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https://www.readbyqxmd.com/read/28905358/prognosis-communication-in-late-life-disability-a-mixed-methods-study
#1
Theresa W Wong, Sean Lang-Brown, Rafael D Romo, Alvin Au-Yeung, Sei J Lee, Patricia J Moran, Jason Karlawish, Rebecca Sudore, Josephine Clayton, Alexander K Smith
IMPORTANCE: Long-term prognosis informs clinical and personal decisions for older adults with late-life disability. However, many clinicians worry that telling patients their prognosis may cause harm. OBJECTIVE: To explore the safety of and reactions to prognosis communication in late-life disability. DESIGN: Participants estimated their own life expectancy and were then presented their calculated life expectancy using a validated prognostic index...
September 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28876412/psychological-model-of-art-adherence-behaviors-in-persons-living-with-hiv-aids-in-mexico-a-structural-equation-analysis
#2
José Luis Ybarra Sagarduy, Julio Alfonso Piña López, Mónica Teresa González Ramírez, Luis Enrique Fierros Dávila
OBJECTIVE: The objective of this study has been to test the ability of variables of a psychological model to predict antiretroviral therapy medication adherence behavior. METHODS: We have conducted a cross-sectional study among 172 persons living with HIV/AIDS (PLWHA), who completed four self-administered assessments: 1) the Psychological Variables and Adherence Behaviors Questionnaire, 2) the Stress-Related Situation Scale to assess the variable of Personality, 3) The Zung Depression Scale, and 4) the Duke-UNC Functional Social Support Questionnaire...
September 4, 2017: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28836985/providing-guidance-for-genomics-based-cancer-treatment-decisions-insights-from-stakeholder-engagement-for-post-prostatectomy-radiation-therapy
#3
James Abe, Jennifer M Lobo, Daniel M Trifiletti, Timothy N Showalter
BACKGROUND: Despite the emergence of genomics-based risk prediction tools in oncology, there is not yet an established framework for communication of test results to cancer patients to support shared decision-making. We report findings from a stakeholder engagement program that aimed to develop a framework for using Markov models with individualized model inputs, including genomics-based estimates of cancer recurrence probability, to generate personalized decision aids for prostate cancer patients faced with radiation therapy treatment decisions after prostatectomy...
August 24, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28795001/evaluation-and-management-of-sport-related-concussions-in-adolescent-athletes
#4
REVIEW
Dilip R Patel, Venu Parachuri, Amrith Shettigar
Sport-related concussions in young athletes are common, generally under reported and often go unrecognized. Concussion in sport may result either from a direct impact to the head or from indirect forces transmitted to the brain from impact elsewhere on the body. Concussions may also result from sudden acceleration, deceleration or rotational forces to the brain. The key features of concussion include confusion, impaired memory and reduced speed of information processing. Recovery may occur from a few days to several weeks or months...
July 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28795000/sport-related-concussions-in-adolescent-athletes-a-critical-public-health-problem-for-which-prevention-remains-an-elusive-goal
#5
REVIEW
Dilip R Patel, Diana Fidrocki, Venu Parachuri
Sport-related concussions in young athletes are common, generally under reported and often unrecognized. Preventive strategies include education, modification of sport rules, use of equipment such as headgears, face masks and mouth guards, and neck muscle training. Evidence is limited to support effectiveness of these preventive measures with the exception of rule modification in some sports. In the United States, laws have been enacted that require medical evaluation and clearance prior to return to play; however, evidence thus far does not show that laws have been effective in reducing the incidence of concussions in sport...
July 2017: Translational pediatrics
https://www.readbyqxmd.com/read/28758431/prodige-prediction-models-in-prostate-cancer-for-personalized-medicine-challenge
#6
A R Alitto, R Gatta, Bgl Vanneste, M Vallati, E Meldolesi, A Damiani, V Lanzotti, G C Mattiucci, V Frascino, C Masciocchi, F Catucci, A Dekker, P Lambin, V Valentini, G Mantini
AIM: Identifying the best care for a patient can be extremely challenging. To support the creation of multifactorial Decision Support Systems (DSSs), we propose an Umbrella Protocol, focusing on prostate cancer. MATERIALS & METHODS: The PRODIGE project consisted of a workflow for standardizing data, and procedures, to create a consistent dataset useful to elaborate DSSs. Techniques from classical statistics and machine learning will be adopted. The general protocol accepted by our Ethical Committee can be downloaded from cancerdata...
