Grounded in a critical feminist methodology, this article undertakes a deconstructive discourse analysis of a newly emergent discourse within nursing care management, "clinical pathways." Using a Foucaultian approach to deconstructive discourse analysis, the power relations inherent in the "clinical pathways" discourse are identified and the underlying philosophical assumptions informing the discourse are explored. The metaphors of "map" and "landscape" are employed to examine the power relations within the discourse of "clinical pathways." Finally, an alternative, praxis-based approach to transforming the discourse of "clinical pathways" from a focus of social control to one of situated engagement and community is proposed.
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http://dx.doi.org/10.1097/00012272-200401000-00002 | DOI Listing |
Alzheimers Dement
December 2024
Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Background: New blood-based and digital biomarkers for Alzheimer's disease (AD) make early detection possible at stages when novel, disease-specific therapies are likely to be most effective. These approaches may offer less invasive, more cost-effective alternatives to traditional methods such as cerebrospinal fluid (CSF) collection or positron emission tomography (PET) imaging for diagnosing and staging AD. Building care pathways leveraging blood-based and digital biomarkers starts with understanding the current biomarker landscape and considering opportunities for widespread implementation in primary care clinical practice.
View Article and Find Full Text PDFAlzheimers Dement
December 2024
University of Pennsylvania, Philadelphia, PA, USA.
Background: With the advent of FDA approved anti-amyloid therapy and recognition of increased side effects in APOE e4 carriers, APOE testing is now recommended for patients considering anti-amyloid therapies such as lecanemab. Given the therapeutic implications and anticipated volume of eligible patients, the traditional model of in-person, pre- and post-test genetic counseling is not feasible to incorporate in clinical pathways. Alternative delivery models, including digital tools and telehealth, will be key in providing APOE genetic counseling support.
View Article and Find Full Text PDFBMJ Open
January 2025
Department of General Surgery, First Medical Center, Chinese PLA General Hospital, Beijing, China
Introduction: Gastric cancer liver metastases (GCLM) is a highly heterogeneous disease with a poor prognosis. The multidisciplinary diagnosis and treatment model is applied throughout the entire treatment process. In addition to the previous RECORD study, which was based on the C-GCLM classification system developed by our team, there is a lack of recent data on patient baseline characteristics, clinical treatment and efficacy evaluation.
View Article and Find Full Text PDFJ Am Dent Assoc
January 2025
Visiting Associate Professor, Dental Public Health, Pitt Dental Medicine, Pittsburgh, PA.
J Inherit Metab Dis
January 2025
Division of Metabolic Diseases and Hepatology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy.
Liver transplantation (LTx) is increasingly used in Urea Cycle Defects (UCDs) to prevent recurrent hyperammonemia and related neurological irreversible injury. Among UCDs, argininosuccinate lyase deficiency (ASLD) has a more complex phenotype than other UCDs, with long-term neurocognitive deficits. Therefore, the role of LTx in ASLD is still debated.
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