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https://www.readbyqxmd.com/read/28086861/managing-shades-of-grey-a-focus-group-study-exploring-community-dwellers-views-on-advance-care-planning-in-older-people
#1
Natasha Michael, Clare O'Callaghan, Emma Sayers
BACKGROUND: Community-dwelling consumers of healthcare are increasing, many aging with life-limiting conditions and deteriorating cognition. However, few have had advance care planning discussions or completed documentation to ensure future care preferences are acted upon. This study examines the awareness, attitudes, and experiences of advance care planning amongst older people and unrelated offspring/caregivers of older people residing in the community. METHODS: Qualitative descriptive research, which included focus groups with older people (55+ years) and older people's offspring/caregivers living in an Australian city and surrounding rural region...
January 13, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28079400/dysphagia-therapy-post-stroke-an-exploration-of-the-practices-and-clinical-decision-making-of-speech-language-pathologists-in-australia
#2
Olivia Jones, Jade Cartwright, Anne Whitworth, Naomi Cocks
PURPOSE: A variety of dysphagia management options are available for the treatment of dysphagia following a stroke, however, it is unknown which of these approaches are most commonly utilised by Australian speech-language pathologists (SLPs) and whether particular factors influence decision-making. METHOD: The aim of this study was to investigate, through an online survey, the treatment practices of SLPs in Australia for the treatment of dysphagia post-stroke and identify the factors influencing treatment decisions...
January 12, 2017: International Journal of Speech-language Pathology
https://www.readbyqxmd.com/read/28075219/how-do-assessments-of-activities-of-daily-living-address-executive-functions-a-scoping-review
#3
Frédérique Poncet, Bonnie Swaine, Elisabeth Dutil, Mathilde Chevignard, Pascale Pradat-Diehl
: Executive functions (EF) allow persons to adapt to situations arising in daily life and can be affected following acquired brain injury (ABI). Measuring the impact of EF impairments on the accomplishment of activities of daily living (ADL) requires specific assessment tools, but choosing the right tool may be difficult. PURPOSE: To conduct a scoping review on how assessments of ADL address EF and EF impairments in persons with ABI. METHOD: A scoping review of literature (peer-reviewed and grey literature) published until August 2014 was conducted...
January 11, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28074990/-assessment-of-patients-capacity-to-give-a-valid-consent
#4
Sebastián Robert B, Juan I Reculé, Juan A Prato
Autonomy is an inherent condition of every ethical act. This attribution is expressed, when decisions are made, as capacity. Physician-patient alliance is defied when there is a reasonable doubt of patients' ability to make a choice, an extraordinarily complex scenario. As a response, in the last few decades multiple tools have been developed aiming to determine in a standardized fashion whether capacity is present or not. In the present article, we present a classification of the most well-known tools and discuss their usefulness, the implications for standardization of capacity, and make recommendations for their use, based in evidence...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28074586/the-theory-and-practice-of-surrogate-decision-making
#5
David Wendler
When a patient lacks decision-making capacity and has not left a clear advance directive, there is now widespread agreement that patient-designated and next-of-kin surrogates should implement substituted judgment within a process of shared decision-making. Specifically, after discussing the "best scientific evidence available, as well as the patient's values, goals, and preferences" with the patient's clinicians, the patient-designated or next-of-kin surrogate should attempt to determine what decision the patient would have made in the circumstances...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074581/conflating-capacity-authority-why-we-re-asking-the-wrong-question-in-the-adolescent-decision-making-debate
#6
Erica K Salter
Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents-their being neither children nor adults-in a variety of ways. However, recently there has been a trend to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28070340/civil-society-engagement-in-multi-stakeholder-dialogue-a-qualitative-study-exploring-the-opinions-and-perceptions-of-meta-members
#7
Gemma L Buckland-Merrett, Catherine Kilkenny, Tim Reed
BACKGROUND: The Medicines Transparency Alliance (MeTA) is an initiative that brings together all stakeholders in the medicines market to create a multi-stakeholder dialogue and improve access, availability and affordability of medicines. Key to this multi-stakeholder dialogue is the participation of Civil Society Organisations. A recent MeTA annual review, identified uneven engagement of civil society organisations in the multi-stakeholder process. This study was designed to explore the engagement of Civil Society Organisations in the MeTA multi-stakeholder process and the factors influencing their participation...
