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share making decisions

Changquan Long, Mingming Zhang, Ruifang Cui, Jie Chen
Category-based inferences allow inductions about novel properties based on categorical memberships (e.g., knowing all trout have genes [premise] allows us to infer that all fish have genes [conclusion]). Natural (N) and artificial (A) domains are the most obvious and traditional distinctions in categorization. The distinct event-related potential (ERP) responses for N and A domains have not yet been examined during category-based inferences. In this study, the differences between ERP inference parameters within N and A domains were measured during inductive decision processing, while controlling the premise-conclusion similarity and premise typicality between those two domains...
August 17, 2018: Scientific Reports
Paul Perversi, John Yearwood, Emilia Bellucci, Andrew Stranieri, Jim Warren, Frada Burstein, Heather Mays, Alan Wolff
BACKGROUND: Ward rounds are an important and ubiquitous element of hospital care with a history extending well over a century. Although originally intended as a means of educating medical trainees and junior doctors, over time they have become focused on supporting clinical practice. Surprisingly, given their ubiquity and importance, they are under-researched and inadequately understood. This study aims to contribute knowledge in human reasoning within medical teams, meeting a pressing need for research concerning the reasoning occurring in rounds...
August 17, 2018: BMC Health Services Research
Denise O'Brien, Mary Casey, Michelle M Butler
OBJECTIVE: To explore women's experiences of the concept of informed choice during pregnancy and childbirth. METHODS: A three-phase action research approach. In the second phase of the study (reported in this paper), 15 women were interviewed to establish their experiences of informed choice. SETTING: Dublin, Ireland in a large maternity hospital. FINDINGS: We found that multiple factors influence how women experience informed choice including; their sense of self and the quality of their relationships with maternity care professionals...
August 14, 2018: Midwifery
Mario Luciano, Corrado De Rosa, Gaia Sampogna, Valeria Del Vecchio, Vincenzo Giallonardo, Michele Fabrazzo, Francesco Catapano, George Onchev, Jiri Raboch, Anastasia Mastrogianni, Zahava Solomon, Algirdas Dembinskas, Petr Nawka, Andrzej Kiejna, Francisco Torres-Gonzales, Lars Kjellin, Kallert Thomas, Fiorillo Andrea
BACKGROUND: The decision to adopt forced medication in psychiatric care is particularly relevant from a clinical and ethical viewpoint. The European Commission has funded the EUNOMIA study in order to develop European recommendations for good clinical practice on coercive measures, including forced medication. METHODS: The recommendations on forced medication have been developed in 11 countries with the involvement of national clinical leaders, key-professionals and stakeholders' representatives...
August 14, 2018: European Psychiatry: the Journal of the Association of European Psychiatrists
Julie Hellesøe Christensen, Paul Bloch, Signe Rysbjerg Møller, Cecilie Prüsse Søgaard, Charlotte Demant Klinker, Jens Aagaard-Hansen, Peter Bentsen
Health promotion increasingly involves collaboration with civil society organisations and the private sector rather than being implemented exclusively by public sector stakeholders. Health in All Policies (HiAP) is an approach that promotes health in policy-making across public sectors. This study explored intersectoral integration and collaboration for health promotion at a local community level through a qualitative single case study of a local community network in Denmark: the Husum Health Network. The paper describes and discusses strengths, weaknesses, and challenges of HiAP-inspired local efforts to build alliances and supportive environments for health within an inter-organisational community-based network...
August 16, 2018: International Journal of Health Planning and Management
Emilie A C Dronkers, Arta Hoesseini, Maarten F de Boer, Marinella P J Offerman
OBJECTIVES: In shared decision making it is important to adequately, timely and actively involve patients in treatment decisions. Sharing prognostic information can be of key importance. This study describes whether and how prognostic information on life expectancy is included during communication on diagnosis and treatment plans between physicians and head and neck (H&N) oncologic patients in different phases of disease. METHODS: A descriptive, qualitative study was performed of n = 23 audiotaped physician-patient conversations in which both palliative and curative treatment options were discussed and questions on prognosis were expected...
