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Decision making

Shalender Bhasin, Juan P Brito, Glenn R Cunningham, Frances J Hayes, Howard N Hodis, Alvin M Matsumoto, Peter J Snyder, Ronald S Swerdloff, Frederick C Wu, Maria A Yialamas
Objective: To update the "Testosterone Therapy in Men With Androgen Deficiency Syndromes" guideline published in 2010. Participants: The participants include an Endocrine Society-appointed task force of 10 medical content experts and a clinical practice guideline methodologist. Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation approach to describe the strength of recommendations and the quality of evidence...
March 17, 2018: Journal of Clinical Endocrinology and Metabolism
Olivier Moranne, Coraline Fafin, Sophie Roche, Maud Francois, Vincent Allot, Jerome Potier, Daniela Babici, Thierry Lobbedez, Marie Matignon, Christophe Mariat, Cecile Vigneau, Cecile Couchoud
Background: Elderly patients with advanced chronic kidney disease require accurate outcome descriptions to make treatment decisions. Methods: The PSPA [Parcours de soins des personnes âgées (Treatment pathways for elderly patients)] prospective multicentre cohort study included 573 such patients with a median age of 82 [interquartile range (IQR) 79-86] years and a median estimated glomerular filtration rate of 14 (IQR 11-17) mL/min/1.73 m2 and studied their 5-year outcomes according to the dialysis component of their treatment plans...
March 19, 2018: Nephrology, Dialysis, Transplantation
Olivier Alexandre Branford
No abstract text is available yet for this article.
March 19, 2018: Aesthetic Surgery Journal
Seiichiro Amemiya, A David Redish
During decision making, hippocampal activity encodes information sometimes about present and sometimes about potential future plans. The mechanisms underlying this transition remain unknown. Building on the evidence that gamma oscillations at different frequencies (low gamma [LG], 30-55 Hz; high gamma [HG], 60-90 Hz; and epsilon, 100-140 Hz) reflect inputs from different circuits, we identified how changes in those frequencies reflect different information-processing states. Using a unique noradrenergic manipulation by clonidine, which shifted both neural representations and gamma states, we found that future representations depended on gamma components...
March 20, 2018: Cell Reports
Bhavik N Modi, Kalpa De Silva, Ronak Rajani, Nick Curzen, Divaka Perera
Importance: Ischemia-guided revascularization is the cornerstone of contemporary management of coronary artery disease and has evolved from noninvasive functional evaluation to real-time assessment with invasive physiological indices during diagnostic catheterization. However, serial/diffuse disease is common, and revascularization decisions often need to be made about individual lesions within the same vessel. It is unclear whether current physiological techniques, such as fractional flow reserve, can be reliably used to discern the individual contribution of lesions within a serially diseased vessel with erroneous measurements, potentially leading to suboptimal revascularization decisions...
March 21, 2018: JAMA Cardiology
Rupen Shah, Kristopher Attwood, Shipra Arya, Daniel E Hall, Jason M Johanning, Emmanuel Gabriel, Anthony Visioni, Steven Nurkin, Moshim Kukar, Steven Hochwald, Nader N Massarweh
Importance: Failure to rescue (FTR), or death after a potentially preventable complication, is a nationally endorsed, publicly reported quality measure. However, little is known about the impact of frailty on FTR, in particular after low-risk surgical procedures. Objective: To assess the association of frailty with FTR in patients undergoing inpatient surgery. Design, Setting, and Participants: This study assessed a cohort of 984 550 patients undergoing inpatient general, vascular, thoracic, cardiac, and orthopedic surgery in the National Surgical Quality Improvement Program between January 1, 2005, and December 31, 2012...
March 21, 2018: JAMA Surgery
Fernando Mitano, Amélia Nunes Sicsú, Luciana de Oliveira Sousa, Rarianne Carvalho Peruhype, Jaqueline Garcia de Almeida Ballestero, Pedro Fredemir Palha
OBJECTIVE: To analyze the discourses of health professionals about the obstacles in the process of detection and reporting of tuberculosis cases in Mozambique. METHOD: Qualitative exploratory study with a theoretical-methodological approach of Discourse Analysis of French matrix. The study was conducted in Mozambique in 2014 at three levels: central, provincial and district. The study included 15 health professionals, 4 physicians, 6 technicians and 5 nursing professionals, who worked in the National Tuberculosis Control Program, with more than 1 year of experience...
