scholarly journals PDE5i as a Cure for Older Adults: An Indicator of Ageist Practices among Physicians

2016 ◽  
Vol 9 (1) ◽  
pp. 77-77
Author(s):  
A. Gewirtz- Meydan ◽  
◽  
M. Mock ◽  
L. Ayalon ◽  
◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Young Patient ◽  
Later Life ◽  
Case Vignette ◽  
Hormonal Changes ◽  
Older Patient ◽  
Age Bias ◽  
Patient Vignette ◽  
Case Vignettes ◽  
On Line

Objective: The aim of this study is to determine whether physicians have an age bias regarding sexual dysfunction in older vs. younger patients in terms of diagnosis, attributed etiology, proposed treatment and perceived prognosis. Design and Method: An on-line survey consisting of one of two, randomly administered, case vignettes, which differed only by age (28 or 78). In both cases, the patient was described as suffering from occasional erectile dysfunction with a clear psychosocial indication. A total of 236 physicians responded to the survey. Overall, 110 physicians received an old patient vignette and 126 physicians received a young patient vignette. Results: Even though both cases presented with a clear psychosocial etiology, the young patient vignette was more likely to be diagnosed with performance anxiety, whereas the old patient vignette with erectile dysfunction. The old patient vignette dysfunction was more likely to be attributed to hormonal changes, health problems and decreased sexual desire. Physicians were more likely to recommend hormonal and PDE5 inhibitors (PDE5i; such as Sildenafil; Vardenafil; Tadalafil) treatment as well as urology referral to the old patient vignette. The young patient vignette was more often referred to a sexologist and received a more positive prognosis than the older patient. Conclusions: This study demonstrates an age bias among physicians regarding sexuality in later life. Of particular note is the increased prescription of PDE5i to the older patient, despite the clear psychosocial indication presented in the case vignette.

End-of-life decision making in critical illness: Perspectives of Asian parents

2021 ◽  
pp. 1-10
Author(s):  
Kristy Xinghan Fu ◽  
Yee Keow Chiong ◽  
Nicola Ngiam
Keyword(s):  
Decision Making ◽  
End Of Life ◽  
Tertiary Care ◽  
Asian Population ◽  
Emergency Department Visits ◽  
Case Vignette ◽  
Healthcare Team ◽  
Care Hospital ◽  
Case Vignettes ◽  
End Of Life Decision

Abstract Objective To explore parents’ perspectives regarding end-of-life (EOL) decisions, factors and possible barriers that influence the EOL decision making process, and to understand parental preferences for communication about EOL care in an Asian population. Method A prospective questionnaire cohort study conducted in a university-based tertiary care hospital. 30 parents of children who had been admitted to general pediatric wards for acute ailments and/or were being followed up in general pediatric outpatient clinics after inpatient admissions or emergency department visits completed 30 interviewer-administered questionnaires. With the first 10 completed questionnaires, we sought feedback on the design of the four case vignettes and related questions. Responses to specific questions related to each case vignette were rated on a Likert scale. Results The majority of parents were able to comprehend and identify with the issues in the case vignettes, which allowed them to respond appropriately. Parents tended to avoid active withdrawal or withholding of life-sustaining treatment. The top three priorities for parents making EOL decisions for their children were: the chance of improvement, the presence of pain or discomfort, and information provided by healthcare staff. Parents reported that they would prefer to know immediately if their child is at risk of dying; they also preferred to get as much information as possible from the healthcare team and thought that meeting with the healthcare team before making EOL decisions was pivotal. Significance of results Parents place highest priorities on their child's likelihood of improvement, perception of their child's pain, and information provided by healthcare professionals in making EOL decisions.

