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Trajectory of illness

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https://www.readbyqxmd.com/read/28061535/perioperative-goal-setting-consultations-by-surgical-colleagues-a-new-model-for-supporting-patients-families-and-surgeons-in-shared-decision-making
#1
Ana Berlin, Anastasia Kunac, Anne C Mosenthal
Patients with postoperative complications are often subjected to prolonged life-sustaining treatment based on erroneous assumptions about their goals of care. Shared decision making (SDM) is an evidence-based approach that helps ensure patients' wishes and values are honored in their course of treatment. Perioperative palliative care can help create goal-concordant trajectories of care for high risk, seriously ill, or complicated patients, through sophisticated prognostication, higher-level communication, and recommendations based on the best available evidence and patients' stated goals and priorities...
November 29, 2016: Annals of Palliative Medicine
https://www.readbyqxmd.com/read/28052777/from-neurological-soft-signs-to-functional-outcome-in-young-individuals-in-treatment-with-secondary-services-for-non-psychotic-disorders-a-path-analysis
#2
A Minichino, M Francesconi, R E Carrión, R Delle Chiaie, A Bevilacqua, M Parisi, S Rullo, F S Bersani, M Biondi, K Cadenhead
BACKGROUND: Functional decline among patients with mental illness is not unique to individuals with psychotic disorders. Despite this, research on early predictors of functional outcome mainly focused on individuals thought to have an 'at risk mental state' (ARMS) for psychosis. There is evidence suggesting that certain early vulnerability markers, such as neurological soft signs (NSS), may explain variability in functional outcomes independent of the level of psychosis risk and the traditional diagnostic classification...
January 5, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28051833/cognitive-benefits-of-exercise-intervention
#3
T Archer, S Ricci, F Massoni, L Ricci, M Rapp-Ricciardi
Exercise, as a potent epigenetic regulator, implies the potential to counteract pathophysiological processes and alterations in most cardiovascular/respiratory cells and tissues not withstanding a paucity of understanding the underlying molecular mechanisms and doseresponse relationships. In the present account, the assets accruing from physical exercise and its influence upon executive functioning are examined. Under conditions of neuropsychiatric and neurologic ill-health, age-related deterioration of functional and biomarker indicators during healthy and disordered trajectories, neuroimmune and affective unbalance, and epigenetic pressures, exercise offers a large harvest of augmentations in health and well-being...
November 2016: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28043715/patients-learning-and-understanding-during-their-breast-cancer-trajectory
#4
Lena Engqvist Boman, Kerstin Sandelin, Yvonne Wengström, Charlotte Silén
OBJECTIVE: To explore how women learn and understand their disease, treatment, care, and life-situation during a breast cancer trajectory. METHOD: Semi-structured individual interviews were performed with 16 women suffering from breast cancer. Qualitative content analysis of data was performed. RESULTS: Three themes describe the women's learning; Interacting with a diversity of information: women interact with a vast amount of information, including perceptions of bodily sensations and events...
December 23, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28042919/trajectories-of-depressive-symptoms-for-bereaved-family-members-of-chronically-ill-patients-a-systematic-review
#5
REVIEW
Su Ching Kuo, Jia Ling Sun, Siew Tzuh Tang
AIMS/OBJECTIVES: To synthesise concepts of distinct depressive-symptom trajectories in published studies by establishing a measurable standard and estimate the prevalence of recategorised trajectories for bereaved families of chronically ill patients. BACKGROUND: Grieving is a dynamic/individualised process. In studies treating depressive-symptom trajectories as heterogeneous, different criteria were used to identify distinct trajectories, resulting in inconsistent findings...
