Enhancing activation in the right temporoparietal junction using theta-burst stimulation: Disambiguating between two hypotheses of top-down control of behavioral mimicry.

Whereas previous research has focused on the role of the rTPJ when consciously inhibiting mimicry, we test the role of the rTPJ on mimicry within a social interaction, during which mimicking occurs nonconsciously. We wanted to determine whether higher rTPJ activation always inhibits the tendency to imitate (regardless of the context) or whether it facilitates mimicry during social interactions (when mimicking is an adaptive response). Participants received either active or sham intermittent theta-burst stimulation (iTBS: a type of stimulation that increases cortical activation) to the rTPJ.

Top Ten Tips Palliative Care Clinicians Should Know About Medical Cannabis.

The use of medical cannabis is increasing significantly throughout the United States in spite of limited and sometimes contradictory data about its effectiveness. Palliative care providers are being asked to consider cannabis as part of symptom-directed treatment regimens although many providers have limited experience recommending medical cannabis and were trained before it was commercially available. This article seeks to dispel myths about medical cannabis and provides a balanced view of the benefits and burdens of this therapeutic option, providing evidence where it exists and offering practicing clinicians guidance on conditions in which medical cannabis is likely to be helpful or burdensome.

Indulgent Foods Can Paradoxically Promote Disciplined Dietary Choices.

As obesity rates continue to rise, interventions promoting healthful choices will become increasingly important. Here, participants ( N = 79) made binary choices between familiar foods; some trials contained a common consequence that had a constant probability of receipt regardless of the participant's choice. We theorized-on the basis of simulations using a value-normalization model-that indulgent common consequences potentiated disciplined choices by shaping other options' perceived healthfulness and tastiness.

Lean in messages increase attributions of women's responsibility for gender inequality.

Although women's underrepresentation in senior-level positions in the workplace has multiple causes, women's self-improvement or "empowerment" at work has recently attracted cultural attention as a solution. For example, the bestselling book states that women can tackle gender inequality themselves by overcoming the "internal barriers" (e.g.

Evaluation of the Measuring and Improving Quality in Palliative Care Survey.

Purpose: To evaluate the reliability, content validity, and variation among sites of a survey to assess facilitators and barriers to quality measurement and improvement in palliative care programs.

Methods: We surveyed a sample of diverse US and Canadian palliative care programs and conducted postcompletion discussion groups. The survey included constructs addressing educational support and training, communication, teamwork, leadership, and prioritization for quality measurement and improvement.

Integrated outpatient palliative care for patients with advanced cancer: A systematic review and meta-analysis.

Background:: Despite increasing emphasis on integration of palliative care with disease-directed care for advanced cancer, the nature of this integration and its effects on patient and caregiver outcomes are not well-understood.

Aim:: We evaluated the effects of integrated outpatient palliative and oncology care for advanced cancer on patient and caregiver outcomes.

Design:: Following a standard protocol (PROSPERO: CRD42017057541), investigators independently screened reports to identify randomized controlled trials or quasi-experimental studies that evaluated the effect of integrated outpatient palliative and oncology care interventions on quality of life, survival, and healthcare utilization among adults with advanced cancer.

Practical Strategies for Optimizing and Integrating Palliative Care in Cancer.

Purpose Of Review: Recent reforms in medical payment coupled with a rapidly evolving pharmacotherapeutic armamentarium is creating a transition in the field of oncology. This transition represents a key period for conceptual reevaluation, providing an opportunity for furthered strategic integration of palliative care within the realm of oncology.

Recent Findings: Historically, oncologists have relied upon prognostic assessments to gauge appropriateness for referrals to specialty palliative care.

Strategic Patient Discharge: the Case of Long-Term Care Hospitals.

Medicare's prospective payment system for long-term acute-care hospitals (LTCHs) provides modest reimbursements at the beginning of a patient's stay before jumping discontinuously to a large lump-sum payment after a prespecified number of days. We show that LTCHs respond to the financial incentives of this system by disproportionately discharging patients after they cross the large-payment threshold. We find this occurs more often at for-profit facilities, facilities acquired by leading LTCH chains, and facilities colocated with other hospitals.

