Search results for "Decision-making"
showing 10 items of 309 documents
Pooled analysis of prospective European studies assessing the impact of using the 21-gene Recurrence Score assay on clinical decision making in women…
2016
PURPOSE: The 21-gene Recurrence Score assay (Oncotype DX) provides prognostic/predictive information in oestrogen receptor positive (ER+) early breast cancer, but access/reimbursement has been limited in most European countries in the absence of prospective outcome data. Recently, two large prospective studies and a real-life 5-year outcome study have been reported. We performed a pooled analysis of prospective European impact studies to generate robust data on impact of use in different clinical subgroups. METHODS: The analysis included four studies (French, German, Spanish, and British) in ER+ human epidermal growth factor receptor 2-negative breast cancer patients (n = 527). Node-positiv…
Intergroup conflict and rational decision making.
2014
The literature has been relatively silent about post-conflict processes. However, understanding the way humans deal with post-conflict situations is a challenge in our societies. With this in mind, we focus the present study on the rationality of cooperative decision making after an intergroup conflict, i.e., the extent to which groups take advantage of post-conflict situations to obtain benefits from collaborating with the other group involved in the conflict. Based on dual-process theories of thinking and affect heuristic, we propose that intergroup conflict hinders the rationality of cooperative decision making. We also hypothesize that this rationality improves when groups are involved …
Advancing beyond the system: telemedicine nurses' clinical reasoning using a computerised decision support system for patients with COPD - an ethnogr…
2017
Abstract Background Telemedicine is changing traditional nursing care, and entails nurses performing advanced and complex care within a new clinical environment, and monitoring patients at a distance. Telemedicine practice requires complex disease management, advocating that the nurses’ reasoning and decision-making processes are supported. Computerised decision support systems are being used increasingly to assist reasoning and decision-making in different situations. However, little research has focused on the clinical reasoning of nurses using a computerised decision support system in a telemedicine setting. Therefore, the objective of the study is to explore the process of telemedicine …
Impact of cardiopulmonary resuscitation on a cannot intubate, cannot oxygenate condition: a randomised crossover simulation research study of the int…
2019
ObjectivesDuring a ‘cannot intubate, cannot oxygenate’ situation, asphyxia can lead to cardiac arrest. In this stressful situation, two complex algorithms facilitate decision-making to save a patient’s life: difficult airway management and cardiopulmonary resuscitation. However, the extent to which competition between the two algorithms causes conflicts in the execution of pivotal treatment remains unknown. Due to the rare incidence of this situation and the very low feasibility of such an evaluation in clinical reality, we decided to perform a randomised crossover simulation research study. We propose that even experienced healthcare providers delay cricothyrotomy, a lifesaving approach, d…
Decision making in a presumptive case of STEMI-like myocarditis
2015
In youngmales, differential diagnosis during chest pain is not always easy. When ECG findings suggest a cardiac origin of such symptoms, myo-pericarditis is usually themost likely hypothesis, beingmore common than Acute Coronary Syndromes (ACS) in the first decades of life [1]. In the presence of ST segment elevation, Troponin release and ventricular wall motion abnormalities, the diagnosis can be challenging, though. In the young a lowcoronary risk profile and atypical symptoms seldom support a working diagnosis of Coronary Heart Disease (CHD), and, therefore, urgent coronary angiography is not recommended routinely, although cases of early ACS are not so rare. In October 2014 a 26-year-ol…
Current state of dental autotransplantation
2010
The aim of this study is to analyse the current situation in dental autotransplantations within the different therapeutic alternatives that the dentist has available to replace a tooth in the dental arcade. For some authors this is an option headed for failure, whereas for others, it is an alternative to keep in mind. In this study we analyse the factors related to the predictability of the technique, based on an analysis of research work published in the scientific literature up to date. We also present two clinical cases performed by our team and their subsequent evaluation. In spite of the satisfactory results seen when reviewing the existing literature, we cannot say that dental autotra…
Patients’ health locus of control and preferences about the role that they want to play in the medical decision-making process
2021
Health locus of control (HLOC) may influence people’s behavior regarding their health as well as their desires to be involved in the medical decision-making. Our study aimed to examine HLOC’s relations with people’s control preferences about the medical decision-making. A total of 153 people filled out the self-administered version of the Control Preference Scale and the Multidimensional Health Locus of Control Scale–form C. The most preferred role is the collaborative one. However, HLOC explained heterogeneity in people’s control preferences: lower scores in external HLOC were related to a greater preference for the active and the collaborative role. From the personalized medicine perspect…
Long-Term Drug Misuse Increases the Risk of Cognitive Dysfunctions in Intimate Partner Violence Perpetrators: Key Intervention Targets for Reducing D…
2019
Intimate partner violence against women (IPVAW) is a major public health problem, with an important mortality rate in women across the world. In this regard, it has been well-established that drug misuse explains (at least in part) an increased risk of IPVAW perpetration. Even though alcohol is the most widely studied drug underlying IPVAW, other drugs, such as cannabis and cocaine also seem to be significant indicators of this type of violence. Nonetheless, little is known about mediators, such as cognitive domains that facilitate proneness to violence after drug consumption. Therefore, the primary objective of the present study was to compare drug misuse patterns and cognitive performance…
Role of clinical and laboratory parameters for treatment choice in patients with inherited FVII deficiency undergoing surgical procedures: evidence f…
2018
Perioperative bleeding is a major concern in patients with factor VII (FVII) deficiency. Evaluating data of 95 FVII-deficient patients undergoing 110 surgical procedures (61 major, 49 minor), we assessed the impact of type of surgery, bleeding phenotype and FVII coagulant activity (FVII:C) levels on perioperative replacement therapy (RT). Compared to those with higher FVII:C levels, patients with <3% FVII:C received a higher number of RT doses (8 vs. 2, P = 0·003) for a longer RT duration (3 days vs. 1 day, P = 0·001), with no difference in RT dose. Similarly, patients with a history of major bleeds received a higher number of RT doses (8·5 vs. 2-3, P = 0·013) for a longer RT duration (2…
The intravascular ultrasound morphometry of iliac veins in subjects without severe chronic venous insufficiency and its implications for treatment in…
2019
Objectives The purpose of this study is to report the intravascular ultrasound morphometry of iliac veins and its relation to demographic and anthropometric factors in subjects without chronic venous insufficiency. Methods Thirty-three patients, without chronic venous insufficiency – qualified to great saphenous vein stripping due to unilateral, primary varicose veins – participated in the study. During the surgery, left and right external iliac veins, common iliac veins and inferior vena cava were interrogated with intravascular ultrasound. The morphometric analysis included measurement of a cross-sectional area at normal, non-stenosed vein segments (ref-CSA) and at the point of the most p…