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https://www.readbyqxmd.com/read/30321895/futility-and-patients-who-insist-on-medically-ineffective-therapy
#1
Laura Cifrese, Fred Rincon
As medical decisions fall under more scrutiny and society demands increasing transparency of care, it is likely that more opportunities for conflicts will emerge. Similarly, with increasing demand and a static supply, the issue of who receives treatment and for how long naturally will arise. This mismatch leads to discussions of resource utilization and limitation of care in light of patients' values and rights. Clinicians should always be forthcoming with the uncertainty of prognostication while also articulating the severity of a patient's disease in relation to the risk and benefits of an intervention...
October 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/30321258/anatomical-study-of-the-chinese-nasal-keystone-region
#2
Zeli Han, Feng Wang, Chengyong Zhou, Adriana Chou
Background: The keystone region is an important anatomical structure to consider in rhinoseptoplasty, because there are few published data regarding the keystone region in Chinese noses. Objectives: The authors sought to describe the anatomy of the Chinese nasal keystone region and provide useful knowledge for rhinoseptoplasty. Methods: Sixteen cadaveric heads (11 males, 5 females) were dissected, measured, and then compared with previously published data...
October 12, 2018: Aesthetic Surgery Journal
https://www.readbyqxmd.com/read/30320710/beyond-competencies-practice-standards-for-emergency-nurse-practitioners-a-model-for-specialty-care-clinicians-educators-and-employers
#3
Elda Ramirez, Lorna Schumann, Donna Agan, Karen Sue Hoyt, Jennifer Wilbeck, Diane Tyler, Dian Dowling Evans
BACKGROUND/PURPOSE: The growth of advanced practice nursing specialties requires additional expertise for practice that goes beyond entry-level competencies, knowledge, skills, and abilities. A practice standards model for specialty nurse practitioners (PSMSNPs) is introduced that differentiates entry-to-practice population foci competencies from advanced specialty practice standards. OBJECTIVES: (a) Differentiate competencies and practice standards in context to specialty NPs using the emergency specialty as the exemplar, (b) articulate the process to develop the PSMSNP that evolved from an evidence-based practice analysis of NPs working in emergency care, (c) apply the PSMSNP for adaptation to other specialties, and (d) provide implications for the utilization of the PSMSNP by educators, clinicians, and employers...
October 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/30320691/three-dimensional-analysis-of-the-correlation-between-soft-tissue-and-bone-of-the-lower-face-using-three-dimensional-facial-laser-scan
#4
Seok Hwan Kim, Ho Seong Shin
BACKGROUND: The prime aims of this study were to establish cephalometric linear and angular normative values of the lower face using a three-dimensional (3D) analysis in Korean individuals, and validate whether the linear and angular measurements using 3D laser scanner are comparable with measurements using 3D computed tomography (CT). METHODS: In this study, 40 Korean individuals aged between 18 and 60 years were enrolled. Using 3D CT scan and 3D laser scanner, linear and angular values of the lower face were measured and recorded...
October 12, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/30320438/family-therapy-approaches-for-anorexia-nervosa
#5
REVIEW
Caroline A Fisher, Sonja Skocic, Kathleen A Rutherford, Sarah E Hetrick
BACKGROUND: Anorexia nervosa (AN) is characterised by a failure to maintain a normal body weight due to a paucity of nutrition, an intense fear of gaining weight or behaviour that prevents the individual from gaining weight, or both. The long-term prognosis is often poor, with severe developmental, medical and psychosocial complications, high rates of relapse and mortality. 'Family therapy approaches' indicate a range of approaches, derived from different theories, that involve the family in treatment...
