Clinical instruments for bedside functional assessment: Convergent validity among the AM-PAC '6-Clicks' and BMAT.

Aims And Objectives: To determine the level of convergent validity of the '6-Clicks' Basic Mobility and Daily Activity with the Bedside Mobility Assessment Tool (BMAT) in patients admitted to a tertiary care academic hospital.

Background: Accurately measuring a patient's ability to mobilise during hospitalisation is necessary but can be challenging. Two instruments, the Activity Measure for Post-Acute Care short-form '6-Clicks' and the BMAT, are commonly used to determine patients' mobility levels; however, these instruments have not been psychometrically evaluated together.

A Framework for Revisiting Brain Death: Evaluating Awareness and Attitudes Toward the Neuroscientific and Ethical Debate Around the American Academy of Neurology Brain Death Criteria.

Background: There remains a lack of awareness around the American Academy of Neurology (AAN) procedural criteria for brain death and the surrounding controversies, leading to significant practice variability. This survey study assessed for existing knowledge and attitude among healthcare professionals regarding procedural criteria and potential change after an educational intervention.

Methods: Healthcare professionals with increased exposure to brain injury at Mayo Clinic hospitals in Arizona and Florida were invited to complete an online survey consisting of 2 iterations of a 14-item questionnaire, taken before and after a 30-minute video educational intervention.

Association of AM-PAC "6-Clicks" Basic Mobility and Daily Activity Scores With Discharge Destination.

Objective: The objective was to use the Activity Measure for Post-Acute Care "6-Clicks" scores at initial physical therapist and/or occupational therapist evaluation to assess (1) predictive ability for community versus institutional discharge, and (2) association with discharge destination (home/self-care [HOME], home health [HHA], skilled nursing facility [SNF], and inpatient rehabilitation facility [IRF]).

Methods: In this retrospective cohort study, initial "6-Clicks" Basic Mobility and/or Daily Activity t scores and discharge destination were obtained from electronic health records of 17,546 inpatient admissions receiving physical therapy/occupational therapy at an academic hospital between October 1, 2015 and August 31, 2018. For objective (1), postacute discharge destination was dichotomized to community (HOME and HHA) and institution (SNF and IRF).

Neuroscience and Brain Death Controversies: The Elephant in the Room.

The conception and the determination of brain death continue to raise scientific, legal, philosophical, and religious controversies. While both the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research in 1981 and the President's Council on Bioethics in 2008 committed to a biological definition of death as the basis for the whole-brain death criteria, contemporary neuroscientific findings augment the concerns about the validity of this biological definition. Neuroscientific evidentiary findings, however, have not yet permeated discussions about brain death.

Ethical and Legal Concerns With Nevada's Brain Death Amendments.

In early 2017, Nevada amended its Uniform Determination of Death Act (UDDA), in order to clarify the neurologic criteria for the determination of death. The amendments stipulate that a determination of death is a clinical decision that does not require familial consent and that the appropriate standard for determining neurologic death is the American Academy of Neurology's (AAN) guidelines. Once a physician makes such a determination of death, the Nevada amendments require the withdrawal of life-sustaining treatment within twenty-four hours with limited exceptions.

Reliability and a correlational analysis of the 6MWT, ten-meter walk test, thirty second sit to stand, and the linear analog scale of function in patients with head and neck cancer.

Objective: The purpose of this study was to establish the test-retest reliability of and relationships between various measures of physical function in a cohort of individuals in the early treatment stages for head and neck cancer (HNC).

Methods: The Six-Minute Walk Test (6MWT), 10-Meter Walk Test (10MWT), 30-Second Sit to Stand (30STS), and Linear Analog Scale of Function (LASF) were administered to 42 participants with a diagnosis of HNC. Test-retest reliability and correlations between the measures are reported.

Legislative Enforcement of Nonconsensual Determination of Neurological (Brain) Death in Muslim Patients: A Violation of Religious Rights.

Death is defined in the Quran with a single criterion of irreversible separation of the ruh (soul) from the body. The Quran is a revelation from God to man, and the primary source of Islamic knowledge. The secular concept of death by neurological criteria, or brain death, is at odds with the Quranic definition of death.

In re guardianship of Hailu: The Nevada Supreme Court casts doubt on the standard for brain death diagnosis.

In the recent court case of In Re Guardianship of Hailu, the Nevada Supreme Court cast doubt on the acceptability of the American Academy of Neurology's guidelines as a medical standard for determining brain death. The Uniform Determination of Death Act, which has been adopted in every state, requires that brain death diagnoses be made in accordance with accepted medical standards. The Court expressed concern that the guidelines fail to ensure that there is an irreversible cessation of all functions of a person's entire brain, which is a component of the Act's definition of death.

Judicial oversight of life-ending withdrawal of assisted nutrition and hydration in disorders of consciousness in the United Kingdom: A matter of life and death.

Mr Justice Baker delivered the Oxford Shrieval Lecture 'A Matter of Life and Death' on 11 October 2016. The lecture created public controversies about who can authorise withdrawal of assisted nutrition and hydration (ANH) in disorders of consciousness (DOC). The law requires court permission in 'best interests' decisions before ANH withdrawal only in permanent vegetative state and minimally conscious state.

When Brain Death Belies Belief.

The case of Jahi McMath has reignited a discussion concerning how society should define death. Despite pronouncing McMath brain dead based on the American Academy of Neurology criteria, the court ordered continued mechanical ventilation to accommodate the family's religious beliefs. Recent case law suggests that the potential for a successful challenge to the neurologic criteria of death provisions of the Uniform Determination of Death Act are greater than ever in the majority of states that have passed religious freedom legislation.

Neuroscience and awareness in the dying human brain: Implications for organ donation practices.

Consciousness has 2 components: wakefulness (arousal) and awareness (perception of the self and the external environment). Functional neuroimaging has identified 2 distinctive functional networks that mediate external awareness of the surrounding environment and internal awareness of the self. Recent studies suggest that awareness is not always associated with wakefulness.