July 31, 2017: Future Oncology
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#7
Benjamin Djulbegovic, Shira Elqayam
Given that more than 30% of healthcare costs are wasted on inappropriate care, suboptimal care is increasingly connected to the quality of medical decisions. It has been argued that personal decisions are the leading cause of death, and 80% of healthcare expenditures result from physicians' decisions. Therefore, improving healthcare necessitates improving medical decisions, ie, making decisions (more) rational. Drawing on writings from The Great Rationality Debate from the fields of philosophy, economics, and psychology, we identify core ingredients of rationality commonly encountered across various theoretical models...
July 20, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28576289/psychological-counseling-as-an-adjunct-to-stuttering-treatment-clients-experiences-and-perceptions
#8
Alanna Lindsay, Marilyn Langevin
PURPOSE: Stuttering can trigger anxiety and other psychological and emotional reactions, and limit participation in society. It is possible that psychological counseling could enhance stuttering treatment outcomes; however, little is known about how clients view such counseling. The purpose of this study was to gain an understanding of clients' experiences with, and perceptions of, a psychological counseling service that was offered as an optional adjunct to speech therapy for stuttering...
June 2017: Journal of Fluency Disorders
https://www.readbyqxmd.com/read/28571666/including-values-in-evidence-based-policy-making-for-breast-screening-an-empirically-grounded-tool-to-assist-expert-decision-makers
#9
Lisa Parker
Values are an important part of evidence-based decision making for health policy: they guide the type of evidence that is collected, how it is interpreted, and how important the conclusions are considered to be. Experts in breast screening (including clinicians, researchers, consumer advocates and senior administrators) hold differing values in relation to what is important in breast screening policy and practice, and committees may find it difficult to incorporate the complexity and variety of values into policy decisions...
March 18, 2017: Health Policy
https://www.readbyqxmd.com/read/28462425/handgun-acquisitions-in-california-after-two-mass-shootings
#10
David M Studdert, Yifan Zhang, Jonathan A Rodden, Rob J Hyndman, Garen J Wintemute
Background: Mass shootings are common in the United States. They are the most visible form of firearm violence. Their effect on personal decisions to purchase firearms is not well-understood. Objective: To determine changes in handgun acquisition patterns after the mass shootings in Newtown, Connecticut, in 2012 and San Bernardino, California, in 2015. Design: Time-series analysis using seasonal autoregressive integrated moving-average (SARIMA) models...
May 16, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28459336/an-official-american-thoracic-society-european-society-of-intensive-care-medicine-society-of-critical-care-medicine-clinical-practice-guideline-mechanical-ventilation-in-adult-patients-with-acute-respiratory-distress-syndrome
#11
Eddy Fan, Lorenzo Del Sorbo, Ewan C Goligher, Carol L Hodgson, Laveena Munshi, Allan J Walkey, Neill K J Adhikari, Marcelo B P Amato, Richard Branson, Roy G Brower, Niall D Ferguson, Ognjen Gajic, Luciano Gattinoni, Dean Hess, Jordi Mancebo, Maureen O Meade, Daniel F McAuley, Antonio Pesenti, V Marco Ranieri, Gordon D Rubenfeld, Eileen Rubin, Maureen Seckel, Arthur S Slutsky, Daniel Talmor, B Taylor Thompson, Hannah Wunsch, Elizabeth Uleryk, Jan Brozek, Laurent J Brochard
BACKGROUND: This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). METHODS: A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. RESULTS: For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H2O) (moderate confidence in effect estimates)...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28412781/molecular-testing-to-optimize-and-personalize-decision-making-in-the-management-of-colorectal-cancer
#12
REVIEW
Marwan Al-Hajeili, Anthony F Shields, Jimmy J Hwang, Raymond C Wadlow, John L Marshall
Recent improvements in our understanding of the biology of colorectal cancer have led to the identification of several important prognostic and predictive markers of disease-associated risk and treatment response for the individual patient. Proper utilization of these biomarkers can enable physicians to tailor therapeutic strategies to maximize the likelihood of response and minimize treatment toxicity. In the management of colorectal cancer, tremendous progress has been made in the development of strategies for immune checkpoint inhibition; in refinement of agents and approaches used in targeted therapy; and in techniques for molecular subtyping of tumor samples that have identified patient subgroups with clinically relevant cellular differences potentially affecting clinical management and treatment outcome...
