Information exchange is an essential component for all involved in the paediatric care encounter. Despite this, most of the research about information exchange concerns adults and the significance of the child’s existence in the encounter have not been given sufficient attention. Therefore, the overall aims of this thesis were twofold. Firstly, the aim was to identify, describe and generate concepts in information exchange between minors, parents/guardians and health care professionals in paediatric care situations. Secondly, the intention was to formulate a theoretical construction, a theory, of the phenomenon of information exchange in paediatric care situations. This thesis is based on four studies. In studies I, II and III grounded theory was used according to Glaser and data have been analyzed using the constant comparative analysis method. Data have been collected through observations and medical records (I, II and III) and also with additional follow-up interviews (III). In study IV, at first a qualitative content analysis of Løgstrup’s ethical demand was conducted and, second, a simultaneous concept analysis of the findings from studies I, II and III and the findings from the qualitative content analysis was carried out. There were a total of 67 participants in the three observational studies: 28 minors (I), 24 parents/guardians (II) and 15 health care professionals (III), who exchanged information in different paediatric care encounters. The information exchange interaction process was resolved by the minors “balancing the circumstances” (I), the parents/guardians used “firm handling” (II) and the health care professionals were “sharing and contributing the responsibility” (III). The qualitative content analysis of Løgstrup’s ethical demand provided the mediation and the social norms. The simultaneous concept analysis finally gave the advanced outcome to intergrade, which means to merge gradually with another through a continuous series of intermediates. At the same time as we intergrade in paediatric care, we protect the totality of minors, recognize the dependency of the parents/guardians and the social interplay by the health care professionals, the information exchange is improved. This thesis emphasizes the importance of health care professionals’ communication skills and the need for education and practice in this topic, in order to improve the information exchange with minors and their parents/guardians from an ethical viewpoint. The theory intergrade explains how this could be applied and implemented.

Psychological studies have shown that information exchange is a key component of effective teamwork. In addition to requesting information that they need for their tasks, members of effective teams often proactively forward information that they believe other teammates require to complete their tasks. We refer to this type of communication as proactive information exchange and the formalization and implementation of this is the subject of this thesis. The important question that we are trying to answer is: under normative conditions, what types of information needs can agent teammates extract from shared plans and how can they use these information needs to proactively forward information to teammates? In the following, we make two key claims about proactive information exchange: first, agents need to be aware of the information needs of their teammates and that these information needs can be inferred from shared plans; second, agents need to be able to model the beliefs of others in order to deliver this information efficiently. To demonstrate this, we have developed an algorithm named PIEX, which, for each agent on a team, reasonably approximates the information-needs of other team members, based on analysis of a shared team plan. This algorithm transforms a team plan into an individual plan by inserting coomunicative tasks in agents' individual plans to deliver information to those agents who need it. We will incorporate a previously developed architecture for multi-agent belief reasoning. In addition to this algorithm for proactive information exchange, we have developed a formal framework to both describe scenarios in which proactive information exchange takes place and to evaluate the quality of the communication events that agents running the PIEX algorithm generate. The contributions of this work are a formal and implemented algorithm for information exchange for maintaining a shared mental model and a framework for evaluating domains in which this type of information exchange is useful.

Thesis (M.S. in Computer Science)--Naval Postgraduate School, December 2003. / Thesis advisor(s): Neil Rowe, Carlyle Wash. Includes bibliographical references (p. 95). Also available online.

Thesis (M.S. in Meteorology and Physical Oceanography)--Naval Postgraduate School, December 2003. / Thesis advisor(s): Carlyle Wash, Neil Rowe. Includes bibliographical references (p. 47-48). Also available online.

With the advent of Network-Centric Warfare (NCW) concepts, Command and Control (C2) Systems need efficient methods for communicating between heterogeneous systems. To extract or exchange various levels of information within the networks requires interoperability between human and machine as well as between machine and machine. This dissertation explores the Information Exchange Framework (IEF) concept of distributed data fusion sensor networks in Network-centric environments. It is used to synthesize integrative battlefield pictures by combining the Battle Management Language (BML) and System Entity Structure (SES) ontology framework for C2 systems. The SES is an ontology framework that can facilitate information exchange in a network environment. From the perspective of the SES framework, BML serves to express pragmatic frames, since it can specify the information desired by a consumer in an unambiguous way. This thesis formulates information exchange in the SES ontology via BML and defines novel pruning and transformation processes of the SES to extract and fuse data into higher level representations. This supports the interoperability between human users and other sensor systems. The efficacy of such data fusion and exchange is illustrated with several battlefield scenario examples.A second intercommunication issue between sensor systems is how to ensure efficient and effective message passing. This is studied by using Cursor-on-Target (CoT), an effort to standardize a battlefield data exchange format. CoT regulates only a few essential data types as standard and has a simple and efficient structure to hold a wide range of message formats used in dissimilar military enterprises. This thesis adopts the common message type into radar sensor networks to manage the target tracking problem in distributed sensor networks.To demonstrate the effectiveness of the proposed Information Exchange Framework for data fusion systems, we illustrate the approach in an air defense operation scenario using DEVS modeling and simulation. The examples depict basic air defense operation procedure. The demonstration shows that the information requested by a commander is delivered in the right way at the right time so that it can support agile decision making against threats.

