scholarly journals To feed, or not to feed? Evaluating enteral nutrition practices in surgical neonates

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Cassandra Anderson ◽  
Manisha Bhatia ◽  
JoAnna Hunter-Squires ◽  
Peter Saula ◽  
Brian Gray
Keyword(s):  
Decision Making ◽  
Enteral Nutrition ◽  
Enteral Feeding ◽  
Pediatric Surgery ◽  
Feeding Practices ◽  
Abdominal Distension ◽  
The United States ◽  
Clinical Factors ◽  
Nutrition Practices ◽  
Decision Making Processes

Background: Early enteral feeding initiation following surgical procedures in neonates has demonstrated several benefits. In high income countries, where parenteral nutrition is readily available, enteral feeding initiation is often delayed. This study seeks to examine clinical factors and decision-making processes that guide nutrition practices in surgical neonates in the United States (US) and Kenya.   Methods: A REDCap survey was developed and distributed to pediatric surgery attendings and fellows at Riley and Peyton Manning Children’s Hospitals in Indiana (US) and Shoe4Africa Children’s and AIC Kijabe Hospitals in Kenya. Nine responses were collected during the initial two-week long pilot, then analyzed using REDCap and SPSS 25.   Results: Responses were collected from eight pediatric surgery attendings and a fellow practicing in Indianapolis, IN. The three most highly ranked clinical factors important for initiation of enteral feeds were stability of the patient, nasogastric or orogastric output color, and gastric output volume. Factors most highly ranked for advancement of feeds included frequency and volume of emesis and abdominal distension. These factors were similarly ranked for foregut and hindgut procedures. Protocols for pyloric stenosis (n=6) include initiation of enteral nutrition within 24-48 hours.  Four of nine respondents felt that surgeons at their institution are not aggressive enough in feeding surgical neonates. The primary perceived barrier to achieving full enteral nutrition was patient gut dysmotility (n=8). All respondents felt that they were similarly (n=4) or more (n=5) proactive in feeding surgical neonates compared to their peers.   Conclusions and Impact: Feeding practices in surgical neonates are dependent on individual clinician decision-making processes and patient factors. Once the data from the Kenyan surgeons is collected, comparisons between practice patterns will be analyzed. Real-world enteral feeding practices will be evaluated in an adjunct observational study, which we hope will inform protocols with earlier enteral feeding initiation in the future.  

Naming Crime Suspects in the News

2017 ◽  
pp. 207-225
Author(s):  
Robin Blom
Keyword(s):  
United States ◽  
Decision Making ◽  
The Netherlands ◽  
News Media ◽  
The United States ◽  
Online Search ◽  
Ethics Codes ◽  
Search Results ◽  
Crime News ◽  
Decision Making Processes

Whereas some news outlets fully identify crime suspects with name, age, address, and other personal details, other news outlets refuse to fully identify any crime suspect—or even people who have been convicted for a crime. News media from a variety of countries have accused and fully identified people of being responsible for crimes, although those persons turned out to be innocent. Yet, when someone types the names of those people in online search engines, for many, stories containing the accusations will turn up at the top of the search results. This chapter examines the positive and negative aspects from those practices by examining journalistic routines in a variety of countries, such as the United States, Nigeria, and The Netherlands. This analysis demonstrates that important ethical imperatives—often represented in ethics codes of professional journalism organizations—can be contradictory in these decision-making processes. Journalists need to weigh whether they would like to “seek truth and report it” or “minimize harm” when describing crime suspects.

