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Decision fatigue

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https://www.readbyqxmd.com/read/28921637/to-serve-or-not-to-serve-ethical-and-policy-implications
#1
Leonard A Jason
The Institute of Medicine (IOM) is one of the nation's more influential health-related non-profit organizations. It plays a large role in shaping health policy by commissioning panels to develop "white papers" describing research and recommendations on a variety of health topics. These white paper publications are often used to help make policy decisions at the legislative and executive levels. Such a prominent institution might seem like a natural ally for policy-related collaborative efforts. As community psychologists, we strongly endorse efforts to positively influence public policy at the national level...
September 18, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28901538/the-impact-of-fatigue-on-the-non-technical-skills-performance-of-critical-care-air-ambulance-clinicians
#2
J A Myers, D M C Powell, S Aldington, D Sim, A Psirides, K Hathaway, M F Haney
BACKGROUND: The relationship between fatigue-related risk and impaired clinical performance is not entirely clear. Non-technical factors represent an important component of clinical performance and may be sensitive to the effects of fatigue. The hypothesis was that the sum score of overall non-technical performance is degraded by fatigue. METHODS: Nineteen physicians undertook two different simulated air ambulance missions, once when rested, and once when fatigued (randomised crossover design)...
September 13, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28886946/postmarketing-safety-surveillance-of-trivalent-recombinant-influenza-vaccine-reports-to-the-vaccine-adverse-event-reporting-system
#3
Emily Jane Woo, Pedro L Moro, Maria Cano, Christopher Jankosky
On January 16, 2013, the Food and Drug Administration approved recombinant hemagglutinin influenza vaccine (RIV3) (Spodoptera frugiperda cell line; Flublok), which is the first completely egg-free flu vaccine licensed in the United States. To improve our understanding of the safety profile of this vaccine, we reviewed and summarized reports to the Vaccine Adverse Event Reporting System (VAERS) following RIV3. Through June 30, 2016, VAERS received 88 reports. Allergic reactions, including anaphylaxis, were the most common type of adverse event...
September 5, 2017: Vaccine
https://www.readbyqxmd.com/read/28882750/grey-areas-new-zealand-ambulance-personnel-s-experiences-of-challenging-resuscitation-decision-making
#4
Natalie Elizabeth Anderson, Merryn Gott, Julia Slark
INTRODUCTION: When faced with a patient in cardiac arrest, ambulance personnel must rapidly make complex decisions with limited information. Much of the research examining decisions to commence, continue, withhold or terminate resuscitation has used retrospective audits of registry data and clinical documentation. This study offers a provider-perspective which characterises uncertainty and highlights clinical, cognitive, emotional and physical demands associated with decision-making in the cardiac arrest context...
September 4, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28871238/overcoming-therapeutic-inertia-in-multiple-sclerosis-care-a-pilot-randomized-trial-applying-the-traffic-light-system-in-medical-education
#5
Gustavo Saposnik, Jorge Maurino, Angel P Sempere, Maria A Terzaghi, Christian C Ruff, Muhammad Mamdani, Philippe N Tobler, Xavier Montalban
BACKGROUND: Physicians often do not initiate or intensify treatments when clearly warranted, a phenomenon known as therapeutic inertia (TI). Limited information is available on educational interventions to ameliorate knowledge-to-action gaps in TI. OBJECTIVES: To evaluate the feasibility and efficacy of an educational intervention compared to usual care among practicing neurologists caring for patients with multiple sclerosis (MS). METHODS: We conducted a pilot double-blind, parallel-group, randomized clinical trial...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28810979/women-veterans-a-population-at-risk-for-fibromyalgia-the-associations-between-fibromyalgia-symptoms-and-quality-of-life
#6
Rita F D'Aoust, Alicia Gill Rossiter, Amanda Elliott, Ming Ji, Cecile Lengacher, Maureen Groer
BACKGROUND: The Institute of Federal Health Care recently published an executive summary from a round table discussion indicating that active duty and retired female military personnel are at high risk for adverse health outcomes unique to military service including complications related to post-traumatic stress disorder (PTSD), unreported sexual trauma, and musculoskeletal problems. In 2008, the Institute of Medicine began to review, evaluate, and summarize the literature on health outcomes in Gulf War-deployed and found sufficient evidence of a causal relationship with PTSD and suggestive evidence of an association with fibromyalgia (FM)...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28805528/pace-investigators-response-is-misleading-regarding-patient-survey-results
#7
Karen D Kirke
The PACE investigators' citation of a patient survey might mislead readers into thinking that the experience of people with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) supports PACE findings. In fact, patient survey evidence directly contradicts the results of the PACE trial. A review of survey data published between 2001 and 2015 reveals that for most patients, graded exercise therapy leads to worsening of symptoms, cognitive behavioural therapy leads to no change in symptoms, and pacing leads to improvement...
