Termination of pregnancy following a Down Syndrome diagnosis: decision-making process and influential factors in a Muslim but secular country, Turkey

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Duygu Adiyaman ◽  
Bahar Konuralp Atakul ◽  
Melda Kuyucu ◽  
Alkim Gulsah Sahingoz Yildirim ◽  
Halil Gursoy Pala
Keyword(s):  
Decision Making ◽  
Down Syndrome ◽  
Chromosome Analysis ◽  
Tertiary Hospital ◽  
Influential Factors ◽  
Termination Of Pregnancy ◽  
Decision Making Process ◽  
Muslim Country ◽  
Hospital Data ◽  
Maternal Characteristics

AbstractShort CommunicationsThis study aims to present the termination of pregnancy (TOP) rates and elucidate the decision-making process following a prenatal diagnosis of Trisomy 21 in Turkey.Objectives and MethodsThis retrospective single-center study was conducted with 146 pregnant women between January 2016 and December 2019 in a tertiary hospital. Data on maternal characteristics, sonographic findings, indications for chromosome analysis, and educational, religious, and economic factors that can influence the parental decision process were collected.ResultsThe TOP rate of Down syndrome (DS) in our center was 78.8%. We concluded that maternal age, earlier diagnosis, indication for chromosome analysis, and previous pregnancies had no effect on the TOP decision. On the other hand, not having a minor or a major sonographic sign, employed mothers, middle- and high-income families, and families having a secondary or higher education tended to terminate the pregnancy affected by DS at statistically higher rates.ConclusionsThere are many studies worldwide investigating the TOP preferences for DS. However, there is limited data about TOP rates and influential factors affecting the decision-making process in Muslim countries. This study contributes by clarifying the factors in the decision-making process and elucidating perspectives about TOP in a Muslim country with a unique status: Turkey.

scholarly journals Termination of pregnancy following a prenatal diagnosis of Down syndrome: A qualitative study of the decision-making process of pregnant couples

2018 ◽  
Vol 97 (10) ◽  
pp. 1228-1236 ◽  
Author(s):  
Stina Lou ◽  
Kathrine Carstensen ◽  
Olav Bjørn Petersen ◽  
Camilla Palmhøj Nielsen ◽  
Lone Hvidman ◽  
...  
Keyword(s):  
Decision Making ◽  
Down Syndrome ◽  
Prenatal Diagnosis ◽  
Qualitative Study ◽  
Termination Of Pregnancy ◽  
Decision Making Process

Factors influencing cruise vacations: the impact of online reviews and environmental friendliness

2019 ◽  
Vol 74 (3) ◽  
pp. 400-415 ◽  
Author(s):  
Frida Bahja ◽  
Cihan Cobanoglu ◽  
Katerina Berezina ◽  
Carolin Lusby
Keyword(s):  
Decision Making ◽  
Influencing Factors ◽  
Online Reviews ◽  
Influential Factors ◽  
Decision Making Process ◽  
Relative Importance ◽  
Environmental Friendliness ◽  
Content Type ◽  
Cruise Line ◽  
The Impact

Purpose The purpose of the study was to discover the relative importance of influencing factors toward booking a cruise vacation. Based on a review of literature, this study focused on exploring the relative importance of six influential factors in cruise customers’ decision-making process: cruise vacation price, cruise duration, distance from the cruise port, itineraries, environmental friendliness of cruise line and cruise online reviews. Design/methodology/approach The complexity of cruise customers’ decision-making process for involving these six attributes with several levels was examined with choice-based conjoint (CBC) analysis. CBC was selected due to its realistic approach to purchase decisions, in the form of trade-offs. The online survey collected data anonymously. The survey was distributed through Amazon’s Mechanical Turk (Mturk) platform. The sample consisted of 450 cruise customers, who had experienced a cruise vacation before. Findings The findings of the study showed that online reviews were the most influential attribute for cruise customers in their cruise decision, followed very closely by the environmental friendliness of the cruise line. The next influential factor was the duration of the cruise vacation, which was followed by distance from the cruise port, cruise itinerary and cruise vacation price. The best and the worst cruise vacation profiles were generated based on the CBC analysis. Practical implications The findings of this study provide some insights with regard to cruise customers’ importance about influencing factors when deciding on a cruise vacation. Originality/value The research provides insides in understanding the influential factors at the last stage of cruise customers’ decision-making process. In this regard, cruise industry can pay more attention in promoting the attributes of a cruise offer as influential factors. Additionally, the findings of this study contribute to the general knowledge about cruise customers’ decision-making process.

