scholarly journals Hospital Factors That Influence ICU Admission Decision-Making: An Ethnographic Study of Six Hospitals

Author(s):  
T.S. Valley ◽  
L. Miles ◽  
H. Kinni ◽  
T.J. Iwashyna ◽  
C.R. Cooke
2021 ◽  
pp. 251484862110150
Author(s):  
Svetoslava Toncheva ◽  
Robert Fletcher

This article explores a case of human–wildlife cohabitation in the Rodopi mountains of Bulgaria, wherein people and brown bears ( Ursus arctos) have adapted to living together in relative harmony. While this is due to a variety of factors, chief among these is the way both people and bears appear to pursue knowledge of one another and act on this knowledge so as to actively minimize potential for conflict. We draw on this case to contribute to growing discussion concerning how nonhumans should be understood and included within conservation policymaking. While conservation has conventionally been understood as something humans do on behalf of other species, a growing body of “more-than-human” research challenges this perspective as “anthropocentric” in arguing that nonhumans should be considered “co-constitutive actors” of the spaces they occupy. Based on this understanding, some go so far as to assert that a “multispecies ethics” demands that nonhumans be actively included in decision-making concerning such spaces’ governance. While our study indeed demonstrates that both humans and bears seem to mold their behavior in relation to their sensing of the other’s behavior, it also demonstrates that knowledge of bears’ behavior is ultimately always interpreted by humans in conservation management. Moreover, different groups of stakeholders hold different knowledge of bears that influence their attitudes and behavior towards the animals. The study thus raises important questions concerning how to incorporate bears (and other nonhumans) within conservation decision-making, and whose knowledge should be privileged in the process.


2020 ◽  
Vol 17 (3) ◽  
pp. 361-391
Author(s):  
Eduardo Guedes Villar ◽  
Karina De Deá Róglio ◽  
Natália Rese

Motivated by an agenda for empirical research on decisions, we seek to understand how an issue or idea is labelled as a "decision". Based on the relational ontology, we used the Actor-Network Theory as a theoretical frame, and particularly the translation perspective. In order to understand the "process of formation and stabilization of decisions" focused on what makes actors act, we conducted an ethnographic study in a social enterprise for 30 months. Through narrative analysis, we propose the (trans)formative trajectories of decisions in which we describe the trajectory of these hybrid entities achieving the status of relative fixity labelled as "the decision". We understand the trajectory as an ongoing translation journey; thus, we tracked decisions in their trajectories of translation, packaging and legitimation. The elements of the organizational decision-making are re-signified as performative texts, which enter the network of relations. Therefore, decisions are (trans)formed on a journey of mediation among multiple actants. When objectified as crystallized texts, the decisions become performative, because they start to organize and participate in the constitution of the ongoing reality. This theoretical framework allowed us to extend the processual understanding of decision-making aligned with the relational ontology and the time-process perspective.


2010 ◽  
Vol 112 (12) ◽  
pp. 3074-3101 ◽  
Author(s):  
Margy Mcclain

Background/Context This article explores the experiences of one Mexican American family as they make a key curriculum choice for their 9-year-old son. Relatively little attention has been paid to parents’ beliefs, attitudes, and, in particular, experiences as they actively engage in—and sometimes affect—their children's schooling. Parents’ agency in utilizing various kinds of educational strategizing, especially immigrant and urban working-class parents, has been overlooked. Deficit theories of low-income families have a long history in educational thought. Although more recent scholarship has debunked these theories, they remain pervasive across the country. Educators often do not recognize the many ways in which urban parents may be involved in their children's schooling. Voices of parents themselves speaking to their experiences with schools are just beginning to emerge. Purpose This article offers a rich example of the educational decision-making process of one Mexican American family. I take a phenomenological approach to examine human agency in specific familial decisions about this child's schooling that support the parents’ own vision of education. Here is a story of thoughtful, reflective decision-making that took place over a period of several years, when the parents finally decided to move their son from a transitional bilingual program at a public school to a parochial school taught in English. Research Design This is a narrative inquiry based on interviews and observations that took place with one family and one focal child through the course of a calendar year. It is situated within the frame of an ethnographic study on the educational life worlds of the family. The analysis draws on van Manen's use of phenomenology to examine how parents reflected upon experience to better understand a situation, resulting in “lived experience,” an understanding of the meanings a particular person finds in an event. Conclusions/Recommendations Immigrant and other urban parents may be actively engaged in their children's education, asking important and valid curriculum questions in ways that remain invisible to educators. I suggest alternatives to deficit theories that render parents’ perspectives invisible. Terms usually reserved for teachers can also be applied to parents: “knowledgeable observers” who make “pedagogically thoughtful” decisions about “curriculum.” This perspective would recommend that educational practice and policy use theoretical frameworks stressing parents’ roles as strong, positive, and active agents on behalf of their children and the need to develop dialogue based on respect. Further qualitative research in particular can provide needed depth in our understanding of parents’ struggles to negotiate the boundaries of culture, history and biography as they guide their children through the complex maze of school.


2020 ◽  
Vol 30 (7) ◽  
pp. 1114-1124
Author(s):  
Isabel Frey ◽  
Marike E. De Boer ◽  
Leonie Dronkert ◽  
A. Jeannette Pols ◽  
Marieke C. Visser ◽  
...  

This is an ethnographic study of decision-making concerning tube feeding in the acute phase after a severe stroke. It is based on 6 months of ethnographic research in three stroke units in the Netherlands, where the decision-making on life-sustaining treatment was studied in 16 cases of severe stroke patients. Data were collected through participant observation and interviews. For this article, the analysis was narrowed down to the decision whether or not the patient should receive tube feeding. The data on tube feeding were assembled and coded according to different modes of dealing with this decision in clinical practice, which we refer to as “repertoires.” We discerned three different repertoires: choice, necessity, and comfort. Each repertoire structures clinical practice differently: It implies distinctive ethical imperatives, central concerns, sources of information, and temporalities. We hope our findings can improve decision-making by uncovering its underlying logics in clinical practice.


2017 ◽  
Vol 65 (6) ◽  
pp. 8S ◽  
Author(s):  
Caitlin Hicks ◽  
Husain Alshaikh ◽  
Devin Zarkowsky ◽  
Ian Bostock ◽  
Mahmoud Malas

2020 ◽  
Author(s):  
Nynikka R. Palmer ◽  
Richard L. Street ◽  
Dean Schillinger ◽  
Janet K. Shim ◽  
Sarah D. Blaschko ◽  
...  

2004 ◽  
Vol 15 (1) ◽  
pp. 32-49 ◽  
Author(s):  
Adrian Grounds ◽  
Loraine Gelsthorpe ◽  
Marie Howes ◽  
David Melzer ◽  
Brian DM Tom ◽  
...  

Sign in / Sign up

Export Citation Format

Share Document