Eye-tracking evidence shows that non-fit messaging impacts attention, attitudes and choice.

When patients have strong initial attitudes about a medical intervention, they might not be open to learning new information when choosing whether or not to receive the intervention. We aim to show that non-fit messaging (messages framed in a manner that is incongruent with recipients' motivational orientation) can increase attention to the message content, thereby de-intensifying an initial attitude bias and reducing the influence of this bias on choice. In this study, 196 students received information about the pros and cons of a vaccine, framed in either a fit or non-fit manner with their motivational orientation.

Credibility-enhancing displays promote the provision of non-normative public goods.

Promoting the adoption of public goods that are not yet widely accepted is particularly challenging. This is because most tools for increasing cooperation-such as reputation concerns and information about social norms-are typically effective only for behaviours that are commonly practiced, or at least generally agreed upon as being desirable. Here we examine how advocates can successfully promote non-normative (that is, rare or unpopular) public goods.

Top Ten Tips Palliative Care Clinicians Should Know About Caring for Children.

Given the limited number of pediatric-specific palliative care programs, palliative care providers of all disciplines may be called on to care for infants, children, and adolescents with serious illness. This article provides a review of the unique components of pediatric palliative care, including key roles within an interdisciplinary team, pediatric developmental considerations, use of medical technology and complexities of symptom management in children with serious illness, hospice utilization, as well as pointers for discussions with families regarding a patient's quality of life and goals of care.

Supportive Care in Lung Cancer: Improving Value in the Era of Modern Therapies.

Driven by a discipline-wide imperative to maximize patient centeredness and value, supportive care services have experienced remarkable growth and acceptance in oncology care. Two such services with a growing evidence base and examples of routine integration into usual oncology care are palliative care and integrative medicine. Both focus on the patient experience with cancer during and after cancer-directed treatments occur, from diagnosis through survivorship or end-of-life care.

Optimizing Outpatient Total Ankle Replacement from Clinic to Pain Management.

Outpatient total ankle arthroplasty is a potential significant source of cost savings. The ability to institute an effective outpatient total ankle program depends on appropriate patient selection, surgeon experience with total ankle replacement, addressing preoperative patient expectations, the involvement of an experienced multidisciplinary care team including experienced anesthesiologists, nurse navigators, recovery room nursing staff and physical therapists, and most importantly, such a program requires complete institutional logistical support.

Implementation of a Market Entry Reward within the United States.

As part of a multifactorial approach to address weak incentives for innovative antimicrobial drug development, market entry rewards (MERs) are an emerging solution. Recently, the Duke-Margolis Center for Health Policy released the Priority Antimicrobial Value and Entry (PAVE) Award proposal, which combines a MER with payment reforms, transitioning from volume-based to "value-based" payments for antimicrobials. Here, the PAVE Award and similar MERs are reviewed, focusing on further refinement and avenues for implementation.

Choose Your Words Wisely: The Impact of Message Framing on Patients' Responses to Treatment Advice.

Other people's words can have a powerful influence on how we interpret our environment, what we expect and experience, what we value, how we feel, what we choose, and how we behave. Placebo (and nocebo) effects are a dramatic example of this. The way in which healthcare professionals discuss, describe, and inform patients about the characteristic effects of a given disease and it prevention, diagnosis and treatment influence patients' feelings and expectations which in turn affects their psychobiological responses to, and subjective experiences and outcomes of the disease and its treatment effects.

Top Ten Tips Palliative Care Clinicians Should Know About Mental Health and Serious Illness.

Palliative care has long recognized the importance of treating the whole person to address a patient's physical, mental, and spiritual suffering. To address psychological suffering, palliative care often draws upon the pharmacotherapy and psychotherapy offered by psychiatry. Several new developments have occurred in the past decade within psychiatry that impact palliative care.

