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https://www.readbyqxmd.com/read/29457244/the-different-moral-bases-of-patient-and-surrogate-decision-making
#1
Daniel Brudney
My topic is a problem with our practice of surrogate decision-making in health care, namely, the problem of the surrogate who is not doing her job-the surrogate who cannot be reached or the surrogate who seems to refuse to understand or to be unable to understand the clinical situation. The analysis raises a question about the surrogate who simply disagrees with the medical team. One might think that such a surrogate is doing her job-the team just doesn't like how she is doing it. My analysis raises the question of whether (or perhaps when) she should be overridden...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29454101/venous-thromboembolism-after-inpatient-surgery-in-administrative-data-vs-nsqip-a-multi-institutional-study
#2
David A Etzioni, Cynthia Lessow, Liliana G Bordeianou, Hiroko Kunitake, Sarah E Deery, Evie Carchman, Christina M Papageorge, George Fuhrman, Rachel L Seiler, James Ogilvie, Elizabeth B Habermann, Yu-Hui H Chang, Samuel R Money
BACKGROUND: Previous studies have documented significant differences between administrative data and registry data in the determination of postoperative venous thromboembolism (VTE). The goal of this study is to characterize discordance between administrative and registry data in the determination of postoperative VTE. STUDY DESIGN: This study was performed using data from the American College of Surgeons NSQIP merged with administrative data from 8 different hospitals (5 different medical centers) between 2013 and 2015...
February 14, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29453834/demystifying-evidence-based-policy-analysis-by-revealing-hidden-value-laden-constraints
#3
Adam M Finkel
Consider any choice that affects some social policy. A decision that considers evidence will, at its heart, contain some kind of explicit or implicit "because" statement: "We are doing X because the evidence says Y." But can evidence ever truly speak for itself, in the sense of being reducible to objective utterances that are either correct or in need of correction? Before answering, consider what you'd prefer. Would you rather receive evidence that was free of any value judgments imposed by human actors, that was laden with value judgments that you agree with, or laden with value judgments that you disagree with? The central assertion of this essay is that, throughout policy analysis but especially in assessments of the costs and benefits of regulating versus encouraging new technologies (cost-benefit analysis, or CBA), the first possibility above is a mirage, and the second and third are self-contradictory...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29453330/interphysician-agreement-on-subclassification-of-myocardial-infarction
#4
Anton Gard, Bertil Lindahl, Gorav Batra, Nermin Hadziosmanovic, Marcus Hjort, Karolina Elisabeth Szummer, Tomasz Baron
OBJECTIVE: The universal definition of myocardial infarction (MI) differentiates MI due to oxygen supply/demand mismatch (type 2) from MI due to plaque rupture (type 1) as well as from myocardial injuries of non-ischaemic or multifactorial nature. The purpose of this study was to investigate how often physicians agree in this classification and what factors lead to agreement or disagreement. METHODS: A total of 1328 patients diagnosed with MI at eight different Swedish hospitals 2011 were included...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29453207/hippocampal-ripple-oscillations-and-inhibition-first-network-models-frequency-dynamics-and-response-to-gaba-modulators
#5
José R Donoso, Dietmar Schmitz, Nikolaus Maier, Richard Kempter
Hippocampal ripples are involved in memory consolidation, but the mechanisms underlying their generation remain unclear. Models relying on interneuron networks in the CA1 region disagree on the predominant source of excitation to interneurons: either 'direct', via the Schaffer collaterals that provide feedforward input from CA3 to CA1, or 'indirect', via the local pyramidal cells in CA1, which are embedded in a recurrent excitatory-inhibitory network. Here, we used physiologically constrained computational models of basket-cell networks to investigate how they respond to different conditions of transient, noisy excitation...
February 16, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29451985/a-comparison-of-barriers-to-accessing-services-for-mental-and-physical-health-conditions-in-a-sample-of-rural-australian-adults
#6
Kate Fennell, Melissa Hull, Martin Jones, James Dollman
INTRODUCTION: The prevalence of chronic disease, mortality and suicide rates is higher in rural Australia than in urban centres. Understanding rural Australians' barriers to accessing health services requires urgent attention. The purpose of this study was to compare barriers to help-seeking for physical and mental health issues among rural South Australian adults. METHODS: A total of 409 people from three rural and remote regions in South Australia completed a computer-assisted telephone interview...
February 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29451834/influenza-vaccination-2014-2015-results-of-a-survey-conducted-among-general-practitioners-in-italy
#7
Miriam Levi, Paolo Bonanni, Marco Biffino, Michele Conversano, Maria Corongiu, Paolo Morato, Tommasa Maio
Introduction The aim of the present study was to evaluate orientation, organizational procedures implemented and difficulties faced by general practitioners (GPs) during the 2014/15 seasonal influenza vaccination programme, as well as GPs' general attitude towards vaccinations. Methods An ad hoc online survey was developed and administered to general practitioners members of the Italian Federation of GPs (Federazione Italiana Medici di Medicina Generale - FIMMG). Overall, 10,000 survey invitations were sent...
