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Shared decision

Leslie Kuhnel
The broad use of social networking and user-generated content has increased the online footprint of many individuals. A generation of healthcare professionals have grown up with online search activities as part of their everyday lives. Sites like Facebook, Twitter, and Instagram have given the public new ways to share intimate details about their public and private lives and the lives of their friends and families. As a result, careproviders have the ability to find out more about their patients with just the tap of a key or the click of a mouse...
2018: Journal of Clinical Ethics
Kathrin Burgmaier, Joy Brandt, Rukshana Shroff, Peter Witters, Lutz T Weber, Jörg Dötsch, Franz Schaefer, Djalila Mekahli, Max C Liebau
Introduction: Autosomal recessive polycystic kidney disease (ARPKD) is a severe hepatorenal disorder of childhood. Early renal disease in ARPKD may require renal replacement therapy and is associated with failure to thrive resulting in a need for nasogastric tube feeding or gastrostomy. In ARPKD patients, the benefit of a gastrostomy in nutrition and growth needs to be weighed against the potential risk of complications of congenital hepatic fibrosis (CHF) and portal hypertension like variceal bleeding. CHF in ARPKD has thus been considered as a relative contraindication for gastrostomy insertion...
2018: Frontiers in Pediatrics
Becky K White, Roslyn C Giglia, Jane A Scott, Sharyn K Burns
BACKGROUND: Breastfeeding is important for infants, and fathers are influential in supporting their partner in their decision to breastfeed and how long they breastfeed for. Fathers can feel excluded from traditional antenatal education and support opportunities but highly value social support from peers. Online health forums can be a useful source of social support, yet little is known about how fathers would use a conversation forum embedded in a breastfeeding-focused app. Milk Man is a mobile app that aimed to increase paternal support for breastfeeding using a range of strategies, including a conversation forum...
June 18, 2018: JMIR MHealth and UHealth
C E Strachan, A Nuwa, D Muhangi, A P Okui, M E H Helinski, J K Tibenderana
BACKGROUND: Successful pre-referral treatment with rectal artesunate (RA) for suspected severe malaria requires operational linkages between community health workers (CHWs) and referral facilities, acceptance of pre-referral treatment and adherence to referral practices by CHWs and caregivers. This qualitative study investigated how community understanding of the concept of 'pre-referral treatment' is used in referral related decision-making following provision of RA in Uganda. METHODS: Narrative interviews were conducted with 30 caregivers of children under five who received RA within the previous three months and the 30 associated CHWs who provided the treatment...
June 19, 2018: BMC Health Services Research
Kyoko Takashima, Yuichi Maru, Seiichi Mori, Hiroyuki Mano, Tetsuo Noda, Kaori Muto
BACKGROUND: Platforms for sharing genomic and phenotype data have been developed to promote genomic research, while maximizing the utility of existing datasets and minimizing the burden on participants. The value of genomic analysis of trios or family members has increased, especially in rare diseases and cancers. This article aims to argue the necessity of protection when sharing data from both patients and family members. MAIN TEXT: Sharing patients' and family members' data collectively raises an ethical tension between the value of datasets and the rights of participants, and increases the risk of re-identification...
June 18, 2018: BMC Medical Ethics
Shifeng Han, Xingzhong Xu
In a two-echelon new energy vehicle (NEV) supply chain consisting of a risk-neutral manufacturer and a risk-averse retailer, the coordination and sustainability problem is investigated. The risk-averse retailer, who makes sales effort and undertakes the incurred effort cost, decides the order quantity and sales effort level under the Conditional Value-at-Risk (CVaR) criterion. We derive the optimal centralized decisions of a vertically integrated supply chain where the retailer is owned by the manufacturer...