September 2018: Oral Oncology
Wouter R Verberne, Janneke Dijkers, Johannes C Kelder, Anthonius B M Geers, Wilbert T Jellema, Hieronymus H Vincent, Johannes J M van Delden, Willem Jan W Bos
BACKGROUND: Conservative care is argued to be a reasonable treatment alternative for dialysis in older patients with advanced chronic kidney disease (CKD). However, comparisons are scarce and generally focus on survival only. Comparative data on more patient-relevant outcomes are needed to truly foster shared decision-making on an individual level, and cost comparison is needed to assess value of care. METHODS: We conducted a retrospective observational single-center cohort study in 366 patients aged ≥70 years with advanced CKD, who chose dialysis (n = 240) or conservative care (n = 126) after careful counselling by a multidisciplinary team in a non-academic teaching hospital in The Netherlands...
August 16, 2018: BMC Nephrology
Vincent D Pellegrini, David S Guzick, Donald E Wilson, C McCollister Evarts
Health care has evolved from a cottage industry to a very complex one comprising nearly one-fifth of the U.S. economy. Large aggregated health care systems have evolved primarily for the purpose of optimizing financial performance by capturing greater market share and taking advantage of economies of scale in care delivery. With the noble intent of providing a broader base of support for the academic mission, academic health centers (AHCs) have followed suit by partnering with community hospitals and organizations with variable prior experience in the education and research arenas...
August 14, 2018: Academic Medicine: Journal of the Association of American Medical Colleges
Megan Schechtman, Keith E Kocher, Michele M Nypaver, Jason J Ham, Melissa K Zochowski, Michelle L Macy
OBJECTIVES: To characterize emergency department (ED) leader's attitudes toward potentially avoidable admissions and experiences with the use of clinical pathways to guide admission decisions, including the challenges and successes with implementation of these pathways. METHODS: A mixed-methods study of Michigan ED leaders was conducted. First, a cross-sectional web-based survey was distributed via email to all 135 hospital-based EDs in the state. Descriptive statistics were calculated...
August 15, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Nathalie Moise, Louise Falzon, Megan Obi, Siqin Ye, Sapana Patel, Christopher Gonzalez, Kelsey Bryant, Ian M Kronish
INTRODUCTION: Nearly 50% of depressed primary care patients referred to mental health services do not initiate mental health treatment. The most promising interventions for increasing depression treatment initiation in primary care settings remain unclear. METHODS: We performed a systematic search of publicly available databases from inception through August 2017 to identify interventions designed to increase depression treatment initiation. Two authors independently selected, extracted data, and rated risk of bias from included studies...
August 14, 2018: Journal of General Internal Medicine
Patricia H Birch, S Adam, R R Coe, A V Port, M Vortel, J M Friedman, F Légaré
Shared decision-making (SDM) is a collaborative approach in which clinicians educate, support, and guide patients as they make informed, value-congruent decisions. SDM improves patients' health-related outcomes through increasing knowledge, reducing decisional conflict, and enhancing experience of care. We measured SDM in genetic counselling appointments with 27 pregnant women who were at increased risk to have a baby with a genetic abnormality. The eight experienced genetic counsellors who participated had no specific SDM training and were unaware that SDM was being assessed...
August 14, 2018: Journal of Genetic Counseling
Peng Zhang, Jules White, Douglas C Schmidt, Gunther Lenz, S Trent Rosenbloom
Secure and scalable data sharing is essential for collaborative clinical decision making. Conventional clinical data efforts are often siloed, however, which creates barriers to efficient information exchange and impedes effective treatment decision made for patients. This paper provides four contributions to the study of applying blockchain technology to clinical data sharing in the context of technical requirements defined in the "Shared Nationwide Interoperability Roadmap" from the Office of the National Coordinator for Health Information Technology (ONC)...
2018: Computational and Structural Biotechnology Journal
Anja Siegle, Matthias Villalobos, Jasmin Bossert, Katja Krug, Laura Hagelskamp, Johannes Krisam, Violet Handtke, Nicole Deis, Jana Jünger, Michel Wensing, Michael Thomas
BACKGROUND: The care needs of patients with a limited prognosis (<12 months median) are complex and dynamic. Patients and caregivers must cope with many challenges, including physical symptoms and disabilities, uncertainty. and compromised self-efficacy. Healthcare is often characterized by disruptions in the transition between healthcare providers. The Milestones Communication Approach (MCA) is a structured, proactive, interprofessional concept that involves physicians and nurses and is aimed at providing coherent care across the disease trajectory...