An Exploration of Ethical Decision-making Processes in the United States and Egypt

2007 ◽  
Vol 82 (3) ◽  
pp. 587-605 ◽  
Author(s):  
Rafik I. Beekun ◽  
Ramda Hamdy ◽  
James W. Westerman ◽  
Hassan R. HassabElnaby
Keyword(s):  
United States ◽  
Decision Making ◽  
Ethical Decision ◽  
Ethical Decision Making ◽  
The United States ◽  
Decision Making Processes

scholarly journals Decision Making for Managing Community Flood Risks: Perspectives of United States Floodplain Managers

2021 ◽  
Author(s):  
Jenna Tyler ◽  
Abdul-Akeem Sadiq ◽  
Douglas S. Noonan ◽  
Rebecca M. Entress
Keyword(s):  
United States ◽  
Decision Making ◽  
Flood Management ◽  
The United States ◽  
Poverty Rate ◽  
Management Decision ◽  
Flood Risks ◽  
Management Decision Making ◽  
Decision Making Processes

AbstractTo reduce flood losses, floodplain managers make decisions on how to effectively manage their community’s flood risks. While there is a growing body of research that examines how individuals and households make decisions to manage their flood risks, far less attention has been directed at understanding the decision-making processes for flood management at the community level. This study aimed to narrow this research gap by examining floodplain managers’ perceptions of the quality of their community’s flood management decision-making processes. Data gathered from interviews with 200 floodplain managers in the United States indicate that most floodplain managers perceive their community’s flood management decision-making processes to be good. The results also indicate that communities participating in the Federal Emergency Management Agency’s Community Rating System, as well as communities with a higher level of concern for flooding and a lower poverty rate, are significantly more likely to report better flood management decision-making processes.

scholarly journals Improving Best Management Practice Decisions in Mixed Land Use and/or Municipal Watersheds: Should Approaches Be Standardized?

Land ◽  
2021 ◽  
Vol 10 (12) ◽  
pp. 1402
Author(s):  
Jason A. Hubbart
Keyword(s):  
Decision Making ◽  
Best Management Practices ◽  
Management Practices ◽  
Management Practice ◽  
The United States ◽  
Decision Makers ◽  
Monitoring Methods ◽  
Best Management ◽  
Mixed Use ◽  
Decision Making Processes

Best management practices (BMP) are defined in the United States Clean Water Act (CWA) as practices or measures that have been demonstrated to be successful in protecting a given water resource from nonpoint source pollution. Unfortunately, the greatest majority of BMPs remain unvalidated in terms of demonstrations of success. Further, there is not a broadly accepted or standardized process of BMP implementation and monitoring methods. Conceivably, if standardized BMP validations were a possibility, practices would be much more transferrable, comparable, and prescriptive. The purpose of this brief communication is to present a generalized yet integrated and customizable BMP decision-making process to encourage decision makers to more deliberately work towards the establishment of standardized approaches to BMP monitoring and validation in mixed-use and/or municipal watersheds. Decision-making processes and challenges to BMP implementation and monitoring are presented that should be considered to advance the practice(s) of BMP implementation. Acceptance of standard approaches may result in more organized and transferrable BMP implementation policies and increased confidence in the responsible use of taxpayer dollars through broad acceptance of methods that yield predictable and replicable results.

Foreign Policy Decision-Making

2019 ◽  
Author(s):  
Jessica D. Blankshain
Keyword(s):  
Decision Making ◽  
Foreign Policy ◽  
Policy Decision ◽  
The United States ◽  
Foreign Policy Analysis ◽  
Political Factors ◽  
Interpersonal Dynamics ◽  
The Us ◽  
Decision Making Processes ◽  
Policy Decision Making

The study of foreign policy decision-making seeks to understand how states formulate and enact foreign policy. It views foreign policy as a series of decisions made by particular actors using specific decision-making processes. The origins of this focus on decision-making are generally traced to the 1950s and 1960s, with the literature increasing in complexity and diversity of approaches in more recent decades. Foreign policy decision-making is situated within foreign policy analysis (a subfield of international relations subfield), which applies theories and methods from an array of disciplines—political science, public administration, economics, psychology, sociology—to understand how states make foreign policy, and how these policies translate into geopolitical outcomes. The literature on foreign policy decision-making is often subdivided based on assumptions about the process by which actors make foreign policy decisions—primarily falling into rational and nonrational decision-making; about who is assumed to make the decision—states, individuals, groups, or organizations; and about the influences believed to be most important in affecting those decisions—international factors, domestic political factors, interpersonal dynamics, etc. While much of the literature focuses on foreign policy decision-making in the United States, there have been attempts to apply models developed in the US context to other states, as well as to generate generalizable theories about foreign policy decision-making that apply to certain types of states.

