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advance directive issues

Andrea T Kozak, Joanna Buscemi, Misty A W Hawkins, Monica L Wang, Jessica Y Breland, Kathryn M Ross, Anupama Kommu
Obesity is a prevalent health care issue associated with disability, premature morality, and high costs. Behavioral weight management interventions lead to clinically significant weight losses in overweight and obese individuals; however, many individuals are not able to participate in these face-to-face treatments due to limited access, cost, and/or time constraints. Technological advances such as widespread access to the Internet, increased use of smartphones, and newer behavioral self-monitoring tools have resulted in the development of a variety of eHealth weight management programs...
October 25, 2016: Journal of Behavioral Medicine
Dongyun Chen, Haiguang Zhu, Shun Yang, Najun Li, Qingfeng Xu, Hua Li, Jinghui He, Jianmei Lu
Water pollution, a worldwide issue for the human society, has raised global concerns on environmental sustainability, calling for high-performance materials for effective treatments. Since the traditional techniques have inherent limitations in treatment speed and efficiency, nanotechnology is subsequently used as an environmental technology to remove pollutants through a rapid adsorption and degradation process. Therefore, here, various adsorbent and photodegradation composite materials leading to effective water remediation are summarized and predicted...
October 26, 2016: Advanced Materials
Margaret O'Donoghue, Suk-Hing Ng, Lorna Kp Suen, Maureen Boost
BACKGROUND: Whilst numerous studies have investigated nurses' compliance with hand hygiene and use of alcohol-based hand rub (ABHR), limited attention has been paid to these issues in allied health staff. Reports have linked infections to breaches in infection control in the radiography unit (RU). With advances in medical imaging, a higher proportion of patients come into contact with RU staff increasing the need for good hand hygiene compliance. This study aimed to evaluate effectiveness on compliance of an intervention to improve awareness of hand hygiene in the RU of a district hospital...
2016: Antimicrobial Resistance and Infection Control
R Aubry
On February 2, 2016, the French parliament adopted legislation creating new rights for the terminally ill. The text modifies and reinforces the rights of patients to end-of-life care and strengthens the status of surrogate decision makers. Under the new regulations, advance directives become legally binding though not unenforceable. Two types of advance directives are distinguished depending on whether the person is suffering or not from a serious illness when drafting them. The attending physician must abide by the patient's advance directives except in three situations: there is a life-threatening emergency; the directives are manifestly inappropriate; the directives are not compatible with the patient's medical condition...
October 21, 2016: Revue Neurologique
P Dhakal, V R Bhatt
Diagnosis and management of hematopoietic cell transplant-associated thrombotic microangiopathy (TA-TMA) are very complex and controversial, given multiple ongoing issues and comorbidities in sick transplant recipients. Complement activation via classic and alternative pathways is emerging as a potential pathogenetic mechanism in the development of TA-TMA. Complement-centric diagnostic strategy using functional and genetic tests may possibly support diagnosis, enhance molecular understanding and direct drug development...
October 24, 2016: Bone Marrow Transplantation
Takao Matsumoto, Yeong-Gi So, Yuji Kohno, Hidetaka Sawada, Ryo Ishikawa, Yuichi Ikuhara, Naoya Shibata
The interactions between magnetic skyrmions and structural defects, such as edges, dislocations, and grain boundaries (GBs), which are all considered as topological defects, will be important issues when magnetic skyrmions are utilized for future memory device applications. To investigate such interactions, simultaneous visualization of magnetic skyrmions and structural defects at high spatial resolution, which is not feasible by conventional techniques, is essential. Here, taking advantages of aberration-corrected differential phase-contrast scanning transmission electron microscopy, we investigate the interaction of magnetic skyrmions with a small-angle GB in a thin film of FeGe1-xSix...
