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https://www.readbyqxmd.com/read/28634769/decision-making-capacity-and-unusual-beliefs-two-contentious-cases-australasian-association-of-bioethics-and-health-law-john-mcphee-law-student-essay-prize-2016
#1
Brent Hyslop
Decision-making capacity is a vital concept in law, ethics, and clinical practice. Two legal cases where capacity literally had life and death significance are NHS Trust v Ms T [2004] and Kings College Hospital v C [2015]. These cases share another feature: unusual beliefs. This essay will critically assess the concept of capacity, particularly in relation to the unusual beliefs in these cases. Firstly, the interface between capacity and unusual beliefs will be examined. This will show that the "using and weighing of information" is the pivotal element in assessment...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28634455/fertilizing-a-patient-engagement-ecosystem-to-innovate-healthcare-toward-the-first-italian-consensus-conference-on-patient-engagement
#2
Guendalina Graffigna, Serena Barello, Giuseppe Riva, Mariarosaria Savarese, Julia Menichetti, Gianluca Castelnuovo, Massimo Corbo, Alessandra Tzannis, Antonio Aglione, Donato Bettega, Anna Bertoni, Sarah Bigi, Daniela Bruttomesso, Claudia Carzaniga, Laura Del Campo, Silvia Donato, Silvia Gilardi, Chiara Guglielmetti, Michele Gulizia, Mara Lastretti, Valeria Mastrilli, Antonino Mazzone, Giovanni Muttillo, Silvia Ostuzzi, Gianluca Perseghin, Natalia Piana, Giuliana Pitacco, Gianluca Polvani, Massimo Pozzi, Livio Provenzi, Giulia Quaglini, Mariagrazia Rossi, Paola Varese, Natalia Visalli, Elena Vegni, Walter Ricciardi, A Claudio Bosio
Currently we observe a gap between theory and practices of patient engagement. If both scholars and health practitioners do agree on the urgency to realize patient engagement, no shared guidelines exist so far to orient clinical practice. Despite a supportive policy context, progress to achieve greater patient engagement is patchy and slow and often concentrated at the level of policy regulation without dialoguing with practitioners from the clinical field as well as patients and families. Though individual clinicians, care teams and health organizations may be interested and deeply committed to engage patients and family members in the medical course, they may lack clarity about how to achieve this goal...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28633647/meeting-the-oral-health-needs-of-12-year-olds-in-china-human-resources-for-oral-health
#3
Xiangyu Sun, Eduardo Bernabé, Xuenan Liu, Shuguo Zheng, Jennifer E Gallagher
BACKGROUND: An appropriate level of human resources for oral health [HROH] is required to meet the oral health needs of population, and enable maximum improvement in health outcomes. The aim of this study was to estimate the required HROH to meet the oral health needs of the World Health Organization [WHO] reference group of 12-year-olds in China and consider the implications for education, practice, policy and HROH nationally. METHODS: We estimated the need of HROH to meet the needs of 12-year-olds based on secondary analysis of the epidemiological and questionnaire data from the 3rd Chinese National Oral Health Survey, including caries experience and periodontal factors (calculus), dentally-related behaviour (frequency of toothbrushing and sugar intake), and social factors (parental education)...
June 20, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28633456/feeding-during-dialysis-risks-and-uncertainties
#4
Rajiv Agarwal, Panagiotis Georgianos
Allowing dialysis patients to eat during the treatment is controversial. It is, therefore, no surprise that practices and policies with respect to intradialytic food consumption vary considerably from unit to unit and from country to country. Those who defend the position of feeding during dialysis reason that intradialytic meals offer a supervised and effective therapy for protein-energy wasting. Those who take the opposite view argue that intradialytic food intake should be avoided for the following three reasons...
