OBJECTIVE To evaluate race differences in tissue plasminogen activator (tPA) refusal among eligible patients with acute ischemic stroke (AIS) in Chicago. METHODS Using the Get With The Guidelines-Stroke registry data from 15 primary stroke centers between January 2013 and June 2015, we performed a retrospective analysis of patients with AIS presenting to the emergency department within 4.5 ho...

OBJECTIVE To evaluate the effect of an intervention targeting parental behavior on stool toileting refusal. METHODS This study population comprised 406 children aged 17 through 19 months from a single suburban private practice. Children were randomly assigned to receive 1 of 2 written toilet-training instructions. Both groups were advised to use a child-oriented approach to toilet training. I...

abstract background: better control of blood sugar and reduction of diabetes complications through insulin therapy could convince people to choose this method. however, patients might refuse insulin therapy due to its painful injection, limitations in daily activities, and hypoglycemia. thus, insulin therapy could have both positive and negative effects on patients’ quality of life (qol). there...

OBJECTIVE To validate a brief measure of vaccination confidence using a large, nationally representative sample of parents. METHODS We analyzed weighted data from 9018 parents who completed the 2010 National Immunization Survey-Teen, an annual, population-based telephone survey. Parents reported on the immunization history of a 13- to 17-year-old child in their households for vaccines includi...

BACKGROUND Many procedures currently require the use of bone grafts to replace or recover bone volume that has been resorbed. However, the patient's opinion and preferences must be taken into account before implementing any treatment. Researchers have focused primarily on assessing the effectiveness of bone grafts rather than on patients' perceptions. Thus, the aim of this study was to explore ...

z Evidence summary The law of informed consent defines the right to informed refusal. Thus, each case must establish: 1) that the patient or decision maker is competent, 2) that the decision is voluntary, and 3) that the physician disclosed the risks of the choice to the patient, including a discussion of risks and alternatives to treatment, and potential consequences of treatment refusal, incl...

Involuntary administration of antipsychotic medication to pretrial criminal defendants raises important and controversial questions. These questions arise especially with defendants who have been adjudicated as incompetent to stand trial and who require medication to be restored to trial-competency and return to face their pending criminal charges. This subject has been fiercely debated for dec...

Public health officials, hospital administrators, forensic directors, jail wardens, judges, prosecutors, and defense attorneys must confront the issue: how should cases of individuals with AIDS dementia be treated when they are found to be permanently incompetent to stand trial? Although charges are sometimes dismissed in advanced cases of dementia, the more common pattern involves placement of...