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https://www.readbyqxmd.com/read/28731905/validation-of-the-prognostic-kidney-donor-risk-index-kdri-scoring-system-of-deceased-donors-for-renal-transplantation-in-the-netherlands
#1
Hessel Peters-Sengers, Martin B A Heemskerk, Ronald B Geskus, Jesper Kers, Jaap J Homan van der Heide, Stefan P Berger, Frederike J Bemelman
BACKGROUND: The prognostic Kidney Donor Risk Index (KDRI)-developed and internally validated in the US-is a widely-used tool to predict transplant outcome of a deceased donor kidney. The KDRI is currently used for longevity matching between donors and recipients in the US. METHODS: We aimed to externally validate the KDRI as proposed by Rao et al, (2009) containing 10 donor factors (KDRIdonor-only) and 1 with 4 additional transplant factors (KDRIfull), with stratification on recipient age and diabetes...
July 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28730671/many-faces-of-rationality-implications-of-the-great-rationality-debate-for-clinical-decision-making
#2
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/28714606/treating-depression-during-pregnancy-are-we-asking-the-right-questions
#3
REVIEW
Cara Angelotta, Katherine L Wisner
BACKGROUND: Major depressive disorder (MDD) is a common complication of pregnancy. Once the diagnosis of MDD is made, the physician must assist the pregnant woman in developing a treatment plan. METHODS: In considering antidepressants, the benefit of medication treatment for maternal disease control must be balanced against the risk of the drug to the developing embryo-fetus. This is an individualized decision depending on the disease characteristics, likelihood of maternal depression response, probability of adverse fetal effects, and patient characteristics and values...
July 17, 2017: Birth defects research
https://www.readbyqxmd.com/read/28711556/medicine-based-evidence-for-individualized-decision-making-case-study-of-systemic-lupus-erythematosis
#4
Ashley E Wivel, Kate Lapane, Christi Kleoudis, Burton H Singer, Ralph I Horwitz
To guide management decisions of an index patient evidence is required from comparisons between approximate matches to the profile of the index case, where some matches contain responses to treatment and others act as controls. We describe a method for constructing clinically relevant histories/profiles using data collected but unreported from two recent phase 3 RCTs assessing belimumab in subjects with clinically active and serologically positive SLE. Outcomes were the SRI (SLE Responder Index) measured at 52 weeks...
July 12, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28709784/individual-decision-making-in-the-causal-pathway-to-addiction-contributions-and-limitations-of-rodent-models
#5
REVIEW
Serge H Ahmed
The causal pathway from vulnerability to drug use and addiction involves a complex interaction between genetic, environmental, and behavioral factors. An individual can intervene on this causal pathway by two major types of individual decision. There is the inaugural, momentous decision to use a drug for the first time. This decision is influenced by both prior knowledge on the drug and its expected effects, and also by prior self-knowledge on one's own vulnerability. After an individual has used a drug for the first time, there is the decision to repeat drug use...
July 12, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28680675/foraging-intention-affects-whether-willow-tits-call-to-attract-members-of-mixed-species-flocks
#6
Toshitaka N Suzuki, Nobuyuki Kutsukake
Understanding how individual behaviour influences the spatial and temporal distribution of other species is necessary to resolve the complex structure of species assemblages. Mixed-species bird flocks provide an ideal opportunity to investigate this issue, because members of the flocks are involved in a variety of behavioural interactions between species. Willow tits (Poecile montanus) often produce loud calls when visiting a new foraging patch to recruit other members of mixed-species flocks. The costs and benefits of flocking would differ with individual foraging behaviours (i...
June 2017: Royal Society Open Science
https://www.readbyqxmd.com/read/28669719/changing-similarity-stable-and-flexible-modulations-of-psychological-dimensions
#7
Michael Dieciuc, Nelson A Roque, Jonathan R Folstein
Successfully categorizing objects requires discriminating between relevant and irrelevant dimensions (e.g., shape, color). Categorization can lead to changes in the visual system that stretch psychological space, making relevant dimensions more distinct and irrelevant dimensions more similar. These changes are known as dimensional modulation (DM) and they can be both stable and flexible in nature. The current study examined the interaction between stable DM and flexible DM, as well as the time course of relative changes in similarity...
