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https://www.readbyqxmd.com/read/27913914/tragedy-in-moral-case-deliberation
#1
Benita Spronk, Margreet Stolper, Guy Widdershoven
In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants...
December 2, 2016: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/27913765/prevalence-of-chronic-conditions-and-multimorbidities-in-a-geographically-defined-geriatric-population-with-diverse-races-and-ethnicities
#2
Eunjung Lim, Krupa Gandhi, James Davis, John J Chen
OBJECTIVE: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. METHOD: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics...
December 2, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/27913758/timing-of-most-recent-health-care-visit-by-older-people-living-with-and-without-hiv-findings-from-the-sage-well-being-of-older-people-study-in-uganda
#3
Joseph O Mugisha, Enid J Schatz, Joel Negin, Paul Mwaniki, Paul Kowal, Janet Seeley
The objective of this article is to document factors associated with the recency of health-care service utilization by people aged 50 years and over living with and without HIV in Uganda. A survey was conducted with 510 Ugandans aged 50 and older, living with and without HIV. The survey included information on sociodemographic characteristics, health state, self-reported chronic conditions, and timing of most recent visit to a health-care facility (time since last visit [TSLV]). We use ordinal logistic regression to identify independent factors associated TSLV...
December 2, 2016: International Journal of Aging & Human Development
https://www.readbyqxmd.com/read/27913692/factors-motivating-hpv-vaccine-uptake-among-vaccinated-and-nonvaccinated-hispanic-young-adult-women
#4
Dionne P Stephens, Hod Tamir, Tami L Thomas
INTRODUCTION: To identify factors influencing human papillomavirus (HPV) vaccination up taking decision making among vaccinated and nonvaccinated Hispanic college women. PARTICIPANTS: Hispanic young women between the ages of 18 and 24 years (N = 49). In total, 26 had not received the HPV vaccine, and 23 had started/completed the vaccine series. METHOD: Participants registered for the study via a psychology research pool at a large public university in the southeast United States after institutional review board approval...
December 2016: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/27913593/higher-heart-rate-variability-is-associated-with-vmpfc-activity-and-increased-resistance-to-temptation-in-dietary-self-control-challenges
#5
Silvia U Maier, Todd A Hare
: Higher levels of self-control in decision making have been linked to better psychosocial and physical health. A similar link to health outcomes has been reported for heart rate variability (HRV), a marker of physiological flexibility. Here, we sought to link these two, largely separate, research domains by testing the hypothesis that greater HRV would be associated with better dietary self-control in humans. Specifically, we examined whether total HRV at sedentary rest (measured as the standard deviation of normal-to-normal intervals, SDNN) can serve as a biomarker for the neurophysiological adaptability that putatively underlies self-controlled behavior...
December 2, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27913574/intended-and-unintended-consequences-of-abortion-law-reform-perspectives-of-abortion-experts-in-victoria-australia
#6
L A Keogh, D Newton, C Bayly, K McNamee, A Hardiman, A Webster, M Bismark
INTRODUCTION: In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform. METHODS: Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached...
