Putting children forward for epilepsy surgery:a qualitative study of UK parents' and health professionals' decision-making experiences

Background Against a backdrop of recommendations for increasing access to and uptake of early surgical intervention for children with medically intractable epilepsy, it is important to understand how parents and professionals decide to put children forward for epilepsy surgery and what their decisional support needs are. Aim The aim of this study was to explore how parents and health professionals make decisions regarding putting children forward for pediatric epilepsy surgery. Methods Individual interviews were conducted with nine parents of children who had undergone pediatric epilepsy surgery at a specialist children's hospital and ten healthcare professionals who made up the children's epilepsy surgery service multidisciplinary healthcare team (MDT). Three MDT meetings were also observed. Data were analyzed thematically. Findings Four themes were generated from analysis of interviews with parents: presentation of surgery as a treatment option, decision-making, looking back, and interventions. Three themes were generated from analysis of interviews/observations with health professionals: triangulating information, team working, and patient and family perspectives. Discussion Parents wanted more information and support in deciding to put their child forward for epilepsy surgery. They attempted to balance the potential benefits of surgery against any risks of harm. For health professionals, a multidisciplinary approach was seen as crucial to the decision-making process. Advocating for the family was perceived to be the responsibility of nonmedical professionals. Conclusion Decision-making can be supported by incorporating families into discussions regarding epilepsy surgery as a potential treatment option earlier in the process and by providing families with additional information and access to other parents with similar experiences.

Elemzés vagy megérzés: a stratégiai döntéshozatal gyakorlata Californiában és Magyarországon = Analysis or Intuition: Strategic decision making in California and Hungary

Stratégiai döntéseket jellemzően a vállalatok felsővezetői, vezérigazgatók és elnökök hoznak. Ennek szellemében 40 felsővezetőt kérdeztünk két nagyon különböző régióban (Kaliforniában és Magyarországon) egy összehasonlító kutatás keretében. A két országban tizenkét válaszadó vezérigazgató, elnök, alelnök, vagy felelős vezető volt (rájuk, mint Vezetőkre hivatkoztunk), miközben nyolcan alapítói és többségi tulajdonosai voltak saját vállalkozásuknak (őket nevezzük Vállalkozóknak). A kutatás három területre irányult: 1) Hogyan hoznak döntéseket a felsővezetők a valóságban a világ e két különböző táján; 2) Mennyiben különböznek - ha egyáltalán különböznek - a Vállalkozók és a Vezetők az alkalmazott döntéshozatali közelítésmódot tekintve, amikor az analitikus gondolkodást az intuícióikkal kombinálják; 3) Mik a hasonlóságok és a különbségek a menedzsment képességekben és a döntéshozatali rutinokban a Vállalkozók és a Vezetők között a vizsgált menedzsment kultúrákban. = Strategic decision making is usually conducted by a firm’s top management, led by the CEO or the President of the company. In keeping with this, 40 top level managers in two very different regions (California, USA and Hungary) were targeted in a comparative research study. In the two countries, twelve of the managers were CEOs, Presidents, Vice Presidents or Chief Officers (hereafter referred to as Executives) while eight were founders and majority owners of their own enterprises (hereafter referred to as Entrepreneurs). The research focused on the following 3 areas: 1) How top level managers really make strategic decisions in these two different parts of the world; 2) How Entrepreneurs and Executives differ, if at all, in their approach to strategic decision making when they combine analytical thinking with their intuition; 3) The similarities and differences in management skills and decision making routines between Entrepreneurs and Executives within the investigated management cultures.

Decision support system for production control: Multiple criteria decision making in practice

This paper presents a development of decision support systems for solving scheduling problems. It consists of two parts — the first describing the production processes which can be handled by the system and the second describing how the system works.