Journal of evaluation in clinical practice
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In the United States, the reluctance of the federal government to impose a national stay-at-home policy in wake of COVID-19 pandemic has left the decision of how to achieve social distancing to individual state governors. We hypothesized that in the absence of formal guidelines, the decision to close a state reflects the classic Weber-Fechner law of psychophysics - the amount by which a stimulus (such as number of cases or deaths) must increase in order to be noticed as a fraction of the intensity of that stimulus. ⋯ when there are not clearly articulated rules to follow, decision-makers resort to simple heuristics, in this case one consistent with the Weber-Fechner law.
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Co-morbidities in colorectal cancer patients complicate hospital care, and their relative importance to post-operative deaths is largely unknown. This study was conducted to examine a range of clinical and sociodemographic factors in relation to post-operative in-hospital deaths in colorectal cancer patients and identify whether these contributions would vary by severity of co-morbidities. ⋯ Identification of relative importance of factors contributing to in-hospital deaths in colorectal cancer patients using ANN may help to enhance patient-centred strategies to meet complex needs during acute surgical care and prevent post-operative in-hospital deaths.
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Randomized Controlled Trial
Assessing the impact of medication management review service for females diagnosed with depression and anxiety: A randomized control trial.
Study participants (n = 73; mean age = 41.8 [SD = 16.27]) had 177 TRPs identified, with 2.42(SD = 1.06) TRPs per patient. At baseline, only 54.8% of the participants reported to be adherent to their treatment, and no significant differences were found between the groups. At follow-up, a significant decline in the number of TRPs was found for the active versus control group (active: 0.58[SD = 0.64], control: 1.78[SD = 1.13], P < .001). A significantly higher proportion of adherent patients was identified in the active (88.9%) versus control group (51.4%), P < .001. Significant improvements in the depression (P < .001) and anxiety (P = .003) scores were detected for the active versus control group. ⋯ The MMR service led to a significant decrease in the number of TRPs, improved adherence, depression, and anxiety scores for females diagnosed with depression and anxiety.
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Postoperative respiratory failure after cardiac surgery (CS-PRF) is a devastating complication and its incidence and predictors vary depending on how it is defined and the patient population. ⋯ Knowledge of predictors for CS-PRF may help identify patients who are at risk for this complication and who may benefit from preventive measures to promote early extubation and to avert reintubation.
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Converging and accumulating evidence for the cross-communication among the nervous, immune, and endocrine systems, a field of study known as psychoneuroimmunology, implicates immunological dysfunction as a shared and common mechanism of both mental and physical illness. For example, psychiatric disorders like schizophrenia, bipolar disorder, major depression, and anxiety disorders have higher prevalence rates across a spectrum of autoimmune conditions compared to the general population. Additionally, subclinical immunological abnormalities are observed in a variety of psychiatric conditions, with chronic inflammation most extensively studied in the pathophysiology of depression. These observations blur the historical distinctions between mental and physical illness, yet clinical practice remains fragmented and primarily focused on differentially treating individual symptoms. ⋯ Utilizing a psychoneuroimmunological lens, health psychologists and clinicians can reconceptualize healthcare through integrative treatment approaches and advocacy for comprehensive policy-level reform at both the individual-level of care as well as community-wide prevention approaches.