword school development. The demand for school development is raised by two sides: on the one hand by political and social groups, on the other by schools themselves. In this way, very different ideas and demands on school development arise. School as institution and schools as highly complex organizations can’t be reformed with programs derived from economy and management methods. The legal and social context as well as school theories, organizational culture, internal structures and the self concept of teachers constitute the frame, in wich school development takes place as a continual process and whose neglect causes frustration and failure.     

面向服务的复杂成形装备产品架构设计与优化

复杂成形装备作为高端制造产业的基础装备,是各产业转型升级和技术进步的重要保障。同时快速发展的互联网与大数据等新兴信息技术已经成为装备制造业创新不可或缺的组成部分,极其深刻地影响着复杂成形装备产业的制造模式、发展战略以及产品的开发方式。本文研究了面向服务的复杂成形装备产品架构设计与优化方法。采用公理化设计的域结构思想,建立需求域、功能域和架构域之间的映射关系;提出了基于QFD的功能生成方法以及功能模型约简方法;利用DMM建立产品架构和服务架构之间的关联关系;利用模块化理论方法,并考虑成本因素对产品架构进行优化。