2018: PloS One
Erica Heiman, S Sam Lim, Gaobin Bao, Cristina Drenkard
OBJECTIVE: African American (AA) people with systemic lupus erythematosus (SLE) are at high morbidity and mortality risk, and they often require multiple medications. Low medication adherence is a highly prevalent, multidimensional problem associated with poor outcomes in people with SLE. Depression, a predictor of low adherence in people with chronic conditions, has been described in over 35% of AAs with SLE. We hypothesized that depressive symptoms would be increasingly associated with low adherence in this population...
June 15, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Kirk Geale, María Álvarez, Maria Polyzoi, Xavier Màlaga, Cristina Pineda, César Hernández
OBJECTIVE: Estimate the budget impact (BI) of introducing local autograft (LA) combined with demineralized bone matrix (LA+DBM) in lumbar spinal fusion (LSF) procedures to treat lumbar degenerative disc disease (LDDD) in Spain. METHODS: A decision tree model was developed to evaluate the 4-year BI associated with introducing LA+DBM putty to replace currently available grafting methods including iliac crest bone graft (ICBG), LA alone, and LA combined with beta-tricalcium phosphate (LA+ceramics), with 30%, 40%, and 30% market shares, respectively...
June 18, 2018: Journal of Medical Economics
Katherine Jackson, Sharon Hamilton, Susan Jones, Steven Barr
OBJECTIVES: The objective of this study is to identify patient reported experiences of using community rehabilitation and/or support services whilst living with a long-term neurological condition, and perceptions of their impact on quality of life. METHODS: Nine electronic databases were searched for peer-reviewed qualitative studies from 2005 to 2016, which met the inclusion criteria. Critical appraisal, data extraction, and quality assessment of 37 included papers were performed by three reviewers...
June 18, 2018: Disability and Rehabilitation
Li-Ting Chen, Fei-Hsiu Hsiao
OBJECTIVE: The aims of this systematic review were to examine the effects of the overall and the different types of the interventions on the do-not-resuscitate (DNR) designation and the time between DNR and death among cancer patients. METHOD: Data were searched from the databases of PubMed, CINAHL, EMbase, Medline, and Cochrane Library through 2 November 2017. Studies were eligible for inclusion if they were (1) randomized control trails, quasi-experimental study, and retrospective observational studies and (2) used outcome indicators of DNR designation rates...
June 18, 2018: Palliative & Supportive Care
Susan Huyck, Gregory Golm, Sajda Ghani, James Mancuso, Tarra Irvin
With the growth in co-development deals between pharmaceutical companies and the increased use of contract research organizations (CROs) in drug development, more and more employees are encountering projects that require working across different companies. Navigating the mix of corporate cultures as well as variations in standards and procedures can lead to unanticipated challenges and delays. The development of ertugliflozin, a recently approved medicine for type 2 diabetes mellitus, involved both co-development and CRO engagement across 4 companies...
January 1, 2018: Therapeutic Innovation & Regulatory Science
Koen P Grootens, Veronique van Thiel, Erwin G T M Hartong
No abstract text is available yet for this article.
June 17, 2018: Bipolar Disorders
Ted R Angradi, Jonathon J Launspach, Rick Debbout
Relative valuation of potentially affected ecosystem benefits can increase the legitimacy and social acceptance of ecosystem restoration projects. As an alternative or supplement to traditional methods of deriving beneficiary preference, we downloaded from social media and classified ≈21,000 photographs taken in two Great Lakes Areas of Concern (AOC), the St. Louis River and the Milwaukee Estuary. Our motivating presumption was that the act of taking a photograph constitutes some measure of the photographer's individual preference for, or choice of, the depicted subject matter among myriad possible subject matter...
April 1, 2018: Journal of Great Lakes Research
Abdullah Alsoghier, Richeal Ni Riordain, Stefano Fedele, Stephen Porter
OBJECTIVES: The numbers of individuals with oral cancer are increasing. This cancer is preceded by oral epithelial dysplasia (OED). There remains no detailed study of the online information presently available for patients with OED or indeed what information such patients may require to be appropriately informed regarding their condition. Hence, the aim of the present study is to assess the patient-oriented web content with respect to OED. METHODS: The first 100 websites yielded from nine searches performed using different search terms and engines were considered...
