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Background. This article presents the results of a pilot study investigating patients' satisfaction thresholds for pharmacological outcomes versus surgical outcomes. Materials and methods. A total of 150 participants were presented with two hypothetical scenarios depicting either pharmacological therapy or surgical interventions. Each scenario described a potential outcome, from a 10% clinical improvement (value 10) to a 100% clinical improvement (value 100) and asked participants to indicate the satisfactory level they would find acceptable. Conclusions. The results revealed distinct patterns in satisfaction thresholds between the two treatment modalities. Between the 150 participants, 52,7% were male and 47,3% female. We also identified a total of 28,8% whom were healthcare workers. Overall, the results for the pharmacological therapy outcomes observed a mean of 60,88 with a standard deviation of 22,77, a median of 60 and a mode of 70; while for the surgical outcomes the mean was 67,81 with a standard deviation of 23,03, the median 85 and the mode 80. We also observed that for the pharmacological therapy outcomes healthcare workers had a lower satisfactory cut off compared to non-healthcare workers. Another interesting finding was that for pharmacological therapy outcomes individuals under 50 y/o had a higher satisfactory cut off compared to individuals over 50 y/o, while for the surgical outcomes we got opposite results. Overall, the findings of this pilot study, even if limited, demonstrated higher minimum satisfaction expectations for surgical outcomes compared to pharmacological therapy outcomes. Specifically, participants tended to require more favorable results and outcomes from surgical interventions to meet their minimum satisfaction criteria. [ABSTRACT FROM AUTHOR]

Background. In Italy, the law n. 219/2017 regarding informed consent states that "Communication time between doctor and patient constitutes treatment time". Legal guardian is designated as a proxy to consent on the child's behalf. The issue of proxy informed consent should be approached with a model for parent-child decision-making that is participatory, collaborative, respects and supports the autonomy of child by recognizing their evolving capacities. We aim to assess the informed consent related to healthcare decisions for medically fragile child, using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). Materials and Methods. An observational study has been conducted at a Child Neuropsychiatry Service, administering a semi-structured interview with customized questionnaire to examine their capacities in four areas of the MacCAT-T. Results were evaluated with the Pearson correlation coefficient for the cognitive and adaptive levels of the Wechsler-Intelligence-Scale-for-Children (WISC-IV) and the Vineland-Adaptive-Behavior-Scales-II (VABS-II). Conclusions. The MacCAT-T domains Understanding, Appreciation, Reasoning, Expressing a Choice were correlated with the cognitive and adaptive levels of the WISC-IV and the VABS-II. Understanding, Appreciation and Expressing a choice have positive correlation with the Communication and Socialization scores of VABS-II; Reasoning has positive correlation with the Working-Memory-Index scores of the WISC-IV. The study enabled to assess the informed consent processes in vulnerable children and although demonstrating how they participate in their care process in a mostly unconscious way, making the frail children more involved in their own care process was possible. Future studies should assess the impact of incorporating MacCAT-T into standard informed consent in other settings. [ABSTRACT FROM AUTHOR]

Background: Ultrashort perfluoroalkyl substances (UsPFAS), characterized by carbon chain lengths of 2 to 4 atoms, represent a distinct subgroup within the broader PFAS class of chemicals. Despite their lower molecular weight, ultrashort PFAS have gained significant attention due to their widespread presence. This article provides a comprehensive review of the topic., Methods: We analyzed 33 articles published between 2017 and 2024 found on Pubmed using "ultrashort PFAS" as keyword. We compared: 1- environmental matrices in which ultrashort PFAS were found, 2- different distribution patterns, 3- degradation pathways, to better understand whether they may resemble longer-chain PFAS, which are known for their bioaccumulation and persistence as "forever chemicals"., Conclusions: The occurrence of ultrashort PFAS has been documented in different environmental matrices (including surface waters, waste waters, precipitations, sediments, soils, and also human serum and urine) indicating widespread environmental exposure. Advanced analytical techniques, such as liquid chromatography-tandem mass spectrometry (LC-MS/MS) and gas chromatography-mass spectrometry (GC-MS), have enabled the sensitive detection and quantification of these compounds at trace levels. Studies keep finding new ultrashort PFAS and have focused on elucidating their sources and fate pathways to better understand their behavior in natural systems. The toxicity of ultrashort PFAS remains an area of active in-vestigation. While less is known about their health effects, studies suggest potential adverse impacts on organisms and ecosystems. This underscores the importance of continued research to assess the eco-logical consequences of ultrashort PFAS exposure and bring up risk management strategies.

Background: In Italy, the law n. 219/2017 regarding informed consent states that "Communication time between doctor and patient constitutes treatment time". Legal guardian is designated as a proxy to consent on the child's behalf. The issue of proxy informed consent should be approached with a model for parent-child decision-making that is participatory, collaborative, respects and supports the autonomy of child by recognizing their evolving capacities. We aim to assess the informed consent related to healthcare decisions for medically fragile child, using the MacArthur Competence Assessment Tool for Treatment (MacCAT-T)., Materials and Methods: An observational study has been conducted at a Child Neuropsychiatry Service, administering a semi-structured interview with customized questionnaire to examine their capacities in four areas of the MacCAT-T. Results were evaluated with the Pearson correlation coefficient for the cognitive and adaptive levels of the Wechsler-Intelligence-Scale-for-Children (WISC-IV) and the Vineland-Adaptive-Behavior-Scales-II (VABS-II)., Conclusions: The MacCAT-T domains Understanding, Appreciation, Reasoning, Expressing a Choice were correlated with the cognitive and adaptive levels of the WISC-IV and the VABS-II. Understanding, Appreciation and Expressing a choice have positive correlation with the Communication and Socialization scores of VABS-II; Reasoning has positive correlation with the Working-Memory-Index scores of the WISC-IV. The study enabled to assess the informed consent processes in vulnerable children and although demonstrating how they participate in their care process in a mostly unconscious way, making the frail children more involved in their own care process was possible. Future studies should assess the impact of incorporating MacCAT-T into standard informed consent in other settings.

Background: This article presents the results of a pilot study investigating patients' satisfaction thresholds for pharmacological outcomes versus surgical outcomes., Materials and Methods.: A total of 150 participants were presented with two hypothetical scenarios depicting either pharmacological therapy or surgical interventions. Each scenario described a potential outcome, from a 10% clinical improvement (value 10) to a 100% clinical improvement (value 100) and asked participants to indicate the satisfactory level they would find acceptable., Conclusions: The results revealed distinct patterns in satisfaction thresholds between the two treatment modalities. Between the 150 participants, 52,7% were male and 47,3% female. We also identified a total of 28,8% whom were healthcare workers. Overall, the results for the pharmacological therapy outcomes observed a mean of 60,88 with a standard deviation of 22,77, a median of 60 and a mode of 70; while for the surgical outcomes the mean was 67,81 with a standard deviation of 23,03, the median 85 and the mode 80. We also observed that for the pharmacological therapy outcomes healthcare workers had a lower satisfactory cut off compared to non-healthcare workers. Another interesting finding was that for pharmacological therapy outcomes individuals under 50 y/o had a higher satisfactory cut off compared to individuals over 50 y/o, while for the surgical outcomes we got opposite results. Overall, the findings of this pilot study, even if limited, demonstrated higher minimum satisfaction expectations for surgical outcomes compared to pharmacological therapy outcomes. Specifically, participants tended to require more favorable results and outcomes from surgical interventions to meet their minimum satisfaction criteria.