A comparative study examining the decision-making processes of medical and nursing staff in weaning patients from mechanical ventilation

Background: Decisions regarding whether or not to institute mechanical ventilation during the later stages of chronic obstructive pulmonary disease is challenging both ethically, emotionally and medically. Caring for these patients is a multifaceted process where nurses play a crucial role. Research question and design: We have investigated how nurses experienced their own role in decision-making processes regarding mechanical ventilation in later stages of chronic obstructive pulmonary disease and how they consider the patients’ role in these processes. We applied a qualitative approach, with six focus-group interviews of nurses (n = 26). Ethical considerations: The Regional Committees for Medical and Health Research Ethics approved the study. Voluntary informed consent was obtained. Findings: The nurses found themselves operating within a cure-directed treatment culture wherein they were unable to stand up for the caring values. They perceived their roles and responsibilities in decision-making processes regarding mechanical ventilation to patients as unclear and unsatisfactory. They also experienced inadequate interdisciplinary cooperation. Discussion: Lack of communication skills, the traditional hierarchical hospital culture together with operating in a medical-orientated treatment culture where caring values is rated as less important might explain the nurses’ absence in participation in the decision about mechanical ventilation. Conclusion: To be able to advocate for the patients’ and their own right to be included in decision-making processes, nurses need an awareness of their own responsibilities. This requires personal courage, leadership who are capable of organising common interpersonal meetings and willingness on the part of the physicians to include and value the nurses’ participation in decision-making processes.

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A EVOLUCIÓN DO MIX ELÉCTRICO EN DIVERSOS PAÍSES EUROPEOS, 1995-2014: ALEMAÑA, FRANCIA, REINO UNIDO, DINAMARCA, ITALIA E ESPAÑA

Revista Galega de Economía ◽

10.15304/rge.26.3.4447 ◽

2017 ◽

Vol 26 (3) ◽

pp. 5-18

Author(s):

Adrián DIOS VICENTE

Keyword(s):

Decision Making ◽

Comparative Study ◽

Descriptive Analysis ◽

Fuel Oil ◽

Business Strategies ◽

Energy Industry ◽

The Past ◽

Decision Making Processes ◽

European Regulations ◽

Electricity Mix

A transformación do mix eléctrico nas últimas décadas foi un dos piaresfundamentais da estratexia empresarial no sector enerxético. Tendo en conta as enormesdiferenzas entre países, a escasa conexión eléctrica europea e o grao de concentraciónempresarial, avalíase a evolución en 6 países europeos. O presente estudo realiza unhaanálise descritiva desta transformación, tendo en conta a evolución de diversas variablescuantitativas no sector. As evolucións son dispares, baseadas moitas veces en realidadesestatais diferentes. A mesma estrutura do sector, dende mercados liberalizados eteoricamente en competencia con outros regulados e baseados en campións nacionaiscomo grandes empresas eléctricas que controlan boa parte do sector impide realidadessemellantes, malia que a regulación europea trata de homologar a realidade continentalpara o sector. Do mesmo xeito, as transformacións internacionais teñen un impactodeterminante na toma de decisións semellantes do sector, malia que moitas veces conestratexias dispares. En particular, a redución do consumo de fuel oil para a produción e aintrodución de novas tecnoloxías renovables son procesos comúns por múltiplesempresas. O presente traballo trata tamén de realizar un estudo comparativo, dende unhaperspectiva rexional, dunha importante empresa eléctrica como Unión Fenosa con parteda contorna europea nos anos de vida da compañía, entre 1982 e 2007.The transformation of the electricity mix in the past decades has become one ofthe cornerstones of business strategies in the energy industry. Whilst weighing theconsiderable differences among countries, the scarce electricity connection in Europe andthe degree of existing business clusters, the evolution is assessed in six Europeancountries. This paper aims to offer a descriptive analysis of such changes, bearing in mindthe evolution of various quantitative variables in the industry. Progress is unalike,frequently based on different state circumstances. The mere structure of the industry,from liberalized markets theoretically competing against other regulated ones which arenational leaders as big electrical companies controlling a huge share of the industry,presents similar circumstances despite the fact that European regulations aims tostandardize conditions throughout the continent in the industry. Likewise, internationaltransformations have a fundamental impact on similar decision-making processes in theindustry, even though these might often result in different strategies. In particular, areduction of fuel oil comsumption encouraging the production and introduction ofrenewable technologies are common processes for several companies. This paper alsoaims to present a regional comparative study between an electricity provider as importantas Unión Fenosa and the European zone during the years the company has existed, ie,between 1982 and 2007