January 2, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28041823/changes-in-levels-of-parental-distress-after-their-child-with-atypical-genitalia-undergoes-genitoplasty
#6
Cortney Wolfe-Christensen, Amy B Wisniewski, Alexandria J Mullins, Kristy J Reyes, Paul Austin, Laurence Baskin, Kerlly Bernabé, Earl Cheng, Allyson Fried, Dominic Frimberger, Denise Galan, Lynette Gonzalez, Saul Greenfield, Thomas Kolon, Bradley Kropp, Yegappan Lakshmanan, Sabrina Meyer, Theresa Meyer, Natalie J Nokoff, Blake Palmer, Dix Poppas, Alethea Paradis, Elizabeth Yerkes, Larry L Mullins
BACKGROUND: The birth of a child with a disorder of sex development (DSD) and atypical genitalia can be traumatizing and isolating for families. Parents of children with DSD are at risk for increased levels of psychological distress, including depression, anxiety, illness uncertainty (IU), post-traumatic stress symptoms (PTSS), and impairments in quality of life (QOL). Our previous report indicated that although the majority of parents of children with atypical genitalia were coping well prior to the child's genitoplasty, approximately 25% of them reported experiencing some type of psychological distress...
December 14, 2016: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28038669/development-and-validation-of-a-new-patient-experience-tool-in-patients-with-serious-illness
#7
Karl M Fernstrom, Nathan D Shippee, Alissa L Jones, Heather R Britt
BACKGROUND: Patients with serious chronic illnesses face increasingly complex care and are at risk of poor experience due to a fragmented health system. Most current patient experience tools are not designed to address the unique care aspects of this population and the few that exist are delivered too late in the disease trajectory and are not administered longitudinally which makes them less useful across settings. METHODS: We developed a new tool designed to address these gaps...
December 30, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/28032249/anxiety-and-depressive-symptoms-among-two-seriously-medically-ill-populations-and-their-family-caregivers-a-comparison-and-clinical-implications
#8
Kelly M Shaffer, Jamie M Jacobs, Jessica N Coleman, Jennifer S Temel, Jonathan Rosand, Joseph A Greer, Ana-Maria Vranceanu
BACKGROUND: Anxiety and depression are common among patients with acute illness and their families. In oncology, psychosocial services addressing these symptoms are increasingly part of regular practice. Less is known about psychiatric distress among patients with acute neurological injury (ANI) and their family caregivers. To highlight this inequity in psychosocial intervention across medical services, we compared anxiety and depressive symptomatology shortly following diagnosis among patients facing incurable cancer or ANI and their family caregivers...
December 28, 2016: Neurocritical Care
https://www.readbyqxmd.com/read/28027683/adjustment-modes-in-the-trajectory-of-progressive-multiple-sclerosis-a-qualitative-study-and-conceptual-model
#9
Angeliki Bogosian, Myfanwy Morgan, Felicity L Bishop, Fern Day, Rona Moss-Morris
OBJECTIVE: We examined cognitive and behavioural challenges and adaptations for people with progressive multiple sclerosis (MS) and developed a preliminary conceptual model of changes in adjustment over time. DESIGN: Using theoretical sampling, 34 semi-structured interviews were conducted with people with MS. Participants were between 41 and 77 years of age. Thirteen were diagnosed with primary progressive MS and 21 with secondary progressive MS. Data were analysed using a grounded theory approach...
December 27, 2016: Psychology & Health
https://www.readbyqxmd.com/read/28012531/improvement-of-psychiatric-symptoms-in-youth-following-resolution-of-sinusitis
#10
Talia Mahony, Douglas Sidell, Hayley Gans, Kayla Brown, Bahare Farhadian, Melissa Gustafson, Janell Sherr, Margo Thienemann, Jennifer Frankovich
INTRODUCTION: Accumulating evidence supports a role for inflammation in psychiatric illness, and the onset or exacerbation of psychiatric symptoms may follow non-CNS infections. Here, we provide the first detailed description of obsessive-compulsive and related psychiatric symptoms arising concurrently with sinusitis. METHODS: We reviewed the charts of 150 consecutive patients evaluated in our Pediatric Acute-onset Neuropsychiatric Syndromes clinic for documented sinusitis as defined by the American Academy of Pediatrics guidelines...