December 2, 2016: Journal of Family Planning and Reproductive Health Care
https://www.readbyqxmd.com/read/27913549/second-line-therapies-in-immune-thrombocytopenia
#7
Rachael F Grace, Cindy Neunert
Immune thrombocytopenia (ITP) is a rare, acquired autoimmune condition characterized by a low platelet count and an increased risk of bleeding. Although many children and adults with ITP will not need therapy beyond historic first-line treatments of observation, steroids, intravenous immunoglobulin (IVIG), and anti-D globulin, others will have an indication for second-line treatment. Selecting a second-line therapy depends on the reason for treatment, which can vary from bleeding to implications for health-related quality of life (HRQoL) to likelihood of remission and patient preference with regard to adverse effects, route of administration, and cost...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913539/prevention-of-central-nervous-system-sequelae-in-sickle-cell-disease-without-evidence-from-randomized-controlled-trials-the-case-for-a-team-based-learning-collaborative
#8
Michael R DeBaun, Allison A King
Since 1998, the National Institutes of Health has funded 5 randomized controlled trials (RCTs) for primary and secondary prevention of strokes in children with sickle cell anemia (SCA). In a systematic fashion, these trials have significantly advanced the care of children with SCA. In the absence of an RCT, clinicians are often compelled to make decisions at the bedside, based on experience, observational studies, and principles of hematology. We will provide an initial example that describes how a team-based, learning collaborative developed a multisite standard care protocol with a low budget (<$10 000 per year) to overcome the intrinsic limitations of advancing the care of neurologic complications in sickle cell disease (SCD)...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913477/the-value-of-quality-of-life-assessment-in-chronic-myeloid-leukemia-patients-receiving-tyrosine-kinase-inhibitors
#9
Fabio Efficace, Laura Cannella
The development of the oral tyrosine kinase inhibitors (TKIs) to treat chronic myeloid leukemia (CML) is one of the great triumphs of cancer research. Although the efficacy of TKIs has dramatically improved the disease-specific overall survival rate, the prevalence of CML is increasing worldwide. Currently, CML patients receive prolonged (even lifelong) treatment, and over the last decade, clinical decision making has become challenging. Therefore, consideration of the effects of TKI therapies on patients' quality of life (QoL) and symptom burden (ie, patient-reported outcomes [PROs]) is now critical to more robustly inform patient care and improve health care quality...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912999/palliative-care-and-physiatry-in-the-oncology-care-spectrum-an-opportunity-for-distinct-and-collaborative-approaches
#10
REVIEW
Vishwa S Raj, Julie K Silver, Terrence M Pugh, Jack B Fu
As cancer evolves from a terminal illness to a chronic medical condition, so too does the view of clinical services. Palliative care and physical medicine and rehabilitation (PM&R) will increase in acceptance because they provide a valuable resource. The overarching theme is improving cancer-related symptoms or treatment-related side effects, improving patient health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision making. Managing symptom burden may improve therapy participation/performance...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912942/assessing-knowledge-about-acupuncture-a-survey-of-people-with-back-pain-in-the-uk
#11
Maddy Greville-Harris, John Hughes, George Lewith, Christina Liossi, Peter White, Cynthia A Graham, Felicity L Bishop
OBJECTIVES: Despite the prevalence of acupuncture treatment in the UK, and the increasing evidence of safety and effectiveness, the information presented to patients by practitioners frequently contains inaccuracies. As knowledge of treatment affects both patient decision-making and treatment outcomes, this study aimed to establish what is known about acupuncture in a sample of people who had, and had not, previously experienced acupuncture. DESIGN: A 15-item questionnaire was constructed to assess knowledge of acupuncture...
December 2016: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/27912780/the-influence-of-cost-per-daly-information-in-health-prioritisation-and-desirable-features-for-a-registry-a-survey-of-health-policy-experts-in-vietnam-india-and-bangladesh
#12
Yot Teerawattananon, Sripen Tantivess, Inthira Yamabhai, Nattha Tritasavit, Damian G Walker, Joshua T Cohen, Peter J Neumann
BACKGROUND: Economic evaluation has been implemented to inform policy in many areas, including coverage decisions, technology pricing, and the development of clinical practice guidelines. However, there are barriers to evidence-based policy in low- and middle-income countries (LMICs) that include limited stakeholder awareness, resources and data availability, as well as the lack of capacity to conduct country-specific economic evaluations. This study aims to survey health policy experts' opinions on barriers to use of cost-effectiveness data in these settings and to obtain their advice on how to make a new cost-per-DALY database being developed by Tufts Medical Center more relevant to LMICs...