August 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28805132/evaluation-of-the-decisional-fatigue-scale-among-surrogate-decision-makers-of-the-critically-ill
#8
Ronald L Hickman, Grant A Pignatiello, Sadia Tahir
Intense emotional distress and impaired information processing have been implicated in reducing a surrogate decision maker's ability to formulate informed health care decisions for a critically ill patient. The heightened intensity of negative emotions, mental effort, and impaired judgment is consistent with the manifestation of decision fatigue. The aim of this article is to describe the validity and reliability of the Decision Fatigue Scale (DFS) among surrogate decision makers of the critically ill. A convenience sample of 101 surrogate decision makers were administered the DFS and a battery of psychosocial instruments at two time points...
August 1, 2017: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/28803942/an-adaptive-individualized-fmri-delay-discounting-procedure-to-increase-flexibility-and-optimize-scanner-time
#9
Mikhail N Koffarnus, Harshawardhan U Deshpande, Jonathan M Lisinski, Anders Eklund, Warren K Bickel, Stephen M LaConte
Research on the rate at which people discount the value of future rewards has become increasingly prevalent as discount rate has been shown to be associated with many unhealthy patterns of behavior such as drug abuse, gambling, and overeating. fMRI research points to a fronto-parietal-limbic pathway that is active during decisions between smaller amounts of money now and larger amounts available after a delay. Researchers in this area have used different variants of delay discounting tasks and reported various contrasts between choice trials of different types from these tasks...
August 10, 2017: NeuroImage
https://www.readbyqxmd.com/read/28800089/fitnet-s-internet-based-cognitive-behavioural-therapy-is-ineffective-and-may-impede-natural-recovery-in-adolescents-with-myalgic-encephalomyelitis-chronic-fatigue-syndrome-a-review
#10
REVIEW
Simin Ghatineh, Mark Vink
The Dutch Fatigue In Teenagers on the interNET (FITNET) study claimed that after 6 months, internet based cognitive behaviour therapy in adolescents with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS), led to a 63% recovery rate compared to 8% after usual care, and that this was maintained at long term follow up (LTFU). Our reanalysis shows that their post-hoc definition of recovery included the severely ill, the unblinded trial had no adequate control group and it used lax selection criteria as well as outcomes assessed via questionnaires rather than objective outcomes, further contributing to exaggerated recovery figures...
August 11, 2017: Behavioral Sciences
https://www.readbyqxmd.com/read/28777117/delays-in-treatment-seeking-decisions-among-women-with-myocardial-infarction
#11
Cynthia Arslanian-Engoren, Linda D Scott
BACKGROUND: Minimizing the time from myocardial infarction (MI) symptom onset to the implementation of lifesaving interventions decreases morbidity and mortality of women who experience an MI. However, not all women seek timely evaluation and treatment for their MI symptoms. OBJECTIVES: The aim of this article is to describe reasons for decision treatment delays among women who experience an initial MI. METHOD: A secondary analysis of narrative data collected as part of a qualitative study examining the triage experiences of women (N = 14) who presented to the emergency department with symptoms of acute MI...
