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https://www.readbyqxmd.com/read/28430569/courage-and-compassion-virtues-in-caring-for-so-called-difficult-patients
#1
Michael Hawking, Farr A Curlin, John D Yoon
What, if anything, can medical ethics offer to assist in the care of the "difficult" patient? We begin with a discussion of virtue theory and its application to medical ethics. We conceptualize the "difficult" patient as an example of a "moral stress test" that especially challenges the physician's character, requiring the good physician to display the virtues of courage and compassion. We then consider two clinical vignettes to flesh out how these virtues might come into play in the care of "difficult" patients, and we conclude with a brief proposal for how medical educators might cultivate these essential character traits in physicians-in-training...
April 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28430292/failure-of-the-vascular-hypothesis-of-multiple-sclerosis-in-a-rat-model-of-chronic-cerebrospinal-venous-insufficiency
#2
Maha M A Zakaria, Shahira Y Mikhael, Azza K Abu Hussein, Rania A Salah El-Din, Hany W Abd El-Malak, Iman H Hewedi, Hany S Nadim
<i>Chronic cerebrospinal venous insufficiency (CCSVI) is a series of stenotic malformations in the cerebrospinal venous outflow routes, which is postulated to cause multiple sclerosis (MS). The hypotheses assumed that CCSVI leads to iron deposition which triggers inflammation and demyelination in MS. Invasive endovascular treatment of CCSVI was initiated based on the previous theory. The present study was designed to validate this hypothesis using a rat model of CCSVI. Bilateral jugular vein ligation (JVL) was performed on female albino rats (n = 15), and sham-operated rats (n = 15) were used as a control group...
2017: Folia Neuropathologica
https://www.readbyqxmd.com/read/28429654/microrna-451-regulates-chemoresistance-in-renal-cell-carcinoma-by-targeting-atf-2-gene
#3
Xiang Sun, Longhua Lou, Kezhao Zhong, Lijuan Wan
Renal cell carcinoma (RCC) is a malignant tumor, which severely threatens human's life, moreover, the multi-drug resistance (MDR) under RCC undoubtedly strengthen the difficulties in the treatment. MiR-451 has been considered to play an important role in regulation of MDR in several cancers, but the role of it in MDR of RCC has not been explored. This study aims to explore the mechanism of miR-451 as a target to regulate chemotherapy resistance, which is crucial for further exploring novel therapy for RCC. Two human cell lines (ACHN and GRC-1) were performed in this study and adriamycin (ADM) was used to construct MDR cell lines...
January 1, 2017: Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28428165/a-framework-for-the-study-of-complex-mhealth-interventions-in-diverse-cultural-settings
#4
Marion A Maar, Karen Yeates, Nancy Perkins, Lisa Boesch, Diane Hua-Stewart, Peter Liu, Jessica Sleeth, Sheldon W Tobe
BACKGROUND: To facilitate decision-making capacity between options of care under real-life service conditions, clinical trials must be pragmatic to evaluate mobile health (mHealth) interventions under the variable conditions of health care settings with a wide range of participants. The mHealth interventions require changes in the behavior of patients and providers, creating considerable complexity and ambiguity related to causal chains. Process evaluations of the implementation are necessary to shed light on the range of unanticipated effects an intervention may have, what the active ingredients in everyday practice are, how they exert their effect, and how these may vary among recipients or between sites...
April 20, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28427889/lost-in-translation-cultural-divides-in-communication-skills-teaching-identified-in-the-icch-2016-student-symposium
#5
Heather K Schopper, Nasteha A Mohamed, Max Seegel, Kseniya Gorina, Jonathan Silverman, Marcy Rosenbaum
OBJECTIVE: To provide a platform for learners' voices at an international conference on communication in healthcare. METHODS: A group of medical students were invited to explore their experiences with communication skills learning at a symposium at the 2016 International Conference on Communication in Healthcare in Heidelberg, DE. RESULTS: Students from the US, Denmark, Germany, and Russia discussed their experiences with communication skills curriculum at their institutions...
