This study aimed (1) to analyze patients' perceived shared decision-making (SDM) experiences over 4 weeks between patients participating or not in multidisciplinary tumor conferences (MTCs) and (2) ...to analyze the association of patients' active participation in and organizational variables of MTCs with patients' perceived SDM experience directly after MTC.
From the N=317 patients, this observational study included patient surveys, observations, and audio transcripts from MTCs with (N=82) and without (N=145) patient participation in six breast and gynecologic cancer centers. We performed t tests for within- and between-group comparisons and linear regression with "patients' perceived SDM experiences in MTC" as the dependent variable.
Patients' perceived SDM experiences increased at 4 weeks after MTC (p<0.001) with lower perceived SDM experiences for participating versus nonparticipating patients (p<0.001). Linear regression showed that the organizational variable "round table seating arrangement" was significantly associated with higher perceived SDM experiences compared with a theater or U-shape arrangement (beta=-0.38, p=0.043; beta=-0.69, p=0.010) directly after MTC.
Results provide first insights into patients' perceived SDM experiences in MTCs. SDM in MTCs is associated with organizational variables of MTCs. A round table seating arrangement in MTCs with patient participation seems important for patients' perceived SDM experiences. The relatively low perceived SDM experiences of participating patients directly after MTC indicates room for improvement, eg concerning patient-centered communication.
Sinclair and Leach fail to investigate how risk factors for suicidal ideation and suicidal behaviour can differ according to age. 1 A 2017 meta-analysis found that early exposure to interpersonal ...violence confers a risk of suicidal ideation and suicide attempts, particularly in young people. 2 Similarly, research indicates that peer victimisation and bullying are risk factors for suicidal ideation at 13 years old and suicide attempts at 15. Acta Psychiatr Scand 2017; 135: 195- 211. doi:10.1111/acps.12679 27995627 3 Geoffroy MC Boivin M Arseneault L. Associations between peer victimisation and suicidal ideation and suicide attempt during adolescence:
Background:
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by impulsivity, inattention, and hyperactivity. Although the literature has explored the ...parental impact of living with a child diagnosed with ADHD, less is known about the ADHD assessment journey for children and the parental experiences of this. A recent service evaluation suggested that exploring parental perceptions of a child’s ADHD assessment pathway could be beneficial in understanding experiences, gathering ideas for future service development, and collecting service user feedback.
Aims and Objective:
The aims were to (a) explore the broad experiences of parents/caregivers accessing the ADHD assessment pathway for their child and (b) explore experiences of remote appointments during the assessment process in consideration of the COVID-19 pandemic.
Methods:
Twelve parents of children who had experienced an ADHD assessment within a CAMHS pathway participated in a telephone-based semi-structured interview. This involved gathering experiences of the CAMHS ADHD pathway from a parental perspective. The evaluation implemented a qualitative design. Qualitative data was analyzed through thematic analysis.
Results:
Results revealed seven main themes. Regarding general experiences of the pathway, parent/caregiver interview responses indicated a sense of relief, feeling understood, and the service being child-focused during the assessment. Difficulties were highlighted within the themes, such as long waiting lists impacting on the child and parent as well as lengthy assessments. In reference to COVID-19 and remote/telephone appointments, interview responses indicated some positives of having remote appointments, such as comfort and convenience. Thus, the strengths of face-to-face communication were highlighted.
Although the distress of a patient is the primary concern of all clinicians, I feel that it is also important to understand the psychological experiences of carers, as they have significant ...responsibility in supporting someone who is mentally ill. I am therefore extremely satisfied to see the recent study by Ranieri et al which has investigated the link between patient admission and caregiver stress. Overall, the article presents a strong finding which could assist in identifying the types of support needed by carers to ensure that their own mental health is protected. However, one limitation of the study that was not identified by the authors is the use of self-report measures. Although the questionnaire instruments used have been found to be reliable measures, participants are not always honest in their responses due to possible embarrassment, or the social desirability bias.
Experiments were conducted in an UK inter‐city train carriage with the aim of evaluating the risk of infection to the SARS‐CoV‐2 virus via airborne transmission. The experiments included in‐service ...CO2 measurements and the measurement of salt aerosol concentrations released within the carriage. Computational fluid dynamics simulations of the carriage airflow were also used to visualise the airflow patterns, and the efficacy of the HVAC filter material was tested in a laboratory. Assuming an infectious person is present, the risk of infection for a 1‐h train journey was estimated to be 6 times lower than for a full day in a well‐ventilated office, or 10–12 times lower than a full day in a poorly ventilated office. While the absolute risk for a typical journey is likely low, in the case where a particularly infectious individual is on‐board, there is the potential for a number of secondary infections to occur during a 1‐h journey. Every effort should therefore be made to minimize the risk of airborne infection within these carriages. Recommendations are also given for the use of CO2 sensors for the evaluation of the risk of airborne transmission on train carriages.
•First insights into communication in MTCs with patient participation.•Patients’ negative emotions were expressed indirectly during their case discussion.•Emotions were mostly linked to diagnosis, ...treatment and possible side effects.•Active patient participation depends on patient characteristics and hospital setting.