June 29, 2017: Brain Research
https://www.readbyqxmd.com/read/28664573/occurrence-of-metachronous-basal-cell-carcinomas-a-prognostic-model
#8
H Smedinga, J A C Verkouteren, E W Steyerberg, A Hofman, T Nijsten, Y Vergouwe
BACKGROUND: A third of patients with a first basal cell carcinoma (BCC) will develop subsequent (metachronous) BCCs. OBJECTIVES: We studied the prognostic effect of the number of previous BCC diagnosis dates a patient has experienced and derived a prediction model to assess the risk of metachronous BCCs that may inform individualized decision making on surveillance. METHODS: We considered participants of north-western European ancestry from a prospective population-based cohort study (Rotterdam Study)...
June 30, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28661825/concussions-in-community-level-rugby-risk-knowledge-and-attitudes
#9
R Kyle Martin, Travis J Hrubeniuk, Christopher D Witiw, Peter MacDonald, Jeff Leiter
BACKGROUND: Rugby is a popular collision sport where participants are at risk of sustaining concussions. Most research focuses on elite-level or youth divisions. Comparatively, little is known about adult community rugby. The aim of this research was to estimate the risk of sustaining a concussion during participation in community-level rugby and summarize the collective knowledge and attitudes toward concussions. HYPOTHESIS: Concussion symptoms will be reported frequently among community-level rugby players and a substantial proportion will report a willingness to continue participation despite the risk...
July 2017: Sports Health
https://www.readbyqxmd.com/read/28632091/a-phenomenological-study-of-romantic-love-for-women-in-late-life
#10
Teresa J Moore, Joanni L Sailor
Romantic love in late life is often beneficial, though not without challenges. Financial concerns and objections of adult children can interfere with a late-life individual's decision to commit to a romantic relationship. In this study, the experience of romantic love for women who enter committed relationships in later life was examined. Fourteen women between the ages of 65 and 84 who had lived the experience of romantic love in late life were interviewed. By using Moustakas's qualitative Transcendental Phenomenological method, several themes emerged to provide a description of the phenomena...
March 3, 2017: Journal of Women & Aging
https://www.readbyqxmd.com/read/28574944/factors-motivating-medical-students-in-selecting-a-career-specialty-relevance-for-a-robust-orthopaedic-pipeline
#11
Raj D Rao, Omar N Khatib, Arnav Agarwal
INTRODUCTION: Selection of a career specialty by medical students is a complex and individualized decision. Our goals were to understand the factors that influenced medical students in selecting their career specialty, identify the stage at which this decision was made, and understand the role of demographics, mentors, and curricula in this process. METHODS: Medical students from 10 institutions participated in a web-based survey. Results were stratified by sex, race/ethnicity, and level of interest in orthopaedic surgery...
July 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28561006/strategies-for-long-term-preservation-of-kidney-graft-function
#12
REVIEW
Thomas Wekerle, Dorry Segev, Robert Lechler, Rainer Oberbauer
Kidney transplantation has become a routine procedure in the treatment of patients with kidney failure, and requires collaboration of experts from different disciplines, such as nephrology, surgery, immunology, pathology, infectious disease medicine, cardiology, and oncology. Grafts can be obtained from deceased or living donors, with different logistical requirements and implications for long-term graft patency. 1-year graft survival rates are greater than 95% in many centres but improvement of long-term function remains a challenge...
May 27, 2017: Lancet
https://www.readbyqxmd.com/read/28553247/education-and-decision-making-an-experimental-study-on-the-framing-effect-in-china
#13
Wen Fan
China's higher education expansion policy has been in effect for almost two decades. Under this policy, a growing number of youths have gained access to higher education, which aims to train students to be more rational. This study examines human rationality at a Chinese college through an experiment based on the risky-choice framing effect. The basic results show no classical framing effect with regard to individual decisions for the entire sample in a benchmark setting. However, when the participants' roles were manipulated and subsamples were investigated, a significant framing effect was found that appeared to be role-related and that varied by sex...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28540647/the-integration-of-social-influence-and-reward-computational-approaches-and-neural-evidence
#14
Damon Tomlin, Andrea Nedic, Deborah A Prentice, Philip Holmes, Jonathan D Cohen
Decades of research have established that decision-making is dramatically impacted by both the rewards an individual receives and the behavior of others. How do these distinct influences exert their influence on an individual's actions, and can the resulting behavior be effectively captured in a computational model? To address this question, we employed a novel spatial foraging game in which groups of three participants sought to find the most rewarding location in an unfamiliar two-dimensional space. As the game transitioned from one block to the next, the availability of information regarding other group members was varied systematically, revealing the relative impacts of feedback from the environment and information from other group members on individual decision-making...