October 15, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/30320123/discrete-subaortic-stenosis-perspective-roadmap-to-a-complex-disease
#6
Danielle D Massé, Jason A Shar, Kathleen N Brown, Sundeep G Keswani, K Jane Grande-Allen, Philippe Sucosky
Discrete subaortic stenosis (DSS) is a congenital heart disease that results in the formation of a fibro-membranous tissue, causing an increased pressure gradient in the left ventricular outflow tract (LVOT). While surgical resection of the membrane has shown some success in eliminating the obstruction, it poses significant risks associated with anesthesia, sternotomy, and heart bypass, and it remains associated with a high rate of recurrence. Although a genetic etiology had been initially proposed, the association between DSS and left ventricle (LV) geometrical abnormalities has provided more support to a hemodynamic etiology by which congenital or post-surgical LVOT geometric derangements could generate abnormal shear forces on the septal wall, triggering in turn a fibrotic response...
2018: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/30319480/articulation-and-dynamics-influence-the-perceptual-attack-time-of-saxophone-sounds
#7
Toni Amadeus Bechtold, Olivier Senn
Perceptual attack time (PAT) is defined as the moment when the most salient rhythmical feature of a sound is perceived. This paper focuses on the PAT of saxophone sounds, investigating how the location of this point in time changes when a note is played with different characteristics. Nine saxophone sounds that differ in articulation and dynamics were examined. Ground truth for PAT was determined in a synchronization judgment experiment with 40 participants. Articulation ( p < 0.001, η2 = 0.316), dynamics ( p < 0...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/30319472/drawing-on-the-arts-to-enhance-salutogenic-coping-with-health-related-stress-and-loss
#8
Ephrat Huss, Tali Samson
The connection between art therapy and specific theories of positive psychology such as Antonovsky's theory of salutogenic sense of coherence (SOC) has been less articulated in the literature. This paper draws a methodological connection between art therapy and SOC, that is, meaning, manageability and comprehensibility, as the components of coping. This theoretical and methodological connection is then explored with a group of participants dealing with the health-stress of cancer. Method: We conducted a large-scale, qualitative study that included fifty transcribed hours of thematically analyzed arts processes and one hundred art works, used to explore salutogenic theory within a support group for recovering oncological patients...
2018: Frontiers in Psychology
https://www.readbyqxmd.com/read/30319244/-i-don-t-know-exactly-what-you-re-referring-to-the-challenge-of-values-elicitation-in-decision-making-for-implantable-cardioverter-defibrillators
#9
Sandra L Carroll, Gayathri Embuldeniya, Jasprit Pannag, Krystina B Lewis, Jeff S Healey, Michael McGillion, Lehana Thabane, Dawn Stacey
Purpose: Patients' values are a key component of patient-centered care and shared decision making in health care organizations. There is limited understanding on how patients' values guide their health related decision making or how patients understand the concept of values during these processes. This study investigated patients' understanding of their values in the context of considering the risks/benefits of receiving an implantable cardioverter-defibrillator (ICD). Patients and methods: A qualitative substudy was conducted within a feasibility trial with first-time ICD candidates randomized to receive a patient decision aid or usual care prior to specialist consultation...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/30318277/mechanism-diagrams-and-abstraction-by-aggregation
#10
Sim-Hui Tee
Mechanism diagrams exhibit visually the organized parts and operations of a biological mechanism. A mechanism diagram can facilitate mechanistic research by providing a mechanistic explanation of the phenomenon of interest. Much research has been focusing on the mechanistic explanation and the explanatory mechanistic models. As a specific type of scientific diagram, a simple mechanism diagram can be explanatory by drawing on the rich explanatory resources of non-depicted background knowledge. The relationship between the visually depicted and the background knowledge is underexplored...
October 11, 2018: Studies in History and Philosophy of Biological and Biomedical Sciences
https://www.readbyqxmd.com/read/30317937/participation-in-science-and-engineering-laboratories-for-students-with-physical-disabilities-survey-development-and-psychometrics
#11
H Jeannis, M Goldberg, K Seelman, M Schmeler, R A Cooper
PURPOSE: The purpose of this study is to address the development of the Full Participation Science and Engineering Accessibility (FPSEA) self-report survey that gathers experiences from students with physical disabilities (SwD-P) using a postsecondary laboratory and to evaluate the survey's stability. METHODS: Survey items were generated from an extensive literature review and recommendations articulated by experts. Think-aloud sessions and content validity index (CVI) were used to determine survey content validity and help finalize survey items...