2017: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/28069249/barriers-to-intensive-care-unit-nurses-autonomy-in-iran-a%C3%A2-qualitative-study
#8
Maryam AllahBakhshian, Nasrollah Alimohammadi, Fariba Taleghani, Ahmadreza Yazdan Nik, Saeed Abbasi, Leila Gholizadeh
BACKGROUND: The acute nature of the intensive care unit (ICU) environment necessitates that urgent clinical decisions are frequently made by the health care team. Therefore, it is important that critical care nurses have the authority to make decisions about their patient care. PURPOSE: The purpose of this study was to explore perceived barriers to the practice of professional autonomy from the perspectives of ICU nurses in Iran. METHODS: In this qualitative study, 28 critical care nurses were interviewed using a semistructured in-depth interview method...
December 20, 2016: Nursing Outlook
https://www.readbyqxmd.com/read/28068864/reliability-and-sources-of-variation-of-the-abilhand-kids-questionnaire-in-children-with-cerebral-palsy
#9
Lex D de Jong, Annemiek van Meeteren, Cornelis H Emmelot, Nanne E Land, Pieter U Dijkstra
PURPOSE: To determine reliability of the ABILHAND-Kids, explore sources of variation associated with these measurement results, and generate repeatability coefficients. METHOD: A reliability study with a repeated measures design was performed in an ambulatory rehabilitation care department from a rehabilitation center, and a center for special education. A physician, an occupational therapist, and parents of 27 children with spastic cerebral palsy independently rated the children's manual capacity when performing 21 standardized tasks of the ABILHAND-Kids from video recordings twice with a three week time interval (27 first-, and 25 second video recordings available)...
January 9, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28062651/an-activist-s-argument-that-participant-values-should-guide-risk-benefit-ratio-calculations-in-hiv-cure-research
#10
David Evans
The patient empowerment movement, spurred by AIDS activism in the 1980s, quickly evolved to encompass how study participants are considered and treated in clinical research. Initially, people fearing death of AIDS sought early access to experimental medications that had not undergone rigorous testing in hopes of extending their lives. Thirty years on, scientists are asking a different set of ethical questions about clinical research, this time in the pursuit of either a sterilising cure or long-term remission for HIV...
January 6, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28057710/-this-man-with-dementia-1-othering-the-person-with-dementia-in-the-court-of-protection
#11
Laura Pritchard-Jones
In recent years, dementia has been subjected to an increasing ethical, legal, and political gaze. This article analyses how the Court of Protection considers the perspective of the person with dementia when making best interests decisions on their behalf under the Mental Capacity Act 2005. The article draws upon feminist and disability literature to highlight how the Court has, on occasions, 'othered' the person with dementia during the process of making best interests decisions. This is despite law and policy increasingly emphasising that the views of the person who lacks capacity should be central to any best interests decision, as well as emphasising the importance of de-stigmatisation of cognitive impairments, such as dementia...
January 5, 2017: Medical Law Review
https://www.readbyqxmd.com/read/28055223/claim-assessment-profile-a-method-for-capturing-healthcare-evidence-in-the-scientific-evaluation-and-review-of-claims-in-health-care-search
#12
Lara Hilton, Wayne B Jonas
BACKGROUND: Grounding health claims in an evidence base is essential for determining safety and effectiveness. However, it is not appropriate to evaluate all healthcare claims with the same methods. "Gold standard" randomized controlled trials may skip over important qualitative and observational data about use, benefits, side effects, and preferences, issues especially salient in research on complementary and integrative health (CIH) practices. This gap has prompted a move toward studying treatments in their naturalistic settings...
January 5, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28052329/creating-academic-structures-to-promote-nursing-s-role-in-global-health-policy
#13
S Gimbel, P Kohler, P Mitchell, A Emami
AIM: We highlight key components of emerging academic structures in global health nursing and explain how this investment can expand nursing's broader engagement in global health policy development. BACKGROUND: Engaging nursing in global health policy development is vital to ensure the scale-up of effective health programmes. Globally, nurses promote development of interprofessional healthcare teams who are responsible for translating sound global health policy and evidence-based programming into practice...
January 4, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28050150/risk-stratification-treatment-selection-and-transplant-eligibility-in-multiple-myeloma-a-qualitative-study-of-the-perspectives-and-self-reported-practices-of-oncologists
#14
T W LeBlanc, A Howson, W Turell, P Sheldon, S C Locke, S A Tuchman, C Gasparetto, S Kaura, Z M Khan, A P Abernethy
BACKGROUND: Since the early 2000s, treatment options for multiple myeloma have rapidly expanded, adding significant complexity to the management of this disease. To our knowledge, no systematic qualitative research on clinical decision-making in multiple myeloma has been published. We sought to characterize how physicians view and implement guidelines and incorporate novel approaches into patient care. METHODS: We designed a semi-structured qualitative interview guide informed by literature review and an expert advisory panel...