BACKGROUND Integrated healthcare systems are believed to be enabled by the electronic exchange of clinical information. Canada and other national health systems are making substantial investments in information technology, in order to liberate and share clinical information between providers, improve the quality and safety of care, and reduce costs, yet we currently have no way of measuring these information flows, nor of understanding whether they contribute to the integration of care delivery. METHODS A literature review and consensus development process (nominal group) were used to provide guidance on system integration measures which are enabled by electronic information exchange. In order to conceptualize the components of electronic information exchange, establish a reference vocabulary for terminology, and guide the development of a questionnaire to gather field data, a formal ontology was developed. Validation of a sub-group of the survey data quality was achieved using the ontology and an unrelated database, demonstrating how ontologies may be used to adapt performance measurement methodologies to systems where constraints such as time-compression, lack of resources or access to needed information are prevalent. RESULTS The survey tool gathered cross-sectoral data from a regional health system which populated a summary measure of inter-provider electronic health information exchange (the eHIE), and measured perceptions of system integration from a single health region. The eHIE indicated that 7 -12% of clinical information that could be shared, was being shared electronically in the health region. ANOVA confirmed a significant correlation between the amount of information being exchanged electronically in this system and respondent perceptions of system integration suggesting that the eHIE may be used as a leading indicator for healthcare system integration. CONCLUSIONS It is possible to conceptualize and quantify inter-provider electronic health information exchange. As complex adaptive systems, healthcare systems are dynamic and open to correction; the use of a leading or proximal indicator such as the eHIE may inform effective policy-making and resource allocation in our pursuit of the goal of seamlessly integrated care.

This study examined a model of the antecedents and outcomes of mentor commitment to workplace mentoring relationships. The proposed model was based on the investment model of commitment. A total of 180 pairs of mentors and their protégés completed surveys that assessed model constructs. Results indicated that mentor relationship satisfaction and investment size predict mentor commitment, whereas mentor quality of alternatives and perceptions of managerial support for mentoring do not predict mentor commitment. Additionally, mentor commitment is associated with information exchange behaviors engaged in by mentors and protégés. These findings suggest that commitment plays an important role in mentoring relationships, and the investment model provides a useful framework for future research on this topic.

Communication competence and medical communication competence served as the theoretical framework for this research that seeks to identify specific communication behaviors associated with what nurses say constitute a communicatively competent patient handoff at the nursing change of shift. Data collected from 286 nurses responding to an online modified Medical Communication Competence Scale posted at www.allnurses.com supported the hypotheses that information exchange (information giving, seeking and verifying) and socioemotional communication behaviors are rated more highly in the best patient handoffs than in the worst ones. Research questions found that the incoming nursing role rated behaviors associated with information verifying and socioemotional communication higher than did the outgoing nursing role, and that the worst handoffs were those in which the incoming nursing role gave the lowest ratings for information-giving behaviors. Additional insight into other communication-related characteristics associated with quality handoffs were provided as well, including location, tools/type and environment for the patient handoff at the nursing change of shift. These findings offer a foundation for future research into development of communication-based standardized patient handoff processes and training that ultimately may reduce patient care errors caused by communication failures during the patient handoff at the nursing change of shift.

Univ., Diss.--Tübingen, 2004. / Literaturverz. S. 527 - 562.

This research focuses on the nature and extent of social relationships between two Late Woodland Lewis phase villages, ca. A.D. 650 to 900, in southern Illinois and western Kentucky. These villages are the Cypress Citadel site in Johnson County, Illinois (111JS76), and the McGilligan Creek site in Livingston County, Kentucky (19LV197). Relationships between the two communities are examined through a detailed comparison of their ceramic assemblages, especially the decorated pottery. Chi square and Cramer's V statistics are used along with the social interaction and information exchange theories to determine the most likely to association between the sites. The results suggest a distancing of the social relations between these sites over their 250-year occupations. With a lack of firm temporal data, however, these conclusions are only a best-fit model. Other significant similarities and differences are noted which provide clues for future avenues of study.