Search results for "Decision making"
showing 10 items of 492 documents
Influence of the Geriatric Oncology Consultation On the Final Therapeutic Decision In Elderly Subjects With Cancer: Analysis of 191 Patients
2014
International audience; Objectives: evaluate the impact of the Geriatric Oncology consultation on the final therapeutic management of cancer in elderly patients aged 70 and older. Design: retrospective study. Setting: the Pilot coordination unit in Geriatric Oncology of Cote d'Or, Burgundy, France. Participants: From January 2010 to December 2010, 191 patients with cancer aged 70 and older. Measurements: the concordance between the treatments proposed following the tumor Board, those proposed following the Geriatric evaluation (GE) and those actually given to the patients was evaluated using the kappa agreement test. Results: One hundred and ninety-one patients were included. Mean age was 8…
The "aRIANNA" Project: An Observational Study on a Model of Early Identification of Patients with Palliative Care Needs through the Integration betwe…
2018
Objective: The aim of this study was to illustrate the characteristics of patients with palliative care (PC) needs, early identified by general practitioners (GPS), and to analyze their care process in home PC services. Background: Early identification and service integration are key components to providing quality palliative care (PC) services ensuring the best possible service for patients and their families. However, in Italy, PC is often provided only in the last phase of life and for oncological patients, with a fragmented service. Methods: Multicenter prospective observational study, lasting in total 18 months, implemented in a sample of Italian Home Palliative Care Units (HPCUs), enr…
Decision making for solitary vestibular schwannoma and contralateral Meniere's disease.
2007
The existence of dual inner ear pathology such as unilateral Meniere’s disease (MD) with a contralateral vestibular schwannoma (VS) is very rare, but provides the otologist with a significant management dilemma. In this study, we present 5 cases of unilateral disabling MD with a contralateral VS in the better hearing ear. Conservative management of the VS is mandated unless there are impending complications, with management directed toward controlling the vertigo attributed to MD. If and when the VS requires intervention, or the hearing in that ear deteriorates to unserviceable levels, cochlear implant of the ear affected by MD prior to addressing the VS provides optimal management.
The carotid pulse check revisited: What if there is no pulse?
2000
This study was undertaken to evaluate the diagnostic accuracy and time required by first responders to assess the carotid pulse in potentially pulseless patients. We conducted a prospective, randomized study of first responders (n = 206; four different training levels) and were blinded as to the patients' conditions in the cardiac operating rooms of a university hospital. Sixteen patients underwent coronary artery bypass surgery on nonpulsatile cardiopulmonary bypasses. Carotid pulse check was performed either during pulsatile (spontaneous) or during nonpulsatile (extracorporeal) circulation. Patients' hemodynamic status at the time of assessment, diagnostic accuracy of the first responders…
Comparing 15D and SF-6D Performance in Fragility Wrist and Hip Fracture Patients in a Two-Year Follow-Up Case-Control Study
2012
Accepted version of an article in the journal:Value in Health. Published available from Elsevier on Science Direct: http://dx.doi.org/10.1016/j.jval.2012.08.2200 Objectives To examine and compare the two utility and health-related quality-of-life (HRQOL) measures 15D and (SF-6D) in fragility wrist and hip fracture patients and controls, study the responsiveness of 15D and SF-6D, and examine the impact of these fractures on changes in 15D and SF-6D scores over 2 years. Methods A total of 152 wrist fracture patients and 164 controls and 61 hip fracture patients and 61 controls with 15D and SF-6D scores were studied. Results The mean 15D score decreased significantly in wrist fracture patients…
Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index
2020
Background Device replacement is the ideal time to reassess health care goals regarding continuing implantable cardioverter-defibrillator (ICD) therapy. Only few data are available on the decision making at this time. Objectives The goals of this study were to identify factors associated with poor prognosis at the time of ICD replacement and to develop a prognostic index able to stratify those patients at risk of dying early. Methods DEtect long-term COmplications after implantable cardioverter-DEfibrillator replacement (DECODE) was a prospective, single-arm, multicenter cohort study aimed at estimating long-term complications in a large population of patients who underwent ICD/cardiac resy…
Withholding or withdrawing of life-sustaining therapy in older adults (≥ 80 years) admitted to the intensive care unit
2018
PURPOSE: To document and analyse the decision to withhold or withdraw life-sustaining treatment (LST) in a population of very old patients admitted to the ICU. METHODS: This prospective study included intensive care patients aged ≥ 80 years in 309 ICUs from 21 European countries with 30-day mortality follow-up. RESULTS: LST limitation was identified in 1356/5021 (27.2%) of patients: 15% had a withholding decision and 12.2% a withdrawal decision (including those with a previous withholding decision). Patients with LST limitation were older, more frail, more severely ill and less frequently electively admitted. Patients with withdrawal of LST were more frequently male and had a longer ICU len…
rTMS evidence of different delay and decision processes in a fronto-parietal neuronal network activated during spatial working memory.
2003
The existence of a specific and widely distributed network for spatial working memory (WM) in humans, involving the posterior parietal cortex and the prefrontal cortex, is supported by a number of neuroimaging studies. We used a repetitive transcranial magnetic stimulation (rTMS) approach to investigate the temporal dynamics and the reciprocal interactions of the different areas of the parieto-frontal network in normal subjects performing a spatial WM task, with the aim to compare neural activity of the different areas in the delay and decision phases of the task. Trains of rTMS at 25 Hz were delivered over the posterior parietal cortex (PPC), the premotor cortex (SFG) and the dorsolateral …
The decision-making process for breast reconstruction after cancer surgery: Representations of heterosexual couples in long-standing relationships
2017
Objectives Most people deal with intrusive life events such as cancer and the care trajectory together with their intimate partners. To our knowledge, no research has studied the involvement of the partner in the decision-making process regarding breast reconstruction (BR) after cancer. This study aimed to gain a better understanding of the couples’ decision-making process for BR in the cancer context and particularly to investigate the partners’ involvement in this process. Method Eighteen participants (nine women who underwent a mastectomy following a first breast cancer and their intimate partners) took part in this study. We conducted semidirective interviews, and a general inductive ap…
Examen des mécanismes d'influence des attributs de recherche
2017
Cette notice présente une synthèse des travaux de recherche menés par Yohan Bernard entre 2001 et 2016 autour des effets sur le comportement des consommateurs des attributs de recherche mis en avant par les producteurs et / ou les distributeurs. En particulier, trois attributs ont fait l’objet d’investigations avancées : le prix, les caractéristiques environnementales des produits et leur pays d’origine. Le document développe une analyse des processus de perception des attributs par le consommateur (chapitre 2). Les représentations mentales qui en découlent sont employées, avec d’autres éléments, pour fonder des intentions comportementales (chapitre 3). Les conditions dans lesquelles les at…