scholarly journals Factors Affecting Decision-Making Processes in Virtual Teams in the UAE

Information ◽  
2020 ◽  
Vol 11 (10) ◽  
pp. 490
Author(s):  
Vida Davidaviciene ◽  
Khaled Al Majzoub ◽  
Ieva Meidute-Kavaliauskiene
Keyword(s):  
Decision Making ◽  
Middle East ◽  
Organizational Performance ◽  
Information Sharing ◽  
Virtual Teams ◽  
United Arab Emirates ◽  
Direct Effect ◽  
The United States ◽  
Factors Affecting ◽  
Decision Making Processes

Organizational reliance on virtual teams (VTs) is increasing tremendously due to the significant benefits they offer, such as efficiently reaching objectives and increasing organizational performance. However, VTs face a lot of challenges that, if overlooked, will prevent them from yielding the required benefits. One of the major issues that hinders the effectiveness of VTs is the decision-making process. There is a lack of scientific research that attempts to understand the factors affecting decision making processes in VTs. Studies in this area have only been done in the United States and Europe. However, such research has not been conducted in the Middle East, where specific scientific solutions are still required to improve the performance of VTs. Therefore, this study is conducted in the Middle East, namely in the United Arab Emirates, to gain scientific knowledge on this region’s specificity. An online questionnaire (Google forms) was used to obtain the necessary data. Hypotheses were developed to test the influence of ICT (Information and communications technologies), language, information sharing, and trust on the decision-making processes, and the effect of decision making on team performance. Structural equational model (SEM) methodology was used to test our proposed model. The results showed that factors such as trust, ICT, and information sharing have a direct effect on decision-making processes, while language has no effect on decision making, and decision-making processes have a direct effect on the performance of the VTs.

INFLUENCE OF LOBBYING ON THE KARABAKH CONFLICT

2020 ◽  
Vol 12 (3) ◽  
pp. 48-52
Author(s):  
Yulduzkhan Imomova ◽  
Keyword(s):  
United States ◽  
Decision Making ◽  
The United States ◽  
Political Position ◽  
Decision Making Processes

This article examines the role and influence of ethnic lobby groups that exert pressure on decision-making processes regarding the Karabakh conflict. The lobby groups actively operate in democratic states such as the United States, Russia and Turkey and form a political position on the war between Azerbaijan and Armenia, which in turn may affect the consequences of the conflict

Secret sauce in collaborative tumor boards: Team-based characteristics that optimize tumor board functionality.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e23015-e23015
Author(s):  
Barbara Oureilidis-DeVivo
Keyword(s):  
Decision Making ◽  
Best Practices ◽  
Organizational Behavior ◽  
Treatment Decision ◽  
The United States ◽  
Interdisciplinary Teams ◽  
Tumor Board ◽  
Treatment Decision Making ◽  
Tumor Boards ◽  
Decision Making Processes

