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https://www.readbyqxmd.com/read/27922795/breast-cancer-risk-reduction-decisions-of-the-brca-positive-patient-an-observational-study-at-a-single-institution
#1
Dana Johns, Jay Agarwal, Layla Anderson, Jian Ying, Wendy Kohlmann
BACKGROUND: BRCA1 and BRCA2 gene mutations carry with them a 50%-80% risk of developing breast cancer. The best choice for managing breast cancer risk in patients with a BRCA1/2 mutation is a highly personal decision. Options for risk management include surveillance with multiple modalities or prophylactic surgical intervention. The goal of this study was to gain a better understanding of contributing factors affecting the decision for managing breast cancer risk made by patients who are BRCA mutation positive and cancer free...
December 6, 2016: Journal of Women's Health
https://www.readbyqxmd.com/read/27913758/timing-of-most-recent-health-care-visit-by-older-people-living-with-and-without-hiv-findings-from-the-sage-well-being-of-older-people-study-in-uganda
#2
Joseph O Mugisha, Enid J Schatz, Joel Negin, Paul Mwaniki, Paul Kowal, Janet Seeley
The objective of this article is to document factors associated with the recency of health-care service utilization by people aged 50 years and over living with and without HIV in Uganda. A survey was conducted with 510 Ugandans aged 50 and older, living with and without HIV. The survey included information on sociodemographic characteristics, health state, self-reported chronic conditions, and timing of most recent visit to a health-care facility (time since last visit [TSLV]). We use ordinal logistic regression to identify independent factors associated TSLV...
December 2, 2016: International Journal of Aging & Human Development
https://www.readbyqxmd.com/read/27908850/we-should-replace-conventional-mental-health-law-with-capacity-based-law
#3
George Szmukler, Brendan D Kelly
As general medicine moves away from 'paternalism' and places an increasing emphasis on patient choice and autonomy, George Szmukler and Brendan D. Kelly debate whether conventional mental health legislation should be replaced with a model that focuses on the person's decision-making capabilities.
December 2016: British Journal of Psychiatry: the Journal of Mental Science
https://www.readbyqxmd.com/read/27828774/ethical-analysis-for-physicians-considering-the-provision-of-life-ending-medication-in-compliance-with-the-california-end-of-life-option-act
#4
D Malcolm Shaner
The End of Life Option Act in California, effective June 9, 2016, permits physicians to prescribe lethal medication to patients confirmed to be terminally ill and capable of independently making and carrying out a decision to ingest deadly medication. Medicine has traditionally excluded the provision of deadly medication from proper practice. Physicians reasonably may hold to that limit. However, honoring a repeated request from a capable, terminally ill patient to receive life-ending medication still can be considered to be a moral and permissible approach to relieve suffering...
2016: Permanente Journal
https://www.readbyqxmd.com/read/27819843/impact-of-functional-deficits-in-instrumental-activities-of-daily-living-in-mild-cognitive-impairment-a-clinical-algorithm-to-predict-progression-to-dementia
#5
Davangere P Devanand, Xinhua Liu, Patrick J Brown
BACKGROUND: The utility of functional deficits in patients with mild cognitive impairment is not established. MATERIALS AND METHODS: In 3886 individuals with mild cognitive impairment evaluated and followed at 34 National Alzheimer Coordinating Center sites, informant-reported Pfeffer Functional Activities Questionnaire (FAQ) items associated with progression to dementia were derived in a training set (n=1943) and tested in the validation set (n=1943). RESULTS: In the training set, the optimal combination comprised 6 FAQ items (FAQ6): difficulties with finances (2 items), remembering events/appointments, playing games of skill, current events, and travel...
November 4, 2016: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/27687535/impact-of-provider-patient-communication-on-cancer-screening-adherence-a-systematic-review
#6
REVIEW
Emily B Peterson, Jamie S Ostroff, Katherine N DuHamel, Thomas A D'Agostino, Marisol Hernandez, Mollie R Canzona, Carma L Bylund
Cancer screening is critical for early detection and a lack of screening is associated with late-stage diagnosis and lower survival rates. The goal of this review was to analyze studies that focused on the role of provider-patient communication in screening behavior for cervical, breast, and colorectal cancer. A comprehensive search was conducted in four online databases between 1992 and 2016. Studies were included when the provider being studied was a primary care provider and the communication was face-to-face...
December 2016: Preventive Medicine
https://www.readbyqxmd.com/read/27627195/machine-learning-approaches-to-personalize-early-prediction-of-asthma-exacerbations
#7
Joseph Finkelstein, In Cheol Jeong
Patient telemonitoring results in an aggregation of significant amounts of information about patient disease trajectory. However, the potential use of this information for early prediction of exacerbations in adult asthma patients has not been systematically evaluated. The aim of this study was to explore the utility of telemonitoring data for building machine learning algorithms that predict asthma exacerbations before they occur. The study dataset comprised daily self-monitoring reports consisting of 7001 records submitted by adult asthma patients during home telemonitoring...