2018: Revista Brasileira de Enfermagem
Philip A Powell, Olivia Wills, Gemma Reynolds, Kaisa Puustinen-Hopper, Jennifer Roberts
In this paper we explored the effects of exposure to images of the suffering and vulnerability of others on altruistic, trust-based, and reciprocated incentivized economic decisions, accounting for differences in participants' dispositional empathy and reported in-group trust for their recipient(s). This was done using a pictorial priming task, framed as a memory test, and a triadic economic game design. Using the largest experimental sample to date to explore this issue, our integrated analysis of two online experiments (total N = 519), found statistically consistent evidence that exposure to images of suffering and vulnerability (vs...
2018: PloS One
Wies Maarse, Chantal W B Boonacker, Henriette F N Swanenburg de Veye, Moshe Kon, Corstiaan C Breugem, Aebele B Mink van der Molen, Johannes J M van Delden
OBJECTIVES: The prenatal diagnosis of oral clefts (OCs) by ultrasound can pose an ethical dilemma. The purpose of this study was to obtain insight into the psychosocial and moral considerations of prospective parents concerning OCs, the burden of OCs and parents' attitude toward possible termination of pregnancy (TOP) in order to improve counseling in the future. DESIGN: Between August 2011 and August 2014, a prospective cohort questionnaire study was administered...
January 1, 2018: Cleft Palate-craniofacial Journal
Leigh Anne Harden, Jennifer Fernandez, Joseph R Milanovich, Brock P Struecker, Stephen R Midway
Blood biochemical and hematology analyses are helpful indicators of the physiologic health of animals, particularly when making conservation and management decisions for threatened species. In this study, we 1) established blood biochemical reference intervals for two populations of threatened, free-ranging ornate box turtles ( Terrapene ornata) in northern Illinois during their active season and 2) examined the effects of individual carapace temperature ( Tc ) on blood biochemical variables by using a Bayesian hierarchic framework...
March 21, 2018: Journal of Wildlife Diseases
David Sturgeon
Over the past four decades, UK governments have moved towards an increasingly pro-market model of healthcare provision. Under this system, patients are not only encouraged, but expected, to take increasing responsibility for healthcare decision-making and the risks that it might entail. This article investigate how and why patients make choices about their health care and how service providers help facilitate this. Between October 2014 and May 2015, the researcher was embedded as an emergency nurse practitioner at two minor injury units in order to undertake direct and participant observation...
March 22, 2018: British Journal of Nursing: BJN
Jacqueline Leigh, Lisa Littlewood
Jacqueline Leigh, Reader, Teaching and Learning, School of Health and Society, University of Salford, , and Lisa Littlewood, Director of Placement and Practice Learning, School of Health and Society, University of Salford, evaluate the changes in the delivery of nurse education as a result of the devolution of health and social care decision-making from Westminster to Greater Manchester.
March 22, 2018: British Journal of Nursing: BJN
Leticia Leon, Luis Rodriguez-Rodriguez, Maria Dolores Aguilar, Juan Ángel Jover, Cristina Vadillo, Marta Redondo, Lydia Abasolo
OBJECTIVE: The aim of this study was to assess the reliability and validity of the Spanish version of the Rosser classification system for disease states in patients with musculoskeletal disorders. METHODS: Our study was based on a questionnaire validation design. Patients were attended at an outpatient rheumatology clinic at Hospital Clínico San Carlos, Madrid, Spain. The Rosser classification system was completed by the physician from the research team (PMQ) and by the patient (HMQ)...
March 21, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Wei Wang, Dong Xing, Yingjian Song, Feiyu Liu
BACKGROUND: Esophageal cancer is one of the worst malignant digestive neoplasms with poor treatment outcomes. Definitive concurrent chemoradiotherapy (CRT) has become the standard nonsurgical treatment option for locally advanced esophageal cancer. The chemotherapeutic drugs 5-fluorouracil and cisplatin have been most commonly used in CRT of esophageal cancer. However, radiotherapy combined with 5-FU/cisplatin often delivers severe toxicity to patients. S-1 as an oral chemotherapeutic drug exhibits higher anti-tumor activity, less adverse effects, and better biological availability...
