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961.
Does the Shoe Fit? Ethical,Legal, and Policy Considerations of Global Positioning System Shoes for Individuals with Alzheimer's Disease 下载免费PDF全文
Y. Tony Yang ScD LLM MPH Charles G. Kels JD 《Journal of the American Geriatrics Society》2016,64(8):1708-1715
As the overall incidence of Alzheimer's disease rises, the burden on caregivers and law enforcement institutions will increase to find individuals who wander. As such, technological innovations that could reduce this burden will become increasingly important. One such innovation is the GPS Shoe. As with any innovation involving the transfer of personal data to third parties, potential pitfalls with respect to loss of privacy and inadequate consent counterbalance the substantial promise of GPS shoes. To some extent, advance planning can mitigate these concerns, wherein individuals willingly elect to be monitored before their impairments progress to a stage that makes such authorization impractical. Nonetheless, tension may arise between the peace of mind of caregivers and family members and other important considerations at the intersection of autonomy, privacy, dignity, and consent. Ultimately, confronting ethical, legal, and policy considerations at the front end of product development and deployment will help ensure that new technologies are used wisely and that their lifesaving potential is realized. 相似文献
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Daniel C. Marson JD PhD Roy C. Martin PhD Virginia Wadley PhD H. Randall Griffith PhD Scott Snyder PhD Patricia S. Goode MD F. Cleveland Kinney MD Anthony P. Nicholas MD PhD Terri Steele MD Britt Anderson MD Edward Zamrini MD Rema Raman PhD Alfred Bartolucci PhD Lindy E. Harrell PhD MD 《Journal of the American Geriatrics Society》2009,57(5):806-814
OBJECTIVES: To investigate financial capacity in patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD) using a clinician interview approach.
DESIGN: Cross-sectional.
SETTING: Tertiary care medical center.
PARTICIPANTS: Healthy older adults (n=75) and patients with amnestic MCI (n=58), mild AD (n=97), and moderate AD (n=31).
MEASUREMENTS: The investigators and five study physicians developed a conceptually based, semistructured clinical interview for evaluating seven core financial domains and overall financial capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made capacity judgments (capable, marginally capable, or incapable) for each financial domain and for overall capacity.
RESULTS: Study physicians made more than 11,000 capacity judgments across the study sample (N=261). Very good interrater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall financial capacity, 95% of physician judgments for older controls were rated as capable, compared with 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD.
CONCLUSION: Physicians and other clinicians can reliably evaluate financial capacity in cognitively impaired older adults using a relatively brief, semistructured clinical interview. Patients with MCI have mild impairment in financial capacity, those with mild AD have emerging global impairment, and those with moderate AD have advanced global impairment. Patients with MCI and their families should proactively engage in financial and legal planning, given these patients' risk of developing AD and accelerated loss of financial abilities. 相似文献
DESIGN: Cross-sectional.
SETTING: Tertiary care medical center.
PARTICIPANTS: Healthy older adults (n=75) and patients with amnestic MCI (n=58), mild AD (n=97), and moderate AD (n=31).
MEASUREMENTS: The investigators and five study physicians developed a conceptually based, semistructured clinical interview for evaluating seven core financial domains and overall financial capacity (Semi-Structured Clinical Interview for Financial Capacity; SCIFC). For each participant, a physician made capacity judgments (capable, marginally capable, or incapable) for each financial domain and for overall capacity.
RESULTS: Study physicians made more than 11,000 capacity judgments across the study sample (N=261). Very good interrater agreement was obtained for the SCIFC judgments. Increasing proportions of marginal and incapable judgment ratings were associated with increasing disease severity across the four study groups. For overall financial capacity, 95% of physician judgments for older controls were rated as capable, compared with 82% for patients with MCI, 26% for patients with mild AD, and 4% for patients with moderate AD.
CONCLUSION: Physicians and other clinicians can reliably evaluate financial capacity in cognitively impaired older adults using a relatively brief, semistructured clinical interview. Patients with MCI have mild impairment in financial capacity, those with mild AD have emerging global impairment, and those with moderate AD have advanced global impairment. Patients with MCI and their families should proactively engage in financial and legal planning, given these patients' risk of developing AD and accelerated loss of financial abilities. 相似文献
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Clostridium difficile (C. difficile) is now the leading cause of nosocomial diarrhea in the USA, accounting for 30% of patients with antibiotic-associated diarrhea, 70% of those with antibiotic-associated colitis, and most cases of pseudomembranous colitis. The organism has evolved over the last 8 years to become more virulent and resistant to antimicrobials (NAP1/027 strain) causing a more severe form of the disease that has increased mortality and healthcare costs. While it is generally accepted that the ... 相似文献
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Outcomes of endoscopic optic nerve decompression in patients with idiopathic intracranial hypertension 下载免费PDF全文
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Techniques for transcatheter retrieval of the occlutech ASD device United Kingdom–European multicenter report 下载免费PDF全文
Suhair O Shebani MBBCh MSc FRCPCH Rizwan Rehman MBChB MRCPCH Demetris Taliotis MBCHB MRCPCH Alan Magee MBBCh MD FRCP Nicholas J Hayes BSc MBChB MRCPCH Osman Baspinar MD Zunzunegui Martínez JD MD Nikolaus Haas MD PhD FRACP Christopher Duke MBChB FRCP 《Catheterization and cardiovascular interventions》2017,89(4):690-698
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Antonino Carbone MD Annunziata Gloghini PhD Alessandra Rinaldo MD FRCSI Kenneth O. Devaney MD JD Raymond Tubbs MD Alfio Ferlito MD DLO DPath FRCS FRCSEd FRCSGlasg FRCSI FHKCORL FDSRCS FRCPath FASCP IFCAP 《Head & neck》2009,31(7):949-961
Although conventional squamous carcinomas can often be recognized with little difficulty by experienced pathologists, it remains a fact that a substantial number of head and neck malignancies are capable of posing real challenges to the diagnostic pathologist. Those head and neck tumors showing the least kinship with normal host tissues—that is, the undifferentiated malignancies—are a particular problem and an approach to dealing with them is traced out below. As a matter of basic light microscopy, these tumors can usually be relegated to 1 of 4 categories: small round cell tumors, spindle cell tumors, large polygonal cell (epithelioid) tumors, and pleomorphic tumors. Once they have been so subclassified, these lesions can then be studied by immunohistochemistry and, when necessary, by molecular methods as well. Immunohistochemistry often permits these tumors to be assigned to a particular tissue type, specifically, epithelial, mesenchymal, lymphoid, or melanocytic. Application of additional immunohistochemical antibodies, in turn, can permit further refinement of this impression (eg, allowing distinction of a neuroendocrine tumor from a carcinoma). In selected instances, molecular techniques (such as in situ hybridization) may be employed both for diagnostic as well as for prognostic purposes. It should be borne in mind, however, that the pathologist's diagnosis will sometimes only be as good as the clinical information provided, which is why the diagnosis of undifferentiated malignancies of the head and neck truly is a multifaceted process, demanding the close cooperation of pathologists, clinicians, and radiologists. © 2009 Wiley Periodicals, Inc. Head Neck, 2009 相似文献