February 16, 2018: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/29450402/modeling-the-consumer-s-perception-of-experiential-marketing-in-the-romanian-private-ophthalmologic-services
#8
Consuela-Mădălina Gheorghe, Iuliana-Raluca Gheorghe, Victor Lorin Purcărea
Introduction. The importance of experience in marketing grew, as the concept itself is very personal and difficult to measure. Experience turns out to be complicated but once placed in a context it gets significant features. As the health care competitive environment increases, marketers are looking for new and effective methods of engaging consumers by using experiential marketing strategies. Moreover, little is known about the consumers' perceptions related to ophthalmologic services. Aim. The objective of this paper was to measure the consumer's perception of experiential marketing in the Romanian private ophthalmologic services by using structural equation modeling...
July 2017: Romanian Journal of Ophthalmology
https://www.readbyqxmd.com/read/29449161/ultrasound-training-in-surgical-critical-care-fellowship-a-survey-of-program-directors
#9
Thomas W Carver
OBJECTIVE: Surgical critical care (SCC) fellows are expected to receive training in critical care ultrasound (CCUS) but training is sporadic and there is no standardized curriculum to guide educators. Previous studies show wide variation in CCUS training during fellowship across specialties but SCC has been underrepresented. This study was performed to assess SCC program directors' views regarding CCUS during fellowship training. DESIGN: Adult SCC program directors were surveyed regarding the role of CCUS in fellowship training...
February 12, 2018: Journal of Surgical Education
https://www.readbyqxmd.com/read/29446553/children-s-moral-experiences-of-crisis-management-in-a-child-mental-health-setting
#10
Marjorie Montreuil, Catherine Thibeault, Linda McHarg, Franco A Carnevale
The experiences of children related to conflict and crisis management in child mental health settings, especially those aged 12 and below, have been rarely studied. This study examined the moral experiences of children related to conflict and crisis management and the related use of restraint and seclusion in a child mental health setting. A 5-month focused ethnography using a participatory hermeneutic framework was conducted in a day hospital programme for children with severe disruptive disorders within a mental health institute...
February 15, 2018: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29439923/less-or-more-maternal-requests-that-go-against-medical-advice
#11
Martine Hollander, Lianne Holten, Annemieke Leusink, Jeroen van Dillen, Esteriek de Miranda
PROBLEM AND BACKGROUND: This study explores the experiences of Dutch midwives and gynaecologists with pregnant women who request more, less or no care during pregnancy and/or childbirth. METHODS: All Dutch midwives and (trainee) gynaecologists were invited to fill out a questionnaire specifically designed for the purposes of this study. Holistic midwives were analysed separately from regular community midwives. FINDINGS: Most maternity care providers in the Netherlands receive requests for less care than recommended at least once a year...
February 10, 2018: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/29436293/parental-and-self-weight-perceptions-in-u-s-children-and-adolescents-nhanes-2005-2014
#12
Jiying Ling, Manfred Stommel
This study aimed to describe the parental and child self-weight perceptions and their associated sociodemographic factors. The 2005-2014 National Health and Nutrition Examination Survey (NHANES) sample of 16,869 children aged 2 to 17 years was used. For overweight/obese children aged 2 to 15 years, 61.2% of parents underestimated their child's weight. For overweight/obese children aged 8 to 17 years, 55.2% underestimated their own weight. For children aged 8 to 15 years, 77.8% parents and children agreed on the weight classification...
February 1, 2018: Western Journal of Nursing Research
https://www.readbyqxmd.com/read/29436176/exploring-the-impact-of-aboriginal-health-placement-experiences-on-the-preparation-of-dietetic-graduates-for-practice-with-aboriginal-communities
#13
Ruby Svarc, Corinne Davis, Helena McDonald, Julia Perruzza, Jennifer Browne, Robyn Delbridge, Keith Morgan, Sharleen O'Reilly, Claire Margerison, Claire Palermo
AIM: A health workforce with the ability to practice with Aboriginal communities is crucial to bridge the health gap between Aboriginal and non-Aboriginal Australians. This study aimed to explore the impact of university Aboriginal health placements on preparing dietetic graduates for practice with Aboriginal communities. METHODS: A mixed methods sequential explanatory design was used. A sample of 594 dietetic graduates was invited to complete a survey that identified Aboriginal health experiences and measured attitudes and self-confidence towards working in Aboriginal health using a five-point Likert scale...
