Older patients and dialysis shared decision-making. Insights from an ethnographic discourse analysis of interviews and clinical interactions.

Objective: To describe and analyse the perspectives and communication practices of kidney clinicians and older patients (aged 60 +) during collaborative education and decision-making about dialysis.

Methods: This qualitative study drew on pluralistic data sources and analytical approaches investigating elicited semi-structured interviews (n = 31) with doctors (n = 8), nurses (n = 8) and patients (n = 15), combined with ethnographic observations, written artefacts and audio-recorded naturally-occurring interactions (n = 23, education sessions n = 4; consultations n = 19) in a tertiary Australian kidney outpatient clinic. Data were analysed for themes and linguistic discourse features.

Mental Health Effects of the COVID-19 Pandemic on Aging Lesbian, Gay, Bisexual, Transgender, and Queer Populations.

Introduction: The COVID-19 pandemic affected numerous subpopulations of people in unique ways. This study evaluated the impact of the COVID-19 pandemic on the mental health status of Broward County's aging lesbian, gay, bisexual, transgender, and queer (LGBTQ) seniors and identified strengths, weaknesses, and opportunities for interventions to enhance positive mental health outcomes. The study was performed from April 2021 through July 2021.

Shared decision making in chronic kidney disease: a qualitative study of the impact of communication practices on treatment decisions for older patients.

Background: Effective interpersonal communication is critical for shared decision-making (SDM). Previous SDM communication training in nephrology has lacked context-specific evidence from ethnographic analysis of SDM interactions with older patients considering treatment options of end stage kidney disease (ESKD). This study explores communication strategies in SDM discussions in nephrology, specifically focusing on older patients considering dialysis as kidney replacement therapy (KRT).

Legal and Ethical Issues in the Neurology of Reproductive Health.

Women may acquire neurologic conditions during their reproductive years. As a result, the potential for pregnancy must be considered when selecting appropriate treatment of these women. Physicians who adhere to the standard of care through sound clinical judgment, use of shared decision-making, provide appropriate and timely consultation and follow-up, and clearly document all aspects of patient care minimize legal liability in the event of an unanticipated pregnancy resulting in fetal harm due to treatment with a teratogenic medication.

Associations of Stay-at-Home Order Enforcement With COVID-19 Population Outcomes: An Interstate Statistical Analysis.

In the United States, state governors initially enacted coronavirus diseases 2019 (COVID-19)-mitigation policies with limited epidemiologic data. One prevailing legislative approach, from March to May 2020, was the implementation of "stay-at-home" (SAH) executive orders. Although social distancing was encouraged, SAH orders varied between states, and the associations between potential legal prosecution and COVID-19 outcomes are currently unknown.

Racial and Ethnic Disparities in COVID-19 Outcomes: Social Determination of Health.

As of 18 October 2020, over 39.5 million cases of coronavirus disease 2019 (COVID-19) and 1.1 million associated deaths have been reported worldwide.

Population-Based Estimation of the Preterm Birth Rate in Lilongwe, Malawi: Making Every Birth Count.

 The objective of this study was to perform a population-based estimation of the preterm birth (PTB) rate in regions surrounding Lilongwe, Malawi.  We partnered with obstetrician specialists, community health workers, local midwives, and clinicians in a 50 km region surrounding Lilongwe, Malawi, to perform a population-based estimation of the PTB rate during the study period from December 1, 2012 to May 19, 2015.  Of the 14,792 births captured, 19.

Population-Based Estimation of Dental Caries and Periodontal Disease Rates of Gravid and Recently Postpartum Women in Lilongwe, Malawi.

 The objective of this study was to determine the rate of dental caries and periodontal disease among gravid and recently postpartum women at five delivery centers within and surrounding Lilongwe, Malawi.  We partnered with obstetric specialists, community health workers, and dentists to perform dental history interviews and dental examinations during the study period from December 2012 to May 2014. Dental examinations were performed according to World Health Organization standards to assess periodontal and oral health status.

Qualitative assessment of knowledge transfer regarding preterm birth in Malawi following the implementation of targeted health messages over 3 years.

