Early Management and Decision Making for the Treatment of Myelomeningocele: A Critique

PEDIATRICS ◽  
1984 ◽  
Vol 73 (4) ◽  
pp. 564-566
Author(s):  
JOHN M. FREEMAN
Keyword(s):  
Decision Making ◽  
Supportive Care ◽  
Ethical Dilemma ◽  
Recent Article ◽  
Early Management ◽  
Early Decision

In a recent article, Gross et al1 have set out to do something about early decision making and the management of children with myelomeningocele. They have set out to evaluate a program that they have developed, claim is workable, and claim addresses the present ethical dilemma surrounding this issue. Have they done something worthwhile? Have they done it well? First, let us look at what they have done. Of 68 babies with myelomeningocele, they have selected 33 babies (48%) for supportive care only. Twenty-six families accepted the team's recommendation and left their child in a special children's shelter. Of these babies, 24 died (mean 37 days). Two babies were treated later at the parents' request.

scholarly journals Responsible Leadership in Sport: An Ethical Dilemma

Societies ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 85
Author(s):  
Kathleen Rodenburg ◽  
Louise Hayes ◽  
Lianne Foti ◽  
Ann Pegoraro
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Ethical Decision ◽  
Olympic Games ◽  
Ethical Decision Making ◽  
Ethical Dilemmas ◽  
Responsible Leadership ◽  
Sports Organizations ◽  
Sport Industry ◽  
A Current

Sports, apart from providing entertainment, can provide an escape from everyday troubles, a community to belong to, and an opportunity to connect to the wider world. As such, sports have contributed to the unification of people, the development of peace and tolerance, and the empowerment of women and young people globally. However, sports’ widespread popularity has also contributed to “big money” opportunities for sports organizations, sporting venues, athletes, and sponsors that have created an environment riddled with ethical dilemmas that make headlines, resulting in protests and violence, and often leave society more divided. A current ethical dilemma faced by agents associated with the Olympic games serves to demonstrate the magnitude and challenges related to resolving ethical dilemmas in the sport industry. A decision-making framework is applied to this current sport’s ethical dilemma, as an example of how better ethical decision making might be achieved.

The Cable Contract

2013 ◽  
pp. 1-7
Author(s):  
Ravichandran Ramamoorthy
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Small Businesses ◽  
Ethical Issues ◽  
Personal Values ◽  
Moral Values ◽  
Decision Making Process ◽  
Government Organization ◽  
Key Stakeholders

The case deals with an ethical dilemma of an entrepreneur. Chandran, a qualified contractor, had secured an electrical contract from a premier government organization. It was a turnkey project to be executed in a given period of time. In the process of work, he comes across major problems. He could not abandon the project or compromise on his moral values. He wanted a way out to salvage this project that was slowly slipping from his control. This case examines the ethical issues that confront small businesses, employees, suppliers and key stakeholders of every organization and explores the mindset of participants, their personal values and their decision making rationale. The participants get an opportunity to identify with the difficult choices a business situation may throw when ethical mindset clashes with the decision making process.

P138 Urinary leukotriene E4 (uLTE4) pharmacodynamic biomarker for early decision making in the AZD9898 adaptive phase i study

2018 ◽  
Author(s):  
J Betts ◽  
B Larsson ◽  
A Jauhiainen ◽  
T Hegelund-Myrbäck ◽  
J Leander ◽  
...  
Keyword(s):  
Decision Making ◽  
Phase I ◽  
Phase I Study ◽  
Early Decision

scholarly journals Ethical Decision- Making Model for Thai Context

2018 ◽  
Vol 8 (2) ◽  
pp. 337
Author(s):  
Thamarat Jangsiriwattana ◽  
Sanober Salman ◽  
Boonthipa Jiantreeangkool
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
Relevant Literature ◽  
Buddhist Philosophy ◽  
Thai People ◽  
Decision Making Models ◽  
Decision Making Model ◽  
Thai Culture

The ethics issue has been receiving massive attention of today’s managers due to the publicized scandals and cases of fraud, bankruptcy and others. For managerial convenience numerous ethical decision making models were proposed by researchers, but six models are widely accepted by ethics based practitioners (Ferrell, Fraedrich & Ferrell, 2008). Each model has unique characteristics, which enhances understanding about ethical dilemma. This paper reviewed the relevant literature and utilized seven models: (Kelly & Elm, 2003; Jones, 1991; Ferrell, Gresham & Fraedrich, 1989; Hunt & Vitell, 1986; Trevino, 1986; Ferrell & Gresham, 1985; Kohlberg, 1969) and then cultivated ethical decision-making model for Thai context. In addition, the authors also reviewed the literature on Thai culture and focused on Buddhist philosophy, beliefs, values and norms of Thai people. Finally, the Seven ethical decision making models and Buddhist philosophy were integrated together to propose a model for ethical decision making for Thai organization.

scholarly journals Development and validation of a clinical score to estimate progression to severe or critical state in COVID-19 pneumonia hospitalized patients

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Francisco Gude ◽  
Vanessa Riveiro ◽  
Nuria Rodríguez-Núñez ◽  
Jorge Ricoy ◽  
Óscar Lado-Baleato ◽  
...  
Keyword(s):  
Decision Making ◽  
Predictive Model ◽  
Disease Progression ◽  
Clinical Laboratory ◽  
Severe Disease ◽  
Invasive Mechanical Ventilation ◽  
Risk Scores ◽  
Brier Score ◽  
Operating Characteristics ◽  
Early Decision

