Factors that Influence Intraoperative Decision-Making Among Pediatric Neurosurgeons: A Grounded Theory Study

2021 ◽  
Author(s):  
Leeat Granek ◽  
Shahar Shapira ◽  
Jonathan Roth ◽  
Shlomi Constantini
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
Pediatric Neurosurgery ◽  
Contextual Data ◽  
Grounded Theory Method ◽  
Data Collection And Analysis ◽  
Relational Factors ◽  
Decision Making Processes ◽  
The Rich ◽  
To Come

Introduction: Pediatric neurosurgery is a sub-specialty of medicine that is responsible for diagnosing, managing, and treating neurological disease in children with the use of surgery. Good intraoperative decisions making is critical to ensuring patient safety, yet almost nothing is known about what factors play a role in intraoperative decisions. As such, the purpose of this paper was to explore the factors that influence intraoperative decisions when pediatric neurosurgeons encounter something unexpected or uncertain during surgery. Methods: The study utilized the Grounded Theory method of data collection and analysis. Twenty-six pediatric neurosurgeons from 12 countries around the world were interviewed between June-October 2020 about the factors that go into making intraoperative decisions. Data was analyzed line by line and constant comparison was used to examine relationships within, and across codes and categories. Results: Pediatric neurosurgeons reflected on six factors while operating in order to come to a decision about how to proceed when they encountered an uncertainty or complication. The study findings resulted in a conceptual model that describes how concrete data including biological and technological factors and contextual data including emotional/relational factors, surgeon factors, and cultural factors influence risk assessment when making an intraoperative decision during surgery. Conclusions: The findings from this research can be used for training and educating surgeons about intraoperative decision-making processes. Pedagogical modules can be developed that includes training sessions on factors that may implicitly and explicitly influence thinking processes during an operation. Surgeons may also benefit from having open discussions with surgical colleagues about the rich, emotional, intellectual scope of the work that they do with all the challenges that these relationships can bring into decision-making in the operating room.

Investigating responses to theft in early modern Wales: communities, thieves and the courts

2004 ◽  
Vol 19 (3) ◽  
pp. 409-430 ◽  
Author(s):  
SHARON HOWARD
Keyword(s):  
Decision Making ◽  
Early Modern ◽  
Local Networks ◽  
Court Records ◽  
Criminological Research ◽  
The Everyday ◽  
Everyday World ◽  
Decision Making Processes ◽  
The Rich ◽  
Communal Responsibility

This article makes use of the rich deposits of pre-trial documents in the court archives of early modern Wales, focusing on the county of Denbighshire, to investigate attitudes and responses to theft. Qualitative research on this subject tends to emphasize or privilege actively law-enforcing behaviour that led to trials; while that is the inevitable emphasis of court records, I argue that we need to examine witness testimonies more closely in order to understand responses that did not match up to the ideals of vigilance and communal responsibility. Drawing on modern criminological research, I explore ‘suspicion’ and the decision-making processes leading to various outcomes: non-action; investigation and prosecution; alternative resolutions that bypassed the courts. Finally, I explore the everyday ‘world of stolen goods’ and its social and economic rewards in local networks of reciprocal favours, gifts and alliances.

scholarly journals "Anishinaabe time": temporalities and impact assessment in pipeline reviews

2020 ◽  
Vol 27 (1) ◽  
Author(s):  
Sakihitowin Awasis
Keyword(s):  
Decision Making ◽  
Political Ecology ◽  
Indigenous Communities ◽  
Self Determination ◽  
Kinship Relations ◽  
Decision Making Processes ◽  
The Rich ◽  
Temporal Modes ◽  
Indigenous Geographies ◽  
And Function