Late-life depression

2014 ◽  
Vol 29 (S3) ◽  
pp. 577-577 ◽  
Author(s):  
K. Ritchie
Keyword(s):  
Depressive Symptomatology ◽  
Late Onset ◽  
Late Life ◽  
Later Life ◽  
The Elderly ◽  
Conclusive Evidence ◽  
First Episode ◽  
Hormonal Changes ◽  
Late Life Depression ◽  
Incident Cases

Late-life depression is highly heterogeneous in clinical presentation, and is also commonly resistant to treatment. While some cases are a continuation of the chronic course of illness beginning in early adulthood, a large number of persons will have a first episode of depression in later life following alife-time of relatively good mental health. While incident cases of major depression tend to decrease with age, the number of persons with clinically significant depressive symptomatology rises. À distinction has often been made between early-onset and late-onset depression, however, there is no conclusive evidence to suggest these are distinct clinical entities. On the other hand observations from a fifteen year prospective population study of psychiatric disorder in the elderly (the ESPRIT Study) supports the alternative idea that depression may be divided into sub-types according to postulated aetiology; for example depression with a strong genetic component, related to hormonal changes, the consequence of trauma; the result of cerebrovascular insult. Exposure to these putative causes may be more common at different points in the life span, thus suggesting age-differences. Our research further suggests that even cases of depression appearing for the first time in late-life, may be initially triggered by risk factors occurring decades before. Our findings suggest, for example, that childhood events may lead to changes in the biology of stress management, which continue throughout life, increasing vulnerability to depression and persisting even after effective treatment of symptoms. Together these observations suggest it may be more meaningful to classify depression in the elderly according to probable principle precipitating factors rather than age.

scholarly journals No evidence of spatial representation of age, but “own-age bias” like face processing found in chimpanzees

2021 ◽  
Author(s):  
Yuri Kawaguchi ◽  
Masaki Tomonaga ◽  
Ikuma Adachi
Keyword(s):  
Response Time ◽  
Face Processing ◽  
Spatial Representation ◽  
Life Stage ◽  
Later Life ◽  
Processing Efficiency ◽  
Age Bias ◽  
Conspecific Adult ◽  
Infant Faces ◽  
Age Category

AbstractPrevious studies have revealed that non-human primates can differentiate the age category of faces. However, the knowledge about age recognition in non-human primates is very limited and whether non-human primates can process facial age information in a similar way to humans is unknown. As humans have an association between time and space (e.g., a person in an earlier life stage to the left and a person in a later life stage to the right), we investigated whether chimpanzees spatially represent conspecifics’ adult and infant faces. Chimpanzees were tested using an identical matching-to-sample task with conspecific adult and infant face stimuli. Two comparison images were presented vertically (Experiment 1) or horizontally (Experiment 2). We analyzed whether the response time was influenced by the position and age category of the target stimuli, but there was no evidence of correspondence between space and adult/infant faces. Thus, evidence of the spatial representation of the age category was not found. However, we did find that the response time was consistently faster when they discriminated between adult faces than when they discriminated between infant faces in both experiments. This result is in line with a series of human face studies that suggest the existence of an “own-age bias.” As far as we know, this is the first report of asymmetric face processing efficiency between infant and adult faces in non-human primates.

scholarly journals The Apparent Locus of Managerial Decision Making and Perceptions of Fairness in Public Personnel Management

2018 ◽  
Vol 48 (3) ◽  
pp. 392-412
Author(s):  
Justin M. Stritch ◽  
Mogens Jin Pedersen
Keyword(s):  
Decision Making ◽  
Public Management ◽  
Case Vignette ◽  
Management Research ◽  
Managerial Decision ◽  
Personnel Decisions ◽  
Heterogeneous Effects ◽  
Perceptions Of Fairness ◽  
Case Vignettes ◽  
Locus Of Decision

A topic that remains underexplored in public management research is how the appearance of a formal rule or policy as guiding personnel decisions may affect employee perceptions of organizational decision outcomes. In this article, we consider how the locus of decision making (e.g., the apparent source of a decision) affects perceptions of a decision’s fairness. We examine this question with three survey experiments using case vignettes, each describing a distinct personnel decision-making scenario. In each case vignette, we manipulate the locus of decision making (a single supervisor, a team of supervisors, or an organizational policy). We find heterogeneous effects across the three case vignettes. We conclude with a discussion of the implications and future directions for public management research.