July 2018: Oral Oncology
Herbert J A Rolden, Gert Jan van der Wilt, Angela H E M Maas, Janneke P C Grutters
OBJECTIVES: As model-based economic evaluations (MBEEs) are widely used to make decisions in the context of policy, it is imperative that they represent clinical practice. Here, we assess the relevance of MBEEs on dabigatran for the prevention of stroke in patients with atrial fibrillation (AF). METHODS: We performed a systematic review on the basis of a developed questionnaire, tailored to oral anticoagulation in patients with AF. Included studies had a full body text in English, compared dabigatran with a vitamin K antagonist, were not dedicated to one or more subgroup(s), and yielded an incremental cost-effectiveness ratio...
June 18, 2018: International Journal of Technology Assessment in Health Care
Sarah Woltz, Pieta Krijnen, Arwen H Pieterse, Inger B Schipper
OBJECTIVE: This study aimed to answer the following research question: What is the knowledge, opinion, and experience of trauma surgeons with respect to shared decision making (SDM)? METHODS: An online survey was sent out in September 2016 to all 257 surgeons registered as a trauma surgeon with the Dutch Association of Trauma Surgery, to gather demographic, knowledge, and practice based information regarding their use of SDM. Results were presented according to the Checklist for Reporting Results of Internet E-Surveys (CHERRIES)...
June 6, 2018: Patient Education and Counseling
Lodewijk C S Res, Bart Lubberts, Shivesh H Shah, Christopher W DiGiovanni
BACKGROUND: Little is known about the health-related quality of life (HRQOL) following adverse bleeding events associated with antithrombotic drug therapy. This systematic review assesses the HRQOL of patients who suffered a bleeding event related to antithrombotic drug use. METHODS: Literature search was performed using PubMed, EMBASE, and the Cochrane Library from inception through June 16, 2017. Studies measuring HRQOL after a bleeding event related to antithrombotic drug therapy for primary or secondary prevention of a thromboembolic event were included...
June 14, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Marcel P Leclerc, Christina Regenbogen, Roy H Hamilton, Ute Habel
Patients with schizophrenia are at increased risk of engaging in violence towards others, compared to both the general population and most other patient groups. We have here explored the role of cortico-limbic impairments in schizophrenia, and have considered these brain regions specifically within the framework of a popular neuroanatomical model of impulsive aggression. In line with this model, evidence in patients with aggressive schizophrenia implicated structural deficits associated with impaired decision-making, emotional control and evaluation, and social information processing, especially in the orbitofrontal and ventrolateral prefrontal cortex...
June 13, 2018: Schizophrenia Research
David Ouyang, Gunsagar Gulati, Richard Ha, Dipanjan Banerjee
BACKGROUND: Proposed changes to the United Network for Organ Sharing heart transplant allocation protocol will prioritize patients receiving temporary mechanical circulatory support (tMCS), including extracorporeal membrane oxygenation (ECMO), percutaneous ventricular assist devices (PVADs), and intra-aortic balloon pumps (IABPs). We sought to evaluate contemporary trends in the incidence and outcomes of patients who required tMCS during the hospitalization before heart transplantation...
April 26, 2018: Journal of Heart and Lung Transplantation
Katie M Moynihan, Melanie A Jansen, Shih-Ning Liaw, Peta M A Alexander, Robert D Truog
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one of paternalism to more informed, shared decision-making. Unfortunately, there is an increasing trend for clinicians to avoid making recommendations, instead providing a "menu" of care options from which patients and families must choose. This seems to be underpinned by the belief that it is unacceptably paternalistic to give guidance as to which course of action may be best to take...
June 13, 2018: Pediatric Critical Care Medicine
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