Indigenous ways of living that embrace multiple temporalities have been largely supplanted by a single, linear colonial temporality. Drawing on theoretical insights from Indigenous geographies and political ecology, this article considers how pipeline reviews come into being through contested temporalities and how dominant modes of time dispossess Indigenous peoples of self-determination in energy decision-making. In particular, Anishinaabe clan governance – a form of kinship that provides both social identity and function based on relations to animal nations – is undermined in colonial decision-making processes. Through analysis of documents from Canada's National Energy Board and interviews with Anishinaabe pipeline opponents, I explore tensions between Anishinaabe and settler temporalities reflected in the 2012-2017 Line 9 pipeline dispute in the Great Lakes region. These include divergent understandings of periodicities, timeframes, kinship relations, and the role of nonhuman temporalities in decision-making. Colonial temporal modes that have been imposed on Indigenous communities foreshorten timescales, depoliticize kinship relations, and discount nonhumans in decision-making – resulting in narrower and more short-sighted project reviews than Anishinaabe temporalities would support. I argue that the rich concepts of kinship, queerness, continuity, and prophecy embedded in Anishinaabe temporalities can inform strategies for decolonizing energy review processes and open possibilities for Indigenous self-determination in energy decision-making.Keywords: Anishinaabe studies, Two-Spirit, Indigenous geographies, temporalities, Indigenous knowledge, energy governance, pipeline, National Energy Board

Autonomous Decision Making and Moral capacities

2009 ◽  
Vol 16 (2) ◽  
pp. 203-218 ◽  
Author(s):  
Albine Moser ◽  
Rob Houtepen ◽  
Harry van der Bruggen ◽  
Cor Spreeuwenberg ◽  
Guy Widdershoven
Keyword(s):  
Type 2 Diabetes ◽  
Decision Making ◽  
Reflective Practice ◽  
Family Care ◽  
Theory Method ◽  
Text Interpretation ◽  
Grounded Theory Method ◽  
Autonomous Decision ◽  
Decision Making Processes

This article examines how people with type 2 diabetes perceive autonomous decision making and which moral capacities they consider important in diabetes nurses' support of autonomous decision making. Fifteen older adults with type 2 diabetes were interviewed in a nurse-led unit. First, the data were analysed using the grounded theory method. The participants described a variety of decision-making processes in the nurse and family care-giver context. Later, descriptions of the decision-making processes were analysed using hermeneutic text interpretation. We suggest first- and second-order moral capacities that nurses specializing in diabetes need to promote the autonomous decision making of their patients. We recommend nurses to engage in ongoing, interactive reflective practice to further develop these moral capacities.

scholarly journals Application of clinical prediction modeling in pediatric neurosurgery: a case study

2021 ◽  
Author(s):  
Hendrik-Jan Mijderwijk ◽  
Thomas Beez ◽  
Daniel Hänggi ◽  
Daan Nieboer
Keyword(s):  
Decision Making ◽  
Prediction Models ◽  
Pediatric Neurosurgery ◽  
Medical Decision ◽  
Clinical Prediction ◽  
Clinical Prediction Models ◽  
Current Form ◽  
Related Risk ◽  
Decision Making Processes

AbstractThere has been an increasing interest in articles reporting on clinical prediction models in pediatric neurosurgery. Clinical prediction models are mathematical equations that combine patient-related risk factors for the estimation of an individual’s risk of an outcome. If used sensibly, these evidence-based tools may help pediatric neurosurgeons in medical decision-making processes. Furthermore, they may help to communicate anticipated future events of diseases to children and their parents and facilitate shared decision-making accordingly. A basic understanding of this methodology is incumbent when developing or applying a prediction model. This paper addresses this methodology tailored to pediatric neurosurgery. For illustration, we use original pediatric data from our institution to illustrate this methodology with a case study. The developed model is however not externally validated, and clinical impact has not been assessed; therefore, the model cannot be recommended for clinical use in its current form.

Uncovering Family Treatment Decision-Making Processes: The Value and Application of Case Study Methods to Family Research

2021 ◽  
pp. 107484072098722
Author(s):  
Ginny L. Schulz ◽  
Katherine Patterson Kelly ◽  
Jane Armer ◽  
Lawrence Ganong
Keyword(s):  
Decision Making ◽  
Treatment Decision ◽  
Family Processes ◽  
Study Methods ◽  
Treatment Decision Making ◽  
Data Collection And Analysis ◽  
Development Data ◽  
Decision Making Processes ◽  
Case Study Methods