Background: In 2012, we performed a needs assessment and gap analysis to qualitatively assess providers' and patients' knowledge and perceptions regarding preterm birth (PTB). During the study, we identified knowledge gaps surrounding methods to reduce the risk of occurrence of PTB and management options if preterm labor/birth occur. We targeted health messages toward these gaps.

Competency-Based Objectives in Global Underserved Women's Health for Medical Trainees.

The Association of Professors of Gynecology and Obstetrics Committee on Global Health developed an inclusive definition of global women's health and competency-based objectives that reflected work internationally, as well as with U.S. vulnerable and underserved populations, such as refugee and immigrant populations or those who would otherwise have compromised access to health care.

A survey of honor-related practices among US obstetricians and gynecologists.

Objective: To assess patterns of honor-related practices-including virginity testing, virginity restoration, and female genital mutilation (FGM)-among US obstetrician-gynecologists (OBGYNs).

Methods: Between June 1 and August 31, 2016, 1000 members of the American College of Obstetricians and Gynecologists were invited by email to complete an anonymous online survey. The survey comprised 42 questions evaluating the demographic and practice characteristics of the respondents.

ESC expert statement on the effects on mood of the natural cycle and progestin-only contraceptives.

Hormonal fluctuations during the natural cycle, as well as progestins used for hormonal contraception, can exert effects on mood especially in vulnerable women. Negative effects of levonorgestrel-releasing intrauterine contraception on mood are rare.

An investigation of the relationship between autonomy, childbirth practices, and obstetric fistula among women in rural Lilongwe District, Malawi.

Background: Obstetric fistula is a childbirth injury caused by prolonged obstructed labor that results in destruction of the tissue wall between the vagina and bladder. Although obstetric fistula is directly caused by prolonged obstructed labor, many other factors indirectly increase fistula risk. Some research suggests that many women in rural Malawi have limited autonomy and decision-making power in their households.

Ethical issues in education: Medical trainees and the global health experience.

With interest in global health experiences (GHEs) by medical trainees remaining high, the number of global health programs offering educational experiences in resource limited settings has proliferated. Development and implementation of GHEs has outpaced the critical evaluation of ethical considerations inherent in these programs. Global health programs must adhere to the four principles of beneficence, nonmaleficence, respect of autonomy, and justice in crafting a GHE focused on maximizing the experience of the learners, host country, and patients.

Managing land application of coal seam water: A field study of land amendment irrigation using saline-sodic and alkaline water on a Red Vertisol.

Coal seam (CS) gas operations coproduce water with gas from confined CS aquifers. This CS water represents a potential agricultural resource if the water is able to be chemically amended to comply with management guidelines. Stoichiometric quantities of sulphur and gypsum amendments can be used to neutralise the alkalinity and reduce the sodicity of CS water respectively.

Health care justice and its implications for current policy of a mandatory waiting period for elective tubal sterilization.

Tubal sterilization during the immediate postpartum period is 1 of the most common forms of contraception in the United States. This time of the procedure has the advantage of 1-time hospitalization, which results in ease and convenience for the woman. The US Collaborative Review of Sterilization Study indicates the high efficacy and effectiveness of postpartum tubal sterilization.

Towards a method for optimized extraction of soluble nutrients from fresh and composted chicken manures.

A preliminary method for extraction of soluble nutrients from organic materials is presented that investigates important characteristics of design for efficient extraction. The study was conducted in Polyvinyl Chloride (PVC) columns (length: 50 and 100 mm, diameter: 87.5 mm) filled with fresh and composted chicken manures, packed to densities in the range of 0.

Gestational weight gain among Hispanic women.

To describe gestational weight gain among Hispanic women and to examine psychological, social, and cultural contexts affecting weight gain. A total of 282 Hispanic women were surveyed post-partum before leaving the hospital. Women were queried about their prepregnancy weight and weight gained during pregnancy.

The current theoretical assumptions of the Bobath concept as determined by the members of BBTA.

The Bobath concept is a problem-solving approach to the assessment and treatment of individuals following a lesion of the central nervous system that offers therapists a framework for their clinical practice. The aim of this study was to facilitate a group of experts in determining the current theoretical assumptions underpinning the Bobath concept.A four-round Delphi study was used.