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[PMID]:29190835
[Au] Autor:Friedman JH
[Ad] Endereço:Editor-in-chief of the Rhode Island Medical Journal, Professor and the Chief of the Division of Movement Disorders, Department of Neurology at the Alpert Medical School of Brown University, chief of Butler Hospital's Movement Disorders Program and first recipient of the Stanley Aronson Chair in Neurodegenerative Disorders.
[Ti] Título:When the doctor is crazier than the patient.
[So] Source:R I Med J (2013);100(12):8-9, 2017 Dec 01.
[Is] ISSN:2327-2228
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:[Full article available at http://rimed.org/rimedicaljournal-2017-12.asp].
[Mh] Termos MeSH primário: Atitude do Pessoal de Saúde
Erros Médicos/psicologia
Médicos/psicologia
[Mh] Termos MeSH secundário: Seres Humanos
Relações Médico-Paciente
Efeito Placebo
Racionalização
Autoavaliação
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180214
[Lr] Data última revisão:
180214
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171201
[St] Status:MEDLINE


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[PMID]:28147409
[Au] Autor:Klein EM; Wölfling K; Beutel ME; Dreier M; Müller KW
[Ad] Endereço:Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz.
[Ti] Título:[Psychological Distress and Acceptance of Violence Legitimizing Masculinity Norms among Adolescents].
[Ti] Título:Psychische Belastung und die Akzeptanz von gewaltlegitimierenden Männlichkeitsnormen bei Jugendlichen..
[So] Source:Psychother Psychosom Med Psychol;67(3-04):152-160, 2017 Apr.
[Is] ISSN:1439-1058
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:The proportion of adolescent migrants in Germany aged 15-20 years has risen to about 29.5% in 2014 according to Federal census statistics. The purpose of the current study was to describe and to compare the psychological strains of adolescent 1 and 2 generation migrants with non-migrants in a representative school survey. Acceptance of violence legitimizing masculinity norms was explored and its correlation with psychological strain was analyzed. Self-reported data of psychological strain (internalizing and externalizing problems) and acceptance of violence legitimizing masculinity were gathered among 8 518 pupils aged 12-19 years across different school types. Among the surveyed adolescents, 27.6% reported a migration background (5.8% 1 generation migrants; 21.8% 2 generation migrants). Particularly 1 generation migrants scored higher in internalizing and externalizing problems than 2 generation migrants or non-migrants. The differences, however, were small. Adolescents with migration background suffered from educational disadvantage, especially 1 generation migrants. Male adolescents reported significantly higher acceptance of violence legitimizing masculinity norms than their female counterparts. Strong agreement with the measured concept of masculinity was found among pupils of lower secondary school and adolescents reported regularly tobacco and cannabis consumption. The acceptance of violence legitimizing masculinity norms was greater among migrants, particularly 1 generation migrants, than non-migrants. Overall, high acceptance of violence legitimizing masculinity norms was related to externalizing problems, which can be understood as dysfunctional coping mechanisms of social disadvantage and a lack of prospects.
[Mh] Termos MeSH primário: Emigrantes e Imigrantes/psicologia
Identidade de Gênero
Masculinidade
Racionalização
Normas Sociais
Estresse Psicológico/complicações
Estresse Psicológico/psicologia
Violência/psicologia
[Mh] Termos MeSH secundário: Adaptação Psicológica
Adolescente
Criança
Feminino
Alemanha
Seres Humanos
Controle Interno-Externo
Masculino
Instituições Acadêmicas
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170202
[St] Status:MEDLINE
[do] DOI:10.1055/s-0042-115932


