Decision making during the prenatal diagnostic procedure. A questionnaire and interview study of 211 women participating in prenatal diagnosis

Counselling in connection with prenatal diagnosis (PND) is a common task for the obstetrician and the midwife. However, the decision making processes of pregnant women are not completely known, for instance, the questions of women's autonomy, the decision on how to act in the case of an abnormal test, and the partner's participation in the decision. A questionnaire and interview study was carried out among 211 women undergoing PND by amniocentesis or chorionic villus biopsy. Most women in the sample indicated that PND was completely voluntary. However, at the same time almost every woman reported that it was difficult to decline from PND when offered. Even before the visit to register at the antenatal clinic, most of the women (83 per cent) had made up their minds to have PND. At the time of the test, many of the participants (62 per cent) had decided in favour of a legal abortion if the test indicated an abnormality in the fetus. At the same time, however, the data indicate a need for reflection and ambivalence, which the medical staff have to accept. In the questionnaire most of the women stated that they and their partners had similar attitudes towards PND, but when interviewed 38 per cent of the women admitted some differences between their own attitudes and their partners'. Although some women reported considerable deliberation and ambivalence, most of them said that they would undergo PND in another pregnancy.     

Case studies of occupational falls from heights: cognition and behavior in context

PROBLEM: The aim of this study was to examine individual workers' cognitive, behavioral, and motivational processes leading up to occupational falls from heights. METHOD: The study is based on 26 semistructured personal interviews and on-site investigations with male workers who reported to an emergency department for treatment of injuries due to falls from heights. RESULTS: A greater number of workers carrying out nonroutine compared to routine tasks perceived, identified, interpreted, and attempted to control a fall hazard. Two cases are presented illustrating how cognition and behavior in context progresses from a lesser to a greater active role in the incident processes. SUMMARY AND IMPACT ON INDUSTRY: The addition of full-scale investigations of how and why workers thought and behaved the way they did in a particular situation can give important clues as to whether preventive measures will be effective in a similar situation in the future.     

Disability among adults injured in motor-vehicle crashes in the United States

INTRODUCTION: Little population-based information exists about the long-term effects of motor-vehicle crash-related injuries. METHOD: We analyzed data from the 1995 National Health Interview Survey Disability (NHIS-D) Supplement to estimate the prevalence of crash-related disability among noninstitutionalized U.S. adults aged 18 years and older. RESULTS: More than 1.2 million adults were living in their homes with the disabling effects of motor-vehicle crash-related injuries in 1995. The prevalence of crash-related disability was highest for persons in their mid-life years, ages 35-64. Half of the respondents had sustained the injuries more than 5 years before the interview. Forty-one percent of working-aged individuals reported being unable to work because of their disability. CONCLUSIONS: Because crash-related disability is most prevalent during the mid-life years, quality of life and productivity may be affected for decades. These findings highlight the personal and societal burden associated with motor-vehicle crash-related disability in the United States.     

Drivers influencing adaptive management: a retrospective evaluation of water quality decisions in South East Queensland (Australia)

This article analyzes interviews with natural resource managers in South East Queensland (SEQ), Australia. The objectives of the research are (i) to apply and test deductive/inductive text analysis methods for constructing a conceptual model of water quality decision-making in SEQ, (ii) to understand the role of information in the decision-making process, and (iii) to understand how to improve adaptive management in SEQ. Our methodology provided the means to quickly and objectively explore interview data and also reduce potential subjective bias normally associated with deductive text analysis methods. At a more practical level, our methodology indicates potential intervention points if one is to influence the decision-making process in the region. Results indicate that relevant information is often ignored in SEQ, with significant consequences for adaptive management. Contextual factors (political, social, and environmental) together with effective communication or lobbying strategies often prevent evidence-based decisions. We propose that in addition to generating information to support decisions, adaptive management also requires an appraisal of the true character of the decision-making process, which includes how stakeholders interact, what information is relevant and salient to management, and how the available information should be communicated to stakeholders and decision-making bodies.

Electronic supplementary material

The online version of this article (doi:10.1007/s13280-014-0537-4) contains supplementary material, which is available to authorized users.     

Integrated mite control in apples in Queensland, Australia

An interdisciplinary team introduced Integrated Mite Control (IMC) to the Queensland apple industry in Australia from 1989 to 1992. Project funding supported the employment of a consultant to monitor mite levels and provide management advice to growers who paid for the service. Interviews at the beginning and end of the project showed widespread adoption of IMC over this period. Overall use of chemicals was not reduced, but the use pattern changed towards wider use of chemicals that are less toxic to predatory mites. The future of IMC in the Queensland apple industry is in doubt because the seasonal nature of apple production does not allow the paid consultancy service to be self-sustaining. Indications are that the integrated approach to pest management may not be generally accepted as a strategic management process while the availability of effective chemicals allows the continuation of a spray routine for mite control. The lack of availability of effective and proven methods of pest control was seen by growers as the major constraint to adoption of IMC.