April 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28344507/patients-experience-of-using-primary-care-services-in-the-context-of-indonesian-universal-health-coverage-reforms
#13
Fitriana Murriya Ekawati, Mora Claramita, Krishna Hort, John Furler, Sharon Licqurish, Jane Gunn
BACKGROUND: The World Health Organization (WHO) recommendation on universal coverage has been implemented in Indonesia as Jaminan Kesehatan Nasional (JKN). It was designed to provide people with equitable and high-quality health care by strengthening primary care as the gate-keeper to hospitals. However, during its first year of implementation, recruitment of JKN members was slow, and the referral rates from primary to secondary care remained high. Little is known about how the public views the introduction of JKN or the factors that influence their decision to enroll in JKN...
2017: Asia Pacific Family Medicine
https://www.readbyqxmd.com/read/28330753/rationale-and-study-protocol-for-the-patient-centered-outcome-aid-pcoa-randomized-controlled-trial-a-personalized-decision-tool-for-newly-diagnosed-ovarian-cancer-patients
#14
L Wenzel, D Mukamel, K Osann, L Havrilesky, L Sparks, J Lipscomb, A A Wright, J Walker, R Alvarez, L Van Le, K Robison, R Bristow, R Morgan, B J Rimel, H Ladd, S Hsieh, A Wahi, D Cohn
No abstract text is available yet for this article.
June 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28219292/a-manner-of-being-body-languages-of-socio-economic-development
#15
Alexandra Antohin
This article proposes to move forward analytical work on the human aspect of socio-economic development, by featuring how personal decisions about physical appearance in effect negotiate socio-ethnic positions and desired economic aims that arise from new technologies of living. By envisioning how the body can serve as a conduit of consciousness-making, tattoos work as one cultural practice that produces an interplay between traditional precedents and contemporary trends and permits reflecting on how the categorizations of rural/urban can behave as a dialectical medium for internal anxieties and debates regarding social transformation...
July 2016: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
https://www.readbyqxmd.com/read/28212121/identification-and-evaluation-of-clinically-significant-prostate-cancer-a-step-towards-personalized-diagnosis
#16
Adnan Ali, Alexander Hoyle, Esther Baena, Noel W Clarke
PURPOSE OF REVIEW: Prostate cancer (PCa) diagnostics are evolving rapidly. The quest to differentiate 'clinically significant' from 'clinically insignificant' disease has gathered momentum, leading to substantial change in traditional diagnostic approaches. Herein, we review the relevant information on currently available biomarkers and assess their ability to help physicians and patients in making a shared and personalized decision based on their individual risk of harbouring clinically significant disease...
May 2017: Current Opinion in Urology
https://www.readbyqxmd.com/read/27997483/familial-creutzfeldt-jakob-disease-cluster-among-an-african-american-family
#17
Matthew G Johnson, Kristy K Bradley, Rebecca L Coffman, Ermias D Belay
Familial Creutzfeldt-Jakob disease (fCJD) results from inheritance of mutations in the prion protein gene. Confirming fCJD diagnosis is essential for informing persons of their potential hereditary risk and for genetic counseling to support personal decisions for genetic testing and family planning. We describe a case of fCJD that was linked to a large cluster of African Americans with fCJD identified through a public health investigation, including 8 confirmed cases and 13 suspected cases involving 7 generations in 1 family...
December 16, 2016: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/27922795/breast-cancer-risk-reduction-decisions-of-the-brca-positive-patient-an-observational-study-at-a-single-institution
#18
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...
June 2017: 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
#19
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...
June 2017: International Journal of Aging & Human Development
https://www.readbyqxmd.com/read/27908850/we-should-replace-conventional-mental-health-law-with-capacity-based-law
#20
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
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