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https://www.readbyqxmd.com/read/28645202/effects-of-mobility-and-multimorbidity-on-inpatient-and-post-acute-health-care-utilization
#1
Kristine E Ensrud, Li-Yung Lui, Lisa Langsetmo, Tien N Vo, Brent C Taylor, Peggy M Cawthon, Meredith L Kilgore, Charles E McCulloch, Jane A Cauley, Marcia L Stefanick, Kristine Yaffe, Eric S Orwoll, John T Schousboe
Background: This study examines effects of mobility and multimorbidity on hospitalization and inpatient and post-acute care (PAC) facility days among older men. Methods: Prospective study of 1701 men (mean age 79.3 years) participating in MrOS Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high...
June 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28645137/-to-take-or-not-to-take-the-association-between-perceived-addiction-risk-expected-analgesic-response-and-likelihood-of-trying-novel-pain-relievers-in-self-identified-chronic-pain-patients
#2
D Andrew Tompkins, Andrew S Huhn, Patrick S Johnson, Michael T Smith, Eric C Strain, Robert R Edwards, Matthew W Johnson
BACKGROUND AND AIMS: Probability discounting refers to the effect of outcome uncertainty on decision making. Using probability discounting, we examined the degree to which self-identified chronic pain patients (CPP) were likely to try a novel analgesic medication given increasing addiction risk. We postulated that propensity for opioid misuse, trait impulsivity, and previous opioid experience would be positively associated with likelihood of risky medication use. DESIGN: This cross-sectional online study determined state/trait associations with addiction-related medication decisions in CPP...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28644786/antecedents-and-consequences-of-medical-students-moral-decision-making-during-professionalism-dilemmas
#3
Lynn Monrouxe, Malissa Shaw, Charlotte Rees
Medical students often experience professionalism dilemmas (which differ from ethical dilemmas) wherein students sometimes witness and/or participate in patient safety, dignity, and consent lapses. When faced with such dilemmas, students make moral decisions. If students' action (or inaction) runs counter to their perceived moral values-often due to organizational constraints or power hierarchies-they can suffer moral distress, burnout, or a desire to leave the profession. If moral transgressions are rationalized as being for the greater good, moral distress can decrease as dilemmas are experienced more frequently (habituation); if no learner benefit is seen, distress can increase with greater exposure to dilemmas (disturbance)...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644784/how-should-physicians-respond-when-the-best-treatment-for-an-individual-patient-conflicts-with-practice-guidelines-about-the-use-of-a-limited-resource
#4
Edmund G Howe
The case presents a physician's ethical conflict, due to limited resources, between his obligations to meet the needs of a community and those of his patient. Elements of the decision-making process (and who should make the decision) are discussed, including the limitations of what ethical reasoning can offer and risks of arbitrary outcomes. Additionally, potential benefits to physicians and their patients of discussing these conflicts, including reducing the physician's moral distress, are noted. I argue that physicians' abilities to make "right" decisions in such situations are limited, and I suggest ways in which physicians can try to preserve their relationships with patients...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28644335/practice-bulletin-number-179-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#5
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644328/practice-bulletin-no-179-summary-breast-cancer-risk-assessment-and-screening-in-average-risk-women
#6
(no author information available yet)
Breast cancer is the most commonly diagnosed cancer in women in the United States and the second leading cause of cancer death in American women (1). Regular screening mammography starting at age 40 years reduces breast cancer mortality in average-risk women (2). Screening, however, also exposes women to harm through false-positive test results and overdiagnosis of biologically indolent lesions. Differences in balancing benefits and harms have led to differences among major guidelines about what age to start, what age to stop, and how frequently to recommend mammography screening in average-risk women (2-4)...
July 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28644263/mind-the-facts
#7
Maureen Shawn Kennedy
Nurses must become active in protecting science and evidence-based decision making.
