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https://www.readbyqxmd.com/read/28748743/community-based-game-intervention-to-improve-south-asian-indian-americans-engagement-with-advanced-care-planning
#1
Kavita Radhakrishnan, Lauren Jodi Van Scoy, Regina Jillapalli, Shubhada Saxena, Miyong T Kim
OBJECTIVE: Advance care planning (ACP) allows individuals to express their preferences for medical treatment in the event that they become incapable of making their own decisions. This study assessed the efficacy of a conversation game intervention for increasing South Asian Indian Americans' (SAIAs') engagement in ACP behaviors as well as the game's acceptability and cultural appropriateness among SAIAs. DESIGN: Eligible community-dwelling SAIAs were recruited at SAIA cultural events held in central Texas during the summer of 2016...
July 27, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28743662/community-game-day-using-an-end-of-life-conversation-game-to-encourage-advance-care-planning
#2
Lauren J Van Scoy, Jean M Reading, Margaret Hopkins, Brandi Smith, Judy Dillon, Michael J Green, Benjamin H Levi
CONTEXT: Advance care planning (ACP) is an important process that involves discussing and documenting one's values and preferences for medical care, particularly end-of-life treatments. OBJECTIVES: This convergent, mixed methods study assessed whether an end-of-life conversation card game is an acceptable and effective means for performing ACP for patients with chronic illness and/or their caregivers when deployed in a community setting. METHODS: 22 games (n=93 participants) were held in community settings surrounding XXX, PA in 2016...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28743661/chronic-pain-patient-physician-engagement-and-family-communication-associated-with-drug-using-hiv-patients-discussing-advanced-care-planning-with-their-physicians
#3
Eric D Hansen, Mary M Mitchell, Tom Smith, Nancy Hutton, Jeanne Keruly, Amy R Knowlton
CONTEXT: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV into a serious chronic illness, warranting patient-provider discussion about advanced care planning (ACP). Evidence is needed to inform physicians on how to approach ACP for these patients. Chronic pain is common in PLWHA, particularly in those who have substance use disorders; although it is known this population is at risk for poorer patient-physician engagement, the effects on ACP are unknown...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28737990/cost-effectiveness-of-novel-agents-in-medicare-patients-with-multiple-myeloma-findings-from-a-u-s-payer-s-perspective
#4
Ying Chen, David R Lairson, Wenyaw Chan, Jinhai Huo, Xianglin L Du
BACKGROUND: Since multiple myeloma (MM) incurs a substantial economic burden in care management, more and more discussion has been generated in recent years about the costs of novel antimyeloma drugs and their associated value. Because of these costs, economic assessment that quantifies value of care over the long-term is essential. OBJECTIVE: To determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with MM in a real-world setting...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28735006/chitosan-as-a-bioactive-polymer-processing-properties-and-applications
#5
REVIEW
A Muxika, A Etxabide, J Uranga, P Guerrero, K de la Caba
Chitin is one of the most abundant natural polysaccharides in the world and it is mainly used for the production of chitosan by a deacetylation process. Chitosan is a bioactive polymer with a wide variety of applications due to its functional properties such as antibacterial activity, non-toxicity, ease of modification, and biodegradability. This review summarizes the most common chitosan processing methods and highlights some applications of chitosan in various industrial and biomedical fields. Finally, environmental concerns of chitosan-based films, considering the stages from raw materials extraction up to the end of life after disposal, are also discussed with the aim of finding more eco-friendly alternatives...
July 19, 2017: International Journal of Biological Macromolecules
https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#6
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28730376/lower-urinary-tract-obstruction-fetal-intervention-based-on-prenatal-staging
#7
Rodrigo Ruano, Timothy Dunn, Michael C Braun, Joseph R Angelo, Adnan Safdar
The authors present an overview of lower urinary tract obstruction (LUTO) in the fetus with a particular focus on the insult to the developing renal system. Diagnostic criteria along with the challenges in estimating long-term prognosis are reviewed. A proposed prenatal LUTO disease severity classification to guide management decisions with fetal intervention to maintain or salvage in utero and neonatal pulmonary and renal function is also discussed. Stage I LUTO (mild form) is characterized by normal amniotic fluid index after 18 weeks, normal kidney echogenicity, no renal cortical cysts, no evidence of renal dysplasia, and favorable urinary biochemistries when sampled between 18 and 30 weeks; prenatal surveillance is recommended...
July 21, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28727724/grandmothering-and-cognitive-resources-are-required-for-the-emergence-of-menopause-and-extensive-post-reproductive-lifespan
#8
Carla Aimé, Jean-Baptiste André, Michel Raymond
Menopause, the permanent cessation of ovulation, occurs in humans well before the end of the expected lifespan, leading to an extensive post-reproductive period which remains a puzzle for evolutionary biologists. All human populations display this particularity; thus, it is difficult to empirically evaluate the conditions for its emergence. In this study, we used artificial neural networks to model the emergence and evolution of allocation decisions related to reproduction in simulated populations. When allocation decisions were allowed to freely evolve, both menopause and extensive post-reproductive life-span emerged under some ecological conditions...
