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communicating risk to patients

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https://www.readbyqxmd.com/read/27910252/memory-performance-on-the-story-recall-test-and-prediction-of-cognitive-dysfunction-progression-in-mild-cognitive-impairment-and-alzheimer-s-dementia
#1
Jong-Hwan Park, Hyuntae Park, Sang Wuk Sohn, Sungjae Kim, Kyung Won Park
AIM: To determine the factors that influence diagnosis and differentiation of patients with mild cognitive impairment (MCI) and Alzheimer's dementia (AD) by comparing memory test results at baseline with those at 1-2-year follow up. METHODS: We consecutively recruited 23 healthy participants, 44 MCI patients and 27 patients with very mild AD according to the National Institute of Neurological and Communicative Diseases and Stroke/Alzheimer's Disease and Related Disorder Association criteria for probable Alzheimer's disease and Petersen's clinical diagnostic criteria...
December 1, 2016: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/27909042/how-australian-general-practitioners-engage-in-discussions-about-alcohol-with-their-patients-a-cross-sectional-study
#2
Emma R Miller, Imogen J Ramsey, Ly Thi Tran, George Tsourtos, Genevieve Baratiny, Ramesh Manocha, Ian N Olver
OBJECTIVE: This study aimed to investigate factors that inhibit and facilitate discussion about alcohol between general practitioners (GPs) and patients. DESIGN: Data analysis from a cross-sectional survey. SETTING AND PARTICIPANTS: 894 GP delegates of a national health seminar series held in five capital cities of Australia in 2014. MAIN OUTCOME MEASURES: Likelihood of routine alcohol enquiry; self-assessed confidence in assessing and managing alcohol issues in primary healthcare...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27905072/communicating-uncertainty-in-benefits-and-harms-a-review-of-patient-decision-support-interventions
#3
Nick Bansback, Madelaine Bell, Luke Spooner, Alysa Pompeo, Paul K J Han, Mark Harrison
BACKGROUND: Interventions designed to help people deliberate and participate in their healthcare choices frequently describe uncertainty in potential benefits and harms. This uncertainty can be generalized to aleatory, or first-order uncertainty, represented by risk estimates, and epistemic, or second-order uncertainty, represented by imprecision in the risk estimates. OBJECTIVES: The aim of this short communication was to review how patient decision support interventions (PDSIs) describe aleatory and epistemic uncertainty...
November 30, 2016: Patient
https://www.readbyqxmd.com/read/27904452/virtual-modelling-of-novel-applicator-prototypes-for-cervical-cancer-brachytherapy
#4
Primoz Petric, Robert Hudej, Noora Al-Hammadi, Barbara Segedin
BACKGROUND: Standard applicators for cervical cancer Brachytherapy (BT) do not always achieve acceptable balance between target volume and normal tissue irradiation. We aimed to develop an innovative method of Target-volume Density Mapping (TDM) for modelling of novel applicator prototypes with optimal coverage characteristics. Patients and methods. Development of Contour-Analysis Tool 2 (CAT-2) software for TDM generation was the core priority of our task group. Main requests regarding software functionalities were formulated and guided the coding process...
December 1, 2016: Radiology and Oncology
https://www.readbyqxmd.com/read/27903766/sudden-unexpected-death-in-epilepsy-measures-to-reduce-risk
#5
REVIEW
Brendan Mclean, Rohit Shankar, Jane Hanna, Caryn Jory, Craig Newman
This review looks at the strategies that may help to reduce the risk of sudden unexpected death in epilepsy beyond that of trying to achieve seizure cessation, which is not possible for up to 30% of patients with epilepsy. These strategies include seizure safety checklists, mobile phone technology, telehealth and various devices currently available or in development. We highlight interventions where there is evidence of benefit, and draw attention for the need both to involve patients with epilepsy in risk reduction and to improve communication with those at risk...