September 14, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27611349/attending-patient-funerals-practices-and-attitudes-of-australian-medical-practitioners
#8
Sofia C Zambrano, Anna Chur-Hansen, Gregory B Crawford
The appropriateness of attending a patient's funeral is a medical dilemma. This paper focuses on 437 doctors who participated in an online survey. Seventy-one percent of GPs, 67% of oncologists, 67% of psychiatrists, 63% of palliative medicine specialists, 52% of surgeons, and 22% of intensive care specialists had attended patient funerals. Significant differences in demographics and between specialties were identified in terms of barriers and benefits associated with attendance. While attendance is a personal decision, there is a need for open discussions in medical education and professional development concerning death and the role of doctors after a patient dies...
September 9, 2016: Death Studies
https://www.readbyqxmd.com/read/27584610/reproductive-planning-in-times-of-zika-getting-pregnant-or-delaying-plans-the-opinion-of-the-brazilian-society-of-assisted-reproduction-committee-a-basis-for-a-bioethical-discussion
#9
Bruno R de Carvalho, Paulo F Taitson, Karina S A G Brandão, Rui Alberto Ferriani, Hitomi M Nakagawa, Adelino A Silva, Joaquim R C Lopes
Although the causality between Zika virus, microcephaly, and other central nervous system disorders has been taken for granted by the scientific community, many uncertainties remain. The gap of knowledge at the moment is large enough to remove part of the confidence physicians have on the advice given to patients - and infertile women in particular - on their reproductive plans. Pretreatment serologic screening is a possible strategy to offer more confidence for individuals choosing to bear children regardless of the Zika virus, but the tests currently available do not seem to be sufficiently adequate...
2016: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/27583821/drug-use-and-misuse-in-the-mountains-a-uiaa-medcom-consensus-guide-for-medical-professionals
#10
Enrico Donegani, Peter Paal, Thomas Küpper, Urs Hefti, Buddha Basnyat, Anna Carceller, Pierre Bouzat, Rianne van der Spek, David Hillebrandt
: Donegani, Enrico, Peter Paal, Thomas Küpper, Urs Hefti, Buddha Basnyat, Anna Carceller, Pierre Bouzat, Rianne van der Spek, and David Hillebrandt. Drug use and misuse in the mountains: a UIAA MedCom consensus guide for medical professionals. High Alt Med Biol. 17:157-184, 2016.-Aims: The aim of this review is to inform mountaineers about drugs commonly used in mountains. For many years, drugs have been used to enhance performance in mountaineering. It is the UIAA (International Climbing and Mountaineering Federation-Union International des Associations d'Alpinisme) Medcom's duty to protect mountaineers from possible harm caused by uninformed drug use...
September 2016: High Altitude Medicine & Biology
https://www.readbyqxmd.com/read/27547914/-i-ve-never-been-a-yes-person-decision-making-participation-and-self-conceptualization-after-severe-traumatic-brain-injury
#11
Lucy Knox, Jacinta M Douglas, Christine Bigby
PURPOSE: Although adults who sustain a severe traumatic brain injury (TBI) require support to make decisions in their lives, little is known about their experience of this process. The aim of this study was to explore how participation in decision making contributes to self-conceptualization in adults with severe TBI. METHOD: We used constructivist grounded theory methods. Data included 20 in-depth interviews with adults with severe TBI. Through a process of constant comparison, analysis involved open and focused coding until clear categories emerged and data saturation was achieved...
August 22, 2016: Disability and Rehabilitation
https://www.readbyqxmd.com/read/27532063/improving-personalized-clinical-risk-prediction-based-on-causality-based-association-rules
#12
Chih-Wen Cheng, May D Wang
Developing clinical risk prediction models is one of the main tasks of healthcare data mining. Advanced data collection techniques in current Big Data era have created an emerging and urgent need for scalable, computer-based data mining methods. These methods can turn data into useful, personalized decision support knowledge in a flexible, cost-effective, and productive way. In our previous study, we developed a tool, called icuARM- II, that can generate personalized clinical risk prediction evidence using a temporal rule mining framework...
September 2015: ACM-BCB: ACM Conference on Bioinformatics, Computational Biology and Biomedicine
https://www.readbyqxmd.com/read/27501652/the-jehovah-s-witness-population-considerations-for-preoperative-optimization-of-hemoglobin
#13
Yasmine N Campbell, Melissa D Machan, Marquessa D Fisher
Most members of the Jehovah's Witness community refuse blood transfusions, and there are variations in what alternatives they will accept depending on their personal decisions. To provide culturally competent care, healthcare providers need to be knowledgeable about substitutions for blood administration as well as the risks and benefits of available alternatives so that they can inform their patients. It has been recognized in the literature that preoperative optimization of hemoglobin levels with alternative treatment modalities through a multidisciplinary approach can improve clinical outcomes in patients who refuse blood products...
