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https://www.readbyqxmd.com/read/28813239/how-should-clinicians-counsel-a-woman-with-a-strong-family-history-of-early-onset-alzheimer-s-disease-about-her-pregnancy
#1
Marianna V Mapes, Barbara M O'Brien, Louise P King
Counseling patients regarding the benefits, harms, and dilemmas of genetic testing is one of the greatest ethical challenges facing reproductive medicine today. With or without test results, clinicians grapple with how to communicate potential genetic risks as patients weigh their reproductive options. Here, we consider a case of a woman with a strong family history of early-onset Alzheimer's disease (EOAD). She is early in her pregnancy and unsure about learning her own genetic status. We address the ethical ramifications of each of her options, which include genetic testing, genetic counseling, and termination versus continuation of the pregnancy...
July 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28793970/historical-perspective-the-pros-and-cons-of-conventional-outcome-measures-in-parkinson-s-disease
#2
Shen-Yang Lim, Ai Huey Tan
BACKGROUND: Conventional outcome measures (COMs) in Parkinson's disease (PD) refer to rating scales, questionnaires, patient diaries and clinically-based tests that do not require specialized equipment. METHODS: It is timely at this juncture - as clinicians and researchers begin to grapple with the "invasion" of digital technologies - to review the strengths and weaknesses of these outcome measures. RESULTS: This paper discusses advances (including an enhanced understanding of PD itself, and the development of clinimetrics as a field) that have led to improvements in the COMs used in PD; their strengths and limitations; and factors to consider when selecting and using a measuring instrument...
July 29, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28766079/lawful-sinners-reproductive-governance-and-moral-agency-around-abortion-in-mexico
#3
Elyse Ona Singer
The Catholic Hierarchy unequivocally bans abortion, defining it as a mortal sin. In Mexico City, where the Catholic Church wields considerable political and popular power, abortion was recently decriminalized in a historic vote. Of the roughly 170,000 abortions that have been carried out in Mexico City's new public sector abortion program to date, more than 60% were among self-reported Catholic women. Drawing on eighteen months of fieldwork, including interviews with 34 Catholic patients, this article examines how Catholic women in Mexico City grapple with abortion decisions that contravene Church teachings in the context of recent abortion reform...
August 1, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28752890/primary-care-in-the-prevention-treatment-and-control-of-cardiovascular-disease-in-sub-saharan-africa
#4
REVIEW
Dike B Ojji, Kim Lamont, Olubunmi I Ojji, Bibiana Nonye Egenti, Karen Sliwa
Cardiovascular disease (CVD) is the frontrunner in the disease spectrum of sub-Saharan Africa, with stroke and ischaemic heart disease ranked seventh and 14th as leading causes of death, respectively, on this sub-continent. Unfortunately, this region is also grappling with many communicable, maternal, neonatal and nutritional disorders. Limited resources and the high cost of CVD treatment necessitate that primary prevention should have a high priority for CVD control in sub-Saharan Africa. One major challenge of such an approach is how to equip primary care to respond promptly and effectively to this burden...
July 28, 2017: Cardiovascular Journal of Africa
https://www.readbyqxmd.com/read/28748948/us-defence-agencies-grapple-with-gene-drives
#5
Ewen Callaway
No abstract text is available yet for this article.
July 21, 2017: Nature
https://www.readbyqxmd.com/read/28714706/hiv-risk-and-multiple-sources-of-heterosexism-among-young-black-men-who-have-sex-with-men
#6
Wilson Vincent, Lance M Pollack, David M Huebner, John L Peterson, Wayne T Steward, Gregory M Rebchook, Erik D Storholm, Susan M Kegeles
OBJECTIVE: This study examined whether the association between social support and condom self-efficacy would be moderated by (a) internalized heterosexism among and (b) enacted heterosexism experienced by young Black men who have sex with men (YBMSM), who contend with high HIV incidence, heterosexism, and low uptake of preexposure prophylaxis. METHOD: Participants were 1,210 YBMSM (ages 18-29) who completed measures of social support, internalized and enacted heterosexism, and condom self-efficacy in 2 large cities in the southern United States as part of a community-level HIV-prevention study...
July 17, 2017: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/28703210/ancient-genome-studies-grapple-with-africa-s-past
#7
Ewen Callaway
No abstract text is available yet for this article.