e23015 Background: Interdisciplinary teams are an indispensable characteristic of modern organizations, particularly in healthcare settings that require specialists to work together to solve multifaceted patient care problems. Multidisciplinary tumor boards (TBs) aim to coordinate multidisciplinary perspectives to help the oncology team devise the best treatment program for the patient. Yet, while this is their purpose, studies have found that TBs do not always achieve that goal effectively. Why are some tumor board (TB) teams more effective than others? This study shed light on key characteristics found among highly effective TBs. It provides a theoretical explanation of their organizational behaviors and structures and their effect on cancer treatment decision-making. The research is grounded in organizational behavior theories that have historical prominence in group decision-making, social hierarchy, and interdisciplinary collaboration, and are used to explain the phenomenon under investigation best. Methods: Qualitative research was used in the study. Data from 44 different TB observations and 18 interviews were gathered over four years at seven research hospitals in the United States and United Kingdom. The data were then coded, analyzed and synthesized with organizational behavior theory to explain the social phenomena under investigation. Results: The study revealed that certain TBs practice strong collaboration displaying high levels of partnership, cooperation, equality, and interdependency, which was incorporated explicitly into their meeting systems to achieve their common goal. Team-based characteristics such as members’ consistent shared preferences and identity, coordinated interactions, a collective learning process, and shared power and partnership are key markers found within these teams that positively influenced treatment decision-making processes and outcomes, earmarking best practices in TB groups. Conclusions: Organizational theory that suggests that for a collaborative process to be effective, team-based mechanisms need to be adopted in which each member respects, trusts, and acknowledges the skills and expertise of other disciplines in the organization, shares team values, decision-making processes, responsibilities, and planning, relies mutually upon other team members, and works outside normal professional boundaries openly and willingly. In an egalitarian structure like that of the TBs reviewed in this study, where preferences and identities are consistent and groups are collaborative, treatment decisions are less biased and incorporate multidisciplinary perspectives. Thus, this study suggests that by possessing both team- and task-based characteristics and practices, TBs engage in best practices, and thereby optimize their functionality.

Why Does Planning Matter in Microclimate Management and Urban Heat Mitigation?

2019 ◽  
pp. 0739456X1988300 ◽  
Author(s):  
Mehdi P. Heris ◽  
Brian Muller ◽  
Alana M. Wilson
Keyword(s):  
United States ◽  
Decision Making ◽  
The United States ◽  
Design Guidelines ◽  
Policy Choices ◽  
Mixed Use ◽  
Decision Making Processes ◽  
Key Variables ◽  
Urban Heat ◽  
Main Factors

In this paper, we examine two mixed-use redevelopment projects in the United States, including both regulatory and procedural contexts, to assess how decision-making processes affected microclimate outcomes. We investigate Belmar in Lakewood, CO and 29th Street Mall in Boulder, CO. Measurements and simulations of microclimate show that Belmar mitigates urban heat more effectively. Policies including building height, street patterns, and landscaping standards were key variables in this outcome. Through interviews and content analysis, we found five main factors shaping those policy choices: (1) urban vision, (2) land use and form controls, (3) design guidelines, (4) public financing, and (5) ownership/condemnation factors.

scholarly journals U.S. Men’s Perceptions and Experiences of Emergency Contraceptives

2015 ◽  
Vol 11 (3) ◽  
pp. 469-478 ◽  
Author(s):  
Rachel L. Wright ◽  
Peter R. Fawson ◽  
Caren J. Frost ◽  
David K. Turok
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Reproductive Health ◽  
Intrauterine Device ◽  
The United States ◽  
Future Research ◽  
Positive Health ◽  
Health Decision ◽  
Decision Making Processes ◽  
Positive Health Outcomes

Research suggests that men should be included in reproductive health decision making to help enhance positive health outcomes for their partners. Men affect the use of contraception and what method is used. Men’s decisions may be affected by different factors such as gender, education, and the nature of their sexual relationship. A qualitative study was conducted to explore males’ experiences and perceptions about emergency contraception (EC), and the meanings males assign to EC. Semistructured in-depth focus groups were held with 15 men who engage in heterosexual activity recruited from a university setting in the United States. Participants expressed egalitarian views of the contraception decision-making processes, a sense of responsibility regarding reproductive decision making, and that society has a negative stigma toward those who use EC. However, there was a lack of knowledge regarding the copper intrauterine device, which was not viewed as a method of EC. Exploring the role and needs of men in reproductive health care discussions and research is an important and growing area. Recommendations are provided for health care practitioners, policy, and future research around men and EC.

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