The aim of this study was two-fold; to examine patient-proxy agreement on the impact of MS on daily life at different points in time and to get more insight in patient-proxy agreement on change over time.. The positive mean differences that were found at baseline and follow-up indicated a tendency for proxy respondents to report more disease impact of MS than the patient did themselves. This tendency of reporting more symptoms and lower levels of functioning by proxy respondents compared to the patients themselves, is in line with other studies on this topic [10, 35]. In contrast to some of the other longitudinal proxy studies [13, 14, 19] we did not see an improvement in agreement over time. Mean directional differences at follow-up were actually statistically significant for both the physical and the psychological scale, which points towards systematic overestimation by proxy respondents. Effect sizes showed that the magnitude of this bias was moderate for both scales.. At both time points, ...
Ms. Whiting described how among patients with chronic conditions, the patient voice and the caregiver voice are often thought to be interchangeable. But, patient and caregiver perspectives can be very different. She described research demonstrating that if the caregiving relationship is strained, a caregiver may overstate the amount of pain a patient is facing. So there is a clear need for a more nuanced approach to identify where caregivers can help and to what degree their voice should be included in data collection.. She highlighted how the caregiver role evolves over time. For example, among young patients who may be unable to self-report, the caregiver voice may be more prominent. But, as the patient matures, they may be able to report on their own signs and symptoms, indicating that at that point a patient-reported outcome should be used. Similarly, among patients with dementia, the patient has a more prominent voice in the beginning. But, as the disease progresses, their ability to report ...
Similar to the previous situation, ethics consults are occasionally obtained when its not clear to the treating team who the surrogate decision maker is or how to navigate conflicts between decision makers. In California and by our policy, a surrogate decision maker can be anyone who knows the patient and his values well enough to make decisions on his behalf. There is no predetermined hierarchy of relationship; a neighbor may be a better surrogate than an estranged spouse who hasnt seen the patient in a decade. Its not uncommon that we find ourselves in complex family and friend relationships with multiple spouses, children, cousins, friends, and parents who all want a say in medical decision making. We hope that all the stakeholders are on the same page and work together to determine whats best for a patient, but this is rare. Especially in the intensive care unit, situations can be emotionally-laden and challenging to achieve a consensus. Furthermore, its quite important to identify a ...
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Prevalence and determinants of misreporting among European children in proxy-reported 24 h dietary recalls.. Börnhorst C, Huybrechts I, Ahrens W, Eiben G, Michels N, Pala V, Molnár D, Russo P, Barba G, Bel-Serrat S, Moreno LA, Papoutsou S, Veidebaum T, Loit H-M, Lissner L, Pigeot I, on behalf of the IDEFICS consortium ...
This study assessed associations between preschoolers objectively measured leisure-time PA and a comprehensive set of subjective (i.e. by parent proxy-report) and objective potential PA correlates across the behavioral, social and physical environmental domains on both family- and community-level (Fig. 1) in a large sample of German preschoolers.. None of the objective community-level social and physical environmental potential correlates were associated with objectively assessed leisure-time PA. In contrast, for the family-level behavioral domain (child participation in organized sports) as well as the subjective (i.e. by parent proxy-report) family-level physical environmental domain (parental perception of neighborhood traffic safety) significant associations with MVPA and TPA were observed. These main findings were consistently seen in both the weekend and weekday afternoon samples.. No associations between PA and the objective community-level social and physical environmental factors from ...
This data collection is comprised of responses from two sets of survey questionnaires, the basic Current Population Survey (CPS) and a survey administered as a supplement to the June 2008 CPS questionnaire on the topic of Fertility.The CPS, administered monthly, collects labor force data about the civilian noninstitutional population living in the United States. Moreover, the CPS provides current estimates of the economic status and activities of this population which includes estimates of total employment (both farm and nonfarm), nonfarm self-employed persons, domestics, and unpaid helpers in nonfarm family enterprises, wage and salaried employees, and estimates of total unemployment. Data from the CPS are provided for the week prior to the administration of the survey.All females 15-44 years old that were eligible for the basic CPS survey were also eligible for the supplement survey, as applicable. Self or proxy responses were allowed for the supplement, that is a single respondent could ...
