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https://www.readbyqxmd.com/read/28644738/national-survey-and-analysis-of-barriers-to-the-utilisation-of-the-2005-mental-capacity-act-by-people-with-bipolar-disorder-in-england-and-wales
#1
Richard Morriss, Mohan Mudigonda, Peter Bartlett, Arun Chopra, Steven Jones
BACKGROUND: The Mental Capacity Act (2005) (MCA) provides a legal framework for advance planning for both health and welfare in England and Wales for people if they lose mental capacity, for example, through mania or severe depression. AIMS: To determine the proportion of people with bipolar disorder (BD) who utilise advance planning, their experience of using it and barriers to its implementation. METHODS: National survey of people with clinical diagnosis of BD of their knowledge, use and experience of the MCA...
June 23, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28642696/how-accumulated-real-life-stress-experience-and-cognitive-speed-interact-on-decision-making-processes
#2
Eva Friedel, Miriam Sebold, Sören Kuitunen-Paul, Stephan Nebe, Ilya M Veer, Ulrich S Zimmermann, Florian Schlagenhauf, Michael N Smolka, Michael Rapp, Henrik Walter, Andreas Heinz
Rationale: Advances in neurocomputational modeling suggest that valuation systems for goal-directed (deliberative) on one side, and habitual (automatic) decision-making on the other side may rely on distinct computational strategies for reinforcement learning, namely model-free vs. model-based learning. As a key theoretical difference, the model-based system strongly demands cognitive functions to plan actions prospectively based on an internal cognitive model of the environment, whereas valuation in the model-free system relies on rather simple learning rules from operant conditioning to retrospectively associate actions with their outcomes and is thus cognitively less demanding...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28642690/autonomy-in-depressive-patients-undergoing-dbs-treatment-informed-consent-freedom-of-will-and-dbs-potential-to-restore-it
#3
Timo Beeker, Thomas E Schlaepfer, Volker A Coenen
According to the World Health Organization, depression is one of the most common and most disabling psychiatric disorders, affecting at any given time approximately 325 million people worldwide. As there is strong evidence that depressive disorders are associated with a dynamic dysregulation of neural circuits involved in emotional processing, recently several attempts have been made to intervene directly in these circuits via deep brain stimulation (DBS) in patients with treatment-resistant major depressive disorder (MDD)...
2017: Frontiers in Integrative Neuroscience
https://www.readbyqxmd.com/read/28642511/the-mental-capacity-act-2005-considerations-for-obtaining-consent-for-dental-treatment
#4
O Modgill, C Bryant, S Moosajee
The Mental Capacity Act 2005 provides a legal framework within which specific decisions must be made when an individual lacks the mental capacity to make such decisions for themselves. With an increasingly aged, medically complex and in some cases socially isolated population presenting for dental care, dentists need to have a sound understanding of the appropriate management of patients who lack capacity to consent to treatment when they present in the dental setting. Patients with acute symptoms requiring urgent care and un-befriended patients present additional complexities...
June 23, 2017: British Dental Journal
https://www.readbyqxmd.com/read/28639478/relation-between-capacity-and-performance-in-paediatric-upper-limb-prosthesis-users
#5
Helen Lindner, Ayako Hiyoshi, Liselotte Hermansson
BACKGROUND: The International Classification of functioning, disability and health refers capacity to what an individual can do in a standardised environment and describes performance as what an individual really does and whether the individual encounters any difficulty in the real-life environment. Measures of capacity and performance can help to determine if there is any gap between them that may restrict participation. The aim of this study was to explore the relationship between capacity scores obtained in a standardised clinical setting and proportional ease of performance obtained from a real-life environment...
June 1, 2017: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/28638609/cognitive-function-and-advanced-kidney-disease-longitudinal-trends-and-impact-on-decision-making
#6
Osasuyi Iyasere, David Okai, Edwina Brown
Background: Cognitive impairment commonly affects renal patients. But little is known about the influence of dialysis modality on cognitive trends or the influence of cognitive impairment on decision-making in renal patients. This study evaluated cognitive trends amongst chronic kidney disease (CKD), haemodialysis (HD) and peritoneal dialysis (PD) patients. The relationship between cognitive impairment and decision-making capacity (DMC) was also assessed. Methods: Patients were recruited from three outpatient clinics...
February 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28637473/sustainability-in-health-care-by-allocating-resources-effectively-share-7-supporting-staff-in-evidence-based-decision-making-implementation-and-evaluation-in-a-local-healthcare-setting
#7
Claire Harris, Kelly Allen, Cara Waller, Tim Dyer, Vanessa Brooke, Marie Garrubba, Angela Melder, Catherine Voutier, Anthony Gust, Dina Farjou
BACKGROUND: This is the seventh in a series of papers reporting Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The SHARE Program was a systematic, integrated, evidence-based program for resource allocation within a large Australian health service. It aimed to facilitate proactive use of evidence from research and local data; evidence-based decision-making for resource allocation including disinvestment; and development, implementation and evaluation of disinvestment projects...