July 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28644081/effects-of-added-lipids-on-digestibility-and-nitrogen-balance-in-oiled-common-murres-uria-aalge-and-western-grebes-aechmophorus-occidentalis-fed-four-formulations-of-a-critical-care-diet
#8
Rebecca S Duerr, Kirk C Klasing
Nutritional support is a primary therapy administered to oiled animals during responses to oil spills, but data informing nutritional decision-making during events are limited. In this study, 44 common murres ( Uria aalge ) and 6 Western grebes ( Aechmophorus occidentalis ), naturally oiled by oceanic seeps off the coast of Ventura and Santa Barbara Counties, CA, USA, were assigned to 1 of 4 groups fed diets with varying levels (6.8% [no added oil], 11%, and 20%) and types (salmon, corn) of oil added to a partially purified basal diet...
June 2017: Journal of Avian Medicine and Surgery
https://www.readbyqxmd.com/read/28643812/-conscience-clause-in-end-of-life-care
#9
Ludovica De Panfilis, Daniela Cattaneo, Luisanna Cola, Maddalena Gasparini, Corinna Porteri, Daniela Tarquini, Alessandro Tiezzi, Simone Veronese, Silvia Zullo, Eugenio Pucci
The article proposes a critical reflection on issues that appeal to the conscience clause as part of end of life care can produce and what can guarantee freedom of conscience, self-determination of those involved and respect for the dignity of the sick person. After a philosophical and normative analysis, the article is organized on the basis of two important documents for discussion: a position paper of Società Italiana di Anestesia Analgesia Rianimazione e Terapia Intensiva (SIAARTI) signed by several scientific societies "Grandi insufficienze d'organo end stage: cure intensive o cure palliative?" and the Design of Law currently being debated "Norme in materia di consenso informato e di disposizioni anticipate di trattamento"...
May 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28643551/provider-advice-about-weight-loss-in-a-primary-care-sample-of-obese-and-overweight-patients
#10
Chanita Hughes Halbert, Melanie Jefferson, Cathy L Melvin, LaShanta Rice, Kemi M Chukwuka
OBJECTIVE: Primary care providers play an important role in obesity prevention and reduction by advising patients about weight loss strategies. This study examined receipt of provider advice to lose weight among primary care patients who were overweight and obese. METHODS: Observational study conducted among primary care patients (n = 282) who completed a survey that measured receipt of provider advice about weight loss/management, chronic health conditions, perceived weight status, and perceptions about shared decision making about weight loss/management...
June 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28643531/difficult-conversations-talking-about-cost-in-audiology-consultations-with-older-adults
#11
Katie Ekberg, Caitlin Barr, Louise Hickson
OBJECTIVE: Financial cost is a barrier for many older adults in their decision to obtain hearing aids (HAs). This study aimed to examine conversations about the cost of HAs in detail within initial audiology appointments. DESIGN: Sixty-two initial audiology appointments were video-recorded. The data were analysed using conversation analysis. STUDY SAMPLE: Participants included 26 audiologists, 62 older adults and 17 companions. RESULTS: Audiologists and clients displayed interactional difficulty during conversations about cost...
June 23, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28643470/the-association-of-hospital-governance-with-innovation-in-taiwan
#12
Chen-Wei Yang, Yu-Hua Yan, Shih-Chieh Fang, Syeda Noorein Inamdar, Hsien-Cheng Lin
Hospitals in Taiwan are facing major changes and innovation is increasingly becoming a critical factor for remaining competitive. One determinant that can have a significant impact on innovation is hospital governance. However, there is limited prior research on the relationship between hospital governance and innovation. The purpose of this study is to propose a conceptual framework to hypothesize the relationship between governance mechanisms and innovation and to empirically test the hypotheses in hospital organizations...
June 23, 2017: International Journal of Health Planning and Management
https://www.readbyqxmd.com/read/28643416/influence-of-academic-training-in-endodontics-and-implantology-on-decision-making-in-undergraduate-students
#13
Kenneth Pineda, Rufino Bueno, Carlos Alvarado, Francesc Abella, Miguel Roig, Fernando Duran-Sindreu
PURPOSE: To evaluate the effect of academic training on decision-making in a group of undergraduates who have undergone training in endodontics and implantology. BASIC PROCEDURES: A single group of undergraduate dentistry students (n = 65) was given a survey consisting of 15 endodontic cases. Each case included periapical radiographs and clinical photographs. Students were asked to select one of the eight proposed treatments. In their 4th year, the students first responded to the survey after completing endodontics...