October 13, 2018: Disability and Rehabilitation. Assistive Technology
https://www.readbyqxmd.com/read/30316992/what-speech-can-tell-us-a-systematic-review-of-dysarthria-characteristics-in-multiple-sclerosis
#12
REVIEW
Gustavo Noffs, Thushara Perera, Scott Camaron Kolbe, Camille Jessica Shanahan, Frederique Maria Christina Boonstra, Andrew Evans, Helmut Butzkueven, Anneke van der Walt, Adam Phillip Vogel
IMPORTANCE: Multiple sclerosis produces neurological impairments that are variable in duration, severity and quality. Speech is frequently impaired, resulting in decreased communication skills and quality of life. Advancements in technology now makes it possible to use quantitative acoustic assessment of speech as biomarkers of disease progression. OBSERVATIONS: Four domains of speech have been identified: articulation (slow articulation and imprecise consonants), voice (pitch and loudness instability), respiration (decreased phonatory time and expiratory pressure) and prosody (longer and frequent pauses, deficient loudness control)...
October 11, 2018: Autoimmunity Reviews
https://www.readbyqxmd.com/read/30314100/on-the-need-of-providing-tooth-morphology-in-descriptions-of-extant-elasmobranch-species
#13
Guillaume Guinot, Sylvain Adnet, Kenshu Shimada, Kenshu Shimada, Charlie J Underwood, Mikael Siversson, David J Ward, JÜrgen Kriwet, Henri Cappetta
Elasmobranchii is a clade of chondrichthyans (cartilaginous fishes) that comprises sharks, skates and rays represented today by approximately 1,200 species. Chondrichthyans have a long evolutionary history dating back to the Late Ordovician (ca. 450 million years ago [Mya]) based on isolated dermal denticles (Janvier 1996). Other remains such as articulated skeletons and teeth are known from the Lower Devonian (ca. 410 Mya: Mader 1986; Miller et al. 2003). The fossil record of modern elasmobranchs (Neoselachii) can be traced back to the Early Permian (ca...
August 20, 2018: Zootaxa
https://www.readbyqxmd.com/read/30314016/new-species-of-grubeulepis-pettibone-1969-eulepethidae-annelida-from-northern-brazil
#14
Allana stÉphanie Tavares Cutrim, Emanuelle Fernandes Praseres, Jhully Mickaelly Vermont Silva ConceiÇÃo, Zafira da Silva De Almeida, Miodeli Nogueira JÚnior, VerÔnica Maria De Oliveira
Eulepethidae is one of the least diverse families of scale polychaetes, with only 23 species described thus far. In this study we describe an additional species of Grubeulepis from unconsolidated substrata from Maranhão, tropical Brazil (ca. 2°S). Grubeulepis serrata sp. nov. differs from other species of the family due to the presence of one pair of eyes, 14 pairs of branchiae, posterior lamellae beginning in the 27th segment, with hooked upper notochaetae and serrated outer edge acicular neurochaeta in the 3rd segment...
June 27, 2018: Zootaxa
https://www.readbyqxmd.com/read/30313922/a-new-species-of-the-genus-leptolalax-anura-megophryidae-from-hunan-china
#15
Yinmeng Hou, Mengfei Zhang, Fei Hu, Siyuan Li, Shengchao Shi, Jun Chen, Xiaoyang Mo, Bin Wang
A new species, Leptolalax mangshanensis sp. nov., is described from the Mangshan National Nature Reserve, in Hunan Province, China. The new species is genetically similar to Leptolalax liui, and morphologically similar to Leptolalax maoershanensis. Morphological characteristics that distinguish the new species from its congeners are a small body size (snout-vent length, SVL, 22.2 mm-27.8 mm in 27 adult males, and 30.2 mm in one adult female); nearly smooth dorsal skin with some small, orange, tubercles and irregular, dark brown stripes, throat and belly scattered with white speckles, weak lateral fringes on toes and rudimentary toe webbing; indistinct longitudinal ridges under toes, and not interrupted at the articulations, iris bicolored with bright orange in the upper half and greyish cream in the lower half...
