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Educational Intervention Improves Older Latinos’ End-of-Life Care Planning
Susanny J. Beltran, PhD, MSW, and colleagues noticed that older Latinos consistently completed advance care planning documentation less frequently compared to the general population. They evaluated an educational intervention to see if it would improve advance care planning readiness and knowledge of older Latino adults.
Ethical Considerations if AI Tools Are Used for Informed Consent
Participants in clinical trials often struggle to comprehend informed consent forms, raising questions on whether they are making truly informed decisions. Artificial intelligence (AI) tools are a potential solution to this longstanding ethical concern. However, the burden is on researchers to ensure that AI-generated documents uphold ethical and regulatory standards.
Nurses Self-Report High Levels of Moral Courage, but Few Are Willing to Act Directly
Nurses reported significant social and professional barriers to act in response to an ethical violation, a recent study found.
Ethicists Can Explore Rationale if Physician Refuses to Continue Life-Prolonging Interventions
Many ethics consults center around a conflict between a family who wants to continue life-prolonging interventions and a physician who refuses to provide it. But does the family understand the rationale for the decision?
Should Trial of Labor Be Offered to Women with Two Previous Cesarean Deliveries and Twin Gestations?
In twin pregnancies among women with two prior cesarean deliveries, there were no significant differences observed in adverse maternal or neonatal outcomes, yet the probability of a successful vaginal birth stood at 37.8%.
Modified Laparoscopic Radical Hysterectomy in Early-Stage Cervical Cancer
In this retrospective cohort study including 276 patients with early-stage cervical cancer, modified tumor-free techniques during laparoscopic radical hysterectomy, including avoidance of a uterine manipulator and vaginal closure prior to colpotomy, demonstrated a lower recurrence rate (1.3% vs. 12.8%) and significantly better two-year disease-free survival (99.3% vs. 91.9%, P = 0.002) compared with traditional laparoscopic radical hysterectomy.
Trends in Contraceptive Use Among Abortion Patients
In this cross-sectional study of 88,550 patients presenting for abortion services in England and Wales in 2018 and 2023, the use of effective methods of contraception decreased over time (hormonal methods: 18.8% vs. 11.3%, P < 0.001; long-acting reversible contraceptives: 3% vs. 0.6%, P < 0.001), while fertility awareness-based methods increased from 0.4% to 2.5% (P < 0.001).
New Guidelines for HPV Testing of Self-Collected Vaginal Specimens
This article outlines national consensus guidelines for the use of human papillomavirus (HPV) testing of self-collected vaginal specimens for cervical cancer screening.
Spinal Cord Compression
Diagnosis and management of acute spinal cord compression can be a challenge for the emergency physician. The clinical presentation can range from intermittent, subtle symptoms to acute loss of motor and/or sensory function. Prompt diagnosis and definitive intervention are crucial to preventing long-term neurologic deficit.
Importance of Dynamic Mitral Regurgitation in Ischemic Cardiomyopathy
A small observational study of patients with ischemic cardiomyopathy and mitral valve regurgitation referred for exercise testing who underwent isometric handgrip exercise showed that the baseline presence or development of severe mitral regurgitation with exercise was predictive of a composite adverse outcome endpoint at one year.