Pessimistic expectations and poorer experiences: The role of (low) extraversion in anticipated and experienced enjoyment of social interaction.

Given research suggesting that social interactions are beneficial, it is unclear why individuals lower in extraversion engage less in social interactions. In this study, we test whether individuals lower in extraversion reap fewer hedonic rewards from social interactions and explore social psychological processes that explain their experiences. Before participants socialized, we measured extraversion, state positive affect, cognitive capacity, and expectations about the social interactions.

Expanding Palliative Medicine across Care Settings: One Health System Experience.

Background: The success of our hospital-based Palliative Care program stimulated requests to duplicate the program across the health system continuum of care.

Objective: To develop a model of care focused on a high-need, high-cost population that could be implemented across all care settings, including hospitals and patients' homes.

Methods: To fiscally support program expansion from hospital to home, we conducted a retrospective cost analysis for home-based Palliative Care (HBPC)-enrolled patients with continuous claims months before program enrollment through date of death.

Top Ten Tips Palliative Care Clinicians Should Know About Interventional Symptom Management Options When Caring for Patients with Gastrointestinal Malignancies.

Patients diagnosed with advanced stages of gastrointestinal (GI) malignancies are often quite symptomatic, with symptoms primarily related to anatomic sites of obstruction. Endoscopic approaches to the palliation of GI malignancies have begun to overtake surgical approaches as first line in interventional management. We brought together a team of interventional gastroenterologists and palliative care experts to collate practical pearls for the types of endoscopic interventions used for symptom management in patients with GI malignancies.

Shopping on the Public and Private Health Insurance Marketplaces: Consumer Decision Aids and Plan Presentation.

Background: The design of the Affordable Care Act's (ACA) health insurance marketplaces influences complex health plan choices.

Objective: To compare the choice environments of the public health insurance exchanges in the fourth (OEP4) versus third (OEP3) open enrollment period and to examine online marketplace run by private companies, including a total cost estimate comparison.

Design: In November-December 2016, we examined the public and private online health insurance exchanges.

Legacy motivations & the psychology of intergenerational decisions.

Critical issues in society today involve long time horizons and multiple generations of people. A central challenge in intergenerational decisions is that the interests of present and future generations are not always aligned. The goals and focus of research on intergenerational decisions has been to (1) identify the key features of intergenerational decisions and use those insights to develop experiments that emulate those features, (2) identify the central barriers to intergenerational beneficence, and importantly, (3) identify variables that lead people to act on the behalf of future generations, void of any material or economic incentive to do so.

Top Ten Tips for Palliative Care Clinicians Caring for Cancer Patients Receiving Immunotherapies.

Patients with cancer face an ever-changing landscape of tumor-directed therapies available to improve quality of life and potentially increase survival. The most recent advances, immunotherapeutics, offer a novel way to target cancer cells by engaging the body's own immune system. Using an expert panel of oncologists, palliative medicine physicians, and dual-trained specialists, we discuss current immunotherapies and their clinical uses, potential side effects and management strategies, and the implications of these newer treatments on goals of care conversations and care coordination.

Top Ten Tips Palliative Care Clinicians Should Know When Caring for Patients with Endometrial Cancer.

Endometrial cancer incidence has been increasing over the last two decades, likely due to the obesity epidemic. The majority of these cancers are confined to the uterus at diagnosis and can be cured with surgery. Overall, five-year disease-specific survival is about 80%, but some patients have locally advanced or metastatic disease that is not amenable to control with radiation and/or chemotherapy.

Information Framing Reduces Initial Negative Attitudes in Cancer Patients' Decisions About Hospice Care.

Background: Negative attitudes toward hospice care might prevent patients with cancer from discussing and choosing hospice as they approach end of life. When making a decision, people often naturally focus on either expected benefits or the avoidance of harm. Behavioral research has demonstrated that framing information in an incongruent manner with patients' underlying motivational focus reduces their negative attitudes toward a disliked option.