December 3, 2016: Health Research Policy and Systems
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#13
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911797/meeting-the-sustainable-development-goals-leads-to-lower-world-population-growth
#14
Guy J Abel, Bilal Barakat, Samir Kc, Wolfgang Lutz
Here we show the extent to which the expected world population growth could be lowered by successfully implementing the recently agreed-upon Sustainable Development Goals (SDGs). The SDGs include specific quantitative targets on mortality, reproductive health, and education for all girls by 2030, measures that will directly and indirectly affect future demographic trends. Based on a multidimensional model of population dynamics that stratifies national populations by age, sex, and level of education with educational fertility and mortality differentials, we translate these goals into SDG population scenarios, resulting in population sizes between 8...
November 29, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27911081/shared-decision-making-in-youth-mental-health-care-using-the-evidence-to-plan-treatments-collaboratively
#15
David A Langer, Amanda Jensen-Doss
The shared decision-making (SDM) model is one in which providers and consumers of health care come together as collaborators in determining the course of care. The model is especially relevant to youth mental health care, when planning a treatment frequently entails coordinating both youth and parent perspectives, preferences, and goals. The present article first provides the historical context of the SDM model and the rationale for increasing our field's use of SDM when planning psychosocial treatments for youth and families...
December 2, 2016: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#16
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27910173/facilitators-and-barriers-to-person-centred-care-in-child-and-young-people-mental-health-services-a-systematic-review
#17
Dawid Gondek, Julian Edbrooke-Childs, Tjasa Velikonja, Louise Chapman, Felicity Saunders, Daniel Hayes, Miranda Wolpert
: Implementation of person-centred care has been widely advocated across various health settings and patient populations, including recent policy for child and family services. Nonetheless, evidence suggests that service users are rarely involved in decision-making, whilst their preferences and goals may be often unheard. The aim of the present research was to systematically review factors influencing person-centred care in mental health services for children, young people and families examining perspectives from professionals, service users and carers...
December 2, 2016: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/27909857/privacy-autonomy-and-public-policy-french-and-north-american-perspectives
#18
Jennifer Merchant
This article raises the question of whether in both the United States and in France, an individual's autonomy and private decision-making right(s) in matters of health care and access to reproductive technologies can be conciliated with the general interest, and more specifically, the role of the State. Can a full-fledged right to privacy, the ability to exercise one's autonomy, exist alongside the general interest, and depend neither on financial resources like in the United States nor on centralised government decisions or the medical hierarchy like in France? The contrast between these two modern democracies justify the importance of comparing them...
December 2, 2016: Theoretical Medicine and Bioethics
https://www.readbyqxmd.com/read/27909632/a-framework-for-navigating-institutional-review-board-irb-oversight-in-the-complicated-zone-of-research
#19
Gretchen E Parker
The treatment therapies and technologies currently emerging from the rapidly evolving health care industry must undergo full examination in a clinical setting if they are to be marketed to the public. All elements of clinical studies involving human subjects must undergo thorough IRB review before study activities can commence. Regulations regarding IRB oversight apply to all clinical studies-including retrospective examinations of private medical data and identifiable biological samples. It is not uncommon for researchers to be unsure whether, or on what level, IRB review and oversight are required for a particular project...
October 25, 2016: Curēus
https://www.readbyqxmd.com/read/27909393/a-comparison-of-multiple-behavior-models-in-a-simulation-of-the-aftermath-of-an-improvised-nuclear-detonation
#20
Nidhi Parikh, Harshal G Hayatnagarkar, Richard J Beckman, Madhav V Marathe, Samarth Swarup
We describe a large-scale simulation of the aftermath of a hypothetical 10kT improvised nuclear detonation at ground level, near the White House in Washington DC. We take a synthetic information approach, where multiple data sets are combined to construct a synthesized representation of the population of the region with accurate demographics, as well as four infrastructures: transportation, healthcare, communication, and power. In this article, we focus on the model of agents and their behavior, which is represented using the options framework...
November 2016: Autonomous Agents and Multi-agent Systems
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