April 12, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28427564/inflammation-in-epileptic-encephalopathies
#6
Oleksii Shandra, Solomon L Moshé, Aristea S Galanopoulou
West syndrome (WS) is an infantile epileptic encephalopathy that manifests with infantile spasms (IS), hypsarrhythmia (in ~60% of infants), and poor neurodevelopmental outcomes. The etiologies of WS can be structural-metabolic pathologies (~60%), genetic (12%-15%), or of unknown origin. The current treatment options include hormonal treatment (adrenocorticotropic hormone and high-dose steroids) and the GABA aminotransferase inhibitor vigabatrin, while ketogenic diet can be given as add-on treatment in refractory IS...
2017: Advances in Protein Chemistry and Structural Biology
https://www.readbyqxmd.com/read/28427130/-to-see-the-future-development-of-burn-medicine-from-the-view-of-holistic-integrative-medicine
#7
D H Hu, K Tao
The therapeutic methods and effects have been improved greatly in the past few decades for burn care and management with several important advancements which have resulted in more effective patient stabilization and significantly decreased mortality in China. However, the challenges still exist, such as how to further improve the recovery of the patients' appearance and function, and how to advance the treatment of severe deep extensive burn injury, etc. The theory of holistic integrative medicine (HIM) provides a new opportunity for the development of clinical medicine...
April 20, 2017: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/28426536/exploring-the-interaction-between-nursing-decision-making-and-patient-outcomes-in-2-european-cancer-centers-a-qualitative-study
#8
Dario Valcarenghi, Annamaria Bagnasco, Giuseppe Aleo, Gianluca Catania, Milko Zanini, Bruno Cavaliere, Franco Carnevale, Loredana Sasso
BACKGROUND: In some clinical settings, nurses have difficulty describing the outcomes of their caring activities. Understanding the reasons for this could help nurse leaders to improve the effectiveness and visibility of nursing practice and safeguard nurses' working conditions. OBJECTIVE: The aims of this study were to understand how nurses working in 2 different adult cancer centers make healthcare decisions and assess the respective outcomes on their patients...
April 20, 2017: Cancer Nursing
https://www.readbyqxmd.com/read/28426344/primary-pediatric-breast-lesions-comparing-the-prevalence-of-malignancies-in-the-middle-east-with-north-america-review-of-1031-cases
#9
Justine S Broecker, Nasim Khoshnam, Laura Thompson, Shady Anis, Nora Kamal, Scott Gillespie, Diana Kantarovich, Diana Metry, Mary Pate Mills, Rachel Drummey, Brianna Williams, Bahig M Shehata
Benign breast masses are uncommon but are becoming more recognized among the pediatric population. Malignant breast lesions are very rare. The aim of our study was to review and compare the demographics, clinical presentation, treatment, and outcomes of breast lesions, including primary malignancies, and to discuss theories that may explain why there is an increased rate of breast cancers diagnosed at a younger age in the Egyptian population. A total of 1031 cases were reviewed. Comparisons were made between the Egyptian (n = 846) and US (n = 185) cohorts...
April 2017: Fetal and Pediatric Pathology
https://www.readbyqxmd.com/read/28425614/stigmatization-and-self-determination-of-preregistration-nurses-a-path-analysis
#10
Dana Perlman, Renee Brighton, Chris Patterson, Lorna Moxham, Ellie K Taylor, Susan Sumskis, Tim Heffernan
The concept of stigma and the stigmatizing behaviours of health-care professionals can have a profound influence on people with mental illness. A key construct that has been identified as influencing our behaviours is self-determination. As such, in the present study, we attempted to examine the connection and influence of motivational measures on the stigmatization of preregistration nurses. Data were collected once using three surveys that measured the motivational responses and stigmatizing behaviours of preregistration nurses after an approved mental health clinical placement...
