The personal identity problem expresses the worry that due to disrupted psychological continuity, one person's advance directive could be used to determine the care of a different person. Even ethicists, who strongly question the possibility of the scenario depicted by the proponents of the personal identity problem, often consider it ...

The problem of violence directed toward general practitioners and their practice staff is acknowledged worldwide. In Australia, the tragic 2006 murder of a Melbourne GP while practising in her surgery highlighted the seriousness of the issue.

OBJECTIVES:: A number of clinical measures of directivity, including the front-to-back ratio (FBR) and front-to-side ratio (FSR), have been suggested to audiologists to monitor the functionality of hearing aids with directional microphones. These suggestions, however, are based on the assumption that directivity measured clinically changes monotonically when compared with changes ...

In the current study we tested whether the dopamine receptor D4 (DRD4) genotype moderates the association of experienced parental problems during childhood (e.g., parental depression, marital discord) with unresolved loss or trauma during the Adult Attachment Interview. To test the specificity of this moderation the role of the serotonin transporter ...

PURPOSE: The reasons are not clear as to why people who need hearing aids and possess them do not use them. We aimed to describe the incidence and predictors of hearing aid ownership and use among older adults. METHODS: We included 2,015 Blue Mountains Hearing Study participants aged ≥55 years ...

To examine sentence recognition and self-report outcomes in hearing-impaired persons with different auditory profiles and who were fitted unilaterally with a bone-anchored hearing aid. Prospective cohort study. Tertiary referral unit. Data were collected of six patients with single-sided deafness (SSD), seven with a mild to severe hearing loss at the ...

Abstract Conclusion: There is no significant difference in speech recognition scores obtained with the Vibrant Soundbridge and the open-fit hearing aid. However, the Vibrant Soundbridge may be superior to open-fit hearing aids in improving hearing at high frequencies (4-8 kHz). Objectives: To assess whether an improvement in speech recognition conferred ...

A unilateral hearing loss is characterized by reduced hearing in one ear. The problems caused by sensory deprivation can be minimized with the use of hearing aids (HA). To analyze the correlation between the prescribed grain and the insertion gain difference and with the results obtained regarding the benefit and ...

Background: Adults with severe and profound hearing loss tend to be long-term, full-time users of amplification who are highly reliant on their hearing aids. As a result of these characteristics, they are often reluctant to update their hearing aids when new features or signal-processing algorithms become available. Due to the ...

Background: Hearing loss is common in older adults. Screening could identify untreated hearing loss and lead to interventions to improve hearing-related function and quality of life. Purpose: To update the 1996 U.S. Preventive Services Task Force evidence review on screening for hearing loss in primary care settings in adults aged ...

Noise-induced hearing loss (NIHL) is a common and preventable injury for farmers. Farmers are frequently exposed to excessive noise, ranking among the top three occupations and industries with the highest risk for hearing loss. Use of hearing protection among farmers is not common. Although the age when NIHL begins among ...

Hearing loss has been associated with cognitive and functional decline in older adults and may be amenable to rehabilitative interventions, but national estimates of hearing loss prevalence and hearing aid use in older adults are unavailable. We analyzed data from the 2005-2006 cycle of the National Health and Nutritional Examination ...

To evaluate the benefits of a bone-anchored hearing aid (BAHA) in the daily lives of hearing-impaired children. Retrospective questionnaire study. Nijmegen Medical Centre, Nijmegen, the Netherlands. Thirty-eight BAHA users with a minimum age of 4 years at BAHA fitting and 1 to 4 years of use, divided into groups with ...

The aim of the study was to assess the audiological findings of a 4-year-old child with a homozygous COL11A2 mutation and to point out the role of continuous follow-ups in children with craniofacial syndromes after the newborn hearing screening. A 4-year-old boy with otospondylomegaepiphyseal dysplasia (OSMED) was followed up after ...

Routine hearing screening can identify patients who are motivated to seek out and adhere to treatment, but little information exists on the cost-effectiveness of hearing screening in a general population of older veterans. We compared the cost-effectiveness of three screening strategies (tone-emitting otoscope, hearing handicap questionnaire, and both together) against ...

Objective: Individuals diagnosed with certain medical conditions, such as those with hearing loss or impairment, may present with symptoms that mimic those of Autism Spectrum Disorders (ASD). Therefore, the aim of this study was to investigate how hearing-compromised toddlers would score relative to toddlers diagnosed with an ASD on a ...