June 19, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28629871/a-review-of-patterns-of-practice-and-clinical-guidelines-in-the-palliative-radiation-treatment-of-uncomplicated-bone-metastases
#5
REVIEW
Vithusha Ganesh, Stephanie Chan, Srinivas Raman, Ronald Chow, Peter Hoskin, Henry Lam, Bo Angela Wan, Leah Drost, Carlo DeAngelis, Edward Chow
BACKGROUND AND PURPOSE: Single fraction radiation treatment (SFRT) is recommended for its equivalence to multiple-fraction (MF) RT in the palliation of uncomplicated bone metastases (BM). However, adoption of SFRT has been slow. MATERIALS AND METHODS: Literature searches for studies published following 2014 were conducted using online repositories of gray literature, Ovid MEDLINE, Embase and Embase Classic, and the Cochrane Central Register of Controlled Trials databases...
June 16, 2017: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
https://www.readbyqxmd.com/read/28629428/study-protocol-evaluation-of-an-online-father-inclusive-universal-parenting-intervention-to-reduce-child-externalising-behaviours-and-improve-parenting-practices
#6
Lucy A Tully, Patrycja J Piotrowska, Daniel A J Collins, Kathleen S Mairet, David J Hawes, Eva R Kimonis, Rhoshel K Lenroot, Caroline Moul, Vicki Anderson, Paul J Frick, Mark R Dadds
BACKGROUND: Parenting interventions that focus on enhancing the quality and consistency of parenting are effective for preventing and reducing externalising problems in children. There has been a recent shift towards online delivery of parenting interventions in order to increase their reach and impact on the population prevalence of child externalising problems. Parenting interventions have low rates of father participation yet research suggests that father involvement may be critical to the success of the intervention...
June 19, 2017: BMC Psychology
https://www.readbyqxmd.com/read/28629403/factors-influencing-professional-life-satisfaction-among-neurologists
#7
Stephanie M Teixeira-Poit, Michael T Halpern, Heather L Kane, Michael Keating, Murrey Olmsted
BACKGROUND: Predicted shortages in the supply of neurologists may limit patients' access to and quality of care for neurological disorders. Retaining neurologists already in practice provides one opportunity to support the overall supply of practicing neurologists. Understanding factors associated with professional life satisfaction (and dissatisfaction) and implementing policies to enhance satisfaction may encourage neurologists to remain in clinical practice. In this paper, we present results from the first study examining factors associated with professional life satisfaction among a large sample of U...
June 19, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28628660/systematic-review-of-emergency-medicine-clinical-practice-guidelines-implications-for-research-and-policy
#8
Arjun K Venkatesh, Dan Savage, Benjamin Sandefur, Kenneth R Bernard, Craig Rothenberg, Jeremiah D Schuur
INTRODUCTION: Over 25 years, emergency medicine in the United States has amassed a large evidence base that has been systematically assessed and interpreted through ACEP Clinical Policies. While not previously studied in emergency medicine, prior work has shown that nearly half of all recommendations in medical specialty practice guidelines may be based on limited or inconclusive evidence. We sought to describe the proportion of clinical practice guideline recommendations in Emergency Medicine that are based upon expert opinion and low level evidence...
2017: PloS One
https://www.readbyqxmd.com/read/28623923/making-hiv-testing-work-at-the-point-of-care-in-south-africa-a-qualitative-study-of-diagnostic-practices
#9
Nora Engel, Malika Davids, Nadine Blankvoort, Keertan Dheda, Nitika Pant Pai, Madhukar Pai
BACKGROUND: Point of care testing promises to reduce delays in diagnosing and initiating treatment for infectious diseases such as Human Immuno-deficiency Virus (HIV). In South Africa, decentralized HIV testing with rapid tests offers important lessons for point of care testing programs. Yet, little is known about the strategies of providers and clients to make HIV testing successful in settings short of equipment, human resources and space. We aimed at examining these strategies. METHODS: This paper is based on a larger qualitative study of diagnostic practices across major diseases and actors in homes, clinics, communities, hospitals and laboratories in South Africa...
June 17, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28623161/the-genetics-of-ischemic-heart-disease-from-current-knowledge-to-clinical-implications
#10
Roberto Elosua, Sergi Sayols-Baixeras
Ischemic heart disease continues to cause high morbidity and mortality. Its prevalence is expected to increase due to population aging, and its prevention is a major goal of health policies. The risk of developing ischemic heart disease is related to a complex interplay between genetic, environmental, and lifestyle factors. In the last decade, considerable progress has been made in knowledge of the genetic architecture of this disease. This narrative review provides an overview of current knowledge of the genetics of ischemic heart disease and of its translation to clinical practice: identification of new therapeutic targets, assessment of the causal relationship between biomarkers and disease, improved risk prediction, and identification of responders and nonresponders to specific drugs (pharmacogenomics)...