AbstractThe prognosis of a patient with COVID-19 pneumonia is uncertain. Our objective was to establish a predictive model of disease progression to facilitate early decision-making. A retrospective study was performed of patients admitted with COVID-19 pneumonia, classified as severe (admission to the intensive care unit, mechanic invasive ventilation, or death) or non-severe. A predictive model based on clinical, laboratory, and radiological parameters was built. The probability of progression to severe disease was estimated by logistic regression analysis. Calibration and discrimination (receiver operating characteristics curves and AUC) were assessed to determine model performance. During the study period 1152 patients presented with SARS-CoV-2 infection, of whom 229 (19.9%) were admitted for pneumonia. During hospitalization, 51 (22.3%) progressed to severe disease, of whom 26 required ICU care (11.4); 17 (7.4%) underwent invasive mechanical ventilation, and 32 (14%) died of any cause. Five predictors determined within 24 h of admission were identified: Diabetes, Age, Lymphocyte count, SaO2, and pH (DALSH score). The prediction model showed a good clinical performance, including discrimination (AUC 0.87 CI 0.81, 0.92) and calibration (Brier score = 0.11). In total, 0%, 12%, and 50% of patients with severity risk scores ≤ 5%, 6–25%, and > 25% exhibited disease progression, respectively. A risk score based on five factors predicts disease progression and facilitates early decision-making according to prognosis.

scholarly journals Influence of Guidelines in Endovascular Therapy Decision Making in Acute Ischemic Stroke

Stroke ◽  
2019 ◽  
Vol 50 (12) ◽  
pp. 3578-3584 ◽  
Author(s):  
Nima Kashani ◽  
Johanna M. Ospel ◽  
Bijoy K. Menon ◽  
Gustavo Saposnik ◽  
Mohammed Almekhlafi ◽  
...  
Keyword(s):  
Decision Making ◽  
Ischemic Stroke ◽  
Endovascular Treatment ◽  
Endovascular Therapy ◽  
American Heart Association ◽  
American Heart ◽  
Heart Association ◽  
Early Management ◽  
Stroke Treatment ◽  
Local Resources

Background and Purpose— The American Heart Association and the American Stroke Association guidelines for early management of patients with ischemic stroke offer guidance to physicians involved in acute stroke care and clarify endovascular treatment indications. The purpose of this study was to assess concordance of physicians’ endovascular treatment decision-making with current American Heart Association and the American Stroke Association stroke treatment guidelines using a survey-approach and to explore how decision-making in the absence of guideline recommendations is approached. Methods— In an international cross-sectional survey (UNMASK-EVT), physicians were randomly assigned 10 of 22 case scenarios (8 constructed with level 1A and 11 with level 2B evidence for endovascular treatment and 3 scenarios without guideline coverage) and asked to declare their treatment approach (1) under their current local resources and (2) assuming there were no external constraints. The proportion of physicians offering endovascular therapy (EVT) was calculated. Subgroup analysis was performed for different specialties, geographic regions, with regard to physicians’ age, endovascular, and general stroke treatment experience. Results— When facing level 1A evidence, participants decided in favor of EVT in 86.8% under current local resources and in 90.6% under assumed ideal conditions, that is, 9.4% decided against EVT even under assumed ideal conditions. In case scenarios with level 2B evidence, 66.3% decided to proceed with EVT under current local resources and 69.7% under assumed ideal conditions. Conclusions— There is potential for improving thinking around the decision to offer endovascular treatment, since physicians did not offer EVT even under assumed ideal conditions in 9.4% despite facing level 1A evidence. A majority of physicians would offer EVT even for level 2B evidence cases.

scholarly journals An Assessment of RFID Applications in Manufacturing Companies

2015 ◽  
Vol 6 (4) ◽  
pp. 33-42 ◽  
Author(s):  
Bartłomiej Gładysz
Keyword(s):  
Decision Making ◽  
Internet Of Things ◽  
Research Program ◽  
Cyber Physical Systems ◽  
Complex Method ◽  
Manufacturing Companies ◽  
Rfid Technology ◽  
Physical Systems ◽  
Early Decision ◽  
Rfid Applications

Abstract The meaning of Cyber Physical Systems and an Internet of Things with indication of RFID position in those concepts was outlined. Research program related to assessment of RFID technology was presented. Author deducted on problems related to RFID implementations and RFID essentially for logistics of manufacturing companies. Research goals and problems were formulated. Tools, techniques, models and methods that could be utilized were proposed and discussed. Research was focused on design of a new method to support early decision making phases for RFID application in logistics of manufacturing companies. Author stated that literature and practice lacks of complex method to answer if RFID is strategically important for the company, which processes should be RFID-supported, how RFID-supported processes should be designed and if RFID-support is rational. Framework for assessment of RFID technology with illustrative example was discussed.

In case of ethical dilemma, break glass: Commentary on ethical decision making in practice.

2007 ◽  
Vol 38 (1) ◽  
pp. 7-12 ◽  
Author(s):  
Jeffrey E. Barnett ◽  
Stephen H. Behnke ◽  
Susan L. Rosenthal ◽  
Gerald P. Koocher
Keyword(s):  
Decision Making ◽  
Ethical Dilemma ◽  
Ethical Decision ◽  
Ethical Decision Making
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