July 6, 2017: Nature
https://www.readbyqxmd.com/read/28690155/plant-breeding-as-the-cornerstone-of-a-sustainable-bioeconomy
#8
REVIEW
Aleksandra Małyska, Jan Jacobi
A prime driver for a bioeconomy is the need to ensure the availability of sufficient biomass feedstock for food, feed, energy and industrial uses. This demand must be properly managed in the face of several challenges, including environmental changes and abrupt climate shifts. Plant breeding and breeding innovation is the cornerstone for sustainable supply of biomass. Not only does research and development in this sector aim at providing high yielding crops in order to maximize production, but R&D in this field will also allow to obtain highly specialized plant varieties with new or improved traits that fit to specific applications...
July 6, 2017: New Biotechnology
https://www.readbyqxmd.com/read/28679803/epidemiology-and-patterns-of-care-at-the-end-of-life-rising-complexity-shifts-in-care-patterns-and-sites-of-death
#9
Melissa D Aldridge, Elizabeth H Bradley
In 2015 an estimated 2.7 million people in the United States (1 percent of the population) died. Although decedents' illness experience varies substantially, important trends in care at the end of life are evident. To identify the most pressing health care policy issues related to end-of-life care, we present a comprehensive picture of the epidemiology and care patterns of people in the last stage of life. We identify three key trends in end-of-life care: increasing diversity in the primary diagnoses of decedents, increases in multimorbidity and illness complexity among people with terminal illnesses, and shifts in patterns of care at the end of life and in sites of death...
July 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28662856/within-and-between-person-and-group-variance-in-behavior-and-beliefs-in-cross-cultural-longitudinal-data
#10
Kirby Deater-Deckard, Jennifer Godwin, Jennifer E Lansford, Dario Bacchini, Anna Silvia Bombi, Marc H Bornstein, Lei Chang, Laura Di Giunta, Kenneth A Dodge, Patrick S Malone, Paul Oburu, Concetta Pastorelli, Ann T Skinner, Emma Sorbring, Laurence Steinberg, Sombat Tapanya, Liane Peña Alampay, Liliana Maria Uribe Tirado, Arnaldo Zelli, Suha M Al-Hassan
This study grapples with what it means to be part of a cultural group, from a statistical modeling perspective. The method we present compares within- and between-cultural group variability, in behaviors in families. We demonstrate the method using a cross-cultural study of adolescent development and parenting, involving three biennial waves of longitudinal data from 1296 eight-year-olds and their parents (multiple cultures in nine countries). Family members completed surveys about parental negativity and positivity, child academic and social-emotional adjustment, and attitudes about parenting and adolescent behavior...
June 26, 2017: Journal of Adolescence
https://www.readbyqxmd.com/read/28661307/policy-approaches-to-improving-housing-and-health
#11
William C Tilburg
Safe and healthy housing conditions are critical to improving population health, particularly for the most vulnerable - young children, senior citizens, and individuals with chronic illnesses and disabilities - who spend more time at home and are more susceptible to illness and injury. Across the country, millions of Americans are exposed to lead, radon, asbestos, volatile organic compounds, pests, mold, carbon monoxide, and tobacco smoke in the home, affecting the air they breathe and the water they drink...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28639475/ecological-correlates-of-multiple-sexual-partnerships-among-adolescents-and-young-adults-in-urban-cape-town-a-cumulative-risk-factor-approach
#12
Evans Muchiri, Clifford Odimegwu, Pamela Banda, Lorreta Ntoimo, Sunday Adedini
Studies in South Africa have reported unsafe levels of risky sexual behvaiours among adolescents and young adults, with the country reporting the highest burden of HIV/AIDS globally, as well as a high rate of teenage pregnancy. While determinants of risky sexual behaviours have been investigated for factors occurring at the individual and household levels, not fully explored in the literature is the effect of community level factors. Furthermore, it is unclear whether risk factors occurring within the ecology of adolescents and young adults act cumulatively to influence their sexual practices...
June 22, 2017: African Journal of AIDS Research: AJAR
https://www.readbyqxmd.com/read/28632445/critique-and-contribute-a-practice-based-framework-for-improving-critical-data-studies-and-data-science
#13
Gina Neff, Anissa Tanweer, Brittany Fiore-Gartland, Laura Osburn
What would data science look like if its key critics were engaged to help improve it, and how might critiques of data science improve with an approach that considers the day-to-day practices of data science? This article argues for scholars to bridge the conversations that seek to critique data science and those that seek to advance data science practice to identify and create the social and organizational arrangements necessary for a more ethical data science. We summarize four critiques that are commonly made in critical data studies: data are inherently interpretive, data are inextricable from context, data are mediated through the sociomaterial arrangements that produce them, and data serve as a medium for the negotiation and communication of values...