July 10, 2018: Zootaxa
https://www.readbyqxmd.com/read/30311969/what-is-the-role-of-sense-of-community-in-multiracial-societies-a-contribution-to-the-community-diversity-dialectic-a-genetic-psychology-approach
#16
Alessia Rochira
Interconnecting the construct of sense of community (SOC), elaborated by McMillan and Chavis, with the notion of social representations, elaborated by Moscovici, this article aims to contribute to advancing an understanding of the relationship between SOC and respect for diversity. Utilizing a genetic psychology approach and the intergroup contact theory, the article articulates 3 levels through which the social representation of community and SOC can be formed and transformed (i.e., microgenetic, ontogenetic, and sociogenetic) to enhance the investigation of the relationship between the 2 phenomena beyond the intraindividual and interindividual levels that tend to emphasize homophily, or preference for similarity...
November 2018: Journal of Community Psychology
https://www.readbyqxmd.com/read/30311837/oral-kinematics-examining-the-role-of-edibility-and-valence-in-the-in-out-effect
#17
Sandra Godinho, Margarida V Garrido, Michael Zürn, Sascha Topolinski
Previous research has revealed a stable preference for words with inward consonantal-articulation patterns (from the front to the back of the mouth; e.g. BENOKA), over outward-words (from the back to the front; e.g. KENOBA). Following the oral approach-avoidance account suggesting that the in-out effect is due to the resemblance between consonantal-articulations patterns and ingestion/expectoration, recent findings have shown that when judging inward-outward names for objects with particular oral functions, valence did not modulate the effect while the oral function did...
October 12, 2018: Cognition & Emotion
https://www.readbyqxmd.com/read/30311751/design-and-control-of-system-for-elbow-rehabilitation-preliminary-findings
#18
Tadeusz Mikołajczyk, Adam Kłodowski, Emilia Mikołajewska, Paweł Walkowiak, Pedro Berjano, Jorge Hugo Villafañe, Francesco Aggogeri, Alberto Borboni, Davide Fausti, Gianluigi Petrogalli
BACKGROUND: The use of an exoskeleton elbow is considered an effective treatment in several pathologies, including post-stroke complications, traumatic brain injury (TBI) and spinal cord injury (SCI), as well as in patients with neurodegenerative disorders. The effectiveness of rehabilitation is closely linked to a suitably chosen therapy. The treatment can be performed only by specialized personnel, significantly supported by the use of automated devices. OBJECTIVES: The aim of this study was to present a novel exoskeleton for elbow rehabilitation without a complicated control system...
October 12, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
https://www.readbyqxmd.com/read/30311227/becoming-good-citizens-of-aging-societies
#19
Nancy Berlinger, Mildred Z Solomon
The ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we've agreed that aging is morally important and that population-level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what is our field's contribution? We argue that it is time for bioethics to turn toward social justice and problems of injustice and that part of doing so is articulating a concept of good citizenship in an aging society that goes beyond health care relationships...
September 2018: Hastings Center Report
https://www.readbyqxmd.com/read/30310744/a-new-species-of-the-odorous-frog-genus-odorrana-amphibia-anura-ranidae-from-southwestern-china
#20
Shize Li, Ning Xu, Jingcai Lv, Jianping Jiang, Gang Wei, Bin Wang
The genus Odorrana is widely distributed in the mountains of East and Southeastern Asia. An increasing number of new species in the genus have been recognized especially in the last decade. Phylogenetic studies of the O. schmackeri species complex with wide distributional range also revealed several cryptic species. Here, we describe a new species in the species complex from Guizhou Province of China. Phylogenetic analyses based on mitochondrial DNA indicated the new species as a monophyly clustered into the Odorrana clade and sister to O...
2018: PeerJ
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