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Registro de Ensaios Clínicos
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[PMID]:27915457
[Au] Autor:Van der Linden L; Decoutere L; Walgraeve K; Milisen K; Flamaing J; Spriet I; Tournoy J
[Ad] Endereço:Pharmacy Department, University Hospitals Leuven, Herestraat 49, 3000, Louvain, Belgium. lorenz.vanderlinden@uzleuven.be.
[Ti] Título:Combined Use of the Rationalization of Home Medication by an Adjusted STOPP in Older Patients (RASP) List and a Pharmacist-Led Medication Review in Very Old Inpatients: Impact on Quality of Prescribing and Clinical Outcome.
[So] Source:Drugs Aging;34(2):123-133, 2017 02.
[Is] ISSN:1179-1969
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients. METHODS: A monocentric, prospective controlled trial was undertaken at the geriatric wards of a large university hospital. Pharmacists applied the RASP list to the drugs reconciled on admission and additionally performed an expert-based medication review, upon which recommendations were provided to the treating physicians. The primary outcome was the composite endpoint of drug discontinuation and dose reduction of drugs taken on admission. Secondary outcomes included RASP-identified potentially inappropriate medications (PIMs), the number of Emergency Department (ED) visits and quality of life (QOL) registered up to 3 months after discharge. RESULTS: On average, patients (n = 172) took 10 drugs on admission and were 84.5 years (standard deviation 4.8) of age. More drugs were discontinued or reduced in dose in the intervention group {control vs.intervention:median (interquartile range [IQR]) 3 (2-5) vs. 5 (3-7); p < 0.001}. More PIMs were discontinued in the intervention group, leading to less PIM at discharge [control vs.intervention:median (IQR) 2 (1-3) vs. 0.5 (0-1); p < 0.001]. No signal of harm was seen, and a significant improvement of QOL and less ED visits without hospitalization were observed. CONCLUSIONS: The combined intervention safely reduced drug use in very old inpatients and outperformed usual geriatric care. An increased QOL was seen, as well as a trend towards less ED visits. ClinicalTrials.gov Identifier: NCT01513265.
[Mh] Termos MeSH primário: Uso de Medicamentos/estatística & dados numéricos
Serviços de Saúde para Idosos/organização & administração
Prescrição Inadequada
Farmacêuticos
Lista de Medicamentos Potencialmente Inapropriados
Racionalização
[Mh] Termos MeSH secundário: Idoso
Idoso de 80 Anos ou mais
Feminino
Idoso Fragilizado
Hospitais Universitários/estatística & dados numéricos
Seres Humanos
Prescrição Inadequada/prevenção & controle
Prescrição Inadequada/estatística & dados numéricos
Masculino
Admissão do Paciente/estatística & dados numéricos
Alta do Paciente/estatística & dados numéricos
Polimedicação
Estudos Prospectivos
Qualidade de Vida
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171114
[Lr] Data última revisão:
171114
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161205
[Cl] Clinical Trial:ClinicalTrial
[St] Status:MEDLINE
[do] DOI:10.1007/s40266-016-0424-8


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[PMID]:26900054
[Au] Autor:Dekker SW
[Ad] Endereço:Griffith University, Safety Science Innovation Lab., Macrossan Building N16 Room 2.21, 170 Kessels Road, Nathan Campus, QLD 4111, Australia. Electronic address: s.dekker@griffith.edu.au.
[Ti] Título:Rasmussen's legacy and the long arm of rational choice.
[So] Source:Appl Ergon;59(Pt B):554-557, 2017 Mar.
[Is] ISSN:1872-9126
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Rational choice theory says that operators and others make decisions by systematically and consciously weighing all possible outcomes along all relevant criteria. This paper first traces the long historical arm of rational choice thinking in the West to Judeo-Christian thinking, Calvin and Weber. It then presents a case study that illustrates the consequences of the ethic of rational choice and individual responsibility. It subsequently examines and contextualizes Rasmussen's legacy of pushing back against the long historical arm of rational choice, showing that bad outcomes are not the result of human immoral choice, but the product of normal interactions between people and systems. If we don't understand why people did what they did, Rasmussen suggested, it is not because people behaved inexplicably, but because we took the wrong perspective.
[Mh] Termos MeSH primário: Comportamento de Escolha
Teoria da Decisão
Racionalização
[Mh] Termos MeSH secundário: História do Século XVI
Seres Humanos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170217
[Lr] Data última revisão:
170217
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160223
[St] Status:MEDLINE


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[PMID]:28190382
[Au] Autor:Garnham A
[Ad] Endereço:a School of Psychology , University of Sussex , UK.
[Ti] Título:Simply rational: Decision making in the real world.
[So] Source:Q J Exp Psychol (Hove);69(6):1245-1246, 2016 Jun.
[Is] ISSN:1747-0226
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Tomada de Decisões
Racionalização
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170309
[Lr] Data última revisão:
170309
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170214
[St] Status:MEDLINE
[do] DOI:10.1080/17470218.2016.1145246


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[PMID]:27802938
[Au] Autor:Heath I
[Ad] Endereço:London, UK.
[Ti] Título:How medicine has exploited rationality at the expense of humanity: an essay by Iona Heath.
[So] Source:BMJ;355:i5705, 2016 Nov 01.
[Is] ISSN:1756-1833
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Medicina Baseada em Evidências
Humanismo
Relações Médico-Paciente
Racionalização
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; VIDEO-AUDIO MEDIA
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170817
[Lr] Data última revisão:
170817
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:161103
[St] Status:MEDLINE
[do] DOI:10.1136/bmj.i5705