The Decision-Making Process for Requests for Late Termination of Pregnancy in Israel

2001 ◽  
Vol 26 (2) ◽  
pp. 98-104 ◽  
Author(s):  
R. Gagin ◽  
O. Oded ◽  
M. Cohen ◽  
J. Itskovitz
Keyword(s):  
Decision Making ◽  
Termination Of Pregnancy ◽  
Decision Making Process

scholarly journals The three-axes model of planning in physical education (El modelo de planificación de tres ejes en Educación Física)

Retos ◽  
2017 ◽  
pp. 313-319
Author(s):  
Jesús Viciana ◽  
Daniel Mayorga-Vega
Keyword(s):  
Decision Making ◽  
Physical Education ◽  
Influential Factors ◽  
Physical Education Teachers ◽  
Decision Making Process ◽  
High Complexity ◽  
Toma De Decisiones ◽  
Practical Recommendations

The high complexity of planning Physical Education is due to the great quantity of factors that influence its process. Consequently, many doubts appear in the decision-making process of any formational stage of Physical Education teachers. There is a lack of theoretical-practical tools that help teachers to be their own constructors of their curriculum by helping them to design their own proposals, instead of using proposals made by others. The main purpose of this study was to provide Physical Education teachers a theoretical and practical framework, which will guide them in the decisional making process during planning, in order to include in their teaching all the influential factors that need to be taken into account. The three-axes model of planning is discussed as a guide for planning Physical Education, helping teachers through practical recommendations and proposing strategies in each axis in order to prepare an effective Physical Education planning.Resumen. La alta complejidad de la planificación de la Educación Física radica en la gran cantidad de factores que influyen en su proceso. Debido a ello, aparecen numerosas dudas en el proceso de toma de decisiones y en cualquier etapa de formación del docente de Educación Física. En determinados aspectos de la enseñanza como la planificación, existe una falta de herramientas teórico-prácticas que ayuden a los profesores a ser constructores de sus propios currículos, que les ayuden a diseñar sus propias propuestas curriculares y evitar así el uso descontextualizado de propuestas hechas por terceros. El principal propósito de este artículo es proporcionar a los profesores de Educación Física un marco teórico y práctico sobre el que basar y guiar sus decisiones de planificación cuando estén preparando sus currículos específicos, incluyendo así todos los factores influyentes que necesitan tener en cuenta en su enseñanza de la Educación Física. El modelo de tres ejes de la planificación es discutido como una guía para planificar la Educación Física, una ayuda de profesores a través de recomendaciones prácticas, y además propone estrategias en cada eje del modelo para preparar un plan efectivo de Educación Física.

A qualitative investigation of the decision-making process of couples considering prenatal screening for Down syndrome

2012 ◽  
Vol 32 (1) ◽  
pp. 57-63 ◽  
Author(s):  
Fran E. Carroll ◽  
Amanda Owen-Smith ◽  
Alison Shaw ◽  
Alan A. Montgomery
Keyword(s):  
Decision Making ◽  
Down Syndrome ◽  
Prenatal Screening ◽  
Decision Making Process ◽  
Qualitative Investigation

scholarly journals Social and cultural construction processes involved in HPV vaccine hesitancy among Chinese women: a qualitative study

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Judy Yuen-man Siu ◽  
Timothy K. F. Fung ◽  
Leo Ho-man Leung
Keyword(s):  
Decision Making ◽  
Hong Kong ◽  
Hpv Vaccine ◽  
Hpv Vaccination ◽  
Influential Factors ◽  
Medical System ◽  
World Health ◽  
Vaccine Hesitancy ◽  
Decision Making Process ◽  
Hpv Vaccines