June 2017: Big Data
https://www.readbyqxmd.com/read/28610529/regulation-is-not-the-only-way
#14
Richard Hatchett
Healthcare regulation is about public protection. Whether the public is at increased risk from a nurse practitioner, and whether that risk can be addressed within the current regulatory framework, has been grappled with by the profession, regulators and employers for years.
June 14, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28592181/grappling-with-the-future-the-messiness-of-pilot-implementation-in-information-systems-design
#15
Morten Hertzum, Maria Ie Manikas, Arnvør Á Torkilsheyggi
Pilot implementation is a method for avoiding unintended consequences of healthcare information systems. This study investigates how learning from pilot implementations is situated, messy, and therefore difficult. We analyze two pilot implementations by means of observation and interviews. In the first pilot implementation, the involved porters saw their improved overview of pending patient transports as an opportunity for more self-organization, but this opportunity hinged on the unclear prospects of extending the system with functionality for the porters to reply to transport requests...
June 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28582994/which-primary-care-model-a-qualitative-analysis-of-ward-based-outreach-teams-in-south-africa
#16
Tessa S Marcus, Jannie Hugo, Champak C Jinabhai
Globally, models of extending universal health coverage through primary care are influenced by country-specific systems of health care and disease management. In 2015 a rapid assessment of the ward-based outreach component of primary care reengineering was commissioned to understand implementation and rollout challenges. AIM: This article aims to describe middle- and lower-level managers' understanding of ward-based outreach teams (WBOTs) and the problems of authority, jurisdiction and practical functioning that arise from the way the model is constructed and has been operationalised...
May 31, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28561700/value-based-medicine-and-integration-of-tumor-biology
#17
Gabriel A Brooks, Linda D Bosserman, Isa Mambetsariev, Ravi Salgia
Clinical oncology is in the midst of a genomic revolution, as molecular insights redefine our understanding of cancer biology. Greater awareness of the distinct aberrations that drive carcinogenesis is also contributing to a growing armamentarium of genomically targeted therapies. Although much work remains to better understand how to combine and sequence these therapies, improved outcomes for patients are becoming manifest. As we welcome this genomic revolution in cancer care, oncologists also must grapple with a number of practical problems...
2017: American Society of Clinical Oncology Educational Book
https://www.readbyqxmd.com/read/28553995/mapping-regulatory-models-for-medicinal-cannabis-a-matrix-of-options
#18
Vendula Belackova, Marian Shanahan, Alison Ritter
Objective The aim of the present study was to develop a framework for assessing regulatory options for medicinal cannabis in Australia.Methods International regulatory regimes for medicinal cannabis were reviewed with a qualitative policy analysis approach and key policy features were synthesised, leading to a conceptual framework that facilitates decision making across multiple dimensions.Results Two central organising dimensions of medicinal cannabis regulation were identified: cannabis supply and patient authorisation (including patient access)...
May 30, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28512758/reporting-practices-for-unsolicited-and-secondary-findings-from-next-generation-sequencing-technologies-perspectives-of-laboratory-personnel
#19
Danya F Vears, Karine Sénécal, Pascal Borry
While next-generation sequencing (NGS) has enormous potential to identify genetic causes of disease, the nature of the technology means that it can also identify additional information about the individual receiving sequencing that is unrelated to the original rationale for testing. Reporting these unsolicited findings (UF) to clinicians, and subsequently to patients, could lead to potentially lifesaving interventions. Most international guidelines provide limited specific recommendations as to whether these UF should be reported...
August 2017: Human Mutation
https://www.readbyqxmd.com/read/28509570/learners-perspectives-on-the-provision-of-condoms-in-south-african-public-schools
#20
W E de Bruin, S Panday-Soobrayan
A stubborn health challenge for learners in South African public schools concerns sexual and reproductive health and rights (SRHR). In 2015, the Department of Basic Education (DBE) proposed the provision of condoms and SRHR-services to learners in schools. This study aimed to contribute to the finalisation and implementation of DBE's policy by exploring learners' perspectives on the provision of condoms and SRHR-services in schools. Sixteen focus group discussions were conducted with learners (n = 116) from 33 public schools, to assess their attitudes, social influences, and needs and desires regarding condom provision and SRHR-services in schools...
May 16, 2017: AIDS Care
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