November 30, 2016: Practical Neurology
https://www.readbyqxmd.com/read/27902487/identification-of-laryngeal-cancer-prognostic-biomarkers-using-an-inflammatory-gene-related-competitive-endogenous-rna-network
#6
Qun He, Linli Tian, Hao Jiang, Jiarui Zhang, Qiang Li, Yanan Sun, Jiannan Zhao, Huijun Li, Ming Liu
Competitive endogenous RNAs (ceRNAs) act as molecular sponges for microRNAs (miRNAs), and are associated with tumorigenesis in various cancers, including laryngeal cancer (LC). In this work, we constructed an LC-specific inflammatory gene-related ceRNA network (IceNet). In IceNet, ceRNAs targeting inflammation-related genes tended to be network hubs. Additionally, the betweenness centralities of these hub ceRNAs were higher than those of the inflammation-related genes themselves, indicating that the hub ceRNAs in this study played critical roles in communication between IceNet molecules...
November 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/27901625/recovery-in-substance-use-disorders-what-to-know-to-inform-practice
#7
Julie Worley
Use of illicit substances and nonmedical use of prescription medication worldwide has increased dramatically in the past several years. Approximately 10% of people who use illicit substances will develop a substance use disorder (SUD). Similar to other chronic health disorders, periods of remission and exacerbation commonly occur in SUDs. Due to stigma and difficulty with definition, terminology related to SUDs has changed and evolved. Terms referring to nonuse of substances such as sobriety and abstinence are likely best replaced with the term remission...
November 30, 2016: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/27900413/recommendations-of-the-german-association-of-anesthesiology-and-intensive-care-medicine-dgai-on-structured-patient-handover-in-the-perioperative-setting-the-sbar-concept
#8
V von Dossow, B Zwissler
Teamwork in the operating room and in the intensive care unit necessitates clear and precise communication; however, interruptions in communication frequently occur, especially in the perioperative phase. Patients are particularly susceptible to deficits in communication, e.g. due to higher stress peaks, simultaneous admission of several patients and concomitant treatment of emergency cases. The German Society of Anesthesiology and Intensive Care Medicine (DGAI) therefore recommends the implementation of the so-called SBAR concept (S situation, B background, A assessment, R recommendation) for standardization of patient handover...
November 29, 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27900229/patient-perception-of-negative-noninvasive-prenatal-testing-results
#9
A Theresa Wittman, S Shahrukh Hashmi, Hector Mendez-Figueroa, Salma Nassef, Blair Stevens, Claire N Singletary
Objective To determine patient perception of residual risk after receiving a negative non-invasive prenatal testing result. Introduction Recent technological advances have yielded a new method of prenatal screening, non-invasive prenatal testing (NIPT), which uses cell-free fetal DNA from the mother's blood to assess for aneuploidy. NIPT has much higher detection rates and positive predictive values than previous methods however, NIPT is not diagnostic. Past studies have demonstrated that patients may underestimate the limitations of prenatal screening; however, patient perception of NIPT has not yet been assessed...
October 2016: American Journal of Perinatology Reports
https://www.readbyqxmd.com/read/27899103/time-to-event-versus-ten-year-absolute-risk-in-cardiovascular-risk-prevention-does-it-make-a-difference-results-from-the-optimizing-risk-communication-optrisk-randomized-controlled-trial
#10
Charles Christian Adarkwah, Nikita Jegan, Monika Heinzel-Gutenbrunner, Felicitas Kühne, Uwe Siebert, Uwe Popert, Norbert Donner-Banzhoff, Sarah Kürwitz
BACKGROUND: The concept of shared-decision-making is a well-established approach to increase the participation of patients in medical decisions. Using lifetime risk or time-to-event (TTE) formats has been increasingly suggested as they might have advantages, e.g. in younger patients, to better show consequences of unhealthy behaviour. In this study, the most-popular ten-year risk illustration in the decision-aid-software arriba(TM) (emoticons), is compared within a randomised trial to a new-developed TTE illustration, which is based on a Markov model...