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[PMID]:26970209
[Au] Autor:Ní Chróinín D; Neto HM; Xiao D; Sandhu A; Brazel C; Farnham N; Perram J; Roach TS; Sutherland E; Day R; Beveridge A
[Ad] Endereço:Department of Geriatric Medicine, St. Vincent's Hospital, Sydney, New South Wales, Australia.
[Ti] Título:Potentially inappropriate medications (PIMs) in older hospital in-patients: Prevalence, contribution to hospital admission and documentation of rationale for continuation.
[So] Source:Australas J Ageing;35(4):262-265, 2016 Dec.
[Is] ISSN:1741-6612
[Cp] País de publicação:Australia
[La] Idioma:eng
[Ab] Resumo:AIM: To establish prevalence, sequelae and documentation of potentially inappropriate medication (PIM) use in older hospital in-patients. METHODS: Notes of all patients ≥65 years old, admitted to our tertiary teaching hospital (January 2013), were retrospectively reviewed, and the Screening Tool of Older Persons' potentially inappropriate Prescriptions applied. RESULTS: Amongst 534 patients, 54.8% (284) were on ≥1 PIM at admission, 26.8% on multiple; 60.8% were discharged on a PIM. Six percent of all admissions were potentially attributable to a PIM; falls associated with risk therapies were commonest (23/30), and often (65.2%) associated with serious injury. Pre-specified subgroup analysis (n = 100) identified 101 PIMs-at-discharge amongst 47 patients. In 82.2%, a clinical rationale for continued prescription was documented, with this communicated to the GP by letter in 71.1%. CONCLUSION: PIMs were common, and contributed to admission and injury. Hospitalisation provides an opportunity for medication rationalisation, and documentation of rationale for any PIM use.
[Mh] Termos MeSH primário: Controle de Formulários e Registros
Hospitais de Ensino
Prescrição Inadequada/efeitos adversos
Pacientes Internados
Registros Médicos
Admissão do Paciente
Serviço de Farmácia Hospitalar
Lista de Medicamentos Potencialmente Inapropriados
[Mh] Termos MeSH secundário: Acidentes por Quedas/prevenção & controle
Fatores Etários
Idoso
Idoso de 80 Anos ou mais
Interações Medicamentosas
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
Feminino
Seres Humanos
Masculino
Reconciliação de Medicamentos
New South Wales/epidemiologia
Polimedicação
Prevalência
Racionalização
Estudos Retrospectivos
Fatores de Risco
Centros de Atenção Terciária
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1702
[Cu] Atualização por classe:170213
[Lr] Data última revisão:
170213
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160313
[St] Status:MEDLINE
[do] DOI:10.1111/ajag.12312


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[PMID]:26749179
[Au] Autor:Cook J; Lewandowsky S
[Ad] Endereço:Global Change Institute, The University of Queensland.
[Ti] Título:Rational Irrationality: Modeling Climate Change Belief Polarization Using Bayesian Networks.
[So] Source:Top Cogn Sci;8(1):160-79, 2016 Jan.
[Is] ISSN:1756-8765
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:UNLABELLED: Belief polarization is said to occur when two people respond to the same evidence by updating their beliefs in opposite directions. This response is considered to be "irrational" because it involves contrary updating, a form of belief updating that appears to violate normatively optimal responding, as for example dictated by Bayes' theorem. In light of much evidence that people are capable of normatively optimal behavior, belief polarization presents a puzzling exception. We show that Bayesian networks, or Bayes nets, can simulate rational belief updating. When fit to experimental data, Bayes nets can help identify the factors that contribute to polarization. We present a study into belief updating concerning the reality of climate change in response to information about the scientific consensus on anthropogenic global warming (AGW). The study used representative samples of Australian and U.S. PARTICIPANTS: Among Australians, consensus information partially neutralized the influence of worldview, with free-market supporters showing a greater increase in acceptance of human-caused global warming relative to free-market opponents. In contrast, while consensus information overall had a positive effect on perceived consensus among U.S. participants, there was a reduction in perceived consensus and acceptance of human-caused global warming for strong supporters of unregulated free markets. Fitting a Bayes net model to the data indicated that under a Bayesian framework, free-market support is a significant driver of beliefs about climate change and trust in climate scientists. Further, active distrust of climate scientists among a small number of U.S. conservatives drives contrary updating in response to consensus information among this particular group.
[Mh] Termos MeSH primário: Mudança Climática
Modelos Psicológicos
Racionalização
[Mh] Termos MeSH secundário: Austrália
Teorema de Bayes
Consenso
Cultura
Seres Humanos
Percepção
Inquéritos e Questionários
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1612
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160111
[St] Status:MEDLINE
[do] DOI:10.1111/tops.12186


