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Gut instinct

Kelly R Klein, Frederick M Burkle, Raymond Swienton, Richard V King, Thomas Lehman, Carol S North
INTRODUCTION: After all large-scale disasters multiple papers are published describing the shortcomings of the triage methods utilized. This paper uses medical provider input to help describe attributes and patient characteristics that impact triage decisions. METHODS: A survey distributed electronically to medical providers with and without disaster experience. Questions asked included what disaster experiences they had, and to rank six attributes in order of importance regarding triage...
2016: PLoS Currents
Timothy G Dinan, John F Cryan
There is a growing realisation that the gut-brain axis and its regulation by the microbiota may play a key role in the biological and physiological basis of neurodevelopmental, age-related and neurodegenerative disorders. The routes of communication between the microbiota and brain are being unravelled and include the vagus nerve, gut hormone signalling, the immune system, tryptophan metabolism or by way of microbial metabolites such as short chain fatty acids. The importance of early life gut microbiota in shaping future health outcomes is also emerging...
September 19, 2016: Journal of Physiology
Jane Warland, Louise M O'Brien, Alexander E P Heazell, Edwin A Mitchell
BACKGROUND: Stillbirth occurring after 28 weeks gestation affects between 1.5-4.5 per 1,000 births in high-income countries. The majority of stillbirths in this setting occur in women without risk factors. In addition, many established risk factors such as nulliparity and maternal age are not amenable to modification during pregnancy. Identification of other risk factors which could be amenable to change in pregnancy should be a priority in stillbirth prevention research. Therefore, this study aimed to utilise an online survey asking women who had a stillbirth about their pregnancy in order to identify any common symptoms and experiences...
2015: BMC Pregnancy and Childbirth
Naomi Attar
No abstract text is available yet for this article.
July 2015: Nature Reviews. Microbiology
Jamilla A Hussain, Kate Flemming, Fliss E M Murtagh, Miriam J Johnson
BACKGROUND AND OBJECTIVE: To ensure that decisions to start and stop dialysis in ESRD are shared, the factors that affect patients and health care professionals in making such decisions must be understood. This systematic review sought to explore how and why different factors mediate the choices about dialysis treatment. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: MEDLINE, Embase, CINAHL, and PsychINFO were searched for qualitative studies of factors that affect patients' or health care professionals' decisions to commence or withdraw from dialysis...
July 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
Louise Lu, Chengfang Liu, Linxiu Zhang, Alexis Medina, Scott Smith, Scott Rozelle
[This corrects the article DOI: 10.1371/journal.pntd.0003643.].
April 2015: PLoS Neglected Tropical Diseases
Louise Lu, Chengfang Liu, Linxiu Zhang, Alexis Medina, Scott Smith, Scott Rozelle
BACKGROUND: Soil-transmitted helminth (STH) infections affect more than two out of every five schoolchildren in the poorest regions of rural China, an alarmingly high prevalence rate given the low cost and wide availability of safe and effective deworming treatment. Understanding of local knowledge, attitudes, and practices regarding STH infection in rural China has until now, been sparse, although such information is critical for prevention and control initiatives. METHODOLOGY/PRINCIPAL FINDINGS: This study aims to elucidate the structural and sociocultural factors that underlie high STH infection rates as well as explain why deworming treatment is rarely sought for children...
March 2015: PLoS Neglected Tropical Diseases
I Z Iqbal, N Kara, C Hartley
OBJECTIVES: It is generally accepted that with experience clinicians develop the ability to identify patients who present with malignancy prior to a formal diagnosis. This ability cannot be quantified, nor is it a plausible substitute for investigation. This study aimed to evaluate the association between instinct and head and neck cancer diagnosis. METHODS: A prospective study of patients requiring urgent diagnostic procedures for suspected cancer between August and December 2010 was performed...
April 2015: Journal of Laryngology and Otology
Gareth Leng
No abstract text is available yet for this article.