Research on how and why family processes influence phenomena is essential to advancing many areas of science. Case study methods offer an approach that overcomes some of the sampling and analysis obstacles researchers face when studying families. This article aims to illustrate the benefits of case study methods for studying complex family processes using an example from treatment decision-making in sickle cell disease. Using survey, observation, and interview data from various family members within multiple family units, we detail our application of the following analytic strategies: (a) proposition-building, (b) pattern-matching, and (c) cross-case synthesis. Incorporating propositions from a conceptual framework assisted us in study development, data collection, and analysis. Development of graphs and matrices to create thematic family profiles uncovered how and why treatment decision-making occurred as a family process in a pediatric chronic illness. Case study methods are an established, but innovative approach to investigating various phenomena in families.

scholarly journals Reconciling relationships with physical activity: a qualitative study of women’s postnatal physical activity decision-making

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sarah Jane Liva ◽  
Wendy Anne Hall ◽  
John Oliffe
Keyword(s):  
Physical Activity ◽  
Decision Making ◽  
Grounded Theory ◽  
Qualitative Study ◽  
Well Being ◽  
Physical Activities ◽  
Individual Interview ◽  
The Core ◽  
Core Category ◽  
Decision Making Processes

Abstract Background Challenges with engaging in postnatal physical activity can negatively affect the health of women and their families. This study investigated women’s physical activity decision-making processes and strategies to support their physical activity as part of a healthy postpartum transition. Methods Thirty healthy women with infants aged 2.5–12 months completed 3-day activity diaries and an individual interview. Using Glaser and Charmaz’s grounded theory methodology, the core category, reconciling relationships with physical activity, was constructed, which explained women’s processes of postnatal physical activity decision-making. Results Through reconciling relationships with physical activity, women discerned the types of physical activity they were comfortable pursuing at various points in the postpartum transition. Based on the meaning physical activity held for participants and their views about risks, supports, and resources, women gauged their capacity and the workability of their physical activity desires. Most women were uncertain of their capacity (physical, emotional) to return to physical activity and viewed the achievement of several or all of their desired physical activities as unworkable. Only a small group of women fully pursued the desirable physical activities they viewed as important for their well-being. Women adjusted the strategies they used to achieve physical activity when their expectations of capacity and workability did not align with their experiences. Some women lacked access to resources or supportive messaging about postpartum physical activity and downgraded their physical activity pursuit after negative personal physical or childcare experiences. Conclusions Women can benefit from discussions about physiological birth recovery and navigating community and peer resources to support physical activity access and the safe return to physical activity following birth.

scholarly journals Adapting to Constraints - A Study of Green Star New Zealand's Effects on Decision Making using Classic Grounded Theory

2021 ◽  
Author(s):  
◽  
Hendrik Prins
Keyword(s):  
Decision Making ◽  
Grounded Theory ◽  
New Zealand ◽  
Construction Industry ◽  
Rating System ◽  
Rating Systems ◽  
Classic Grounded Theory ◽  
Decision Making Processes ◽  
Insight Into ◽  
Core Variable

<p>Over the last 25 years building rating systems have been developed to quantify and promote sustainable development in the construction industry. Many countries have now developed their own rating system and some systems have been adapted for international use. The different outcomes and results from their use have been under much scrutiny from developers, clients, industry, and academics. Concerns such as increased cost, points buying, and discrepancies between the rated design and completed projects have been identified.   In order to better understand why these concerns occur, the Green Star New Zealand rating system – adapted from Green Star Australia – was studied to quantify its effects on rated projects. The overall aim of this thesis was to investigate the effects of Green Star New Zealand on the decision making process. Specifically, the way in which this system affects the decision making processes during the design of a rated building was investigated to provide insight into reasons why these different outcomes may occur.   This was undertaken through a classic grounded theory study during which professionals experienced in the use of Green Star were interviewed, and the data collected from the interviews was inductively analysed to generate conceptual theory and concepts. The interview data and discussion with the participants identified that decision making is affected largely through the different constraints and conditions encountered when using Green Star and how they are adapted to. These are applied to decision making through a number of different ways, being directly or indirectly related to Green Star, something decided on with or without prior experience, or internal or external to the design team.  The analysis identified several categories which explained processes and behaviours resulting from the use of Green Star. These are ‘managing Green Star requirements’, ‘credit targeting’, ‘working with unknowns’, ‘disconnection of knowledge’, and ‘balancing project requirements’. It is these categories that caused adaptation to emerge as the primary process of resolving constraints, with ‘adapting to constraints’ emerging as the core variable.</p>

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