Next Issue
Previous Issue

Table of Contents

J. Pers. Med., Volume 3, Issue 3 (September 2013), Pages 124-262

  • Issues are regarded as officially published after their release is announced to the table of contents alert mailing list.
  • You may sign up for e-mail alerts to receive table of contents of newly released issues.
  • PDF is the official format for papers published in both, html and pdf forms. To view the papers in pdf format, click on the "PDF Full-text" link, and use the free Adobe Readerexternal link to open them.
View options order results:
result details:
Displaying articles 1-7
Export citation of selected articles as:

Research

Jump to: Review, Other

Open AccessArticle Examining the Relationship between Choice, Therapeutic Alliance and Outcomes in Mental Health Services
J. Pers. Med. 2013, 3(3), 191-202; doi:10.3390/jpm3030191
Received: 3 July 2013 / Revised: 13 August 2013 / Accepted: 14 August 2013 / Published: 20 August 2013
Cited by 4 | PDF Full-text (416 KB) | HTML Full-text | XML Full-text
Abstract
Background: Self-determination within mental health services is increasingly recognized as an ethical imperative, but we still know little about the impact of choice on outcomes among people with severe mental illnesses. This study examines whether choice predicts outcomes and whether this relationship is
[...] Read more.
Background: Self-determination within mental health services is increasingly recognized as an ethical imperative, but we still know little about the impact of choice on outcomes among people with severe mental illnesses. This study examines whether choice predicts outcomes and whether this relationship is mediated by therapeutic alliance. Method: The study sample of 396 participants completed a survey measuring choice, therapeutic alliance, recovery, quality of life and functioning. Multivariate analyses examined choice as a predictor of outcomes, and Sobel tests assessed alliance as a mediator. Results: Choice variables predicted recovery, quality of life and perceived outcomes. Sobel tests indicated that the relationship between choice and outcome variables was mediated by therapeutic alliance. Implications: The study demonstrates that providing more choice and opportunities for collaboration within services does improve consumer outcomes. The results also show that collaboration is dependent on the quality of the relationship between the provider and consumer. Full article
Open AccessArticle Cancer Genetic Counselor Information Needs for Risk Communication: A Qualitative Evaluation of Interview Transcripts
J. Pers. Med. 2013, 3(3), 238-250; doi:10.3390/jpm3030238
Received: 9 May 2013 / Revised: 14 August 2013 / Accepted: 23 August 2013 / Published: 3 September 2013
Cited by 2 | PDF Full-text (483 KB) | HTML Full-text | XML Full-text
Abstract
Personalized medicine is a model of healthcare that is predictive, personalized, preventive and participatory (“P4 Medicine”). Genetic counselors are an ideal group to study when designing tools to support cancer P4 Medicine activities more broadly. The goal for this work was to gain
[...] Read more.
Personalized medicine is a model of healthcare that is predictive, personalized, preventive and participatory (“P4 Medicine”). Genetic counselors are an ideal group to study when designing tools to support cancer P4 Medicine activities more broadly. The goal for this work was to gain a better understanding of the information cancer genetic counselors seek from their patients to facilitate effective information exchange for discussing risk. This was an analysis of a qualitative data set from interviews of eight cancer genetic counselors, recruited from three institutions. Genetic counselors at each site were interviewed using a semi-structured, open-ended questionnaire. A selective coding approach was used to determine major themes associated with genetic counseling information needs for communicating risk. We generated a model for understanding categories of genetic counseling information needs to support risk communication activities. Common activities for risk communication included risk assessment and tailoring communication. Categories of information needs included: (a) clinical patient characteristics, (b) social and cognitive patient characteristics and (c) patient motivation and goals for the genetic counseling session. A logical next step is for this model to inform the design of software systems for pre-visit patient planning and delivering just-in-time educational information to facilitate cancer risk communication activities. Full article
Open AccessArticle A Method for Biomarker Directed Survival Prediction in Advanced Non-Small-Cell Lung Cancer Patients Treated with Carboplatin-Based Therapy
J. Pers. Med. 2013, 3(3), 251-262; doi:10.3390/jpm3030251
Received: 30 July 2013 / Revised: 27 August 2013 / Accepted: 30 August 2013 / Published: 12 September 2013
PDF Full-text (407 KB) | HTML Full-text | XML Full-text
Abstract
Platinum-based chemotherapy is a primary treatment of choice for advanced non-small-cell lung cancer (NSCLC). Analytical methods to specifically evaluate biomarkers predictive of therapeutic efficacy have not been developed. Two randomized phase III trials of carboplatin-based chemotherapy in advanced NSCLC were used for learning
[...] Read more.
Platinum-based chemotherapy is a primary treatment of choice for advanced non-small-cell lung cancer (NSCLC). Analytical methods to specifically evaluate biomarkers predictive of therapeutic efficacy have not been developed. Two randomized phase III trials of carboplatin-based chemotherapy in advanced NSCLC were used for learning and validating the predictive value of ERCC1 in situ protein levels, as measured by accurate quantitative analysis (AQUA). A novel Bayesian method was applied to identify the outcome-based threshold in the learning trial only. Overall survival (OS) was assessed by Kaplan-Meier analysis with log rank testing to determine statistical significance in the validating trial. For patients treated with gemcitabine and carboplatin, the median OS was 9.5 months (95% CI 6.7 to 11.8) for the high ERCC1 group compared to 15.6 months (95% CI 11.6 to 24.8) for the low ERCC1 group in the validation trial (log rank p-value = 0.007). The hazard ratio for low ERCC1 was 0.598 (95% CI, 0.394 to 0.908; p = 0.016) relative to high ERCC1 adjusted for age, sex, and histology. Conclusions: Patients with advanced NSCLC could be stratified into high and low ERCC1 expression groups. Patients with low levels benefited from platinum-based chemotherapy, whereas those with high levels did not. Full article
(This article belongs to the Special Issue Feature Paper 2013)

