Care-Captaining

Save My Kid ◽  
2020 ◽  
pp. 45-76
Author(s):  
Amanda M. Gengler
Keyword(s):  
Management Strategy ◽  
Illness Management ◽  
Medical Centers ◽  
Do So

Chapter 3 profiles parents whose primary illness management strategy was care-captaining. In describing the process through which three different sets of parents accessed and negotiated care at elite medical centers, the author demonstrates the advantages that care-captaining can garner families who are able to do so successfully and shows how physicians interpreted their efforts. Surprisingly, parents’ care-captaining efforts could help physicians feel better as well.

Metastatic Patterns of Cancers: Results From a Large Autopsy Study

2008 ◽  
Vol 132 (6) ◽  
pp. 931-939 ◽  
Author(s):  
Guy diSibio ◽  
Samuel W. French
Keyword(s):  
Quantitative Description ◽  
Primary Cancer ◽  
Autopsy Study ◽  
Regional Lymph Nodes ◽  
Design Review ◽  
Medical Centers ◽  
Metastatic Patterns ◽  
Quantitative Analyses ◽  
Metastatic Sites ◽  
Do So

Abstract Context.—Many studies have addressed metastatic patterns seen among various cancers. No recent studies, however, provide quantitative analyses of such patterns arising from a broad range of cancers based primarily on postmortem tissue analyses. Objective.—To provide a quantitative description of metastatic patterns among different primary cancers based on data obtained from a large, focused autopsy study. Design.—Review of data from 3827 autopsies, performed between 1914 and 1943 on patients from 5 affiliated medical centers, comprising 41 different primary cancers and 30 different metastatic sites. Results.—Testicular cancers were most likely to metastasize (5.8 metastases per primary cancer), whereas duodenal cancers were least likely to do so (0.6 metastases per primary cancer). Preferred metastatic sites varied among the primary cancers analyzed. Overall, regional lymph nodes were the most common metastatic target (20.6% of total), whereas testes were the least common (0.1% of total). Conclusions.—Not surprisingly, different primary cancers tended to metastasize, with differing frequencies, to different sites. These varying metastatic patterns might be helpful in deducing the origins of cancers whose primary sites are unclear at presentation.

scholarly journals Self-management of mood and/or anxiety disorders through physical activity/exercise

2017 ◽  
Vol 37 (5) ◽  
pp. 149-159 ◽  
Author(s):  
Louise Pelletier ◽  
Shamila Shanmugasegaram ◽  
Scott B Patten ◽  
Alain Demers
Keyword(s):  
Physical Activity ◽  
Anxiety Disorders ◽  
Household Income ◽  
Physical Inactivity ◽  
Management Strategy ◽  
Self Management ◽  
Depression And Anxiety ◽  
Income Adequacy ◽  
Will Power ◽  
Do So

Introduction Physical activity/exercise is regarded as an important self-management strategy for individuals with mental illness. The purpose of this study was to describe individuals with mood and/or anxiety disorders who were exercising or engaging in physical activity to help manage their disorders versus those who were not, and the facilitators for and barriers to engaging in physical activity/exercise. Methods For this study, we used data from the 2014 Survey on Living with Chronic Diseases in Canada—Mood and Anxiety Disorders Component. Selected respondents (n = 2678) were classified according to the frequency with which they exercised: (1) did not exercise; (2) exercised 1 to 3 times a week; or (3) exercised 4 or more times a week. We performed descriptive and multinomial multiple logistic regression analyses. Estimates were weighted to represent the Canadian adult household population living in the 10 provinces with diagnosed mood and/or anxiety disorders. Results While 51.0% of the Canadians affected were not exercising to help manage their mood and/or anxiety disorders, 23.8% were exercising from 1 to 3 times a week, and 25.3% were exercising 4 or more times a week. Increasing age and decreasing levels of education and household income adequacy were associated with increasing prevalence of physical inactivity. Individuals with a mood disorder (with or without anxiety) and those with physical comorbidities were less likely to exercise regularly. The most important factor associated with engaging in physical activity/exercise was to have received advice to do so by a physician or other health professional. The most frequently cited barriers for not exercising at least once a week were as follows: prevented by physical condition (27.3%), time constraints/too busy (24.1%) and lack of will power/self-discipline (15.8%). Conclusion Even though physical activity/exercise has been shown beneficial for depression and anxiety symptoms, a large proportion of those with mood and/or anxiety disorders did not exercise regularly, particularly those affected by mood disorders and those with physical comorbidities. It is essential that health professionals recommend physical activity/exercise to their patients, discuss barriers and support their engagement.