September 2017: Dimensions of Critical Care Nursing: DCCN
https://www.readbyqxmd.com/read/28765250/validating-rheumatoid-arthritis-remission-using-the-patients-perspective-results-from-a-special-interest-group-at-omeract-2016
#12
Linda A Rasch, Maarten Boers, Catherine L Hill, Marieke Voshaar, Wijnanda Hoogland, Maarten de Wit, Caroline Flurey, Bev Davis, Merete Lund Hetland, Cecilie Heegaard Brahe, Laure Gossec, George A Wells, Peter Tugwell, Bindee Kuriya, Niti Goel, Jasvinder A Singh, Cátia Duarte, José Da Silva, Dirkjan van Schaardenburg, Susanna Proudman, Lilian H D van Tuyl
OBJECTIVE: The Outcome Measures in Rheumatology (OMERACT) working group on the patients' perspective on remission in rheumatoid arthritis (RA) has been working on this topic since 2010. At OMERACT 2016, progress and preliminary data on validity of measurement instruments for pain, fatigue, and independence in remission in RA were presented, and future directions were explored. METHODS: A special interest group was organized, in which the current data on the patients' perspective on remission were presented...
August 1, 2017: Journal of Rheumatology
https://www.readbyqxmd.com/read/28760403/health-related-quality-of-life-for-immediate-versus-delayed-androgen-deprivation-therapy-in-patients-with-asymptomatic-non-curable-prostate-cancer-trog-03-06-and-vcog-pr-01-03-toad-a-randomised-multicentre-non-blinded-phase-3-trial
#13
Gillian M Duchesne, Henry H Woo, Madeleine King, Steven J Bowe, Martin R Stockler, Alice Ames, Catherine D'Este, Mark Frydenberg, Andrew Loblaw, Shawn Malone, Jeremy Millar, Keen Hun Tai, Sandra Turner
BACKGROUND: Androgen-deprivation therapy in patients with prostate cancer who have relapsed with rising prostate-specific antigen concentration only (PSA-only relapse), or with non-curable but asymptomatic disease at diagnosis, could adversely affect quality of life at a time when the disease itself does not. We aimed to compare the effect of immediate versus delayed androgen-deprivation therapy on health-related quality of life over 5 years in men enrolled in the TOAD (Timing of Androgen Deprivation) trial...
July 28, 2017: Lancet Oncology
https://www.readbyqxmd.com/read/28750908/a-systematic-review-of-the-effectiveness-of-interruptive-medication-prescribing-alerts-in-hospital-cpoe-systems-to-change-prescriber-behavior-and-improve-patient-safety
#14
REVIEW
N Page, M T Baysari, J I Westbrook
OBJECTIVES: To assess the evidence of the effectiveness of different categories of interruptive medication prescribing alerts to change prescriber behavior and/or improve patient outcomes in hospital computerized provider order entry (CPOE) systems. METHODS: PubMed, Embase, CINAHL and the Cochrane Library were searched for relevant articles published between January 2000 and February 2016. Studies were included if they compared the outcomes of automatic, interruptive medication prescribing alert/s to a control/comparison group to determine alert effectiveness...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28741453/no-effect-of-levothyroxine-and-levothyroxine-induced-subclinical-thyrotoxicosis-on-the-pharmacokinetics-of-sorafenib-in-healthy-male-subjects
#15
Funan Huang, Antoinette Ajavon, Erya Huang, John Lettieri, Rong Liu, Carol Peña, Matthias Berse
BACKGROUND: Patients receiving the multikinase inhibitor sorafenib for locally recurrent or metastatic, progressive, differentiated thyroid carcinoma (DTC) refractory to radioactive iodine often receive concomitant levothyroxine for thyrotropin (TSH) suppression. In the Phase 3 DTC trial (DECISION), sorafenib exposure was approximately twofold higher than that observed in other cancers. This study assessed sorafenib pharmacokinetics without and with concomitant levothyroxine to examine whether a levothyroxine interaction or levothyroxine-induced subclinical thyrotoxicosis results in increased sorafenib exposure in patients with DTC...