June 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28621017/overview-of-systematic-reviews-effective-home-support-in-dementia-care-components-and-impacts-stage-1-psychosocial-interventions-for-dementia
#11
REVIEW
Paul Clarkson, Jane Hughes, Chengqiu Xie, Matthew Larbey, Brenda Roe, Clarissa M Giebel, David Jolley, David Challis
AIM: To synthesise evidence to identify the components of effective psychosocial interventions in dementia care to inform clinical practice, policy and research. BACKGROUND: With population ageing dementia represents a significant care challenge with 60% of people with dementia living at home. DESIGN: Overview of systematic reviews with narrative summary. DATA SOURCES: Electronic searches of published systematic reviews in English using Cochrane Database of Systematic Reviews, DARE, EPPI-Centre, between September 2013 - April 2014...
June 16, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28620503/general-practice-views-of-managing-childhood-obesity-in-primary-care-a-qualitative-analysis
#12
Jennifer E O'Donnell, Rachel Foskett-Tharby, Paramjit S Gill
OBJECTIVE: To explore general practice staff views of managing childhood obesity in primary care. DESIGN: A qualitative study to elicit the views of clinical and non-clinical general practice staff on managing childhood obesity. SETTING: Interviews were conducted at 30 general practices across England. These practices were interviewed as part of the Quality and Outcomes Framework Pilot Study. PARTICIPANTS: A total of 52 staff from 30 practices took part in a semi-structured interview...
June 2017: JRSM Open
https://www.readbyqxmd.com/read/28619025/evaluating-the-effectiveness-of-a-healthy-lifestyle-clinician-in-addressing-the-chronic-disease-risk-behaviours-of-community-mental-health-clients-study-protocol-for-a-randomised-controlled-trial
#13
Caitlin Fehily, Kate Bartlem, John Wiggers, Paula Wye, Richard Clancy, David Castle, Sonia Wutzke, Chris Rissel, Andrew Wilson, Paul McCombie, Fionna Murphy, Jenny Bowman
BACKGROUND: People with a mental illness experience a greater morbidity and mortality from chronic diseases relative to the general population. A higher prevalence of modifiable health risk behaviours such as smoking, poor nutrition, physical inactivity and harmful alcohol consumption contribute substantially to this disparity. Despite clinical practice guidelines recommending that mental health services routinely provide care to address these risk behaviours, the provision of such care is consistently reported to be low internationally and in Australia...
June 15, 2017: Trials
https://www.readbyqxmd.com/read/28618902/secondary-prevention-where-we-are
#14
Ugo Corrà, Massimo F Piepoli
The Sixth Joint Task Force of the European Society of Cardiology (ESC) and Other Societies on Cardiovascular Disease Prevention in Clinical Practice Guidelines have been published in 2016: greater emphasis has been placed on a population-based approach, on disease-specific interventions and on female-specific conditions, younger individuals and ethnic minorities. The ESC guidelines underscore that a lifetime approach to cardiovascular risk is important as both risk and prevention are dynamic and continuous...
June 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28618868/appropriate-use-criteria-for-hyaluronic-acid-in-the-treatment-of-knee-osteoarthritis-in-the-united-states
#15
Arup K Bhadra, Roy Altman, Vinod Dasa, Karen Myrick, Jeffrey Rosen, Vijay Vad, Peter Vitanzo, Michelle Bruno, Hillary Kleiner, Caryn Just
OBJECTIVE: A workgroup of clinical experts has developed an Appropriate Use Criteria (AUC) for the use of hyaluronic acid (HA) in the treatment of osteoarthritis (OA) of the knee. The increasingly broad and varied use of HA injections, lack of published clinical guidance, and limited coverage for their use has created the imperative to establish appropriateness criteria. METHODS: The experts of this workgroup represent rheumatology, orthopedic surgery, physiatry, sports medicine, and nursing clinicians with substantive knowledge of intra-articular HA therapy...