February 13, 2018: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29433576/barriers-and-facilitators-to-the-implementation-of-a-paediatric-palliative-care-team
#14
Lisa M Verberne, Marijke C Kars, Sasja A Schepers, Antoinette Y N Schouten-van Meeteren, Martha A Grootenhuis, Johannes J M van Delden
BACKGROUND: Over the last decade, paediatric palliative care teams (PPCTs) have been introduced to support children with life-limiting diseases and their families and to ensure continuity, coordination and quality of paediatric palliative care (PPC). However, implementing a PPCT into an organisation is a challenge. The objective of this study was to identify barriers and facilitators reported by healthcare professionals (HCPs) in primary, secondary or tertiary care for implementing a newly initiated multidisciplinary PPCT to bridge the gap between hospital and home...
February 12, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29433497/a-painful-experience-of-limited-understanding-healthcare-professionals-experiences-with-palliative-care-of-people-with-severe-dementia-in-norwegian-nursing-homes
#15
May Helen Midtbust, Rigmor Einang Alnes, Eva Gjengedal, Else Lykkeslet
BACKGROUND: People dying with dementia have significant healthcare needs, and palliative care, with its focus on comfort and quality of life, should be made available to these patients. The aim of this study was to explore and increase knowledge of healthcare professionals' experiences with palliative care to people with severe dementia in nursing homes. METHODS: To describe the phenomenon under investigation, we used a phenomenological research approach grounded in the philosophy of Husserl...
February 13, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29431139/the-attitudes-towards-defensive-medicine-among-physicians-of-obstetrics-and-gynaecology-in-china-a-questionnaire-survey-in-a-national-congress
#16
Lan Zhu, Lei Li, Jinghe Lang
OBJECTIVE: The study aimed to determine prevalence, patterns and risk factors of defensive medicine by obstetricians and gynaecologists across China. DESIGN: This is a questionnaire survey by written and on-line interview for participants. PARTICIPANTS: Among 1804 registered physicians participating at the 2017 Congress of Chinese Obstetricians and Gynecologists Association in Chengdu City, Sichuan Province, China, from 17 to 20 August 2017, 1486 participants (82...
February 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29425624/internet-and-social-media-use-for-antibiotic-related-information-seeking-findings-from-a-survey-among-adult-population-in-italy
#17
Rossella Zucco, Francesco Lavano, Rosa Anfosso, Aida Bianco, Claudia Pileggi, Maria Pavia
BACKGROUND: The Internet represents an increasingly common source of health-related information. Internet and Social Media can be used to promote a prudent use of antibiotics. OBJECTIVE: To establish the extent of Internet and Social Media use to search for antibiotic related information and the potential implications in health care among adult population in Italy. METHODS: This cross-sectional study was conducted from March to May 2017, among a sample of parents of public school students...
March 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29424285/shifting-syndromes-sex-chromosome-variations-and-intersex-classifications
#18
David Andrew Griffiths
The 2006 'Consensus statement on management of intersex disorders' recommended moving to a new classification of intersex variations, framed in terms of 'disorders of sex development' or DSD. Part of the rationale for this change was to move away from associations with gender, and to increase clarity by grounding the classification system in genetics. While the medical community has largely accepted the move, some individuals from intersex activist communities have condemned it. In addition, people both inside and outside the medical community have disagreed about what should be covered by the classification system, in particular whether sex chromosome variations and the related diagnoses of Turner and Klinefelter's syndromes should be included...
February 2018: Social Studies of Science
https://www.readbyqxmd.com/read/29424244/social-comparisons-in-adults-with-type-2-diabetes-patients-reasons-for-target-selection
#19
Danielle Arigo, Max Cornell, Joshua M Smyth
OBJECTIVE: To examine reasons for selecting a social comparison target (i.e. a specific other for relative self-evaluation), and their influence on affect and motivation for self-care, in type 2 diabetes (T2DM). DESIGN: Adults with T2DM (n = 180, MA1c = 7.6%) chose to read about one of four targets. Participants rated five reasons for their choice (strongly disagree - strongly agree), and rated affect and self-care motivation before and after reading. RESULTS: To boost confidence in my ability to manage diabetes was rated highest overall (ps < 0...
February 9, 2018: Psychology & Health
https://www.readbyqxmd.com/read/29419420/diaphragmatic-flutter
#20
Dean Walton, Michael Bonello, Malcolm Steiger
A 78-year-old woman presented with involuntary movements of her abdomen, which started after a right hemispheric stroke. She had irregular, variable, hyperkinetic predominantly right-sided abdominal wall movements. MR scan of brain confirmed a recent infarct in the right occipitotemporal lobe and the right cerebellum. Diaphragmatic fluoroscopy confirmed high-frequency flutter as the cause of her abdominal movements and confirmed the diagnosis of van Leeuwenhoek's disease. Anthonie van Leeuwenhoek first described this condition in 1723 and had the condition himself...
February 1, 2018: Practical Neurology
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