Hearing impairment has far-reaching consequences for affected individuals, in terms of quality of life indicators. In the public health care sector of South Africa the hearing-impaired population is faced with limited aural rehabilitation services. This study evaluated self-reported outcomes of aural rehabilitation in a group of adults in the public ...

Background: Hearing loss is a common sensory impairment experienced by older persons. Evidence shows that the use of hearing aids and/or assistive listening devices (ALDs) can benefit those with a hearing loss but that historically the uptake and use of these technologies has remained relatively low compared with the number ...

A 49-year-old woman developed a catatonic mute state a few weeks after methadone overdose. Clinical, radiological and histological findings were consistent with toxic spongiform leukoencephalopathy, which adds a potentially deadly side-effect to a generally considered safe substitution for heroin.

False passage and loss of airway during tracheostomy are not uncommon, especially in patients with short and thick necks. Distorted neck anatomy following either repeated insertion attempts or due to underlying malignancy may make it very difficult to locate the trachea even while attempting open/surgical tracheostomy, despite good exposure of ...

Clinical consultations generate questions that can be informed by published (and unpublished) evidence. This is the basis for evidence-based practice. Finding answers involves searching available electronic databases. We describe a method for rephrasing or 'framing' clinical questions into population, intervention, comparator and outcome terms that helps to determine the best ...

An essential component of any clinical intervention or clinically invasive procedure in the perioperative setting will involve the use of instruments. It is therefore essential that all practitioners in the perioperative setting are able to identify the instruments required for a case, for both preparation and checking purposes, be able ...

Indirect evidence is crucial for successful statistical practice. Sometimes, however, it is better used informally. Future efforts should be directed toward understanding better the connection between statistical methods and scientific problems.

The results of clinical studies on the value of preemptive analgesia are far from being unanimous. There are a number of potential problems related to preemptive analgesia that could lead to controversy regarding its clinical significance. The following potential problems are analyzed: (1) terminology, (2) approach to reveal the effect ...

In clinical practice, a classification of seizures based on clinical signs and symptoms leads to an improved understanding of epilepsy-related issues and therefore strongly contributes to a better patient care. The inverse problem involves inferring the anatomical brain localization of a seizure from the scalp surface EEG, a concept we ...

In response to the growing number of the HIV-positive patients in the Islamic Republic of Iran, the Iranian Ministry of Health and Education established several special clinics in all Iranian provinces to provide treatment and care to HIV-positive patients. The Rafsanjan AIDS Clinic is one such clinic that was set ...

AIMS: The aim of the study was to determine the rates of trachoma in Aboriginal communities and to compare clinical assessment with photographic assessment for the presence of signs of trachoma. METHODS: Five Aboriginal communities in the Katherine region of the Northern Territory, Australia, were assessed for the presence of ...

The following paper explores how working in Venezuela, a country that has gone through 20 years of economic and political problems, has highlighted the gap between clinical and community approaches in dealing with the sufferings of our consultants. Our efforts to develop theoretical and practical tools that can address the ...

Hemodialysis (HD) vascular access dysfunction is currently a huge clinical problem for which there are no effective therapies. There are, however, a number of promising technologies that are currently at the experimental or clinical trial stage. We believe that the application of these novel technologies in combination with better clinical ...

Marriage and family therapy (MFT) faculty and graduate students rated the "typical" or predictable behaviors of husbands or wives coming for therapy using the Georgia Marriage Q-sort. Scores were compared with previously published scores for both "ideal" couples (i.e., showing positive behaviors, attitudes, and problem-solving skills) and a sample of ...

The clinical problem of bladder cancer is its high recurrence and progression, and that the most sensitive and specific means of monitoring is cystoscopy, which is invasive and has poor patient compliance. Biomarkers for recurrence and progression could make a great contribution, but in spite of decades of research, no ...

BACKGROUND: The vast amounts of clinical data collected in electronic health records (EHR) is analogous to the data explosion from the "-omics" revolution. In the EHR clinicians often maintain patient-specific problem summary lists which are used to provide a concise overview of significant medical diagnoses. We hypothesized that by tapping ...

PURPOSE: To demonstrate how a previously described conceptual framework of physician-patient communication can inform the application of existing theory and the extension of new theory regarding the impact of patient-reported outcomes (PROs) in clinical practice. METHOD: We used a communication framework to guide interpretation of empirical results relating to three ...

Unwanted facial and body hair is a common problem, generating a high level of interest for treatment innovations. A wide range of modalities for the management of unwanted hair have been advocated over the years with varying degrees of clinical success. Most recently, lasers and light sources have been used ...