July 2017: Cartilage
https://www.readbyqxmd.com/read/28614077/structure-operation-and-experience-of-clinical-ethics-consultation-2007-2013-a-report-from-the-massachusetts-general-hospital-optimum-care-committee
#16
Ellen M Robinson, Wendy Cage, Kimberly Erler, Sharon Brackett, Julia Bandini, Alexandra Cist, M Cornelia Cremens, Eric L Krakauer, Andrew Courtwright
We describe the structure, operation, and experience of the Massachusetts General Hospital ethics committee, formally called the Edwin H. Cassem Optimum Care Committee, from January 2007 through December 2013. Founded in 1974 as one of the nation's first hospital ethics committees, this committee has primarily focused on the optimum use of life-sustaining treatments. We outline specific sociodemographic and clinical characteristics of consult patients during this period, demographic differences between the adult inpatient population and patients for whom the ethics committee was consulted, and salient features of the consults themselves...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28610738/blood-pressure-and-blood-sugar-assessment-by-recent-dental-school-graduates
#17
Michael N Hatton, Heather Orom, Patrick L Anders
OBJECTIVE: Recent dental school graduates' willingness to assess blood pressure and blood sugar in practice is positively influenced by having a workplace policy fostering these assessments. Negative influences toward these assessments include practice culture issues and time management concerns. The aim of this study was to determine whether 2010-2014 graduates of the School of Dental Medicine at Buffalo, NY (UB-SDM) continue to assess blood pressure and capillary blood sugar after graduation...
July 2017: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
https://www.readbyqxmd.com/read/28605124/developing-abilities-to-navigate-through-the-grey-zones-in-complex-environments-nurses-reasons-for-applying-to-a-clinical-ethics-residency-for-nurses
#18
Martha Jurchak, Pamela J Grace, Susan M Lee, Danny G Willis, Angelika A Zollfrank, Ellen M Robinson
BACKGROUND AND PURPOSE: Nurses face complex ethical issues in practice and have to determine appropriate actions. An inability to conceptualize or follow a preferred course of action can give rise to moral uncertainty or moral distress. Both moral uncertainty and moral distress are problematic for nurses and their patients. A program designed to increase nurse confidence in moral decision making, the clinical ethics residency for nurses (CERN), was offered selectively to nurses affiliated with two academic medical centers...
June 12, 2017: Journal of Nursing Scholarship
https://www.readbyqxmd.com/read/28604252/surrogate-mother-praiseworthy-or-stigmatized-a-qualitative-study-on-perceptions-of-surrogacy-in-assam-india
#19
Anna Arvidsson, Polly Vauquline, Sara Johnsdotter, Birgitta Essén
BACKGROUND: Surrogacy is a reproductive practice that has been strongly marketed in India as a solution for childless couples. As a result, the number of surrogacy clinics is increasing. Meanwhile, a global discourse on surrogacy, originating from a Western perspective, has characterized surrogacy as being exploitative of women in low-income settings, where poverty drives them to become surrogate mothers. OBJECTIVE: This study explored perspectives on surrogacy from men and women in Assam, an Indian state known to be a low-income setting...
2017: Global Health Action
https://www.readbyqxmd.com/read/28604232/barriers-and-facilitators-influencing-death-at-home-a-meta-ethnography
#20
Abdul Samad Wahid, Meelad Sayma, Shiraz Jamshaid, Doa'a Kerwat, Folashade Oyewole, Dina Saleh, Aaniya Ahmed, Benita Cox, Claire Perry, Sheila Payne
BACKGROUND: In many countries, achieving a home death represents a successful outcome from both a patient welfare and commissioning viewpoint. Significant variation exists in the proportion of home deaths achieved internationally, with many countries unable to meet the wishes of a large number of patients. This review builds on previous literature investigating factors influencing home death, synthesising qualitative research to supplement evidence that quantitative research in this field may have been unable to reach...
June 1, 2017: Palliative Medicine
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