scholarly journals HUBUNGAN PEMANFAATAN TUMBUHAN PASAK BUMI (Eurycoma longifolia Jack.) SEBAGAI OBAT TRADISIONAL DAN BIOAKTIVITASNYA

2019 ◽  
Vol 10 (2) ◽  
pp. 109
Author(s):  
Marina Silalahi
Keyword(s):  
Erectile Dysfunction ◽  
Traditional Medicine ◽  
Production Quality ◽  
Activity Increase ◽  
Cultivation Method ◽  
Eurycoma Longifolia ◽  
Review Articles ◽  
On Line ◽  
Eurycoma Longifolia Jack ◽  
The Relationship

Pasak bumi (Eurycoma longifolia Jack.) is a species belonging Simarobuaceae has been long used as traditional medicine, which known very well as aphrosidiac. The studies have been conducted to reveal the benefits of E. longifolia through ethnobotany, phytochemical, and bioessay approaches, but the review articles on the its utilization and bioactivity limited. This article is based on scientific articles published on line or off-line, then synthesized so that to be information the relationship between use and bioactivity. Ethnobotany of E. longifolia have been used as a medicine for fever, malaria, improve stamina, antimalarial, antidiabetic, anticancer, aphrodisiac, overcoming erectile dysfunction. Bioactivity of E. longifolia is antiosteoporotic, antimicrobial, aphrodisiac, anticancer, angiogenesis, and hepatoprotective. Eurycomanone has activity as an antimalaria, antipyretic, aphrodisiac, and cytotoxic. The quassinoids, coumarin and glycosides of El have activity increase the production, quality, totality, synthesis and release of spermatozoa. Eurycoma longifolia is very potential to be developed as an antiosteoporotic and aprosidiac drug, but until now most of it is harvested directly from the forest, so to preserve it, we need to study the cultivation method.

A Clinical Tutorial in Stuttering: Case Vignette

2015 ◽  
Vol 25 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Craig Coleman ◽  
Lindsey Miller ◽  
Mary E. Weidner
Keyword(s):  
Comprehensive Assessment ◽  
Case Vignette ◽  
Treatment Approaches ◽  
Clinical Paper ◽  
Assessment And Treatment ◽  
Case Vignettes

This clinical paper focuses on a case vignette for a teenager who stutters to highlight comprehensive assessment and treatment of stuttering. The case emphases the need for assessment and treatment approaches that focus on the multi-dimensional nature of stuttering. Case vignettes may be one way to help clinicians gain a better understanding of stuttering assessment and treatment.

An Object-Oriented Architecture Model for International Information Systems?

2011 ◽  
pp. 1-21
Author(s):  
Hans Lehmann
Keyword(s):  
Information Systems ◽  
Development Strategy ◽  
Case Vignette ◽  
Theory Approach ◽  
Functional Changes ◽  
Architecture Model ◽  
Case Vignettes ◽  
Object Technology ◽  
The One ◽  
Architecture And Design

Analysing four case vignettes in a grounded theory approach, this exploratory paper investigates the architecture and design principles of international information systems. A two-dimensional topology for international information systems—suggested in previous research—was confirmed as a useful architecture paradigm. In its terms, international information systems are configured from two elements: ‘Core’ systems (common for the whole enterprise) on the one hand and ‘Local’ systems (different for each site) on the other. The interface between the two is a third component. One case vignette in particular highlights the logical and organisational difficulties in defining these systems elements. Object orientation as the fundamental design principle is investigated as an approach to provide a solution for this problem. Because it enables implementation differentiation and flexibility for future functional changes, it is conjectured that object technology is an optimal—technical—development strategy for international information systems. Directions for further research are outlined.