June 2016: AANA Journal
https://www.readbyqxmd.com/read/27468772/introduction-priority-setting-equitable-access-and-public-involvement-in-health-care
#14
Albert Weale, Katharina Kieslich, Peter Littlejohns, Aviva Tugendhaft, Emma Tumilty, Krisantha Weerasuriya, Jennifer A Whitty
Purpose - The purpose of this paper is to introduce the special issue on improving equitable access to health care through increased public and patient involvement (PPI) in prioritization decisions by discussing the conceptualization, scope and rationales of PPI in priority setting that inform the special issue. Design/methodology/approach - The paper employs a mixed-methods approach in that it provides a literature review and a conceptual discussion of the common themes emerging in the field of PPI and health priority setting...
August 15, 2016: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/27444340/breastfeeding-the-illusion-of-choice
#15
Lauren M Dinour, Yeon K Bai
BACKGROUND: Breastfeeding is frequently described as a woman's decision, yet this choice is often illusionary owing to suboptimal social and structural supports. Despite passage of the Patient Protection and Affordable Care Act (2010) that requires all qualifying employers to provide mothers "reasonable" break time and a private, non-bathroom space to express breast milk, the majority of women in the United States still do not have access to both accommodations. THE PROBLEM: At least three issues may be influencing this suboptimal implementation at workplaces: 1) federal law does not address lactation space functionality and accessibility, 2) federal law only protects a subset of employees, and 3) enforcement of the federal law requires women to file a complaint with the United States Department of Labor...
September 2016: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/27443849/attitude-towards-organ-donation-in-german-medical-students
#16
Tobias Terbonssen, Utz Settmacher, Christine Wurst, Olaf Dirsch, Uta Dahmen
PURPOSE: It is well known that personal decision making in respect to organ donation is highly dependent on the balance of knowledge, trust, and fear. We wanted to explore the attitude of German medical students towards organ donation and investigate the relationship between knowledge, trust, and fear in this special subgroup. METHODS: We conducted an online survey utilizing (1) the snowball effect of using Facebook groups and advertisement as well as (2) mailing lists of medical faculties in Germany for distribution...
July 21, 2016: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/27437678/trends-of-teenage-pregnancy-in-brazil-2000-2011
#17
Raquel Ferreira Vaz, Denise Leite Maia Monteiro, Nádia Cristina Pinheiro Rodrigues
OBJECTIVE: To evaluate the frequency of teenage pregnancy in Brazil, from 2000 to 2011, in all five Brazilian macroregions and age groups (10-14 and 15-19 years), correlating it with the human development index (HDI). METHOD: Descriptive epidemiological study, with cross-sectional design, performed by searching the database of the National Health System (Datasus), using information from the Information System (Sinasc). RESULTS: There was a decrease in the percentage of live births (LB) from teenage mothers (10-19 years) in Brazil (23...
July 2016: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/27356694/clinical-prognostic-score-for-predicting-disease-remission-with-differentiated-thyroid-cancers
#18
Charoonsak Somboonporn, Ampica Mangklabruks, Ammarin Thakkinstian, Patravoot Vatanasapt, Suwannee Nakaphun
BACKGROUND: Differentiated thyroid cancer is the most common endocrine malignancy with a generally good prognosis. Knowing long-term outcomes of each patient helps management planning. The study was conducted to develop and validate a clinical prognostic score for predicting disease remission in patients with differentiated thyroid cancer based on patient, tumor and treatment factors. MATERIALS AND METHODS: A retrospective cohort study of 1,217 differentiated thyroid cancer patients from two tertiary-care hospitals in the Northeast of Thailand was performed...
2016: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/27346402/-prognostic-differences-of-phenotypes-in-pt1-2n0-invasive-breast-cancer-a-large-cohort-study-with-cluster-analysis
#19
Z Wang, W H Wang, S L Wang, J Jin, Y W Song, Y P Liu, H Ren, H Fang, Y Tang, B Chen, S N Qi, N N Lu, N Li, Y Tang, X F Liu, Z H Yu, Y X Li
OBJECTIVE: To find phenotypic subgroups of patients with pT1-2N0 invasive breast cancer by means of cluster analysis and estimate the prognosis and clinicopathological features of these subgroups. METHODS: From 1999 to 2013, 4979 patients with pT1-2N0 invasive breast cancer were recruited for hierarchical clustering analysis. Age (≤40, 41-70, 70+ years), size of primary tumor, pathological type, grade of differentiation, microvascular invasion, estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER-2) were chosen as distance metric between patients...
June 23, 2016: Zhonghua Zhong Liu za Zhi [Chinese Journal of Oncology]
https://www.readbyqxmd.com/read/27346032/integrating-patient-preference-into-treatment-decisions-for-men-with-prostate-cancer-at-the-point-of-care
#20
David C Johnson, Dana E Mueller, Allison M Deal, Mary W Dunn, Angela B Smith, Michael E Woods, Eric M Wallen, Raj S Pruthi, Matthew E Nielsen
PURPOSE: Men with clinically localized prostate cancer face an archetypal "preference sensitive" treatment decision. A shared decision making process incorporating patient values and preferences is paramount. We evaluated the benefit of a novel decision making application, and investigated associations between patient preferences and treatment choice. MATERIALS AND METHODS: We used a novel, web based application that provides education, preference measurement and personalized decision analysis for patients with newly diagnosed prostate cancer...
June 23, 2016: Journal of Urology
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