August 14, 2018: Trials
Gregory Moore, Jessica Reszel, Thierry Daboval, Brigitte Lemyre, Conor Barker, Sandra Dunn
BACKGROUND AND OBJECTIVES: The decision to attempt resuscitation or provide palliative care at birth for extremely preterm infants between 22-25 weeks remains complex. The purpose of this study was to identify facilitators and barriers to implementation of a clinical practice guideline developed to support shared decision-making for these cases. METHODS: A purposeful sample of healthcare providers, involved in the care of one of five cases of anticipated extremely preterm birth, was recruited for interviews...
August 14, 2018: Journal of Maternal-fetal & Neonatal Medicine
Annoek Louwers, Jessica Warnink-Kavelaars, Miryam Obdeijn, Mick Kreulen, Frans Nollet, Anita Beelen
BACKGROUND: Little is known about the effects of upper-extremity surgery on the manual performance of children and adolescents with cerebral palsy (CP). This clinical cohort study describes our experience with patient selection based on multidisciplinary assessment and shared decision-making and the effects of upper-extremity surgery on manual performance and patient-relevant outcomes. METHODS: All patients (up to 20 years of age) with CP referred to our multidisciplinary team for evaluation for upper-extremity surgery between July 2011 and May 2017 were included...
August 15, 2018: Journal of Bone and Joint Surgery. American Volume
M Raspa, T Fitzgerald, R D Furberg, A Wylie, R Moultrie, M DeRamus, A C Wheeler, L McCormack
BACKGROUND: Little is known about how individuals with fragile X syndrome (FXS) and their families use technology in daily life and what skills individuals with FXS can perform when using mobile technologies. METHODS: Using a mixed-methods design, including an online survey of parents (n = 198) and a skills assessment of individuals with FXS (n = 6), we examined the experiences and abilities of individuals with FXS for engaging with mobile technology. RESULTS: Parents reported that individuals with FXS often used technology in their daily lives, with variations based on age of child, sex, autism status, depression, and overall ability...
August 13, 2018: Journal of Intellectual Disability Research: JIDR
Alison T Brenner, Teri L Malo, Marjorie Margolis, Jennifer Elston Lafata, Shynah James, Maihan B Vu, Daniel S Reuland
Importance: The US Preventive Services Task Force recommends that shared decision making (SDM) involving a thorough discussion of benefits and harms should occur between clinicians and patients before initiating lung cancer screening (LCS) with low-dose computed tomography. The Centers for Medicare & Medicaid Services require an SDM visit using a decision aid as a prerequisite for LCS coverage. However, little is known about how SDM about LCS occurs in practice. Objective: To assess the quality of SDM about the initiation of LCS in clinical practice...
August 13, 2018: JAMA Internal Medicine
Rita F Redberg
No abstract text is available yet for this article.
August 13, 2018: JAMA Internal Medicine
Yoshitsugu Obi, Danh V Nguyen, Hui Zhou, Melissa Soohoo, Lishi Zhang, Yanjun Chen, Elani Streja, John J Sim, Miklos Z Molnar, Connie M Rhee, Kevin C Abbott, Steven J Jacobsen, Csaba P Kovesdy, Kamyar Kalantar-Zadeh
OBJECTIVE: To develop and validate a risk prediction model that would help individualize treatment and improve the shared decision-making process between clinicians and patients. PATIENTS AND METHODS: We developed a risk prediction tool for mortality during the first year of dialysis based on pre-end-stage renal disease characteristics in a cohort of 35,878 US veterans with incident end-stage renal disease who transitioned to dialysis treatment between October 1, 2007, and March 31, 2014 and then externally validated this tool among 4284 patients in the Kaiser Permanente Southern California (KPSC) health care system who transitioned to dialysis treatment between January 1, 2007, and September 30, 2015...
August 10, 2018: Mayo Clinic Proceedings
Thomas B Silverman, Alejandro Vanegas, Awilda Marte, Jennie Mata, Margaret Sin, Juan Carlos Rodriguez Ramirez, Wei-Yann Tsai, Katherine D Crew, Rita Kukafka
BACKGROUND: BRCA1 and BRCA2 mutations confer a substantial breast risk of developing breast cancer to those who carry them. For this reason, the United States Preventative Services Task Force (USPSTF) has recommended that all women be screened in the primary care setting for a family history indicative of a mutation, and women with strong family histories of breast or ovarian cancer be referred to genetic counseling. However, few high-risk women are being routinely screened and fewer are referred to genetic counseling...
August 13, 2018: BMC Health Services Research
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