Review

Jump to: Research, Other

Open AccessReview Antisense Therapy in Neurology
J. Pers. Med. 2013, 3(3), 144-176; doi:10.3390/jpm3030144
Received: 27 May 2013 / Revised: 26 July 2013 / Accepted: 29 July 2013 / Published: 2 August 2013
Cited by 12 | PDF Full-text (911 KB) | HTML Full-text | XML Full-text
Abstract
Antisense therapy is an approach to fighting diseases using short DNA-like molecules called antisense oligonucleotides. Recently, antisense therapy has emerged as an exciting and promising strategy for the treatment of various neurodegenerative and neuromuscular disorders. Previous and ongoing pre-clinical and clinical trials have
[...] Read more.
Antisense therapy is an approach to fighting diseases using short DNA-like molecules called antisense oligonucleotides. Recently, antisense therapy has emerged as an exciting and promising strategy for the treatment of various neurodegenerative and neuromuscular disorders. Previous and ongoing pre-clinical and clinical trials have provided encouraging early results. Spinal muscular atrophy (SMA), Huntington’s disease (HD), amyotrophic lateral sclerosis (ALS), Duchenne muscular dystrophy (DMD), Fukuyama congenital muscular dystrophy (FCMD), dysferlinopathy (including limb-girdle muscular dystrophy 2B; LGMD2B, Miyoshi myopathy; MM, and distal myopathy with anterior tibial onset; DMAT), and myotonic dystrophy (DM) are all reported to be promising targets for antisense therapy. This paper focuses on the current progress of antisense therapies in neurology. Full article
Open AccessReview Effect Model Law: An Approach for the Implementation of Personalized Medicine
J. Pers. Med. 2013, 3(3), 177-190; doi:10.3390/jpm3030177
Received: 12 July 2013 / Revised: 31 July 2013 / Accepted: 9 August 2013 / Published: 15 August 2013
Cited by 2 | PDF Full-text (648 KB) | HTML Full-text | XML Full-text
Abstract
The effect model law states that a natural relationship exists between the frequency (observation) or the probability (prediction) of a morbid event without any treatment and the frequency or probability of the same event with a treatment. This relationship is called the effect
[...] Read more.
The effect model law states that a natural relationship exists between the frequency (observation) or the probability (prediction) of a morbid event without any treatment and the frequency or probability of the same event with a treatment. This relationship is called the effect model. It applies to a single individual, individuals within a population, or groups. In the latter case, frequencies or probabilities are averages of the group. The relationship is specific to a therapy, a disease or an event, and a period of observation. If one single disease is expressed through several distinct events, a treatment will be characterized by as many effect models. Empirical evidence, simulations with models of diseases and therapies and virtual populations, as well as theoretical derivation support the existence of the law. The effect model could be estimated through statistical fitting or mathematical modelling. It enables the prediction of the (absolute) benefit of a treatment for a given patient. It thus constitutes the theoretical basis for the design of practical tools for personalized medicine. Full article