One in five deaths in the U.S. occurs in or shortly after discharge from an intensive care unit (ICU), typically following decisions made by surrogate decision makers to forego life prolonging treatment. A large body of empirical research has identified deficiencies in care processes that contribute to three important problems: 1) family members often experience poor quality communication with ICU clinicians, leading to lasting psychological distress associated with the ICU experience; 2) patients near the end of life frequently receive invasive, expensive treatment that is inconsistent with their values and preferences, and 3) end-of-life care is a major contributor to health care costs.[8, 9] Although advance care planning can prevent some unwanted treatment, many patients wish for a trial of intensive treatment when the prognosis is uncertain, and therefore it seems likely that the need for interventions to improve in-the-moment decisions by surrogates will persist.[10, 11]. In a pilot ...
Hers what I find troubling and ultimately depressing about the drinking and driving problem.. We know, without a doubt, that alcohol consumption impairs and inhibits normal human mental abilities, to which we would generically refer as "judgement capacity" or the ability to make rational, well-informed decisions. This is the main reason that in the medical profession (in which I work) a patients right to decide about his/her medical treatment becomes null and void if he/she is intoxicated, barring a legally-recognized surrogate decision maker that is at the bedside to accept that responsibility or a legal document stating the same (an "advanced directive", etc). Thus every day in ERs across this country we are doing things (invasive things, painful things, risky things) to patients "against their will" because we determine that they are either intoxicated or have sustained a brain injury or are acutely psychotic (etc) and are therefore not competent to decide for themselves. Granted, what we ...
We have a successful track record in recovering service charge arrears and unpaid rent on behalf of Residential Management Companies and Managing Agents.
Carstensen, Bendix; Read, Stephanie H; Friis, Soren; Sund, Reino; Keskimäki, Ilmo; Svensson, Ann-Marie; Lung, Richard; Wild, Sarah H; Kerssens, Joannes; Harding, Jessica L; Magliano, Dianna J; Gudbjörnsdottir, Soffia; on behalf of the Diabetes and Cancer Research Consortium (2016) ...
The Mental Capacity Act 2005 has provided unified scope in the British medical system for proxy consent with regard to medical decisions, in the form of a lasting power of attorney. While the intentions are to increase the autonomous decision making powers of those unable to consent, the author of this paper argues that the whole notion of proxy consent collapses into a paternalistic judgement regarding the other persons best interests and that the new legislation introduces only an advisor, not a proxy with the moral authority to make treatment decisions on behalf of another. The criticism is threefold. First, there is good empirical evidence that people are poor proxy decision makers as regards accurately representing other peoples desires and wishes, and this is therefore a pragmatically inadequate method of gaining consent. Second, philosophical theory explaining how we represent other peoples thought processes indicates that we are unlikely ever to achieve accurate simulations of others ...
Internal Medicine Module 2: Informed Consent - Surrogate Decision Making. This case explores the best course of action when a surrogate decision maker refuses bypass surgery for her husband even when the primary care physician, cardiologist, and cardiac surgeon all recommend it as the best treatment option. Virtual Mentor is a monthly bioethics journal published by the American Medical Association.
One of the hardest things veterinarians have to do is to counsel owners about assessing a pets quality of life as it begins to decline. Because our animals cant verbalize their specific desires when it comes to end of life care, owners and, to a lesser extent, veterinarians are forced into the role of proxy decision makers. We have the ability to extend or end a sick or injured pets life, and deciding what he or she would want under the circumstances is never easy.. Quality of life (QoL) surveys are helpful during this difficult time. They can focus our attention on the most important aspects of what the patient is experiencing. A single QoL survey provides some information, particularly at the extremes of the contentment - suffering continuum, but these tools really shine when they are performed on a frequent and regular basis. In this way, current scores can be compared to those taken in the past. Owners and veterinarians can then more easily pick up trends and address problems before they ...