July 2017: PLoS Computational Biology
https://www.readbyqxmd.com/read/28727486/association-of-physician-orders-for-life-sustaining-treatment-form-use-with-end-of-life-care-quality-metrics-in-patients-with-cancer
#9
Sandra L Pedraza, Stacey Culp, Mark Knestrick, Evan Falkenstine, Alvin H Moss
PURPOSE: Many patients with advanced cancer receive aggressive treatment near the end of life. The Physician Orders for Life-Sustaining Treatment (POLST) form is an innovation that converts patient preferences into medical orders. We compared the end-of-life care of patients with advanced cancer who had completed POLST forms with that of patients who had advance directives (ADs). METHODS: We studied 2,159 West Virginians with ADs and/or POLST forms in the West Virginia e-Directive Registry who died as a result of cancer between January 2011 and February 2016...
July 20, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28725864/dying-from-cancer-communication-empathy-and-the-clinical-imagination
#10
Larry D Cripe, Richard M Frankel
Medical oncologists and patients with advanced cancer struggle to discuss prognosis, goals, options, and values in a timely fashion. As a consequence, many patients die receiving aggressive treatment potentially inconsistent with their fully informed preferences and experience increased symptom burden and distress. The goals of patient - oncologist communication include exchanging information, building relationship, and engaging in shared decisions. Empathy is perhaps especially essential to effective patient - oncologist communication when the end of life is approaching...
June 2017: Journal of patient experience
https://www.readbyqxmd.com/read/28724606/sex-and-gender-differences-in-hypertensive-kidney-injury
#11
Jennifer C Sullivan, Ellen Gillis
Hypertension is a complex, multifaceted disorder, affecting approximately 1 on 3 adults in the United States. Although hypertension occurs in both men and women, there are distinct sex differences in the way in which they develop hypertension, with women having a lower incidence of hypertension until the sixth decade of life. Despite observed sex differences in hypertension, little is known about the molecular mechanisms underlying the development of hypertension in females, primarily due to their underrepresentation in both clinical and experimental animal studies...
July 19, 2017: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/28724221/impact-of-the-nsaid-diclofenac-on-survival-development-behaviour-and-health-of-embryonic-and-juvenile-stages-of-brown-trout-salmo-trutta-f-fario
#12
Simon Schwarz, Hannah Schmieg, Marco Scheurer, Heinz-R Köhler, Rita Triebskorn
The NSAID diclofenac is controversially discussed with respect to its environmental relevance. Since further information is need to assess whether diclofenac should be included as substance of priority in the EU water framework directive, we investigated the impact of this analgesic on the embryonic development of brown trout (Salmo trutta f. fario) from fertilized egg until the end of sac-fry stage and studied effects in juvenile fish six months post hatch. Embryos were exposed to five test concentrations (0...
July 14, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28719564/the-new-apgar-score-a-checklist-to-enhance-quality-of-life-in-geriatric-patients-with-hip-fracture
#13
Joseph Bernstein, Sara Weintraub, Eric Hume, Mark D Neuman, Stephen L Kates, Jaimo Ahn
For geriatric patients with hip fractures, the broken bone is the reason for admission, but only part of the overall disease. Indeed, it may be more helpful to consider the patient having geriatric hip fracture syndrome or sustaining a hip attack, as there are many associated medical, social, psychological, and other problems to which attention must be paid. To that end, we have identified a series of 10 steps, collected into a checklist, that can be undertaken for all patients with geriatric hip fracture. In homage to the maxim "we come into the world under the brim of the pelvis and go out through the neck of the femur," we defined our checklist by the acronym APGAR SCORE, named after the classic checklist of the same name used to assess a newborn child...
July 19, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28718858/donationsutredningen-%C3%A3-ppnar-f%C3%A3-r-nya-organdonatorer-kr%C3%A3-ver-reflexion-om-m%C3%A3-nniskov%C3%A3-rdesprincipen-och-samtycke
#14
Stellan Welin
Swedish white paper on donation can give more donors without compromising ethics The White Paper on organ donation (SOU 2015:84) proposes new regulations for organ donation. In particular it spells out that it is permissible to take medical steps to preserve organs while the patient is still alive. It is proposed that this should be allowed after the medical team has declared that the continuation of life sustaining treatment is futile. The white paper opens up for donation after cardiac death. There has been some critique of the white paper for lack of deeper ethical discussions...