OBJECTIVES: To assess the feasibility and generalizability of STD clinic samples for studying STD-related knowledge, attitudes, and behaviors (KAB), and healthcare preferences among individuals at high risk for STDs in the same community. STUDY DESIGN: An STD clinic and a community sample were selected from each of two urban areas ...

Herbal preparations are rampantly used in the treatment of AIDS in endemic regions. Despite beneficial effects from the use of some plant preparations, the issues that still have to be addressed comprise the interaction between herbal preparations and antiretrovirals, lack of conclusive clinical trials of widely used plants, and ethical ...

The availability of timely, accurate, comprehensive, and coded clinical problem lists is essential for supporting a range of healthcare activities. Evidence and experience suggest, however, that problem lists are frequently out-of-date, sometimes omit clinically important problems, and contain uncoded entries. Here, we describe a study being performed at Partners HealthCare ...

Musculoskeletal problems are very common, and clinical assessment is central to their appropriate management; however, many clinicians are not sufficiently competent to carry out this assessment. A standardized approach to the clinical assessment of a musculoskeletal problem is, therefore, necessary, whether the patient is presenting to primary care, rheumatology or ...

In the interest of designing an automated high-level, longitudinal clinical summary of a patient record, we analyze traditional ways in which medical problems pertaining to the patient are summarized in the electronic health record. The patient problem list has become a commonly used proxy for a summary of patient history ...

PRIMARY OBJECTIVE: This study examined the relationships between the Frontal Systems Behaviour Scale (FrSBe), neuropsychological tests and community integration outcomes among individuals with a history of TBI. METHODS: Seventy-six individuals with a history of TBI were consecutively recruited from patients seen in a Neuropsychology clinic in an academic healthcare setting. ...

KP-1461, an experimental HIV drug already in a phase II trial, works so differently from other antiretrovirals that at first glance it looked like science fiction, and we found it hard to take seriously as a current possibility today. In fact this drug is highly credible, and based on elegant ...

Unraveling the root of the metazoan tree of life has been a difficult task since the time of Haeckel and the invention of phylogenetics. Even considerable amounts of recent molecular data have not provided a generally accepted answer. Here, we review the major problems of this phylogenetic conundrum and provide ...

OBJECTIVE: The objective is to ascertain whether people in partial remission (IPR) or in full remission (IR) of their ADHD symptoms continue to have neuropsychological deficits and clinical and psychosocial problems. METHOD: IPR and IR groups are compared with fully symptomatic ADHD patients and normal controls. RESULTS: The results show ...

STUDY OBJECTIVE: To evaluate the reliability of a newly developed taxonomy--the Clinical Pharmacist Recommendation (CPR) taxonomy--to classify clinical pharmacy interventions. DESIGN: The CPR taxonomy was developed and refined in three phases. In each phase, reviewers independently reviewed recommendations made by a clinical pharmacist-physician team and categorized them into mutually exclusive ...

One of the key problems in healthcare informatics is the inability to share patient records across enterprises. To address this problem, an important industry initiative called "integrating the healthcare enterprise (IHE)" specified the "cross enterprise document sharing (XDS)" profile. In the IHE XDS, healthcare enterprises that agree to work together ...

Although arteriovenous (AV) fistulae are the preferred form of dialysis access, they continue to have significant problems with both early and late failures. Despite the magnitude of the clinical problem, however, there are unfortunately no effective therapies for AV fistula failure. We believe that this inability to intervene is partly ...

A summary is presented of both the theoretical and clinical points made by the contributors to this issue of Journal of Clinical Psychology: In Session on the multiplicity of self. It is argued that there are many theoretical and clinical commonalities in the diverse range of psychotherapies that have been ...

BACKGROUND: Dentists report that the complexity and poor usability of practice management systems (PMSs) are factors in the slow adoption of computers at chairside. METHODS: Three dental informatics researchers performed heuristic evaluations of four PMSs to identify potential usability problems that may be encountered during the clinical care process. Each ...

OBJECTIVE: Knowledge of distinct motivations and reasons toward or against future trial participation is invaluable to any organization conducting trial research. Study delays often occur due to lack of recruitment. This study's primary objective was to compare veteran and nonveteran motivations and reasons. METHODS: People in two outpatient waiting rooms ...

In this paper, I argue that Counselling Psychology's professional identification with pluralism poses significant emotional problems for trainees. An important factor in such problems may be the trainee's sense of disappointment and disillusion that the route to professional and personal self-transformation will not be achieved via a set of universal ...