Radiological Assessment of Morphological Changes of Lumbar Spine: From First to 9th Decade of Life.

STUDY DESIGN: Analysis of lumbar spine radiograms of 1,496 Jeju islanders of Korea. PURPOSE: To look into the age- and gender-matched incidences of morphological changes and their severities. OVERVIEW OF LITERATURE: There have been several prior research on the prevalence and severity of age-related diseases, both related and unrelated. Those offer some fundamental clinical data for clinicians. METHODS: Radiograms of 1,496 patients (555 males and 941 females) from the first to 9th decade were examined for this study. Sagittal and coronal alignment, disc space narrowing, spur formation including diffuse idiopathic spinal hyperostosis (DISH), spondylolisthesis, and ballooned discs associated with biconcave bodies due to osteoporosis were among the parameters of lumbar spine morphologies examined on high-quality radiographs by both human observers and computers. RESULTS: The alignment of the lumbar spine altered after birth and set at growth maturity, and then the curve was maintained till the end of the 5th decade afterward and the curve gradually hypolordotic. There were three types of coronal alignment abnormalities can be seen: idiopathic, osteopathic, and discogenic (degenerative lumbar scoliosis [DLS]). DLS developed after 6th decade. There was no scoliosis associated with spondylolysis or the post-laminofacetectomy period. Disc space narrowing and corporal spur formation were not seen till the end of 3rd decade comparatively speaking, the corporal spurs generated in the non-scoliotic spine were smaller than those in the scoliotic spine. DISH began to appear in the 5th-decade patients and its incidences increased gradually afterward. Porosis-related vertebral body collapse started to happen after 6th decade. There are three different types of spondylolisthesis: anterior, posterior, and lateral. The lateral slip occurred only in the scoliotic spine. All types were related to degenerative discs. CONCLUSIONS: It has been shown that the morphology of the lumbar spine changes throughout time.

Revisiting a Time of Study: Older Adults Learning Through Grieving.

A brief reflection of encountering four older adult women who claimed self-transformation through learning in late life grief.

A Sample Size Extractor for RCT Reports.

Sample size is an important indicator of the power of randomized controlled trials (RCTs). In this paper, we designed a total sample size extractor using a combination of syntactic and machine learning methods, and evaluated it on 300 Covid-19 abstracts (Covid-Set) and 100 generic RCT abstracts (General-Set). To improve the performance, we applied transfer learning from a large public corpus of annotated abstracts. We achieved an average F1 score of 0.73 on the Covid-Set testing set, and 0.60 on the General-Set using exact matches. The F1 scores for loose matches on both datasets were over 0.74. Compared with the state-of-the-art tool, our extractor reports total sample sizes directly and improved F1 scores by at least 4% without transfer learning. We demonstrated that transfer learning improved the sample size extraction accuracy and minimized human labor on annotations.

Hospice Admission Assessment.

Hospice admission assessment is a pivotal encounter for patient/family and hospice representative. For patient/family, the admission is the threshold by which a particular level of care can commence and, symbolically, a certain marker in health status trajectory is reached. For hospice representative, the admission episode is an occasion to inaugurate an ambience that can serve to frame future hospice care experiences for the patient/family. Through a narrative lens, hospice admission assessment can be seen as experiential time and space, where patient's and family's stories are mindfully and deliberately witnessed and explored. Through the practice of narrative mining, the hospice representative can better understand others' offered stories of reality, which will better inform the plan of palliation and hospice care.

Anticipatory Grief: A Mere Concept?

Anticipatory grief (AG) has been studied, debated, and written about for several decades. This type of grief is also recognized in hospice and palliative care (HPC). The question, however, is whether the reality of AG is sufficiently upheld by professionals at the point of concrete service delivery. In other words, is AG a mere concept or is everyday practice of HPC duly informed of AG as evidenced by the resulting care delivery?

When ab ≠ c - c': published errors in the reports of single-mediator models.

Accurate reports of mediation analyses are critical to the assessment of inferences related to causality, since these inferences are consequential for both the evaluation of previous research (e.g., meta-analyses) and the progression of future research. However, upon reexamination, approximately 15% of published articles in psychology contain at least one incorrect statistical conclusion (Bakker & Wicherts, Behavior research methods, 43, 666-678 2011), disparities that beget the question of inaccuracy in mediation reports. To quantify this question of inaccuracy, articles reporting standard use of single-mediator models in three high-impact journals in personality and social psychology during 2011 were examined. More than 24% of the 156 models coded failed an equivalence test (i.e., ab = c - c'), suggesting that one or more regression coefficients in mediation analyses are frequently misreported. The authors cite common sources of errors, provide recommendations for enhanced accuracy in reports of single-mediator models, and discuss implications for alternative methods.

Waking.

An indubitable aspect of laboring in the realm of hospice care is the "everydayness" of human loss or the stark encounter of death in the human experience. This can pose as opportunity to adopt each day in a particular manner. As such, the focus of my reflection is on transposing certain dynamics of a (funeral) wake to broader professional and personal socioexistential processes.

Grief and palliative care: mutuality.

Grief and palliative care are interrelated and perhaps mutually inclusive. Conceptually and practically, grief intimately relates to palliative care, as both domains regard the phenomena of loss, suffering, and a desire for abatement of pain burden. Moreover, the notions of palliative care and grief may be construed as being mutually inclusive in terms of one cueing the other. As such, the discussions in this article will center on the conceptualizations of the mutuality between grief and palliative care related to end-of-life circumstances. Specifically, the complementarity of grief and palliative care, as well as a controvertible view thereof, will be considered.

Untaming grief ? For palliative care physicians.

Little doubt (if any) remains as to the assured importance of physicians possessing praxis regarding psychosocial issues, including grief dynamics, in order to tend to dying and sorrowing people. It stands to reason then that palliative care physicians become knowledgeable enough about the phenomenon of grief. But imperative nuances must also be considered: what sort of knowledge on grief, as well as how much of such knowledge, is enough? This article poses topical queries on the importance of the palliative care physician exercising a deliberate agenda to persistently refine one's personal framework or beliefs regarding grief. In doing so, it is proposed physicians will engender improved self-knowledge, which will serve to better poise themselves toward being with and purposefully encountering aggrieved others.

Making explicit the contention in hospice care.

At the core of hospice remains the defining nature of mortals tending to other mortals facing diagnosed terminality. Such situations are pregnant with meanings. As mortals are subjective beings, social engagements become inundated with meaning differences. This alludes to the inescapable occurrence of collisions and conflicts in meaning. It would behoove us to make explicit the contention that exists in hospice care, given that death is the nonnegotiable outcome to be diversely faced by all involved persons whose lived approaches related to death issues may characteristically lack unanimity. Toward elucidating the inherently contentious nature of hospice care, the dynamical influence of external forces that overlie thanatological matters in society and the complex human dynamic in hospice care situations are discussed. Practice suggestions for hospice staff are offered.

Death-talks: transformative learning for physicians.

Conversations between physicians and their patients concerning terminal conditions are undoubtedly an uneasy process. These conversations are referred in this article as death-talks. Death-talks are social engagements among meaning-making human beings, and such encounters comprise complex grief dynamics as well as opportunities for personal insight. Towards preparing for and improving upon such sensitive and crucial talks, physicians must become growingly informed of their own existential standpoints in order to exude a more authentic presence. Transformative Learning is a theory of adult learning offering a rationale for physicians to exercise critically reflexive learning towards formulating a more meaningful medical and human care for those who are dying and their grieving relations.