Awareness of autism in adulthood

2018 ◽  
Author(s):  
Traolach S. Brugha
Keyword(s):  
Case Vignette ◽  
Ordinary Life ◽  
Problematic Behaviour ◽  
The World ◽  
Case Vignettes

In its milder forms, autism is widespread, but often not considered as an explanation for odd, egocentric, rigid, and/or potentially socially problematic behaviour. The reader is encouraged in this chapter to consider how autism might present in the world in which (s)he works and lives. A series of case vignettes are then used (in this chapter), drawn from ordinary life settings (work, college, neighbourhood, family, etc.) to illustrate and inform awareness, and possible consideration of autism that has been missed earlier in the person’s life. Questions are posed following each case vignette that the reader is asked to try to answer. Care recommendations then follow.

Psychosocial Factors in Decision-Making of Patient Eligibility for Allogeneic Bone Marrow Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 3324-3324
Author(s):  
Brian J. Bolwell ◽  
Linda McLellan ◽  
Elizabeth Kuczkowski ◽  
Jane Dabney ◽  
Victoria Wentling ◽  
...  
Keyword(s):  
Decision Making ◽  
Bone Marrow ◽  
Allogeneic Bone Marrow Transplantation ◽  
Solid Organ Transplantation ◽  
Case Vignette ◽  
Solid Organ ◽  
Allogeneic Bone ◽  
Post Transplant ◽  
Allogeneic Bmt ◽  
Case Vignettes

Abstract Oncologists specializing in bone marrow transplants (BMT) make daily decisions about appropriate medical candidates for allogeneic BMT based on clinical criteria. It is not clear how, and if, patient eligibility decisions are made based on psychosocial criteria. Although setting limits of patient eligibility based on psychosocial criteria has been researched in solid organ transplantation, data is sparse in BMT. This report focuses on physician responses to a psychosocial survey. An IRB approved survey was mailed to members of the ASBMT (North America) mailing list. Of 704 members, 663 were deemed viable respondents: excluded were non-physician members and physicians specializing in research or not working with allogeneic BMT patients. These surveys were mailed in April 2004. As of 7/6/04, 253 surveys were returned, representing a 38% response rate. Average age of responders was 47 years. Average number of years experience in BMT was 14, with a range of 2–39 years. 17 case vignettes were presented. These vignettes asked whether or not it was appropriate to proceed with allo BMT (assuming an appropriate donor was available) based on a specific psychosocial problem. In virtually every case vignette, at least 10% of respondents stated they would not proceed with allogeneic BMT based on the issues raised in the vignette. In seven case vignettes, the majority of respondents stated that they would recommend not proceeding with BMT. The general theme/construct of these 7 vignettes appears to be ability to comply with treatment plans. Specifically, the following were case vignettes in which the majority of respondents recommended not to proceed with transplant: no caregiver available to assist with the patient post-transplant (do not proceed = 70%); the patient is actively alcoholic (do not proceed = 62%); the patient is non-compliant (do not proceed = 75%); the patient is currently suicidal (do not proceed = 84%); the patient is currently using addictive illicit drugs (do not proceed = 73%); the patient has mild dementia (do not proceed = 55%); the patient cannot pay for the transplant (do not proceed = 52%). Conversely, the following case vignettes were less worrisome to the survey respondents, and in general represented surmountable psychosocial and/or clinical issues. These vignettes included; a history of prior suicidal attempts although not currently suicidal (proceed with transplant = 86%); controlled schizophrenia (proceed with transplant = 83%); daily marijuana use (proceed with transplant = 82%); smokes tobacco (proceed with transplant = 79%); morbid obesity (proceed with transplant = 71%); major depression (proceed with transplant = 84%). These findings underline the importance of post-transplant longitudinal care in determining the ultimate success of an allogeneic BMT, and underscore their importance in patient eligibility decision-making. These findings also illustrate that psychosocial variables play a significant role in determining patient eligibility for allogeneic BMT and that there is no clear-cut consensus on this topic, highlighting the need for ongoing clinical research.

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