April 20, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28423839/a-semantic-framework-for-logical-cross-validation-evaluation-and-impact-analyses-of-population-health-interventions
#11
Arash Shaban-Nejad, Anya Okhmatovskaia, Eun Kyong Shin, Robert L Davis, Brandi E Franklin, David L Buckeridge
Most chronic diseases are a result of a complex web of causative and correlated factors. As a result, effective public health or clinical interventions that intend to generate a sustainable change in these diseases most often use a combination of strategies or programs. To optimize comparative effectiveness evaluations and select the most efficient intervention(s), stakeholders (i.e. public health institutions, policy-makers and advocacy groups, practitioners, insurers, clinicians, and researchers) need access to reliable assessment methods...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28422576/mechanisms-of-action-contributing-to-reductions-in-suicide-attempts-following-brief-cognitive-behavioral-therapy-for-military-personnel-a-test-of-the-interpersonal-psychological-theory-of-suicide
#12
Craig J Bryan, David S Wood, Alexis May, Alan L Peterson, Evelyn Wertenberger, M David Rudd
Brief cognitive behavioral therapy (BCBT) is associated with significant reductions in suicide attempts among military personnel. However, the underlying mechanisms of action contributing to reductions in suicide attempts in effective psychological treatments remain largely unknown. The present study conducted a secondary analysis of a randomized controlled trial of BCBT versus treatment as usual (TAU) to examine the mechanisms of action hypothesized by the interpersonal-psychological theory of suicide (IPT): perceived burdensomeness, thwarted belongingness, and fearlessness about death...
April 19, 2017: Archives of Suicide Research: Official Journal of the International Academy for Suicide Research
https://www.readbyqxmd.com/read/28421871/exploring-predictors-of-work-competence-in-schizophrenia-the-role-of-theory-of-mind
#13
Margherita Bechi, Marco Spangaro, Alessandro Pigoni, Elena Ripamonti, Mariachiara Buonocore, Federica Cocchi, Laura Bianchi, Carmelo Guglielmino, Antonella Rita Mastromatteo, Roberto Cavallaro, Marta Bosia
In schizophrenia employment rate is dramatically low, also among patients receiving job support interventions. Recent studies showed a direct relationship between neurocognitive deficits and work functioning, as well as proving the benefits of combined neurocognitive and work interventions. Current evidence also supports a role of Theory of Mind (ToM), on work functioning. However, the effect of integrated rehabilitation programmes including a social cognitive training on job outcome is still less explored...
April 19, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28421644/the-clinical-application-of-suicide-risk-assessment-a-theory-driven-approach
#14
Sean M Mitchell, Sarah L Brown, Jared F Roush, Angelea D Bolaños, Andrew K Littlefield, Andrew J Marshall, Danielle R Jahn, Robert D Morgan, Kelly C Cukrowicz
The interpersonal theory of suicide posits that thwarted belongingness (TB) and perceived burdensomeness (PB) increase suicide ideation; however, studies have found mixed results regarding this hypothesis among psychiatric inpatients. This study aimed to (a) demonstrate how assessing TB and PB using the Interpersonal Needs Questionnaire (INQ) can provide clinically useful information and (b) investigate how statistical methodology may impact the clinical application of the INQ. Participants were 139 (Sample 1) and 104 (Sample 2) psychiatric inpatients...
April 18, 2017: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/28421479/understanding-medical-students-experience-with-stress-and-its-related-constructs-a-focus-group-study-from-singapore
#15
Julia Farquhar, Desiree Lie, Angelique Chan, Mandy Ow, Arpana Vidyarthi
OBJECTIVE: In order to protect medical students from burnout and its untoward psychiatric effects, it is imperative to understand their stress, burnout, coping, and resilience experiences. This study aimed to derive collective definitions from the medical student perspective, to identify common themes of students' experiences, and to distinguish pre-clinical and clinical year students' experiences relating to these four constructs. METHODS: The authors conducted focus groups of medical students in Singapore across 4 years using a semi-structured question guide...