May 24, 2017: Cognitive, Affective & Behavioral Neuroscience
https://www.readbyqxmd.com/read/28525539/prediction-of-multiple-recurrent-events-a-comparison-of-extended-cox-models-in-bladder-cancer
#15
Hilde Smedinga, Ewout W Steyerberg, Willemien Beukers, David van Klaveren, Ellen C Zwarthoff, Yvonne Vergouwe
Recurrence of bladder cancer can occur repeatedly in the same patient after treatment of the primary tumor. Models predicting the risk of a next recurrence may inform individualized decision-making on surveillance frequency. We aimed to assess the usefulness of extensions of the Cox proportional hazards model for repeated events in this context. We analyzed 531 Dutch patients with bladder cancer (1990-2012) with information on 7 pre-specified predictors at the time of diagnosing the primary and recurrent tumors...
May 19, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28523437/using-participatory-action-research-to-develop-a-working-model-that-enhances-psychiatric-nurses-professionalism-the-architecture-of-stability
#16
Martin Salzmann-Erikson
Ward rules in psychiatric care aim to promote safety for both patients and staff. Simultaneously, ward rules are associated with increased patient violence, leading to neither a safe work environment nor a safe caring environment. Although ward rules are routinely used, few studies have explicitly accounted for their impact. To describe the process of a team development project considering ward rule issues, and to develop a working model to empower staff in their daily in-patient psychiatric nursing practices...
May 18, 2017: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/28508814/plausibility-of-individual-decisions-from-random-forests-in-clinical-predictive-modelling-applications
#17
Dieter Hayn, Harald Walch, Jörg Stieg, Karl Kreiner, Hubert Ebner, Günter Schreier
BACKGROUND: Machine learning algorithms are a promising approach to help physicians to deal with the ever increasing amount of data collected in healthcare each day. However, interpretation of suggestions derived from predictive models can be difficult. OBJECTIVES: The aim of this work was to quantify the influence of a specific feature on an individual decision proposed by a random forest (RF). METHODS: For each decision tree within the RF, the influence of each feature on a specific decision (FID) was quantified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28496355/cannabis-as-a-substitute-for-prescription-drugs-a-cross-sectional-study
#18
James M Corroon, Laurie K Mischley, Michelle Sexton
BACKGROUND: The use of medical cannabis is increasing, most commonly for pain, anxiety and depression. Emerging data suggest that use and abuse of prescription drugs may be decreasing in states where medical cannabis is legal. The aim of this study was to survey cannabis users to determine whether they had intentionally substituted cannabis for prescription drugs. METHODS: A total of 2,774 individuals were a self-selected convenience sample who reported having used cannabis at least once in the previous 90 days...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28470830/a-critique-of-the-principle-of-respect-for-autonomy-grounded-in-african-thought
#19
Kevin G Behrens
I give an account how the principle of 'respect for autonomy' dominates the field of bioethics, and how it came to triumph over its competitors, 'respect for persons' and 'respect for free power of choice'. I argue that 'respect for autonomy' is unsatisfactory as a basic principle of bioethics because it is grounded in too individualistic a worldview, citing concerns of African theorists and other communitarians who claim that the principle fails to acknowledge the fundamental importance of understanding persons within the nexus of their communal relationships...
May 3, 2017: Developing World Bioethics
https://www.readbyqxmd.com/read/28462745/the-efficiency-of-the-local-health-systems-investigating-the-roles-of-health-administrations-and-health-care-providers
#20
Laura Anselmi, Mylène Lagarde, Kara Hanson
The analysis of efficiency in health care has largely focussed either on individual health care providers, or on sub-national health systems conceived as a unique decision-making unit. However, in hierarchically organized national health services, two separate entities are responsible for turning financial resources into services at the local level: health administrations and health care providers. Their separate roles and the one of health administrations in particular have not been explicitly considered in efficiency analysis...
May 2, 2017: Health Economics, Policy, and Law
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