Is it Really All about the Money? Reconsidering Non-Financial Interests in Medical Research

2012 ◽  
Vol 40 (3) ◽  
pp. 467-481 ◽  
Author(s):  
Richard S. Saver
Keyword(s):  
Medical Research ◽  
Conflicts Of Interest ◽  
Major Change ◽  
Academic Medical Centers ◽  
Department Of Health ◽  
Medical Centers ◽  
Institutional Review ◽  
Academic Medical ◽  
Financial Interests ◽  
Do So

Conflicts of interest have been reduced to financial conflicts. The National Institutes of Health’s (NIH) new rules for managing conflicts of interest in medical research, the first major change to the regulations in over 15 years, address only financial ties. Although several commentators urged that the regulations also cover non-financial interests, the Department of Health and Human Services declined to do so. Similarly, the Institute of Medicine’s (IOM) influential 2009 Conflict of Interest Report focuses almost exclusively on financial conflicts. Institutional policies at academic medical centers and guidance from professional bodies and medical journals also primarily emphasize financial ties. Even broadly worded rules are applied more readily to financial ties than non-financial interests, such as the regulations that restrict institutional review board (IRB) members with conflicting interests from participating in protocol reviews.

Optimizing active surveillance for low-risk prostate cancer: Characterizing provider and patient perspectives.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 250-250
Author(s):  
Archana Radhakrishnan ◽  
Lalita Subramanian ◽  
Aaron Rankin ◽  
Ted A. Skolarus ◽  
Daniela Wittmann ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Active Surveillance ◽  
Management Strategy ◽  
Low Risk ◽  
Barriers And Facilitators ◽  
Academic Medical Centers ◽  
Medical Centers ◽  
Academic Medical ◽  
Risk Prostate Cancer ◽  
Low Risk Prostate Cancer

250 Background: The number of men on active surveillance (AS) for low-risk prostate cancer is rapidly increasing. While AS requires routine clinical exams, labs, imaging, and prostate biopsies, many men do not receive all recommended components. Understanding the perspectives of key stakeholders regarding recommended surveillance is critical to ensuring the optimization of AS as a management strategy. Methods: We conducted in-depth, semi-structured, virtual interviews with a purposive sample of 15 men with low-risk prostate cancer who were on AS as their primary management strategy and their partners, and 15 urologists and 19 primary care providers (PCPs) with experience in AS management between June 2020 and March 2021. We used the Theoretical Domains Framework (TDF), an implementation science framework developed to understand determinants of behaviors and to inform the design of interventions, to guide our interview guide. Questions assessed knowledge, barriers and facilitators, and preferences for provider roles in AS management. Interviews were recorded, transcribed, and deductively coded into TDF domains and constructs. Three independent coders iteratively developed and used a shared coding framework. Participant recruitment continued until data saturation by group. Results: Our study included 15 men (on AS between 1-16 years), 5 partners, 15 urologists (3 female, 5 in private practice, 3 in academic medical centers), and 19 PCPs (9 female, 4 in community practices, 15 in academic medical centers). The TDF domain of “knowledge” and the construct, “barriers and facilitators” were most commonly reported as factors impacting receipt of recommended surveillance across all groups. While urologists were most knowledgeable about AS, PCPs noted limitations in understanding for whom AS is recommended, and what it entails. Patients who had made an effort to research or learn about AS found that this knowledge enabled them to be proactive about receiving all recommended components. Urologists and patients noted several common procedural barriers to receiving recommended surveillance, including pain with repeated biopsies, and becoming lost to follow-up. Patients and PCPs were uncertain about what tests were needed and when. Urologists were concerned about PCP knowledge while PCPs described insufficient communication from urologists as barriers to shared care. Procedural facilitators included electronic medical records (EMR) to remind providers and patients of frequency and timing of tests. Conclusions: Key opportunities for optimizing AS include improving patient and PCP knowledge about the components and delivery of AS, facilitating communication between providers, and leveraging EMR to ensure those on AS are followed. The development of an intervention that combines several of these components will be critical to ensuring men on AS receive the recommended surveillance.

Holding replication studies to mainstream standards of evidence

2018 ◽  
Vol 41 ◽  
Author(s):  
Duane T. Wegener ◽  
Leandre R. Fabrigar
Keyword(s):  
Replication Studies ◽  
Replication Research ◽  
Standards Of Evidence ◽  
Do So

AbstractReplications can make theoretical contributions, but are unlikely to do so if their findings are open to multiple interpretations (especially violations of psychometric invariance). Thus, just as studies demonstrating novel effects are often expected to empirically evaluate competing explanations, replications should be held to similar standards. Unfortunately, this is rarely done, thereby undermining the value of replication research.

Electron Microscopy of a Herpesvirus Isolated from Marek's Disease in Duck and Chicken Embryo Fibroblast Cultures

1968 ◽  
Vol 26 ◽  
pp. 222-223 ◽  
Author(s):  
Keyvan Nazerian
Keyword(s):  
Inclusion Bodies ◽  
Chicken Embryo Fibroblast ◽  
Marek's Disease ◽  
Marek’S Disease ◽  
Duck Embryo Fibroblast ◽  
Multinucleated Cells ◽  
Viral Particles ◽  
Infected Cells ◽  
And Control ◽  
Do So