November 29, 2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27898586/an-update-on-sodium-glucose-co-transporter-2-inhibitors-for-the-treatment-of-diabetes-mellitus
#11
Daniel S Hsia, Owen Grove, William T Cefalu
PURPOSE OF REVIEW: Sodium-glucose co-transporter-2 (SGLT2) inhibitors are the newest class of oral antihyperglycemic agents that have been approved for the treatment of diabetes mellitus. Over the past year, there have been significant developments in both the safety and efficacy of this class of medications that are presented in this review. RECENT FINDINGS: Apart from data on the glucose-lowering effect of SGLT2 inhibitors, other metabolic benefits have been demonstrated for this class of medications...
November 24, 2016: Current Opinion in Endocrinology, Diabetes, and Obesity
https://www.readbyqxmd.com/read/27896978/development-and-performance-of-text-mining-algorithms-to-extract-socioeconomic-status-from-de-identified-electronic-health-records
#12
Brittany M Hollister, Nicole A Restrepo, Eric Farber-Eger, Dana C Crawford, Melinda C Aldrich, Amy Non
Socioeconomic status (SES) is a fundamental contributor to health, and a key factor underlying racial disparities in disease. However, SES data are rarely included in genetic studies due in part to the difficultly of collecting these data when studies were not originally designed for that purpose. The emergence of large clinic-based biobanks linked to electronic health records (EHRs) provides research access to large patient populations with longitudinal phenotype data captured in structured fields as billing codes, procedure codes, and prescriptions...
2016: Pacific Symposium on Biocomputing
https://www.readbyqxmd.com/read/27896909/homeless-patients-perceptions-about-using-cell-phones-to-manage-medications-and-attend-appointments
#13
Leticia R Moczygemba, Lauren S Cox, Samantha A Marks, Margaret A Robinson, Jean-Venable R Goode, Nellie Jafari
OBJECTIVES: The objectives of this study were to (1) describe homeless persons' access and use of cell phones and their perceptions about using cell phone alerts to help manage medications and attend health care appointments and (2) identify demographic characteristics, medication use and appointment history and perceptions associated with interest in receiving cell phone alerts to manage medications and appointments. METHODS: A cross-sectional survey was conducted in 2013 at a homeless clinic in Virginia...
November 29, 2016: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27895096/icrp-and-radiological-protection-in-medicine
#14
Claire Cousins
Standards in relation to radiological protection in medicine are well-documented, particularly with the recent update of the Basic Safety Standards. The principles of justification and optimisation remain key, as dose limitation is not applicable in medical practice. Appropriate justification relies on the knowledge, experience and discretion of the relevant medical practitioners and this may be overlooked in the race for diagnosis and treatment. One argument would be further regulation of medical exposures, although it is difficult to see how this could be imposed without denying patients essential investigations and treatments...
November 28, 2016: Radiation Protection Dosimetry
https://www.readbyqxmd.com/read/27892885/vitamin-k-antagonists-for-stroke-prevention-in-hemodialysis-patients-with-atrial-fibrillation-a-systematic-review-and-meta-analysis
#15
Hans Van Der Meersch, Dirk De Bacquer, An S De Vriese
BACKGROUND: The use of vitamin K antagonists (VKAs) in hemodialysis patients with atrial fibrillation (AF) is controversial. No randomized trials are available and observational studies have yielded conflicting results, engendering a large clinical practice variability and physician uncertainty. An unresolved but highly relevant question is whether AF poses a true risk of ischemic stroke in hemodialysis and whether any form of oral anticoagulation is therefore warranted. METHODS: We conducted a systematic review of studies that compared the incidence of ischemic stroke and bleeding in hemodialysis patients with AF taking VKA and those not taking VKA...