Abstract Background HPV vaccine is a prophylactic vaccine to prevent HPV infections. Recommended by the World Health Organization, this vaccine is clinically proven to be one of the most effective preventive measures against the prevalence of cervical cancer and other HPV-associated cancers and chronic genital conditions. However, its uptake rate among women in Hong Kong is insignificant—only approximately 2.9% adolescent girls and 9.7% female university students received HPV vaccination in 2014. With the notion of Critical Medical Anthropology, we aimed to identify if different influential factors, ranging from individual, societal, and cultural, are involved in the decision-making process of whether to receive HPV vaccination. Methods We adopted a qualitative approach and conducted in-depth individual semistructured interviews with 40 women in Hong Kong between May and August 2017. Results We noted that the following factors intertwined to influence the decision-making process: perceptions of HPV and HPV vaccine; perceived worthiness of HPV vaccines, which was in turn influenced by vaccine cost, marriage plans, and experiences of sexual activities; history of experiencing gynecological conditions, stigma associated with HPV vaccination, acquisition of information on HPV vaccines, distrust on HPV vaccines, and absence of preventive care in the healthcare practice. Conclusions HPV vaccination is promoted in a manner that is “feminized” and “moralized” under the patriarchal value system, further imposing the burden of disease on women, and leading to health inequality of women in pursuing the vaccination as a preventive health behaviour as a result. We believe that this ultimately results in an incomplete understanding of HPV, consequently influencing the decision-making process. The “mixed-economy” medical system adopting capitalist logic also molds a weak doctor–patient relationship, leading to distrust in private practice medical system, which affects the accessibility of information regarding HPV vaccination for participants to make the decision.

scholarly journals Physicians’ Views and Agreement about Patient- and Context-Related Factors Influencing ICU Admission Decisions: A Prospective Study

2021 ◽  
Vol 10 (14) ◽  
pp. 3068
Author(s):  
Stéphane Cullati ◽  
Thomas V. Perneger ◽  
Fabienne Scherer ◽  
Mathieu Nendaz ◽  
Monica Escher
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Advanced Disease ◽  
Kappa Statistic ◽  
Tertiary Hospital ◽  
Decision Making Process ◽  
Related Factors ◽  
Code Status ◽  
Icu Admission ◽  
Admission Decisions

Background: Single patient- and context-related factors have been associated with admission decisions to intensive care. How physicians weigh various factors and integrate them into the decision-making process is not well known. Objectives: First, to determine which patient- and context-related factors influence admission decisions according to physicians, and their agreement about these determinants; and second, to examine whether there are differences for patients with and without advanced disease. Method: This study was conducted in one tertiary hospital. Consecutive ICU consultations for medical inpatients were prospectively included. Involved physicians, i.e., internists and intensivists, rated the importance of 13 factors for each decision on a Likert scale (1 = negligible to 5 = predominant). We cross-tabulated these factors by presence or absence of advanced disease and examined the degree of agreement between internists and intensivists using the kappa statistic. Results: Of 201 evaluated patients, 105 (52.2%) had an advanced disease, and 140 (69.7%) were admitted to intensive care. The mean number of important factors per decision was 3.5 (SD 2.4) for intensivists and 4.4 (SD 2.1) for internists. Patient’s comorbidities, quality of life, preferences, and code status were most often mentioned. Inter-rater agreement was low for the whole population and after stratifying for patients with and without advanced disease. Kappa values ranged from 0.02 to 0.34 for all the patients, from −0.05 to 0.42 for patients with advanced disease, and from −0.08 to 0.32 for patients without advanced disease. The best agreement was found for family preferences. Conclusion: Poor agreement between physicians about patient- and context-related determinants of ICU admission suggests a lack of explicitness during the decision-making process. The potential consequences are increased variability and inequity regarding which patients are admitted. Timely advance care planning involving families could help physicians make the decision most concordant with patient preferences.

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