The Dementia Risk Assessment (DRA) is an online tool consisting of questions about known risk factors for dementia, a novel verbal memory test, and an informant report of cognitive decline. Its primary goal is to educate the public about dementia risk factors and encourage clinical evaluation where appropriate. In Study 1, more than 3,000 anonymous persons over age 50 completed the DRA about themselves; 1,000 people also completed proxy reports about another person. Advanced age, lower education, male sex, complaints of severe memory impairment, and histories of cerebrovascular disease, Parkinsons disease, and brain tumor all contributed significantly to poor memory performance. A high correlation was obtained between proxy-reported decline and actual memory test performance. In Study 2, 52 persons seeking first-time evaluation at dementia clinics completed the DRA prior to their visits. Their responses (and those of their proxy informants) were compared to the results of independent evaluation by
A secondary analysis of prospective data pooled from five placebo-controlled randomised trials for smoking reduction conducted in Europe, USA and Australia. This article is intended to give an overview of the current status of MCE. Characterization of Fluorescent Proteins for Three- and Four-Color Live-Cell Imaging in S. We conclude that lipase A and B are distinctly different enzymes and that they are probably viagra without prescription not related polymorphic forms of one another. We undertook to describe the genetic and protein composition of subglottic stenosis (SGS) by measuring an array of protein expression and messenger RNA levels within human SGS tissue. Prednisone was administered at a median starting dosage of 1.8 mg/kg/d (0.82 mg/lb/d), PO, with dosage tapered during the first month of treatment. Comparison of self and proxy ratings for motor performance of individuals with Parkinson generic cialis tadalafil disease. CT by three-dimensional reconstruction can provide more special ...
Assess and compare the patient reported and parent proxy cognitive problems (child + teen) quality of life across multiple time points using the Peds Quality of Life version 3. Assessment was performed across all risk groups. The QL scoring is a 5-point Likert scale from 0 (never) to 4 (almost always). Scores are transformed on a scale from 0 to 100. Items are reverse scored and linearly transformed to a 0-100 scale as follows: 0=100, 1=75, 2=50, 3=25, and 4=0. Total score is the sum of all items over the number of items answered on all scales. The higher the score, the better the quality of life ...
Editor Phil attended a NACE Seminar held on behalf of both LABC and Environmental Health based upon Chimney, Combustion appliance, and Smoke Nuisance
We represented a cable company that was contacted by the Federal Communications Commission regarding alleged noncompliance with the FCCs leakage reporting and annual reporting, found on forms 320 & 325. The client was threatened with a loss of their license. We worked on behalf of the client to negotiate with the FCC to resolve the alleged reporting issues that were noncompliance, and the client was able to avoid all threatened fines and franchising penalties. We also have advised the client on a number of municipal franchise agreements ...
即係代表某人的意思 另外送上常用片語四十個 1. first of all 首先 First of all, a warm welcome to cour company. 首先,誠摯地歡迎你加入我們公司。 2. in the meantime 同時 In the meantime, can you give me some thoughts and come up with any recommendations? 同時,你能給我一些想法與建議嗎? 3. from ones point of view 從某人的觀點來看 I would like to agree with Marketings suggestion as this…
I have made your name known to those whom you gave me from the world. They were yours, and you gave them to me, and they have kept your word. Now they know that everything you have given me is from you; for the words that you gave to me I have given to them, and they have received them and know in truth that I came from you; and they have believed that you sent me. I am asking on their behalf; I am not asking on behalf of the world, but on behalf of those whom you gave me, because they are yours. All mine are yours, and yours are mine; and I have been glorified in them. And now I am no longer in the world, but they are in the world, and I am coming to you. Holy Father, protect them in your name that you have given me, so that they may be one, as we are one. ...
FILED JUNE 16, 1998. No. 107059. MARIAN HAGERMAN, In Her Own Behalf And On Behalf of KEITH HAGERMAN, Deceased. Plaintiff-Appellant,. v GENCORP AUTOMOTIVE, Self-Insured,. Defendant-Appellee.. ...
When a booking is made, the lead name on the booking guarantees that he/she has the authority to accept on behalf of the party, the terms of the booking conditions.
Based on early discussion with the TEP, a decision was made to replace the domain "client satisfaction" specified in the language of the DRA with the broader concept of "client experience." Unlike satisfaction, experience comprises both objective ("Do you know the name of your case manager") and subjective ("Is your case manager helpful?") assessments of program services and supports. Furthermore, client experience data capture a broader array of outcomes and are not influenced solely by an individuals personal metric.. The subjectivity of satisfaction measures makes them challenging for individuals with cognitive disabilities and precludes (or may preclude) data collection from proxy sources. While, by definition, client experience measures are derived from client-reported data, arguments can be made for using knowledgeable proxy respondents when clients are unable to respond for themselves. At the same time, proxy respondents can introduce potential biases that must be recognized.14,15 In our ...