A herpes-like virus has been isolated from duck embryo fibroblast (DEF) cultures inoculated with blood from Marek's disease (MD) infected birds. Cultures which contained this virus produced MD in susceptible chickens while virus negative cultures and control cultures failed to do so. This and other circumstantial evidence including similarities in properties of the virus and the MD agent implicate this virus in the etiology of MD.Histochemical studies demonstrated the presence of DNA-staining intranuclear inclusion bodies in polykarocytes in infected cultures. Distinct nucleo-plasmic aggregates were also seen in sections of similar multinucleated cells examined with the electron microscope. These aggregates are probably the same as the inclusion bodies seen with the light microscope. Naked viral particles were observed in the nucleus of infected cells within or on the edges of the nucleoplasmic aggregates. These particles measured 95-100mμ, in diameter and rarely escaped into the cytoplasm or nuclear vesicles by budding through the nuclear membrane (Fig. 1). The enveloped particles (Fig. 2) formed in this manner measured 150-170mμ in diameter and always had a densely stained nucleoid. The virus in supernatant fluids consisted of naked capsids with 162 hollow, cylindrical capsomeres (Fig. 3). Enveloped particles were not seen in such preparations.

Debates in Dysphagia Management: How Do You Use Evidence-Based Practice in Your Dysphagia Patient Care?

2011 ◽  
Vol 20 (4) ◽  
pp. 121-123
Author(s):  
Jeri A. Logemann
Keyword(s):  
Decision Making ◽  
Patient Care ◽  
Clinical Outcomes ◽  
Clinical Judgment ◽  
Clinical Decision Making ◽  
Evidence Based Practice ◽  
Clinical Decision ◽  
Evidence Based ◽  
Clinical Method ◽  
Do So

Evidence-based practice requires astute clinicians to blend our best clinical judgment with the best available external evidence and the patient's own values and expectations. Sometimes, we value one more than another during clinical decision-making, though it is never wise to do so, and sometimes other factors that we are unaware of produce unanticipated clinical outcomes. Sometimes, we feel very strongly about one clinical method or another, and hopefully that belief is founded in evidence. Some beliefs, however, are not founded in evidence. The sound use of evidence is the best way to navigate the debates within our field of practice.

An Overview of Facilities Providing Clinical Services for Persons Who Stutter in Kuwait

2016 ◽  
Vol 1 (4) ◽  
pp. 79-95
Author(s):  
Latifa Alsalmi ◽  
Robert Mayo
Keyword(s):  
Special Education ◽  
Department Heads ◽  
Clinical Services ◽  
Medical Settings ◽  
Non Profit ◽  
Future Studies ◽  
Language Services ◽  
Medical Centers ◽  
Clinical Directors

Presently, no clear picture is available about the facilities providing clinical services for persons who stutter (PWS) in Kuwait. This information is crucial for any awareness program to be established in the future. The purpose of this study was to identify clinical facilities and speech-language personnel that provide services for PWS in Kuwait. Participants consisted of 21 clinical directors of governmental medical centers, non-profit clinics, and private clinics as well as department heads of governmental school clinics where speech-language services were provided. Participants were interviewed regarding the availability of speech-language services within their centers and whether or not PWS receive services. The results revealed that four out of five governmental medical centers with a total of 32 speech-language pathologists (SLPs) provided services for PWS. Additionally, 12 schools of special education were found to have 62 SLPs on their staff providing fluency services for students. Finally, two stand-alone private clinics and one non-profit clinic provided services for PWS. Results indicated an overall shortage of SLPs in the country, especially in medical settings. This study sets the foundation for a series of future studies investigating the type and quality of stuttering services provided by the identified facilities in Kuwait.

175: Regionalization of Partial and Radical Nephrectomy to Specific Medical Centers

2005 ◽  
Vol 173 (4S) ◽  
pp. 47-48
Author(s):  
Brent K. Hollenbeck ◽  
David A. Taub ◽  
Rodney L. Dunn ◽  
John T. Wei
Keyword(s):  
Radical Nephrectomy ◽  
Medical Centers

The Persnickety Pervasiveness of Rating Enhancement in Personality Assessment

2020 ◽  
pp. 1-13
Author(s):  
Alicia A. Stachowski ◽  
John T. Kulas
Keyword(s):  
Response Bias ◽  
Personality Assessment ◽  
Current Paper ◽  
Psychological Measurement ◽  
Shared Sets ◽  
Self Reports ◽  
Original Target ◽  
Target Profile ◽  
Do So ◽  
Normative Influences

Abstract. The current paper explores whether self and observer reports of personality are properly viewed through a contrasting lens (as opposed to a more consonant framework). Specifically, we challenge the assumption that self-reports are more susceptible to certain forms of response bias than are informant reports. We do so by examining whether selves and observers are similarly or differently drawn to socially desirable and/or normative influences in personality assessment. Targets rated their own personalities and recommended another person to also do so along shared sets of items diversely contaminated with socially desirable content. The recommended informant then invited a third individual to additionally make ratings of the original target. Profile correlations, analysis of variances (ANOVAs), and simple patterns of agreement/disagreement consistently converged on a strong normative effect paralleling item desirability, with all three rater types exhibiting a tendency to reject socially undesirable descriptors while also endorsing desirable indicators. These tendencies were, in fact, more prominent for informants than they were for self-raters. In their entirety, our results provide a note of caution regarding the strategy of using non-self informants as a comforting comparative benchmark within psychological measurement applications.

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