Bridging Care Gaps for Older Women Undergoing Percutaneous Coronary Intervention.

This paper reviews the distinct clinical, pathophysiological, and therapeutic challenges faced by older women undergoing percutaneous coronary intervention (PCI). Older women present with a greater comorbidity burden, smaller coronary vessels, and post-menopausal hormonal changes, which increase procedural complexity and adverse cardiovascular outcomes. Despite these challenges, older women are less likely to receive evidence-based therapies, resulting in higher risks of major adverse cardiovascular events (MACE) and bleeding.

Uncovering Patient and Caregiver Goals for Goal-Concordant Care in Kidney Therapy Decisions.

Context: In kidney therapy (KT) decisions, goal-concordant decision-making is recognized to be important, yet alignment with patients' goals during dialysis initiation is not always achieved.

Objectives: To explore older patients' and caregivers' hopes, goals, and fears related to KT and communication of these elements with members of their health care team.

Methods: The study included patients aged ≥75 years with an estimated glomerular filtration rate ≤25 mL/min/1.

When Is Iatrogenic Harm Negligent?

Iatrogenesis refers to harm experienced by patients resulting from medical care, whereas negligence is more narrowly conceived as deviation from standard care. While all harm resulting from negligence is iatrogenic, not all iatrogenic injury is negligent. This commentary on a case about a patient with a minoritized identity at the end of his life argues that criteria by which an iatrogenic injury is deemed negligent depend on how practice standards are defined.

Sleep disturbance and psychological distress among hospitalized children in India: Parental perceptions on pediatric inpatient experiences.

Purpose: Investigate parental perceptions of children's sleep disturbance and psychological distress associated with an inpatient stay in a low-resource hospital setting.

Design And Methods: Demographic and validated survey instruments were adapted for administration to parents of children in the medical wards of a tertiary hospital in India. Parents proficient in English, Hindi, Tamil, or Telugu with a child age 4-12 years admitted for at least 48 h were eligible to participate.

Improving Nitrogen Use Efficiency Through Overexpression of Alanine Aminotransferase in Rice, Wheat, and Barley.

Nitrogen is an essential nutrient for plants, but crop plants are inefficient in the acquisition and utilization of applied nitrogen. This often results in producers over applying nitrogen fertilizers, which can negatively impact the environment. The development of crop plants with more efficient nitrogen usage is, therefore, an important research goal in achieving greater agricultural sustainability.

The Gut Microbial Diversity of Newly Diagnosed Diabetics but Not of Prediabetics Is Significantly Different from That of Healthy Nondiabetics.

Type 2 diabetes (T2D) is a complex metabolic syndrome characterized by insulin dysfunction and abnormalities in glucose and lipid metabolism. The gut microbiome has been recently identified as an important factor for development of T2D. In this study, a total of 102 subjects were recruited, and we have looked at the gut microbiota of prediabetics (PreDMs) ( = 17), newly diagnosed diabetics (NewDMs) ( = 11), and diabetics on antidiabetic treatment (KnownDMs) ( = 39) and compared them with healthy nondiabetics (ND) ( = 35).

Family Caregivers' Characterization of Conversations Following an ACP Event.

Background: Advance care planning (ACP) has been shown to benefit patients and families, yet little is known about how an ACP event impacts communication and conversation about end-of-life treatment wishes and the content of such conversations between patients and family caregivers.

Objective: To characterize post-ACP conversations regarding medical wishes between seriously ill patients and their family caregivers.

Participants: Patients with advanced illness and family caregivers.

A Randomized Controlled Trial of Strategies to Improve Family Members' Preparedness for Surrogate Decision-Making.

Objective: To evaluate 2 strategies for preparing family members for surrogate decision-making.

Design: A 2 × 2 factorial, randomized controlled trial testing whether: (1) comprehensive online advance care planning (ACP) is superior to basic ACP, and (2) having patients engage in ACP together with family members is superior to ACP done by patients alone.

Setting: Tertiary care centers in Hershey, Pennsylvania, and Boston, Massachusetts.

Medical and physician assistant students' views on integrating comics into medical education.

This article was migrated. The article was marked as recommended. : This study explored comics as a tool for teaching medical and physician assistant (PA) students about end-of-life decisions and advance care planning.