Advanced dementia refers to later stage dementia, where a person loses physical and cognitive function. Find out about living with advanced dementia, caregivers experiences, communciation in advanced dementia, and what caregivers can offer.
While the decision whether to place a feeding tube in a patient with advanced dementia can be influenced by cultural or religious values, each individual should choose whether they would want a feeding tube placed in the event of various health situations — including advanced dementia.
Attorneys Matthew L. Williams and Tara R. Devine obtained an $18.5 million settlement on behalf of a child who suffered a serious brain injury due to a delay in the diagnosis and treatment of meningitis.
10 causes of an itchy face. How does a hot flash feel?. Q&A: LGBT patients with Alzheimers disease and their caregivers face specific challenges. New study aims to understand surrogate decision challenges for LGBT patients with Alzheimers. Win a Dude Ranch Vacation in Random Drawing. The...
سپاس بیکران حضور دکتر باقر ثنایی ، به خاطر تلاش هایش در حوزه سنجش خانواده و ازدواج . به امید روزی که محضرش را درک کنم .. http://www.raahenoo.com/. ...
CORE SpringMeeting25th April 2013Lily Kak on behalf of the GNAPteamLily Kak, USAID (on behalf of the GNAP team)Core Spring MeetingApril 26, 2013
Watch our transformation unfold in the above video.. Weve created a colourful animation that explains what the rebrand is all about and the benefits it brings to our customers and the company - take a look!. On behalf of Activa (soon to be L&R), Id like to take this opportunity to thank you for choosing our products and services. If you have any questions at all, please dont hesitate to contact a member of our team ...
Our Environmental, Social and Governance Report highlights our commitment to sustainability and describes our work on behalf of our clients and the communities we seek to serve. Explore Report. ...
Court of Appeals of Texas, First District,Mar. 16, 2017,VICTOR KAREH, M.D., Appellant v. TRACY WINDRUM, INDIVIDUALLY, AS REPRESENTATIVE OF THE ESTATE OF LANCER WINDRUM, AND ON BEHALF OF HER MINOR CHILDREN, B.W., J.W., AND H.W., Appellee
I would like to receive offers, and be contacted by, or on behalf of NESTLÉ® through phone, SMS, and email, about NESTLÉ®, its brands, special offers, consumer research and promotions ...
Lehr Middlebrooks & Vreeland, P.C., practices labor and employment law on behalf of management, with a focus on the rights that management can exercise, rather than those.... ...
ACP advocates on behalf on internists and their patients on a number of timely issues. Learn about where ACP stands on the following areas:. ...
I do enjoy watching you make a complete ass out of yourself on a daily basis, all of those guests watching who are on the fence can see the fallacious nature of your ridiculous assertions, so in the end.... you are doing more to create more atheists than I could ever do by posting well thought out, researched and substantiated posts disproving the faith...so on behalf of atheists everywhere, thank you for being so incapable in articulating your faith, and disproving your own point of view with each and every post...nicely done, please stick around so the deconversion rates will continue to rise ...
Detailed below are science projects undertaken for, or managed on behalf of, Defra by the Contractor/Funded Organisation selected.. ...
Detailed below are science projects undertaken for, or managed on behalf of, Defra by the Contractor/Funded Organisation selected.. ...
|Posting on behalf of Bruce Cullen from Cookdown| Have you ever spent hours tuning a group in SCOM, only to discover several other groups need
by Falagas, M and Skalidis, T and Vardakas, K and Legakis, N and Tsiplakou, S and Papaioannou, V and Trikka-Graphakos, E and Charalampakis, N and Sereti, C and Lebessi, E and Bozavoutoglou, E and Vogiatzakis, E and Moraiti, H and Xanthaki, A and Toutouza, M and Fountoulis, K and Perivolioti, E and Kraniotaki, H and Bournia, M and Vourli, S and Peteinaki, E and Chatzipanagiotou, S and Ioannidis, A and Makri, A and Daskalaki, M and Staikou, E and Tzannetou, K and Prifti, H and Mentessidou, K and Maltezou, A and Platsouka, E and Skarmoutsou, N and Spiliopoulou, I and Christofidou, M and Falagas, M and Vardakas, K and Triarides, N and Legakis, N and Legakis, N and Skalidis, T and Falagas, M and Kyriakidou, M and Hellenic Cefiderocol Study Grp and Hellenic Cefiderocol Study Group and on behalf of the Hellenic Cefiderocol Study Group ...