April 18, 2017: Academic Psychiatry
https://www.readbyqxmd.com/read/28420604/a-digital-tool-to-promote-alcohol-and-drug-use-screening-brief-intervention-and-referral-to-treatment-skill-translation-a-mobile-app-development-and-randomized-controlled-trial-protocol
#16
Derek D Satre, Khanh Ly, Maria Wamsley, Alexa Curtis, Jason Satterfield
BACKGROUND: Translation of knowledge and skills from classroom settings to clinical practice is a major challenge in healthcare training, especially for behavioral interventions. For example, screening, brief intervention, and referral to treatment (SBIRT) is a highly-promoted approach to identifying and treating individuals at risk for alcohol or drug problems, yet effective, routine use of SBIRT has lagged. OBJECTIVE: The objective of this paper is to describe the development, pilot testing, and trial protocol of a mobile app based on the theory of planned behavior (TPB) to promote SBIRT skill translation and application...
April 18, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28420270/stages-of-change-in-audiology-comparison-of-three-self-assessment-measures
#17
Elisabeth Ingo, K Jonas Brännström, Gerhard Andersson, Thomas Lunner, Ariane Laplante-Lévesque
OBJECTIVE: In a clinical setting, theories of health behaviour change could help audiologists and other hearing health care professionals understand the barriers that prevent people with hearing problems to seek audiological help. The transtheoretical (stages of change) model of health behaviour change is one of these theories. It describes a person's journey towards health behaviour change (e.g. seeking help or taking up rehabilitation) in separate stages: precontemplation, contemplation, preparation, action, and, finally, maintenance...
April 19, 2017: International Journal of Audiology
https://www.readbyqxmd.com/read/28419682/game-theoretical-mapping-of-causal-interactions-underlying-visuo-spatial-attention-in-the-human-brain-based-on-stroke-lesions
#18
Monica N Toba, Melissa Zavaglia, Federica Rastelli, Romain Valabrégue, Pascale Pradat-Diehl, Antoni Valero-Cabré, Claus C Hilgetag
Anatomical studies conducted in neurological conditions have developed our understanding of the causal relationships between brain lesions and their clinical consequences. The analysis of lesion patterns extended across brain networks has been particularly useful in offering new insights on brain-behavior relationships. Here we applied multiperturbation Shapley value Analysis (MSA), a multivariate method based on coalitional game theory inferring causal regional contributions to specific behavioral outcomes from the characteristic functional deficits after stroke lesions...
April 17, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28419473/translating-the-cognitive-model-of-ptsd-to-the-treatment-of-very-young-children-a-single-case-study-of-an-8-year-old-motor-vehicle-accident-survivor
#19
Benjamin Goodall, Isobel Chadwick, Anna McKinnon, Aliza Werner-Seidler, Richard Meiser-Stedman, Patrick Smith, Tim Dalgleish
Posttraumatic stress disorder (PTSD) is a clinical condition that occurs after a discrete traumatic event, such as an accident or assault. Research into PTSD has primarily been adult-focused; however, there is a growing body of evidence evaluating the theory and treatment of PTSD in young children. Consequently, cognitive behavior therapy (CBT) interventions for PTSD in youth have been developed that focus on 3 core components of the cognitive model-a disorganized memory of the trauma, maladaptive appraisals of the trauma and its effects (meanings), and dysfunctional coping mechanisms (management)...
May 2017: Journal of Clinical Psychology
https://www.readbyqxmd.com/read/28418323/the-personality-profile-of-tinnitus-sufferers-and-a-nontinnitus-control-group
#20
Mithila Durai, Mary G O'Keeffe, Grant D Searchfield
BACKGROUND: Chronic tinnitus (phantom perception of sound) significantly disrupts quality of life in 15-20% of those who experience it. Understanding how certain personality traits impact tinnitus perception and distress can be beneficial for the development of interventions to improve the lives of tinnitus sufferers. PURPOSE: Four key self-reported personality traits (social closeness, stress reaction, alienation, and self-control) were identified from previous research as being associated with tinnitus...
April 2017: Journal of the American Academy of Audiology
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