October 24, 2016: Scientific Reports
Dan Zhang, Peng Shi, Qing-Guo Wang, Li Yu
A networked control system (NCS) is a control system which involves a communication network. In NCSs, the continuous-time measurement is usually sampled and quantized before transmission. Then, the measurement is transmitted to the remote controller via the communication channel, during which the signal may be delayed, lost or even sometimes not allowed for transmission due to the communication or energy constraints. In recent years, the modeling, analysis and synthesis of networked control systems (NCSs) have received great attention, which leads to a large number of publications...
October 20, 2016: ISA Transactions
Clement Chung
PURPOSE: Current strategies for managing neuroendocrine tumors (NETs) in adult patients are reviewed, with a focus on medication safety concerns. SUMMARY: NETs usually originate in the gastrointestinal or bronchopulmonary tract. Symptoms due to hormonal hypersecretion often occur in patients with foregut or midgut NETs or liver metastases. Surgical resection is recommended for most localized NETs, while systemic cytotoxic chemotherapy is typically used for high-grade and pancreatic tumors...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
Lai Heng Lee
The group of new oral anticoagulants or NOACs, now termed direct oral anticoagulants or DOACs, with their favourable results from large scale phase III clinical trials, represent a major advancement and expanded armamentarium in antithrombotic therapy. Dabigatran, rivaroxaban, apixaban and edoxaban are now in clinical routine use for prevention and treatment of arterial and venous thrombotic diseases as addressed in their clinical trials. Usage of the DOACs is expected to increase as clinicians gain more experience and reassurance with data from the real world studies which are generally consistent with that from clinical trials...
2016: Thrombosis Journal
Carla J Rash, Maxine Stitzer, Jeremiah Weinstock
This article introduces the special issue on contingency management (CM), an efficacious intervention for the treatment of substance use disorders with low uptake in clinical settings that is not commensurate with evidence for efficacy. In this special issue of the Journal of Substance Abuse Treatment, we present 16 articles representing the latest research in efficacy, implementation, and technological advances related to CM. Combined, this collection of articles highlights the diverse populations, settings, and applications of CM in the treatment of substance use disorders...
September 28, 2016: Journal of Substance Abuse Treatment
K W Miskowiak, C V Ott, J Z Petersen, L V Kessing
Cognitive impairment is a core feature of Major Depressive Disorder (MDD) but treatments targeting cognition are lacking. Numerous pre-clinical and clinical studies have investigated potential cognition treatments, but overall the evidence is conflicting. We conducted a systematic search following the PRISMA guidelines on PubMed and PsychInfo to evaluate the extant evidence and methodological challenges in randomized controlled trials (RCTs) of biological, psychological and behavioural candidate treatments targeting cognition in MDD...
October 13, 2016: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
John G Cagle, Philip Osteen, Paul Sacco, Jodi Jacobson Frey
CONTEXT: Hospice social workers are charged with completing a psychosocial assessment for every new enrollee. This assessment is part of the patient's comprehensive assessment and serves to inform the plan of care and key quality indicators. OBJECTIVES: To review the content of hospice social work assessments because little is known about what assessment topics are included or overlooked. METHODS: Using a clustered random sample from all 50 states, we contacted hospice agencies and requested a blank copy of the social work assessment completed at intake...
October 12, 2016: Journal of Pain and Symptom Management
Doreen C Harper, Teena M McGuinness, Jean Johnson
BACKGROUND: The Doctor of Nursing Practice (DNP) degree positions nurse practitioners (NPs) and other advanced practice registered nurses, with clinical competencies similar to other disciplines requiring doctoral education (medicine, physical therapy, psychology, and pharmacy). In addition, all these disciplines also offer residencies. However, nursing is the only discipline that does not require a doctoral degree and/or have a systematic approach to residency training for advanced practice roles...
August 31, 2016: Nursing Outlook
Ping Li, Hua Chun Zeng
In recent years, metal-organic frameworks (MOFs) have been employed as heterogeneous catalysts or utilized as solid precursors for synthesis of catalytic materials. However, conventional MOFs and their derivatives, which normally have relatively large particle sizes, exhibit limited mass transfer and modest catalytic activities owing to lengthy diffusion path and less exposed active sites. On the other hand, it has been generally conceived that nanoscale MOFs will be beneficial to materials utilization as well as to mass diffusion, but the instability of nano-MOFs poses a serious issue on their practical applications...