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[PMID]:26651419
[Au] Autor:Eikelboom JW; Cook RJ; Barty R; Liu Y; Arnold DM; Crowther MA; Devereaux PJ; Ellis M; Figueroa P; Gallus A; Hirsh J; Kurz A; Roxby D; Sessler DI; Sharon Y; Sobieraj-Teague M; Warkentin TE; Webert KE; Heddle NM
[Ad] Endereço:Department of Medicine, McMaster University, Hamilton, ON, Canada; Population Health Research Institute, Hamilton, ON, Canada; Thrombosis & Atherosclerosis Research Institute, Hamilton, ON, Canada. Electronic address: eikelbj@mcmaster.ca.
[Ti] Título:Rationale and Design of the Informing Fresh versus Old Red Cell Management (INFORM) Trial: An International Pragmatic Randomized Trial.
[So] Source:Transfus Med Rev;30(1):25-9, 2016 Jan.
[Is] ISSN:1532-9496
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Although red blood cell transfusion is a potentially lifesaving intervention in severely anemic and acutely bleeding patients, some observational studies have suggested that prolonged red cell storage before transfusion is associated with harm. INFORM is a large, pragmatic, randomized controlled trial comparing the effect of the shorter storage with longer storage red blood cell transfusions on inhospital mortality in hospitalized patients who require a blood transfusion. The trial is being conducted in centers in Australia, Canada, Israel, and the United States and is expected to enroll 31497 patients. If the results of INFORM indicate that shorter storage red blood cell transfusion is associated with superior outcomes compared with standard issue red blood cell transfusion, consideration may be given to shortening blood storage times. If, in contrast, the INFORM trial provides no evidence of harm from longer storage red blood cells, clinicians and patients may be reassured that current blood inventory management strategies are appropriate.
[Mh] Termos MeSH primário: Preservação de Sangue/métodos
Transfusão de Eritrócitos/métodos
Projetos de Pesquisa
[Mh] Termos MeSH secundário: Adulto
Austrália
Preservação de Sangue/normas
Canadá
Transfusão de Eritrócitos/normas
Seres Humanos
Israel
Seleção de Pacientes
Racionalização
Resultado do Tratamento
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; PRAGMATIC CLINICAL TRIAL; RANDOMIZED CONTROLLED TRIAL; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1611
[Cu] Atualização por classe:161230
[Lr] Data última revisão:
161230
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151215
[St] Status:MEDLINE


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[PMID]:26641306
[Au] Autor:Anttila M; Strangman W; York R; Tomas C; Wright JL
[Ad] Endereço:UNCW Center for Marine Science , 5600 Marvin K. Moss Lane, Wilmington, North Carolina 28409, United States.
[Ti] Título:Biosynthetic Studies of 13-Desmethylspirolide C Produced by Alexandrium ostenfeldii (= A. peruvianum): Rationalization of the Biosynthetic Pathway Following Incorporation of (13)C-Labeled Methionine and Application of the Odd-Even Rule of Methylation.
[So] Source:J Nat Prod;79(3):484-9, 2016 Mar 25.
[Is] ISSN:1520-6025
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Understanding the biosynthesis of dinoflagellate polyketides presents many unique challenges. Because of the remaining hurdles to dinoflagellate genome sequencing, precursor labeling studies remain the only viable way to investigate dinoflagellate biosynthesis. However, prior studies have shown that polyketide chain assembly does not follow any of the established processes. Additionally, acetate, the common precursor for polyketides, is frequently scrambled, thus compromising interpretation. These factors are further compounded by low production yields of the compounds of interest. A recent report on the biosynthesis of spirolides, a group belonging to the growing class of toxic spiroimines, provided some insight into the polyketide assembly process based on acetate labeling studies, but many details were left uncertain. By feeding (13)C methyl-labeled methionine to cultures of Alexandrium ostenfeldii, the producing organism of 13-desmethylspirolide C, and application of the odd-even methylation rule, the complete biosynthetic pathway has been established.
[Mh] Termos MeSH primário: Dinoflagelados/química
Toxinas Marinhas/metabolismo
Metionina/metabolismo
Compostos de Espiro/metabolismo
[Mh] Termos MeSH secundário: Vias Biossintéticas
Dinoflagelados/genética
Toxinas Marinhas/química
Metionina/análogos & derivados
Metionina/química
Metilação
Estrutura Molecular
Ressonância Magnética Nuclear Biomolecular
Policetídeos
Racionalização
Compostos de Espiro/química
[Pt] Tipo de publicação:JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Nm] Nome de substância:
0 (13-desmethylspirolide C); 0 (Marine Toxins); 0 (Polyketides); 0 (Spiro Compounds); 0 (spirolide A); AE28F7PNPL (Methionine); BN630929UL (methionine methyl ester)
[Em] Mês de entrada:1608
[Cu] Atualização por classe:160325
[Lr] Data última revisão:
160325
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:151208
[St] Status:MEDLINE
[do] DOI:10.1021/acs.jnatprod.5b00869



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