December 2016: Current Oncology
https://www.readbyqxmd.com/read/28049599/effective-orifice-area-during-exercise-in-bileaflet-mechanical-valve-prostheses
#15
Philippe B Bertrand, Matteo Pettinari, Hélène De Cannière, Herbert Gutermann, Christophe J P Smeets, David Verhaert, Robert A Dion, Pascal Verdonck, Pieter M Vandervoort
BACKGROUND: The aims of this study were to investigate the evolution of the transprosthetic pressure gradient and effective orifice area (EOA) during dynamic bicycle exercise in bileaflet mechanical heart valves and to explore the relationship with exercise capacity. METHODS: Patients with bileaflet aortic valve replacement (n = 23) and mitral valve replacement (MVR; n = 16) prospectively underwent symptom-limited supine bicycle exercise testing with Doppler echocardiography and respiratory gas analysis...
December 31, 2016: Journal of the American Society of Echocardiography
https://www.readbyqxmd.com/read/28049454/identifying-mechanisms-for-facilitating-knowledge-to-action-strategies-targeting-the-built-environment
#16
Ghazal S Fazli, Maria I Creatore, Flora I Matheson, Sara Guilcher, Vered Kaufman-Shriqui, Heather Manson, Ashley Johns, Gillian L Booth
BACKGROUND: In recent years, obesity-related diseases have been on the rise globally resulting in major challenges for health systems and society as a whole. Emerging research in population health suggests that interventions targeting the built environment may help reduce the burden of obesity and type 2 diabetes. However, translation of the evidence on the built environment into effective policy and planning changes requires engagement and collaboration between multiple sectors and government agencies for designing neighborhoods that are more conducive to healthy and active living...
January 3, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28045624/bayesian-baskets-a-novel-design-for-biomarker-based-clinical-trials
#17
Lorenzo Trippa, Brian Michael Alexander
Purpose Biomarker-based clinical trials provide efficiencies during therapeutic development and form the foundation for precision medicine. These trials must generate information on both experimental therapeutics and putative predictive biomarkers in the context of varying pretrial information. We generated an efficient, flexible design that accommodates various pretrial levels of evidence supporting the predictive capacity of biomarkers while making pretrial design choices explicit. Methods We generated a randomization procedure that explicitly incorporates pretrial estimates of the predictive capacity of biomarkers...
January 3, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28040231/differences-between-pediatricians-and-internists-in-advance-care-planning-for-adolescents-with-cancer
#18
Nobuyuki Yotani, Yoshiyuki Kizawa, Haruo Shintaku
OBJECTIVE: To evaluate differences between pediatricians and internists in the practice of and barriers to advance care planning (ACP) for adolescent patients with cancer. STUDY DESIGN: A self-reported questionnaire was administered to assess the practice of ACP, advance directives, and barriers to ACP for adolescent patients with cancer. All 3392 Japanese board-certified hematologists were surveyed, and 600 hematologists (227 pediatricians, 373 internists) who take care of adolescent patients with cancer with decision-making capacity were analyzed...
December 28, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/28031301/social-mobilization-and-community-engagement-central-to-the-ebola-response-in-west-africa-lessons-for-future-public-health-emergencies
#19
Amaya M Gillespie, Rafael Obregon, Rania El Asawi, Catherine Richey, Erma Manoncourt, Kshiitij Joshi, Savita Naqvi, Ade Pouye, Naqibullah Safi, Ketan Chitnis, Sabeeha Quereshi
Following the World Health Organization (WHO) declaration of a Public Health Emergency of International Concern regarding the Ebola outbreak in West Africa in July 2014, UNICEF was asked to co-lead, in coordination with WHO and the ministries of health of affected countries, the communication and social mobilization component-which UNICEF refers to as communication for development (C4D)-of the Ebola response. For the first time in an emergency setting, C4D was formally incorporated into each country's national response, alongside more typical components such as supplies and logistics, surveillance, and clinical care...
December 23, 2016: Global Health, Science and Practice
https://www.readbyqxmd.com/read/28030464/selecting-health-care-improvement-projects-a-methodology-integrating-cause-and-effect-diagram-and-analytical-hierarchy-process
#20
Özlem Müge Testik, Amir Shaygan, Erdi Dasdemir, Guray Soydan
OBJECTIVES: It is often vital to identify, prioritize, and select quality improvement projects in a hospital. Yet, a methodology, which utilizes experts' opinions with different points of view, is needed for better decision making. METHODS: The proposed methodology utilizes the cause-and-effect diagram to identify improvement projects and construct a project hierarchy for a problem. The right improvement projects are then prioritized and selected using a weighting scheme of analytical hierarchy process by aggregating experts' opinions...
January 2017: Quality Management in Health Care
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