January 2017: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/28009643/palliative-care-and-chronic-obstructive-pulmonary-disease-where-the-lines-meet
#11
Sarah E Harrington, Elizabeth Rogers, Megan Davis
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and is expected to increase as the population ages. Patients have a high symptom burden, low healthcare quality of life, and unmet needs at the end of life. This review highlights specific palliative care needs of patients with advanced COPD and opportunities to integrate palliative care into standard practice. RECENT FINDINGS: There are many barriers to providing integrated palliative care in COPD, including difficulty with prognostication, communication barriers surrounding advance care planning, and lack of access to specialty palliative care...
December 21, 2016: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/28001466/the-intensive-palliative-care-unit-changing-outcomes-for-hospitalized-cancer-patients-in-an-academic-medical-center
#12
Haipeng Zhang, Constance Barysauskas, Elizabeth Rickerson, Paul Catalano, Joseph Jacobson, Carol Dalby, Charlotta Lindvall, Kathy Selvaggi
BACKGROUND: Patients with advanced cancer often require complex symptom management. At Dana-Farber/Brigham and Women's Cancer Center, the intensive palliative care unit (IPCU) admits symptomatic oncology patients with uncontrolled symptoms throughout the trajectory of illness. Patients are uniquely managed by an interdisciplinary team of clinicians who focus on symptom management and advance care planning. OBJECTIVE: The purpose of our analysis was to investigate goals-of-care outcomes and healthcare utilization after admission to the IPCU...
December 21, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27988073/longitudinal-trajectories-of-cortical-thickness-as-a-biomarker-for-psychosis-in-individuals-with-22q11-2-deletion-syndrome
#13
Seetha Ramanathan, Leah M Mattiaccio, Ioana L Coman, Jo-Anna C Botti, Wanda Fremont, Stephen V Faraone, Kevin M Antshel, Wendy R Kates
OBJECTIVE: 22q11.2 deletion syndrome (DS) or velo-cardio-facial syndrome (VCFS) is a genetic condition that has been identified as the highest genetic risk factor for developing psychotic illnesses. This unique biological nature of 22q11DS provides a valuable opportunity to explore predictive biomarkers of psychosis. In this study, we examined the relationship of cortical thickness and surface area between various brain regions and prodromal symptoms of psychosis. METHODS: 75 probands with 22q11DS, 32 age-matched controls and 28 siblings underwent MRIs over 2 or 3 timepoints...
December 14, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27978770/the-20-year-longitudinal-trajectories-of-social-functioning-in-individuals-with-psychotic-disorders
#14
Eva Velthorst, Anne-Kathrin J Fett, Avraham Reichenberg, Greg Perlman, Jim van Os, Evelyn J Bromet, Roman Kotov
OBJECTIVE: Social impairment is a long-recognized core feature of schizophrenia and is common in other psychotic disorders. Still, to date the long-term trajectories of social impairment in psychotic disorders have rarely been studied systematically. METHODS: Data came from the Suffolk County Mental Health Project, a 20-year prospective study of first-admission patients with psychotic disorders. A never-psychotic comparison group was also assessed. Latent class growth analysis was applied to longitudinal data on social functioning from 485 respondents with schizophrenia spectrum disorders and psychotic mood disorders, and associations of the empirically derived trajectories with premorbid social adjustment, diagnosis, and 20-year outcomes were examined...
December 16, 2016: American Journal of Psychiatry
https://www.readbyqxmd.com/read/27978457/neural-activations-are-related-to-body-shape-anxiety-and-outcomes-in-adolescent-anorexia-nervosa
#15
Jie Xu, Jessica A Harper, Erin A Van Enkevort, Kelsey Latimer, Urszula Kelley, Carrie J McAdams
Anorexia nervosa (AN) is an illness that frequently begins during adolescence and involves weight loss. Two groups of adolescent girls (AN-A, weight-recovered following AN) and (HC-A, healthy comparison) completed a functional magnetic resonance imaging task involving social evaluations, allowing comparison of neural activations during self-evaluations, friend-evaluations, and perspective-taking self-evaluations. Although the two groups were not different in their whole-brain activations, anxiety and body shape concerns were correlated with neural activity in a priori regions of interest...