June 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28634769/decision-making-capacity-and-unusual-beliefs-two-contentious-cases-australasian-association-of-bioethics-and-health-law-john-mcphee-law-student-essay-prize-2016
#8
Brent Hyslop
Decision-making capacity is a vital concept in law, ethics, and clinical practice. Two legal cases where capacity literally had life and death significance are NHS Trust v Ms T [2004] and Kings College Hospital v C [2015]. These cases share another feature: unusual beliefs. This essay will critically assess the concept of capacity, particularly in relation to the unusual beliefs in these cases. Firstly, the interface between capacity and unusual beliefs will be examined. This will show that the "using and weighing of information" is the pivotal element in assessment...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28634767/including-people-with-dementia-in-research-an-analysis-of-australian-ethical-and-legal-rules-and-recommendations-for-reform
#9
Nola M Ries, Katie A Thompson, Michael Lowe
Research is crucial to advancing knowledge about dementia, yet the burden of the disease currently outpaces research activity. Research often excludes people with dementia and other cognitive impairments because researchers and ethics committees are concerned about issues related to capacity, consent, and substitute decision-making. In Australia, participation in research by people with cognitive impairment is governed by a national ethics statement and a patchwork of state and territorial laws that have widely varying rules...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28630539/theorizing-time-in-abortion-law-and-human-rights
#10
Joanna N Erdman
The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion-pregnant women...
June 2017: Health and Human Rights
https://www.readbyqxmd.com/read/28623384/the-role-of-cardiopulmonary-exercise-testing-for-decision-making-in-patients-with-repaired-tetralogy-of-fallot
#11
REVIEW
Frederic Dallaire, Rachel M Wald, Ariane Marelli
Tetralogy of Fallot is the most common form of cyanotic congenital heart disease. As a result of the surgical strategies employed at the time of initial repair, chronic pulmonary regurgitation (PR) is prevalent in this population. Despite sustained research efforts, patient selection and timing of pulmonary valve replacement (PVR) to address PR in young asymptomatic patients with repaired tetralogy of Fallot (rToF) remain a fundamental but as yet unanswered question in the field of congenital heart disease...
June 16, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28617191/operator-models-for-delivering-municipal-solid-waste-management-services-in-developing-countries-part-b-decision-support
#12
Reka Soós, Andrew D Whiteman, David C Wilson, Cosmin Briciu, Sofia Nürnberger, Barbara Oelz, Ellen Gunsilius, Ekkehard Schwehn
This is the second of two papers reporting the results of a major study considering 'operator models' for municipal solid waste management (MSWM) in emerging and developing countries. Part A documents the evidence base, while Part B presents a four-step decision support system for selecting an appropriate operator model in a particular local situation. Step 1 focuses on understanding local problems and framework conditions; Step 2 on formulating and prioritising local objectives; and Step 3 on assessing capacities and conditions, and thus identifying strengths and weaknesses, which underpin selection of the operator model...
June 1, 2017: Waste Management & Research
https://www.readbyqxmd.com/read/28613138/a-neuropsychological-study-of-older-adult-first-time-sex-offenders
#13
Marcelo Rodriguez, Philip Boyce, John Hodges
BACKGROUND/AIMS: The issue of whether sex offenders have cognitive deficits remains controversial. The objective of this study was to compare the neuropsychological function of older adult first time sex-offenders (FTSO), who had not previously been charged with a sexual offence prior to the age of 50, to historical long-term sex offenders (HSO) and non-sex offenders (NSO). The hypotheses were (a) that FTSO would demonstrate greater deficits in executive function, decision-making, and memory compared to non-sex offenders; and (b) the HSOs would present similar neuropsychological deficits to non-sex offenders...
June 14, 2017: Neurocase
https://www.readbyqxmd.com/read/28608451/commissioning-and-equity-in-primary-care-in-australia-views-from-primary-health-networks
#14
Julie Henderson, Sara Javanparast, Tamara MacKean, Toby Freeman, Fran Baum, Anna Ziersch
This paper reports findings from 55 stakeholder interviews undertaken in six Primary Health Networks (PHNs) in Australia as part of a study of the impact of population health planning in regional primary health organisations on service access and equity. Primary healthcare planning is currently undertaken by PHNs which were established in 2015 as commissioning organisations. This was a departure from the role of Medicare Locals, the previous regional primary health organisations which frequently provided services...