September 2014: Experimental Physiology
Lora L Cork
Emergency nurses assess patients using objective and subjective data. When the charge nurse takes report from a paramedic, another form of assessment occurs. By eliciting apt data and using trauma-scoring criteria, a decision to enact a "trauma code" occurs. Considering the cost and staff utilization, it is important for the charge nurse to make sound decisions when activating a trauma code. The objective of this study is to explore the validity of nurses' use of intuition in patients to predict the severity of their injuries, and whether it impacts their choice to institute a trauma code...
September 2014: Journal of Trauma Nursing: the Official Journal of the Society of Trauma Nurses
Cybéle L Abad, Richard H Moseley, Christopher J Crnich, Sanjay Saint, Nasia Safdar
Foreword. In this Journal feature, information about a real patient is presented in stages (boldface type) to an expert clinician, who responds to the information, sharing his or her reasoning with the reader (regular type). The authors' commentary follows. Stage. A 30-year-old woman presented to..
August 7, 2014: New England Journal of Medicine
Carmen Peota
No abstract text is available yet for this article.
February 2014: Minnesota Medicine
Jop de Vrieze
No abstract text is available yet for this article.
January 17, 2014: Science
Julian Bion
Barriers to the use of selective digestive decontamination include concerns about emergence of resistant organisms, over-estimation of current performance in preventing ventilator-associated pneumonia (VAP), alternative methods of preventing VAP, and misunderstanding of mechanisms of action. A definitive cluster-randomised trial should be undertaken that incorporates practitioner concerns and effect-size preferences.
2013: Critical Care: the Official Journal of the Critical Care Forum
Jon Cohen
No abstract text is available yet for this article.
October 4, 2013: Science
Ryan M Antiel, Farr A Curlin, Katherine M James, Jon C Tilburt
INTRODUCTION: Physicians vary in their moral judgments about health care costs. Social intuitionism posits that moral judgments arise from gut instincts, called "moral foundations." The objective of this study was to determine if "harm" and "fairness" intuitions can explain physicians' judgments about cost-containment in U.S. health care and using cost-effectiveness data in practice, as well as the relative importance of those intuitions compared to "purity", "authority" and "ingroup" in cost-related judgments...
2013: Philosophy, Ethics, and Humanities in Medicine: PEHM
Mona Mischke, Torsten Plösch
Substantial evidence links early postnatal nutrition to the development of obesity later in life. However, the molecular mechanisms of this connection must be further elucidated. Epigenetic mechanisms have been indicated to be involved in this process, referred to as metabolic programming. Therefore, we propose here that early postnatal nutrition (breast and formula feeding) epigenetically programs the developing organs via modulation of the gut microbiome and influences the body weight phenotype including the predisposition to obesity...
June 15, 2013: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
Yael Schenker, Douglas B White, Megan Crowley-Matoka, Daniel Dohan, Greer A Tiver, Robert M Arnold
BACKGROUND: Surrogates of critically ill patients in the intensive care unit (ICU) want honest prognostic information, but they also want to hear good news. There has been little examination of how surrogates navigate these dual needs or how clinicians should respond. OBJECTIVE: The aim of this study was explore how surrogates in the ICU experience and cope with prognostic information and describe their recommendations for clinicians. METHODS: We conducted a qualitative interview study with 30 surrogates facing life-sustaining treatment decisions in five ICUs in Pittsburgh, Pennsylvania...
March 2013: Journal of Palliative Medicine
Ann Van den Bruel, Matthew Thompson, Frank Buntinx, David Mant
OBJECTIVE: To investigate the basis and added value of clinicians' "gut feeling" that infections in children are more serious than suggested by clinical assessment. DESIGN: Observational study. SETTING: Primary care setting, Flanders, Belgium. PARTICIPANTS: Consecutive series of 3890 children and young people aged 0-16 years presenting in primary care. MAIN OUTCOME MEASURES: Presenting features, clinical assessment, doctors' intuitive response at first contact with children in primary care, and any subsequent diagnosis of serious infection determined from hospital records...
2012: BMJ: British Medical Journal
Jennifer Sprinks
No abstract text is available yet for this article.
July 18, 2012: Nursing Standard
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