Speech-language pathologists (SLPs), and really their patients, are often faced with challenging clinical decisions to be made. Patients may decline interventions recommended by the SLP and are often inappropriately labeled "noncompliant." The inappropriateness of this label extends beyond the negative charge; the patient's right to refuse is, in fact, protected by law. Anecdotal exchanges, social media platforms, and American Speech-Language-Hearing Association forums have recently revealed that many SLPs are struggling with the patient's right to decline. Many are not comfortable with the informed consent process and what entails patients' capacity to make their own medical decisions. Here, we discuss the basics of clinical decision-making ethics with intent to minimize the clinician's discomfort with the right to refuse those thickened liquids and eliminate the practice of defensive medicine.
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http://dx.doi.org/10.1055/s-0039-1688838 | DOI Listing |
Pediatr Surg Int
December 2024
Department of Pediatric Critical Care, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Tel-Hashomer, Israel.
Background: Burns in children are often complex injuries, leading to prolonged length of stay (LOS) and significant morbidity. LOS in pediatric intensive care units (PICUs) is a key measure for evaluating illness severity, clinical outcomes, and quality of care. Accurate prediction of LOS is vital for improving care planning and resource allocation.
View Article and Find Full Text PDFActa Neurochir (Wien)
December 2024
Medical Faculty of Heidelberg University, Heidelberg, Germany.
Introduction: Tumorous growths in the sellar region pose significant clinical challenges due to their proximity to critical visual structures such as the optic chiasm and optic nerves. Given their proximity to the optic system, these tumors are often diagnosed due to a progressive decrease in visual acuity. Thus, surgical intervention is crucial to prevent irreversible damage, as timely decompression can halt the progression of edema and subsequent optic atrophy.
View Article and Find Full Text PDFPsychopharmacology (Berl)
December 2024
Department of Medicinal Chemistry, School of Pharmacy, Medical College of Virginia Campus, Virginia Commonwealth University, 800 E. Leigh St., STE 205, Richmond, VA, 23219-0540, USA.
Rationale α-ET (α-ethyltryptamine), a homolog of the classical hallucinogen α-methyltryptamine, was once prescribed clinically as an antidepressant. Classical psychedelic drugs are currently of interest as potential pharmacotherapy for psychiatric disorders. Objectives Drug discrimination was used to (a) determine if α-ET-like stimulus effects could be engendered by the prototypical phenylalkylamines MDMA ("Ecstasy") or MDA ("Love Drug") and (b) evaluate the α-ET-like stimulus effects of four synthesized aryl-substituted monomethoxy analogs of α-ET (4-OMe-, 5-OMe-, 6-OMe- and 7-OMe-α-ET).
View Article and Find Full Text PDFEur Eat Disord Rev
December 2024
Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Objective: We aimed to examine the cognitive profile in adolescents with anorexia nervosa (AN) and its association with traits of autism spectrum disorder (ASD) and ADHD. In addition, resemblance in the cognitive profile between youths with AN and their parents was explored.
Methods: Adolescent females with acute AN (n = 20) and a healthy comparison group (n = 28) completed neuropsychological tasks of set-shifting (Trail making test, Wisconsin Card Sorting Test) and central coherence (Rey Complex Figures Task, Group Embedded Figures Test, object assembly subtest).
ACS Nano
December 2024
The Fifth Affiliated Hospital, Guangdong Provincial Key Laboratory of Molecular Target & Clinical Pharmacology, the NMPA and State Key Laboratory of Respiratory Disease, the School of Pharmaceutical Sciences, Guangzhou Medical University, Guangzhou 511436, China.
Tumor-specific cytotoxic T cell immunity is critically dependent on effective antigen presentation and sustained signal transduction. However, this immune response is frequently compromised by the inherently low immunogenicity of breast cancer and the deficiency in major histocompatibility complex class I (MHC-I) expression. Herein, a chimeric peptide-engineered stoichiometric polyprodrug (PDPP) is fabricated to potentiate the cytotoxic T cell response, characterized by a high drug loading capacity and precise stoichiometric drug ratio, of which the immunogenic cell death (ICD) inducer of protoporphyrin IX (PpIX) and the epigenetic drug of decitabine (DAC) are condensed into a polyprodrug called PpIX-DAC.
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