December 5, 2016: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/27942087/twenty-first-century-macro-trends-in-the-institutional-fabric-of-science-bibliometric-monitoring-and-analysis
#16
Robert J W Tijssen, Jos Winnink
Some say that world science has become more 'applied', or at least more 'application-oriented', in recent years. Replacing the ill-defined distinction between 'basic research' and 'applied research', we introduce 'research application orientation' domains as an alternative conceptual and analytical framework for examining research output growth patterns. To distinguish possible developmental trajectories we define three institutional domains: 'university', 'industry', 'hospitals'. Our macro-level bibliometric analysis takes a closer look at general trends within and across some 750 of the world's largest research-intensive universities...
2016: Scientometrics
https://www.readbyqxmd.com/read/27932396/narrative-aversion-challenges-for-the-illness-narrative-advocate
#17
Kathy Behrendt
Engaging in self-narrative is often touted as a powerful antidote to the bad effects of illness. However, there are various examples of what may broadly be termed "aversion" to illness narrative. I group these into three kinds: aversion to certain types of illness narrative; aversion to illness narrative as a whole; and aversion to illness narrative as an essentially therapeutic endeavor. These aversions can throw into doubt the advantages claimed for the illness narrator, including the key benefits of repair to the damage illness does to identity and life-trajectory...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/27930401/embedding-a-palliative-approach-in-nursing-care-delivery-an-integrated-knowledge-synthesis
#18
Richard Sawatzky, Pat Porterfield, Della Roberts, Joyce Lee, Leah Liang, Sheryl Reimer-Kirkham, Barb Pesut, Tilly Schalkwyk, Kelli Stajduhar, Carolyn Tayler, Jennifer Baumbusch, Sally Thorne
A palliative approach involves adapting and integrating principles and values from palliative care into the care of persons who have life-limiting conditions throughout their illness trajectories. The aim of this research was to determine what approaches to nursing care delivery support the integration of a palliative approach in hospital, residential, and home care settings. The findings substantiate the importance of embedding the values and tenets of a palliative approach into nursing care delivery, the roles that nurses have in working with interdisciplinary teams to integrate a palliative approach, and the need for practice supports to facilitate that embedding and integration...
December 6, 2016: ANS. Advances in Nursing Science
https://www.readbyqxmd.com/read/27928829/mapping-the-illness-trajectories-of-insomnia-a-biographical-disruption
#19
Janet M Y Cheung, Bandana Saini, Delwyn J Bartlett, Tracey-Lea Laba, Paul H Mason
The insomnia illness experience can be conceptualised as a form of biographical disruption. Using a critical interpretive phenomenological lens 51 in-depth semi-structured interviews were conducted with patients from specialist sleep and psychology clinics (n = 22) and the general community (n = 29). Patients' narratives revealed key phases of their illness trajectories as they recognise, rethink and respond to insomnia. Their biographical events served as reference points for both patient groups to make sense of their illness experiences as they transitioned from a perceived state of sleeplessness to clinical insomnia...
December 7, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27917433/deaths-among-elderly-patients-in-the-emergency-department-a-needs-assessment-for-end-of-life-care
#20
Rakhee Yash Pal, Win Sen Kuan, Yiwen Koh, Kuhan Venugopal, Irwani Ibrahim
INTRODUCTION: Elderly patients with serious chronic diseases often present to the emergency department (ED) in the last moments of their life, many with identifiable trajectories of dying: organ failure; advanced cancer; and chronic frailty. These patients and their families may benefit more from good end-of-life (EOL) care provision than the standard resuscitative approach. This study aimed to determine the incidence and nature of death among patients aged 65 years and above in an ED, and characterise their trajectories of dying...
December 5, 2016: Singapore Medical Journal
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