Annually resolved coral delta O-18 and Sr/Ca records from southwestern Puerto Rico are used to investigate Caribbean climate variability between 1751 and 2004 C. E. Mean surface ocean temperatures in this region have increased steadily by about 2 degrees C since the year 1751, with Sr/Ca data indicating 2.1 +/- 0.8 degrees C and delta O-18 data indicating 2.7 +/- 0.5 degrees C. Coral geochemical records from across the tropics demonstrate that regional variability is important for understanding climate variations at centennial time scales. A strong multidecadal salinity signal in the oxygen isotope data correlates with observed multidecadal temperature variations in the Northern Hemisphere. Instrumental wind and precipitation data indicate that the most recent coral isotopic variations are caused by expansion and contraction of the steep regional salinity gradient, forced by trade wind anomalies through meridional Ekman transport. The timing of the fluctuations suggests that the ...
Undiagnosed and untreated pain is a serious and frequent problem in persons with advanced dementia, leading to behavioural problems, such as decrease in daily functioning, sleep problems, depression and apathy. In many ways, pain therefore can negatively influence quality of life (QoL). Although pain is difficult to assess in persons with advanced dementia, the impact on QoL is believed to be huge. The long-term care facility (LTCF) organisations of the University Network of the Care sector South Holland (UNC-ZH) find their biggest challenge in preserving QoL in the course of dementia. Until now, there are no proven effective interventions on QoL in persons with dementia in LTCF, as was recently established in a systematic review. However, several interventions are effective in diminishing mediators (such as challenging behaviour and depressed mood) of QoL, including pharmacological treatment of pain. In a large Norwegian nursing home trial, pain treatment was effective in improving agitated ...
The second edition of this internationally acclaimed title is the ideal handbook for those involved in conducting epidemiological research. The objective of most epidemiological studies is to relate exposure to putative causal agents to the occurrence of a particular disease. The achievement of this objective depends critically on accurate measurement of exposure. This book reviews principles and techniques that can be applied to measuring a wide range of exposures, including demographic, behavioral, medical, genetic, and environmental factors. The book covers questionnaire design, conducting personal interviews, abstracting information from medical records, use of proxy respondents, and measurements from human specimens and in the environment. It gives a comprehensive account of measurement error and the estimation of its effects, and the design, analysis, and interpretation of validity and reliability studies. Emphasis is given to the ways in which the validity of measurements can be ...
The objective of the present study was to report on the measurement properties of the Pediatric Quality of Life Inventory (PedsQL) Neurofibromatosis Type 1 Module for pediatric patients ages 5-25 from the perspectives of patients and parents. The 104-item PedsQL NF1 Module and 23-item PedsQL Generic Core Scales were completed in a multi-site national study by 323 patients and 335 parents (343 families). Patients were diagnosed with NF1 using the National Institutes of Health diagnostic criteria. In addition to a Total Scale Score, 18 unidimensional scales were derived measuring skin itch bother, skin sensations, pain, pain impact, pain management, cognitive functioning, speech, fine motor, balance, vision, perceived physical appearance, communication, worry, treatment anxiety, medicines, stomach discomfort, constipation, and diarrhea ...
Burdensome, costly interventions that do not improve the quality of life or extend survival are experienced by nursing home residents with advanced dementia.
Policies and practices in haemostasis testing among laboratories in Croatia: a survey on behalf of a Working Group for Laboratory Coagulation of the Croatian Society of Medical Biochemistry and Laboratory Medicine. . Biblioteca virtual para leer y descargar libros, documentos, trabajos y tesis universitarias en PDF. Material universiario, documentación y tareas realizadas por universitarios en nuestra biblioteca. Para descargar gratis y para leer online.
(Source: www.channelnewsasia.com) SINGAPORE: A pair of Singaporean siblings was jailed for 16 months on Thursday (Jan 11) for receiving and laundering US$320,000 on behalf of a Kuala Lumpur-based syndicate.Shaqilah Mohamad Rafie, 25, and her brother Rausyan Sajjad Mohamad Rafie, 24, pleaded guilty on Thursday evening to two charges each of receiving stolen property - hundreds of thousands…
There are different requirements and restrictions for purchases for an agency versus purchases for personal use. When you check Buying on...