July 14, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28718015/capable-and-credible-challenging-nutrition-science
#15
EDITORIAL
Bart Penders, Anna Wolters, Edith F Feskens, Fred Brouns, Machteld Huber, Els L M Maeckelberghe, Gerjan Navis, Theo Ockhuizen, Jogchum Plat, Jan Sikkema, Marianne Stasse-Wolthuis, Pieter van 't Veer, Marcel Verweij, Jan de Vries
Nutrition science has enriched our understanding of how to stay healthy by producing valuable knowledge about the interaction of nutrients, food, and the human body. Nutrition science also has raised societal awareness about the links between food consumption and well-being, and provided the basis for food regulations and dietary guidelines. Its collaborative and interdisciplinary research has accomplished much, scientifically and socially. Despite this, nutrition science appears to be in crisis and is currently confronted with a public reluctance to trust nutritional insights...
July 17, 2017: European Journal of Nutrition
https://www.readbyqxmd.com/read/28716618/evaluation-of-a-video-based-seminar-to-raise-healthcare-professionals-awareness-of-culturally-sensitive-end-of-life-care
#16
Dulce M Cruz-Oliver, Theodore K Malmstrom, Michael Roegner, Gwen Yeo
OBJECTIVE: To investigate the effect of a newly developed telenovela, or video soap opera, on healthcare professionals (HCP)' awareness of caregivers' stress and patients' cultural approaches to end-of-life (EOL) care decisions. METHODS: A multi-center cross-sectional study among three communities in New York, Miami and Missouri. Participants from a convenience sample of multidisciplinary HCP were randomly assigned to view power point presentation with either a control-video or an intervention-telenovela about caregiving as part of a one- hour audiovisual seminar and completed a pre-posttest questionnaire to evaluate reaction and learning...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28714397/prognostic-value-of-copeptin-in-chronic-kidney-disease-from-general-population-to-end-stage-renal-disease
#17
Edyta Golembiewska, Anna Machowska, Peter Stenvinkel, Bengt Lindholm
Arginine vasopressin (AVP), also known as antidiuretic hormone (ADH), is released in response to osmotic and non-osmotic stimuli and plays a key role in many physiologic and pathologic processes. The main function of AVP is the control of fluid homeostasis by inducing water conservation by the kidney, but it also stimulates arteriolar vasoconstriction and the release of adrenocorticotropic hormone (ACTH). These actions are mediated by different AVP receptors located on various target cells. Produced in hypothalamus from a larger precursor, pre-proAVP, AVP is produced in equimolar amounts to copeptin, a glycopeptide with yet unknown biologic function...
July 14, 2017: Current Protein & Peptide Science
https://www.readbyqxmd.com/read/28714254/microbial-biotechnology-addressing-the-plastic-waste-disaster
#18
Tanja Narancic, Kevin E O'Connor
Oceans are a major source of biodiversity, they provide livelihood, and regulate the global ecosystem by absorbing heat and CO2 . However, they are highly polluted with plastic waste. We are discussing here microbial biotechnology advances with the view to improve the start and the end of life of biodegradable polymers, which could contribute to the sustainable use of marine and coastal ecosystems (UN Sustainability development goal 14).
July 17, 2017: Microbial Biotechnology
https://www.readbyqxmd.com/read/28712987/the-tailored-study-a-randomized-controlled-trial-to-improve-surrogate-decision-making
#19
Daniel P Sulmasy, Mark T Hughes, Gayane Yenokyan, Joan Kub, Peter B Terry, Alan B Astrow, Julie A Johnson, Grace Ho, Marie T Nolan
CONTEXT: Patients with terminal illnesses often require surrogate decision makers. Prior research has demonstrated high surrogate stress, and that despite standards promoting substituted judgment, most patients do not want their surrogates to make pure substituted judgments for them. It is not known how best to help loved ones fulfill the surrogate role. OBJECTIVES: To test the effectiveness of an intervention to help surrogate decision makers. METHODS: 166 patients (41% with ALS and 59% with gastrointestinal cancers) and their surrogates at 2 university medical centers were randomized to an intensive nurse-directed discussion of the end of life Decision Control Preferences of the patient (TAILORED) or a discussion of nutrition (CONTROL); 163 completed baseline interviews and underwent the intervention...
July 13, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28711755/palliative-care-clinicians-caring-for-patients-before-and-after-continuous-flow-left-ventricular-assist-device
#20
Sara E Wordingham, Colleen K McIlvennan, Timothy J Fendler, Amy L Behnken, Shannon M Dunlay, James N Kirkpatrick, Keith M Swetz
Left ventricular assist devices (LVADs) are an available treatment option for carefully-selected patients with advanced heart failure. Initially developed as a bridge to transplantation, LVADs are now also offered to patients ineligible for transplantation as destination therapy (DT). Individuals with a DT-LVAD will live the remainder of their lives with the device in place. While survival and quality of life improve with LVADs compared to medical therapy, complications persist including bleeding, infection, and stroke...
July 12, 2017: Journal of Pain and Symptom Management
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