October 4, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892625/progress-at-the-intersection-of-patient-safety-and-medical-liability-insights-from-the-ahrq-patient-safety-and-medical-liability-demonstration-program
#16
M Susan Ridgely, Michael D Greenberg, Michelle B Pillen, James Bell
OBJECTIVE: To identify lessons learned from the experience of the Agency for Healthcare Research and Quality (AHRQ) Patient Safety and Medical Liability (PSML) Demonstration Program. DATA SOURCES/STUDY SETTING: On September 9, 2009, President Obama directed the Secretary of Health and Human Services to authorize demonstration projects that put "patient safety first" with the intent of reducing preventable adverse outcomes and stemming liability costs. Seven demonstration projects received 3 years of funding from AHRQ in the summer of 2010, and the program formally came to a close in June 2015...
December 2016: Health Services Research
https://www.readbyqxmd.com/read/27890646/laparoscopic-hysterectomy-with-morcellation-versus-abdominal-hysterectomy-for-presumed-fibroids-an-updated-decision-analysis-following-the-2014-fda-safety-communications
#17
Matthew T Siedhoff, Kemi M Doll, Daniel L Clarke-Pearson, Sarah E Rutstein
Previous decision analyses demonstrate the safety of minimally invasive hysterectomy for presumed benign fibroids, accounting for the risk of occult leiomyosarcoma and the differential mortality risk associated with laparotomy. Studies published since the 2014 Food and Drug Administration safety communications offer updated leiomyosarcoma incidence estimates. Incorporating these studies suggests that mortality rates are low following hysterectomy for presumed benign fibroids overall, and a minimally invasive approach remains a safe option...
November 24, 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/27890630/arteriovenous-renal-replacement-therapy-in-end-stage-left-sided-heart-failure-patients-has-detrimental-effect-on-patients-with-impaired-right-ventricular-function
#18
Evangelos Repasos, Elisabeth Kaldara, Christos Pantsios, Chris Kapelios, Emmeleia Nana, Spiridon Vernadakis, Christina Melexopoulou, Konstantinos Malliaras, John Boletis, John N Nanas
INTRODUCTION: Chronic intermittent renal replacement therapy(RRT) is an alternate method of decongestion for patients presenting with diuretic-resistant, end-stage heart failure(HF) and cardiorenal syndrome. The optimal method of vascular access has not been confirmed. This study compared the 6-month outcomes of patients with end-stage HF after the creation of arteriovenous communications (AVC) versus other means of RRT. METHODS: We treated 40 patients with chronic, intermittent, ambulatory RRT, of whom 15 (37...
November 23, 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/27890543/hearing-care-intervention-for-persons-with-dementia-a-pilot-study
#19
Sara K Mamo, Olivia Nirmalasari, Carrie L Nieman, Matthew K McNabney, Allison Simpson, Esther S Oh, Frank R Lin
OBJECTIVE: Hearing loss is a commonly unmet need among adults with dementia that may exacerbate common dementia-related behavioral symptoms. Accessing traditional audiology services for hearing loss is a challenge because of high cost and time commitment. To improve accessibility and affordability of hearing treatment for persons with dementia, there is a need for unique service delivery models. The purpose of this study is to test a novel hearing intervention for persons with dementia and family caregivers delivered in outpatient settings...
September 22, 2016: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27889901/a-novel-approach-to-screening-for-familial-hypercholesterolemia-in-a-large-public-venue
#20
Megan Campbell, Jessa Humanki, Heather Zierhut
The primary aim of this study was to test the feasibility of a public health screening program to identify individuals at high risk of familial hypercholesterolemia through a novel screening approach at a large public venue. A finger-prick, non-fasting lipid panel was obtained, and a survey which consisted of 44 open- and close-ended questions divided into four sections: medical and family history of FH, opinions of cascade genetic testing, patient activation, and demographics was completed. A total of 971 participants met criteria and completed a cholesterol screen...
November 26, 2016: Journal of Community Genetics
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