September 2017: Thyroid: Official Journal of the American Thyroid Association
https://www.readbyqxmd.com/read/28729130/information-needs-about-palliative-care-and-euthanasia-a-survey-of-patients-in-different-phases-of-their-cancer-trajectory
#16
Kim Beernaert, Chloë Haverbeke, Simon Van Belle, Luc Deliens, Joachim Cohen
OBJECTIVE: We assessed information provision and information needs about illness course, treatments, palliative care and euthanasia in cancer patients. METHODS: Cancer patients consulting a university hospital (N=620) filled out a questionnaire. Their cancer related data were collected through the treating oncologist. This study is performed in Belgium, where "palliative care for all" is a patient's right embedded in the law and euthanasia is possible under certain conditions...
July 1, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28715350/a-prospective-multisite-international-validation-of-the-complex-regional-pain-syndrome-severity-score
#17
R Norman Harden, Christian Maihofner, Elias Abousaad, Jean-Jacques Vatine, Amy Kirsling, Roberto S G M Perez, Maxine Kuroda, Florian Brunner, Michael Stanton-Hicks, Johan Marinus, Jacobus J van Hilten, Sean Mackey, Frank Birklein, Tanja Schlereth, Angela Mailis-Gagnon, Joe Graciosa, Sara B Connoly, David Dayanim, Michael Massey, Hadas Frank, Anatoly Livshitz, Stephen Bruehl
Clinical diagnosis of complex regional pain syndrome (CRPS) is a dichotomous (yes/no) categorization, a format necessary for clinical decision making. Such dichotomous diagnostic categories do not convey an individual's subtle gradations in the severity of the condition over time and have poor statistical power when used as an outcome measure in research. This prospective, international, multicenter study slightly modified and further evaluated the validity of the CRPS Severity Score (CSS), a continuous index of CRPS severity...
August 2017: Pain
https://www.readbyqxmd.com/read/28686501/improved-treatment-decisions-in-patients-with-esophageal-cancer
#18
Cecilie Delphin Amdal, Anne-Birgitte Jacobsen, Ragnhild Sørum Falk, Egil Johnson, Silje Skjelsvik Os, Trond Warloe, Kristin Bjordal
BACKGROUND: Patients with esophageal cancer seldom achieve long-term survival. This prospective cohort study investigated the selection of patients likely to benefit from curative treatment and whether information on patients' health-related quality of life (HRQL) would assist treatment decisions in the multidisciplinary team. METHODS: Consecutive patients completed HRQL assessments and clinical data were collected before start of treatment. Logistic regression analyses identified clinical factors associated with treatment intent in patients with stage-III disease...
July 7, 2017: Acta Oncologica
https://www.readbyqxmd.com/read/28684922/emerging-use-of-everolimus-in-the-treatment-of-neuroendocrine-tumors
#19
REVIEW
Pablo Gajate, Olga Martínez-Sáez, Teresa Alonso-Gordoa, Enrique Grande
Neuroendocrine tumors (NETs) consist of a diverse family of malignancies, which are derived from neuroendocrine cells, most commonly originating from the gastroenteropancreatic (GEP) tract or the bronchopulmonary system. In general, NETs are more indolent than epithelial tumors, with median survival rates of longer than 30 months. The upregulation of mTOR pathway has been shown to play a pivotal role in NET pathogenesis. Inhibition of mTOR protein with everolimus represents a progress in the treatment of advanced NETs...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28682835/technologic-distractions-part-1-summary-of-approaches-to-manage-alert-quantity-with-intent-to-reduce-alert-fatigue-and-suggestions-for-alert-fatigue-metrics
#20
REVIEW
Sandra L Kane-Gill, Michael F O'Connor, Jeffrey M Rothschild, Nicholas M Selby, Barbara McLean, Christopher P Bonafide, Maria M Cvach, Xiao Hu, Avinash Konkani, Michele M Pelter, Bradford D Winters
OBJECTIVE: To provide ICU clinicians with evidence-based guidance on tested interventions that reduce or prevent alert fatigue within clinical decision support systems. DESIGN: Systematic review of PubMed, Embase, SCOPUS, and CINAHL for relevant literature from 1966 to February 2017. PATIENTS: Focus on critically ill patients and included evaluations in other patient care settings, as well. INTERVENTIONS: Identified interventions designed to reduce or prevent alert fatigue within clinical decision support systems...
September 2017: Critical Care Medicine
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