June 23, 2017: Australian Endodontic Journal: the Journal of the Australian Society of Endodontology Inc
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#14
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28643034/assessing-internet-based-information-used-to-aid-patient-decision-making-about-surgery-for-perianal-crohn-s-fistula
#15
J H Marshall, D M Baker, M J Lee, G L Jones, A J Lobo, S R Brown
BACKGROUND: Decision-making in perianal Crohn's fistula (pCD) is preference sensitive. Patients use the internet to access healthcare information. The aim of this study was to assess the online information and patient decision aids relating to surgery for pCD. METHODS: A search of Google™ and the Decision Aids Library Inventory (DALI) was performed using a predefined search strategy. Patient-focussed sources providing information about pCD surgery were included in the analysis...
June 22, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28643018/heterogeneity-of-gata2-related-myeloid-neoplasms
#16
REVIEW
Shinsuke Hirabayashi, Marcin W Wlodarski, Emilia Kozyra, Charlotte M Niemeyer
The GATA2 gene codes for a master hematopoietic transcription factor that is essential for the proliferation and maintenance of hematopoietic stem and progenitor cells. Heterozygous germline mutations in GATA2 have been initially associated with several clinical entities that are now collectively defined as GATA2 deficiency. Despite pleiotropic clinical manifestations, the high propensity for the development of myelodysplastic syndromes (MDS) constitutes the most common clinical denominator of this major MDS predisposition syndrome...
June 22, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/28643013/preoperative-measurement-of-the-modified-glasgow-prognostic-score-predicts-patient-survival-in-non-metastatic-renal-cell-carcinoma-prior-to-nephrectomy
#17
Takuya Tsujino, Kazumasa Komura, Tomohisa Matsunaga, Yuki Yoshikawa, Tomoaki Takai, Taizo Uchimoto, Kenkichi Saito, Naoki Tanda, Rintaro Oide, Koichiro Minami, Hirofumi Uehara, Seong Ho Jeong, Kohei Taniguchi, Hajime Hirano, Hayahito Nomi, Naokazu Ibuki, Kiyoshi Takahara, Teruo Inamoto, Haruhito Azuma
PURPOSE: The modified Glasgow Prognostic Score (mGPS) by measurement of serum C-reactive protein and albumin levels has been shown to provide prognostic value in various cancer types. The purpose of this study was to evaluate whether preoperative assessment of the mGPS predicts patient survival outcome in renal cell carcinoma (RCC). MATERIALS AND METHODS: Clinicopathological and follow-up data in 219 RCC patients, all of whom underwent curative or non-curative nephrectomy, were collected...
June 22, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28642960/comment-on-teaching-metacognition-in-clinical-decision-making-using-a-novel-mnemonic-checklist-an-exploratory-study
#18
William Kelly
No abstract text is available yet for this article.
June 2017: Singapore Medical Journal
https://www.readbyqxmd.com/read/28642696/how-accumulated-real-life-stress-experience-and-cognitive-speed-interact-on-decision-making-processes
#19
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/28642693/exposure-to-unsolvable-anagrams-impairs-performance-on-the-iowa-gambling-task
#20
Katrin Starcke, Janet D Agorku, Matthias Brand
Recent research indicates that external manipulations, such as stress or mood induction, can affect decision-making abilities. In the current study, we investigated whether the exposure to an unsolvable task affected subsequent performance on the Iowa Gambling Task. Participants were randomly assigned to a condition in which they were exposed to unsolvable anagrams (n = 20), or a condition in which they worked on solvable anagrams (n = 22). Afterwards, all participants played the Iowa Gambling Task, a prominent task that measures decision making under uncertain conditions with no explicit rules for gains and losses...
2017: Frontiers in Behavioral Neuroscience
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