Patients with advanced malignancy have decisions to make about next steps that are multifactorial and highly ramified. At each step, they, their loved ones, and their health care providers will attempt to make right decisions and avoid wrong ones. Beyond bare ethical principles, these patients face tensions between what they hope for, what is possible, and what those around them expect and advise. This article uses a case-based approach to explore the balance between prognostication and directive counsel; affective forecasting and decisional regret; hope and the therapeutic misconception; and issues of patient ownership and abandonment at the end of life.
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http://dx.doi.org/10.1016/j.soc.2021.03.002 | DOI Listing |
J Nurs Adm
December 2024
Author Affiliations: Senior Operations Leader, Analytics and Nurse Scientist (Dr Kim), Kaiser Permanente National Patient Care Services, Oakland; Assistant Clinical Professor (Dr Kim), Community Health Systems, University of California, San Francisco School of Nursing, San Francisco; Professor Emeritus (Dr Latham), California State University, Fullerton, School of Nursing, Fullerton; Education Program Coordinator (Dr Krom), Assistant Professor of Medicine (Dr Krom), Cedars-Sinai Marina Del Ray Hospital, Marina Del Ray; Director (Dr Failla), Nursing Workforce Transitions, Caster Nursing Institute, Sharp HealthCare, San Diego; Regional Director and Nurse Scientist (Dr Kawar), Nursing Research and EBP Program, Kaiser Permanente Southern California and Hawaii Patient Care Services, Pasadena.
Disseminating research or evidence-based practice is not straightforward. As more clinical nurses, executive nurse leaders, nurse scientists, and faculty contribute to new knowledge, there is an increasing need to support the processes to publish and disseminate manuscripts to advance healthcare. Nurse administrators and leaders are key influencers and supporters to bolster expertise and resources to publish.
View Article and Find Full Text PDFJ Neurosurg
January 2025
Departments of1Neurological Surgery.
Objective: Tumor consistency, or fibrosity, affects the ability to optimally resect meningiomas, especially with recent trends evolving toward minimally invasive approaches. The authors' team previously validated a practical 5-point scale for intraoperative grading of meningioma consistency. The impact of meningioma consistency on surgical management and outcomes, however, has yet to be explored.
View Article and Find Full Text PDFJ Neurosurg
January 2025
1Department of Neurology, Centre for Leading Medicine and Advanced Technologies of IHM, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui.
Objective: Endovascular treatment (EVT) is an effective treatment for patients with acute vertebrobasilar artery complex occlusion (VBAO). However, the benefit of bridging thrombolysis prior to EVT remains controversial. The purpose of the present study is to explore the best treatment strategy between bridging treatment (BT) and direct EVT in patients with acute VBAO.
View Article and Find Full Text PDFJ Am Med Inform Assoc
January 2025
Institute of Data Science, National University of Singapore, 117602, Singapore.
Objectives: This study introduces Smart Imitator (SI), a 2-phase reinforcement learning (RL) solution enhancing personalized treatment policies in healthcare, addressing challenges from imperfect clinician data and complex environments.
Materials And Methods: Smart Imitator's first phase uses adversarial cooperative imitation learning with a novel sample selection schema to categorize clinician policies from optimal to nonoptimal. The second phase creates a parameterized reward function to guide the learning of superior treatment policies through RL.
Natural killer (NK) cells have proven to be safe and effective immunotherapies, associated with favorable treatment responses in chronic myeloid leukemia (CML). Augmenting NK cell function with oncological drugs could improve NK cell-based immunotherapies. Here, we used a high-throughput drug screen consisting of over 500 small-molecule compounds to systematically evaluate the effects of oncological drugs on primary NK cells against CML cells.
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