Other

Jump to: Research, Review

Open AccessOpinion “Just Caring”: Can We Afford the Ethical and Economic Costs of Circumventing Cancer Drug Resistance?
J. Pers. Med. 2013, 3(3), 124-143; doi:10.3390/jpm3030124
Received: 13 May 2013 / Revised: 7 July 2013 / Accepted: 9 July 2013 / Published: 16 July 2013
Cited by 2 | PDF Full-text (405 KB) | HTML Full-text | XML Full-text
Abstract
Personalized medicine has been presented in public and professional contexts in excessively optimistic tones. In the area of cancer what has become clear is the extraordinary heterogeneity and resilience of tumors in the face of numerous targeted therapies. This is the problem of
[...] Read more.
Personalized medicine has been presented in public and professional contexts in excessively optimistic tones. In the area of cancer what has become clear is the extraordinary heterogeneity and resilience of tumors in the face of numerous targeted therapies. This is the problem of cancer drug resistance. I summarize this problem in the first part of this essay. I then place this problem in the context of the larger political economic problem of escalating health care costs in both the EU and the US. In turn, that needs to be placed within an ethical context: How should we fairly distribute access to needed health care for an enormous range of health care needs when we have only limited resources (money) to meet virtually unlimited health care needs (cancer and everything else)? This is the problem of health care rationing. It is inescapable as a moral problem and requires a just resolution. Ultimately that resolution must be forged through a process of rational democratic deliberation. Full article
Open AccessConcept Paper Open Access Integrated Therapeutic and Diagnostic Platforms for Personalized Cardiovascular Medicine
J. Pers. Med. 2013, 3(3), 203-237; doi:10.3390/jpm3030203
Received: 22 June 2013 / Revised: 4 August 2013 / Accepted: 10 August 2013 / Published: 21 August 2013
Cited by 7 | PDF Full-text (2789 KB) | HTML Full-text | XML Full-text
Abstract
It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due
[...] Read more.
It is undeniable that the increasing costs in healthcare are a concern. Although technological advancements have been made in healthcare systems, the return on investment made by governments and payers has been poor. The current model of care is unsustainable and is due for an upgrade. In developed nations, a law of diminishing returns has been noted in population health standards, whilst in the developing world, westernized chronic illnesses, such as diabetes and cardiovascular disease have become emerging problems. The reasons for these trends are complex, multifactorial and not easily reversed. Personalized medicine has the potential to have a significant impact on these issues, but for it to be truly successful, interdisciplinary mass collaboration is required. We propose here a vision for open-access advanced analytics for personalized cardiac diagnostics using imaging, electrocardiography and genomics. Full article

Journal Contact

MDPI AG
JPM Editorial Office
St. Alban-Anlage 66, 4052 Basel, Switzerland
jpm@mdpi.com
Tel. +41 61 683 77 34
Fax: +41 61 302 89 18
Editorial Board
Contact Details Submit to JPM
Back to Top