March 2018: Medicine (Baltimore)
Martin Schweiger, Angela Lorts, Jennifer Conway
PURPOSE OF REVIEW: Increased miniaturization of ventricular assist devices (VADs) and new mechanical support strategies (MCS) has increased the use of MCS in the pediatric and congenital heart disease (CHD) population. This comes with the need for care providers specialized in this field to determine optimal patient and device selection, and to improve outcomes and decrease complication rates for new innovative strategies. A review of the published literature in this field is timely and relevant...
March 20, 2018: Current Opinion in Organ Transplantation
Wolf Osterode, Sandra Schranz, Galateja Jordakieva
Mental and physical stress is common in physicians during night shifts. Neurocognitive effects of sleep deprivation as well as alterations in hormonal and metabolic parameters have previously been described. The aim of this crossover study was to evaluate the effects of night-shift work with partial sleep deprivation on steroid hormone excretion and possible associations with mood, sleep characteristics and cognitive functions in physicians. In total, 34 physicians (mean age 42 ± 8.5 years, 76.5% male) from different departments of the General Hospital of Vienna, Austria, were randomly assigned to two conditions: a regular day shift (8 h on duty, condition 1) and a continuous day-night shift (24 h on duty, condition 2)...
March 21, 2018: Chronobiology International
Claire O'Callaghan, Julie M Hall, Alessandro Tomassini, Alana J Muller, Ishan C Walpola, Ahmed A Moustafa, James M Shine, Simon J G Lewis
BACKGROUND: Models of hallucinations emphasize imbalance between sensory input and top-down influences over perception, as false perceptual inference can arise when top-down predictions are afforded too much precision (certainty) relative to sensory evidence. Visual hallucinations in Parkinson's disease (PD) are associated with lower-level visual and attentional impairments, accompanied by overactivity in higher-order association brain networks. PD therefore provides an attractive framework to explore contributions of bottom-up versus top-down disturbances in hallucinations...
November 2017: Biological Psychiatry: Cognitive Neuroscience and Neuroimaging
Michael Galgano, Jared Fridley, Adetokunbo Oyelese, Albert Telfian, Thomas Kosztowski, David Choi, Ziya L Gokaslan
Metastatic spinal disease is a source of significant morbidity in patients with cancer. Recent advancements in adjuvant oncologic therapy has led to increased survival for many patients who harbor neoplastic disease. As a result of this, the chance of developing metastatic spinal disease over the course of a cancer patient's lifespan has increased. Symptomatic metastatic spinal disease can cause significant morbidity including severe pain, neurologic deficit, and loss of ambulation. Current treatment of these patients typically involves the use of multiple modalities, including surgery, radiation, and chemotherapy...
March 21, 2018: Expert Review of Anticancer Therapy
Francesco Sparano, Michele Cavo, Pasquale Niscola, Tommaso Caravita, Fabio Efficace
PURPOSE: We performed a systematic review to quantify the amount of evidence-based data available on patient-reported outcomes (PRO) in Relapsed/Refractory Multiple Myeloma (RRMM) patients and to examine the added value of such studies in supporting clinical decision-making. METHODS: We conducted a search in PubMed/Medline and the Cochrane Library to identify studies published between January 1990 and May 2017. All studies, regardless of the design, including patients with RRMM and also evaluating PRO were considered...
March 20, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
Allicia Imada, Nathaniel Nelms, David Halsey, Michael Blankstein
Background: Following total knee and hip arthroplasty, patient progress can be assessed with patient-reported outcome measures (PROMs) and performance-based outcome measures (PBOMs). The American Joint Replacement Registry 2016 guide recommends collecting several measures, including Patient Reported Outcome Measure Information System Global, Knee Injury and Osteoarthritis Outcome Score Jr, and Hip Injury and Osteoarthritis Outcome Score Jr. This study aimed to assess the current and anticipated use of PROMs and PBOMs by New England physical therapists...
March 2018: Arthroplasty Today
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