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Covid-19: A Different Economic Crisis but the Same Paradigm of Democratic Deficit in the EU

Politics and Governance ◽

10.17645/pag.v9i2.3923 ◽

2021 ◽

Vol 9 (2) ◽

pp. 252-264

Author(s):

Dina Sebastião

Keyword(s):

Decision Making ◽

Comparative Study ◽

Economic Crisis ◽

National Interest ◽

Process Tracing ◽

Democratic Deficit ◽

Economic Crises ◽

Ideological Debate ◽

Decision Making Processes ◽

The Eu

Based on a normative orientation and an interdisciplinary perspective, this is a comparative study, using the process tracing methodology, between the EU responses to Eurozone and Covid-19 crises to assess if, despite different outcomes, institutional decision-making processes evidence a change. The study concluded that the EU democratic deficit remains, which assumes special features in economic crises, providing a political oversize power to the economically hegemonic states, thus constraining ideological debate and making national interest prevail over politicisation. This perpetuates the conversion of structural economic positions into political power at the expense of political representative power and democracy.

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Cognitive Processing of Miscommunication in Interactive Listening: An Evaluation of Listener Indecision and Cognitive Effort

Journal of Speech Language and Hearing Research ◽

10.1044/2020_jslhr-20-00128 ◽

2021 ◽

pp. 1-17

Author(s):

Jennifer M. Roche ◽

Arkady Zgonnikov ◽

Laura M. Morett

Keyword(s):

Decision Making ◽

Cognitive Processing ◽

Language Processing ◽

Cognitive Effort ◽

Mouse Tracking ◽

Computer Mouse ◽

Decision Making Processes ◽

Computer Mouse Tracking ◽

Listening Task ◽

Processing Effort

Purpose The purpose of the current study was to evaluate the social and cognitive underpinnings of miscommunication during an interactive listening task. Method An eye and computer mouse–tracking visual-world paradigm was used to investigate how a listener's cognitive effort (local and global) and decision-making processes were affected by a speaker's use of ambiguity that led to a miscommunication. Results Experiments 1 and 2 found that an environmental cue that made a miscommunication more or less salient impacted listener language processing effort (eye-tracking). Experiment 2 also indicated that listeners may develop different processing heuristics dependent upon the speaker's use of ambiguity that led to a miscommunication, exerting a significant impact on cognition and decision making. We also found that perspective-taking effort and decision-making complexity metrics (computer mouse tracking) predict language processing effort, indicating that instances of miscommunication produced cognitive consequences of indecision, thinking, and cognitive pull. Conclusion Together, these results indicate that listeners behave both reciprocally and adaptively when miscommunications occur, but the way they respond is largely dependent upon the type of ambiguity and how often it is produced by the speaker.

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“It's Not Humanly Possible to Do Everything”: Perspectives on Intervention Decision-Making Processes of Parents of Children with Autism Spectrum Disorders

Perspectives on Language Learning and Education ◽

10.1044/lle22.1.13 ◽

2015 ◽

Vol 22 (1) ◽

pp. 13-21 ◽

Cited By ~ 5

Author(s):

Erinn Finke ◽

Kathryn Drager ◽

Elizabeth C. Serpentine

Keyword(s):

Decision Making ◽

Individualized Education Program ◽

Children With Autism ◽

Autism Spectrum ◽

Sources Of Information ◽

Individual Decision ◽

Decision Making Processes ◽

Spectrum Disorders ◽

Interview Methodology ◽

Communication Interventions

Purpose The purpose of this investigation was to understand the decision-making processes used by parents of children with autism spectrum disorder (ASD) related to communication-based interventions. Method Qualitative interview methodology was used. Data were gathered through interviews. Each parent had a child with ASD who was at least four-years-old; lived with their child with ASD; had a child with ASD without functional speech for communication; and used at least two different communication interventions. Results Parents considered several sources of information for learning about interventions and provided various reasons to initiate and discontinue a communication intervention. Parents also discussed challenges introduced once opinions of the school individualized education program (IEP) team had to be considered. Conclusions Parents of children with ASD primarily use individual decision-making processes to select interventions. This discrepancy speaks to the need for parents and professionals to share a common “language” about interventions and the decision-making process.

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