June 12, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28604116/the-cognitive-decline-in-older-patients-with-end-stage-renal-disease-cope-study-rationale-and-design
#15
Noeleen Berkhout-Byrne, Marije H Kallenberg, André Gaasbeek, Ton J Rabelink, Sebastiaan Hammer, Mark A van Buchem, Matthias J van Osch, Lucia J M Kroft, Henk Boom, Simon P Mooijaart, Marjolijn van Buren
BACKGROUND: Older patients with end stage renal disease (ESRD) are at increased risk for cognitive decline, but detailed studies of the magnitude of cognitive decline on dialysis or comprehensive conservative management (CCM) are lacking and the underlying pathophysiological mechanisms have poorly been studied. OBJECTIVE: To describe the rationale and design of the COPE study. Study objectives are firstly to examine the severity of cognitive impairment in older patients reaching ESRD before dialysis and the rate of decline after dialysis or CCM initiation...
June 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28599360/lessons-learned-from-khartoum-flash-flood-impacts-an-integrated-assessment
#16
Mohamad Ibrahim Mahmood, Nadir Ahmed Elagib, Finlay Horn, Suhair A G Saad
This study aims at enabling the compilation of key lessons for decision makers and urban planners in rapidly urbanizing cities regarding the identification of representative, chief causal natural and human factors for the increased level of flash flood risk. To achieve this, the impacts of flash flood events of 2013 and 2014 in the capital of Sudan, Khartoum, were assessed using seven integrated approaches, i.e. rainfall data analysis, document analysis of affected people and houses, observational fieldwork in the worst flood affected areas, people's perception of causes and mitigation measures through household interviews, reported drinking water quality, reported water-related diseases and social risk assessment...
June 8, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28597858/policy-and-governance-to-address-depression-and-suicide-in-bhutan-the-national-suicide-prevention-strategy
#17
Gampo Dorji, Sonam Choki, Kinga Jamphel, Yeshi Wangdi, Tandin Chogyel, Chencho Dorji, Damber Kumar Nirola
Suicide and mental disorders are a growing public health issue in Bhutan, due in part to a rapidly transitioning society. The burden of suicide has been recognized by the Royal Government of Bhutan and, as a result, it introduced the country's first ever national suicide-prevention plan in 2015. The 3-year action plan takes a holistic approach to making suicide-prevention services a top social priority, through strengthening suicide-prevention policies, promoting socially protective measures, mitigating risk factors and reaching out to individuals who are at risk of suicide or affected by incidents of suicide...
April 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28596046/capacity-evaluation-requests-in-the-medical-setting-a-retrospective-analysis-of-underlying-psychosocial-and-ethical-factors
#18
Stephen Pesanti, Brandon Hamm, Bryn Esplin, Matt Karafa, Xavier F Jimenez
BACKGROUND: Psychosocial and ethical variables influence physicians in requesting decision-making capacity (DMC) evaluations. Previous authors have classified certain DMC evaluation requests as "unwarranted" when there is no explicit suspicion or evidence that the patient might lack DMC. OBJECTIVE: To explore psychosocial and ethical reasons motivating both "warranted" and "unwarranted" DMC evaluation requests by physicians in the medical setting. METHODS: A retrospective electronic health record review was approved by the institutional review board...
March 28, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28588896/promoting-transparency-accountability-and-access-through-a-multi-stakeholder-initiative-lessons-from-the-medicines-transparency-alliance
#19
Taryn Vian, Jillian C Kohler, Gilles Forte, Deirdre Dimancesco
BACKGROUND: Barriers to expanding access to medicines include weak pharmaceutical sector governance, lack of transparency and accountability, inadequate attention to social services on the political agenda, and financing challenges. Multi-stakeholder initiatives such as the Medicines Transparency Alliance (MeTA) may help overcome these barriers. Between 2008 and 2015, MeTA engaged stakeholders in the pharmaceutical sectors of seven countries (Ghana, Jordan, Kyrgyzstan, Peru, Philippines, Uganda, and Zambia) to promote access goals through greater transparency...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28588508/individual-differences-in-subjective-utility-and-risk-preferences-the-influence-of-hedonic-capacity-and-trait-anxiety
#20
Jonathon R Howlett, Martin P Paulus
Individual differences in decision-making are important in both normal populations and psychiatric conditions. Variability in decision-making could be mediated by different subjective utilities or by other processes. For example, while traditional economic accounts attribute risk aversion to a concave subjective utility curve, in practice other factors could affect risk behavior. This distinction may have important implications for understanding the biological basis of variability in decision-making and for developing interventions to improve decision-making...
2017: Frontiers in Psychiatry
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