October 14, 2016: ACS Applied Materials & Interfaces
Sasanka Dalapati, Cheng Gu, Donglin Jiang
Enormous research efforts are focusing on the design and synthesis of advanced luminescent systems, owing to their diverse capability in scientific studies and technological developments. In particular, fluorescence systems based on aggregation-induced emission (AIE) have emerged to show great potential for sensing, bio-imaging, and optoelectronic applications. Among them, integrating AIE mechanisms to design porous polymers is unique because it enables the combination of porosity and luminescence activity in one molecular skeleton for functional design...
October 14, 2016: Small
Mary E Torrence
This introductory article provides an overview of preharvest food safety activities and initiatives for the past 15 years. The section on traditional areas of preharvest food safety focuses on significant scientific advancements that are a culmination of collaborative efforts (both public health and agriculture) and significant research results. The highlighted advancements provide the foundation for exploring future preharvest areas and for improving and focusing on more specific intervention/control/prevention strategies...
October 2016: Microbiology Spectrum
Emre Brookes, Patrice Vachette, Mattia Rocco, Javier Pérez
Size-exclusion chromatography coupled with SAXS (small-angle X-ray scattering), often performed using a flow-through capillary, should allow direct collection of monodisperse sample data. However, capillary fouling issues and non-baseline-resolved peaks can hamper its efficacy. The UltraScan solution modeler (US-SOMO) HPLC-SAXS (high-performance liquid chromatography coupled with SAXS) module provides a comprehensive framework to analyze such data, starting with a simple linear baseline correction and symmetrical Gaussian decomposition tools [Brookes, Pérez, Cardinali, Profumo, Vachette & Rocco (2013 ▸)...
October 1, 2016: Journal of Applied Crystallography
P S Sidhu
In these days of political vagueness, to use a kinder term, although many would describe the situation as turmoil, in Europe, there are success stories to be lauded. Notwithstanding the direction individual countries choose in relation to closer or not so close co-operation in Europe and the direction the political agenda will travel over the next few years, I believe science and in particular medicine has benefited enormously form close co-operation across the European Union and with colleagues outside this political and trading block of nations...
October 2016: Ultraschall in der Medizin
Tim Aitman, Paraminder Dhillon, Aron M Geurts
Future prospects continue to be strong for research using the rat as a model organism. New technology has enabled the proliferation of many new transgenic and knockout rat strains, the genomes of more than 40 rat strains have been sequenced, publications using the rat as a model continue to be produced at a steady rate, and discoveries of disease-associated genes and mechanisms from rat experiments abound, frequently with conservation of function between rats and humans. However, advances in genome technology have led to increasing insights into human disease directly from human genetic studies, pulling more and more researchers into the human genetics arena and placing funding for model organisms and their databases under threat...
October 1, 2016: Disease Models & Mechanisms
Maria Fusaro, Maurizio Gallieni, Maria Antonietta Rizzo, Andrea Stucchi, Pierre Delanaye, Etienne Cavalier, Rosa M A Moysés, Vanda Jorgetti, Giorgio Iervasi, Sandro Giannini, Fabrizio Fabris, Andrea Aghi, Stefania Sella, Francesco Galli, Valentina Viola, Mario Plebani
Vitamin K (phylloquinone or vitamin K1 and menaquinones or vitamin K2) plays an important role as a cofactor in the synthesis of hepatic blood coagulation proteins, but recently has also aroused an increasing interest for its action in extra-hepatic tissues, in particular in the regulation of bone and vascular metabolism. The accurate measurement of vitamin K status in humans is still a critical issue. Along with indirect assays, such as the undercarboxylated fractions of vitamin K-dependent proteins [prothrombin, osteocalcin (OC), and matrix gla protein], the direct analysis of blood levels of phylloquinone and menaquinones forms might be considered a more informative and direct method for assessing vitamin K status...
October 12, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
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