To investigate (a) how many questions and negative emotions (cues/concerns) breast and/or gynecologic cancer patients and companions express during their case discussion in multidisciplinary tumor conferences (MTCs), (b) with which topics the emotions are linked, and (c) which patient- and context-related characteristics determine patients’ communicative behavior.
This observational study included audio/video recordings of MTCs with patient participation in three breast and gynecological cancer centers. Using the Verona Coding Definitions of Emotional Sequences, patients’ and companions’ questions and negative emotions expressed were analyzed. Multiple regression analyses were used to determine associations between communicative behavior and patient- and context-related characteristics.
We identified 607 questions and 230 cues/concerns expressed by patients/companions in 82 case discussions in MTCs. The number of questions was significantly associated with the hospital. In case discussions with patients who had need for psychological support and who were accompanied, more questions were asked by patients/companions.
The results show that active patient participation does not depend only on patient characteristics, but also on the hospital setting.
If cancer centers want to enable patient participation in MTCs, they must define the role of the patient before. Subsequently, conditions must be created to enable this role expectation.
Objective
Patients' participation is part of patient‐centeredness, but it is so far unclear whether providers in multidisciplinary tumor conferences (MTCs) with patient participation communicate in a ...patient‐centered way. Our aim is to explore (a) to what extent providers ask questions to breast and gynecological cancer patients during case discussion in MTCs, (b) how providers respond to patients' expressions of emotions during case discussions, and (c) which patient‐ and context‐related characteristics and responses are associated with patients' trust in the treatment team after the case discussion.
Methods
This observational study included survey data and audio recordings of MTCs with patient participation at three breast and gynecological cancer centers. Providers' questions to patients and responses to patients' emotional expressions were coded using the Verona Coding Definitions of Emotional Sequences. The response can be explicitly or non‐explicitly related to the emotion and space‐reducing or space‐providing. Multiple linear regression analysis was used to determine associations between providers' responses, patient‐ and context‐related characteristics, and patients' trust in the treatment team after the case discussion.
Results
We analyzed 82 case discussions (77 breast, 5 breast and gynecological cancer patients). Providers asked a total of 646 questions, of which 86% were polar (yes/no). Providers gave 303 responses to a total of 230 emotional expressions by patients. Non‐explicit responses were associated with more trust when they were space‐providing, but with less trust when space‐reducing.
Conclusions
The frequency of providers' closed questions and space‐reducing responses to emotions shows that patient‐centered communication rarely takes place in MTCs with patient participation.
We have used non-cytopathic (ncp) and cytopathic (cp) bovine viral diarrhoea viruses (BVDV) to determine how the two biotypes affect mannose receptor (MR)-mediated endocytosis and fluid phase uptake ...in bovine monocytes. We have demonstrated that endocytosis in uninfected monocytes after 1
h of culture was mediated by the MR and fluid phase uptake, and after 24
h of culture it was mediated via fluid phase uptake only. Both cp and ncp BVDV affected the mechanisms of antigen uptake in monocytes. Endocytosis in BVDV infected monocytes, unlike in uninfected cells, was MR-independent and mediated by fluid phase uptake after 1
h of infection. The 24-h-BVDV infection changed the antigen uptake mechanisms to become MR- and fluid phase uptake-dependent. We conclude that antigen uptake, an important antigen presenting cell (APC) function, is affected in the early stage of BVDV infection during the first 24
h, with both BVDV biotypes, cp and ncp, having similar effects on monocyte antigen uptake in cattle. By influencing the early antigen uptake function of APC, BVDV might disrupt the function of monocytes as professional APC and contribute to the specific immunotolerance to BVDV.
To systematically review the literature and determine clinical balance or gait tests appropriate for use in older adults with dementia.
Databases PubMed, EMBASE and CINAHL were searched ...(inception-April 2020). Inclusion criteria: participants were diagnosed with dementia and reliability or validity was evaluated for clinical balance or gait tests. Exclusion criteria: not published in English or unable to extract data.
Twenty-two studies evaluating 35 clinical balance or gait tests were included. For community-dwelling individuals, the Modified Clinical Test of Sensory Interaction in Balance, gait velocity, Step Test and the Timed Up and Go had good relative and absolute reliability. For institutional-dwelling individuals the Berg Balance Scale, the Groningen Meander Walk Test, and 6-Meter Walk Test had excellent relative and absolute reliability. The Groningen Meander Walk Test was the only recommended test that has been validated.
Reliable clinical tests of balance and gait for use in people with dementia exist, yet few have been validated. Additionally, to comprehensively assess balance, clinicians must utilise multiple tests. Future research should evaluate the psychometric properties of clinical balance and gait tests so as to identify those appropriate for use in people with dementia across setting, severity and dementia type.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK, VSZLJ
10.
Desenvolvimento urbano e educação Bertazzo, Emily Kruger
Cordis: Revista Eletrônica de História Social da Cidade,
05/2024, Letnik:
1, Številka:
31
Journal Article
PDF
