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https://www.readbyqxmd.com/read/28444477/ethical-conflicts-in-the-treatment-of-fasting-muslim-patients-with-diabetes-during-ramadan
#1
Ilhan Ilkilic, Hakan Ertin
BACKGROUND: For an effective treatment of patients, quality-assured safe implementation of drug therapy is indispensable. Fasting during Ramadan, an essential religious practice for Muslims, affects Muslim diabetics' drug use in a number of different ways. OBJECTIVES: Ethical problems arising from fasting during the month of Ramadan for practicing Muslim patients are being discussed on the basis of extant research literature. Relevant conflicts of interest originating in this situation are being analysed from an ethical perspective...
April 25, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28444039/the-health-regionalization-process-from-the-perspective-of-the-transation-cost-theory
#2
Leyla Gomes Sancho, Daniela Savi Geremia, Sulamis Dain, Fabiano Geremia, Cláudio José Silva Leão
This study analyzes the incidence of transaction costs in the regionalization process of health policies in the Brazilian federal system. In this work, regionalized health actions contracted and agreed between federal agencies have assumed a transactional nature. A conceptual theoretical essay of reflective nature was prepared with the purpose of questioning and proposing new approaches to improve the health regionalization process. The main considerations suggest that institutional management tools proposed by the standards and regulations of the Unified Health System have a low potential to reduce transaction costs, especially due to hardships in reconciling common goals among the entities, environment surrounded by uncertainty, asymmetries and incomplete information, bounded rationality and conflict of interest...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444005/promoting-and-regulating-generic-medicines-brazil-in-comparative-perspective
#3
Elize Massard da Fonseca, Kenneth C Shadlen
Promoting the use of generic drugs can constitute a core instrument for countries' national pharmaceutical policies, one that reduces drug expenditure while expanding health care access. Despite the potential importance of such policy measures and the differences among national practices, scholars embarking on comparative analysis lack a roadmap for determining which dimensions of generic drug policy to assess and compare. This report fills that gap by considering national rules and regulations across four dimensions deemed crucial to any evaluation: demonstrated therapeutic equivalence; pharmaceutical packaging and labeling; drug prescription; and drug substitution...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28438177/responding-to-non-communicable-diseases-in-zambia-a-policy-analysis
#4
Mulenga M Mukanu, Joseph Mumba Zulu, Chrispin Mweemba, Wilbroad Mutale
BACKGROUND: Non-communicable diseases (NCDs) are an emerging global health concern. Reports have shown that, in Zambia, NCDs are also an emerging problem and the government has begun initiating a policy response. The present study explores the policy response to NCDs by the Ministry of Health in Zambia using the policy triangle framework of Walt and Gilson. METHODS: A qualitative approach was used for the study. Data collected through key informant interviews with stakeholders who were involved in the NCD health policy development process as well as review of key planning and policy documents were analysed using thematic analysis...
April 24, 2017: Health Research Policy and Systems
https://www.readbyqxmd.com/read/28437564/conflicts-of-interest-issues-response-to-lucas-et-al
#5
Niels Lynøe, Göran Elinder, Boubou Hallberg, Måns Rosén, Pia Sundgren, Anders Eriksson
Lucas et al (1) maintain that there were substantial flaws in the way our review on shaken baby syndrome (2) was conducted and in our choice of research focus. They suggest that the reason for these major shortcomings was that the expert panel lacked clinicians and scientists with deep knowledge in the research area. This article is protected by copyright. All rights reserved.
April 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#6
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28437174/more-than-fever-thermoregulatory-responses-to-immunological-stimulation-and-consequences-of-thermoregulatory-strategy-on-innate-immunity-in-gopher-tortoises-gopherus-polyphemus
#7
Jeffrey M Goessling, Craig Guyer, Mary T Mendonça
Organisms possess a range of thermoregulatory strategies that may vary in response to sickness, thereby driving important life-history consequences. Because the immune system is vital to maintaining organism function, understanding the suite of immune responses to infection indicates basic costs and benefits of physiological strategies. Here, we assessed consequences of thermoregulation and seasonality on immune function in both immunologically stimulated and nonstimulated gopher tortoises (Gopherus polyphemus)...
July 2017: Physiological and Biochemical Zoology: PBZ
https://www.readbyqxmd.com/read/28434183/impacts-of-forestry-on-boreal-forests-an-ecosystem-services-perspective
#8
REVIEW
Tähti Pohjanmies, María Triviño, Eric Le Tortorec, Adriano Mazziotta, Tord Snäll, Mikko Mönkkönen
Forests are widely recognized as major providers of ecosystem services, including timber, other forest products, recreation, regulation of water, soil and air quality, and climate change mitigation. Extensive tracts of boreal forests are actively managed for timber production, but actions aimed at increasing timber yields also affect other forest functions and services. Here, we present an overview of the environmental impacts of forest management from the perspective of ecosystem services. We show how prevailing forestry practices may have substantial but diverse effects on the various ecosystem services provided by boreal forests...
April 22, 2017: Ambio
https://www.readbyqxmd.com/read/28433757/surgical-volunteerism-or-voluntourism-are-we-doing-more-harm-than-good
#9
EDITORIAL
Faheem Ahmed, Madeline Grade, Carl Malm, Sophia Michelen, Na'eem Ahmed
The significant rise in the number of international health electives undertaken by medical students and doctors in the US, Canada and UK reflects acknowledgement of the inter-connected nature of these challenges to health systems and the drive to help solve them. However, the next generation of international volunteers often operate under a conflicting duality: whilst many of their role models have devoted their lives to global health following a similar volunteering experience, there are pervasive ethical problems associated with short-term global health work that must be identified and addressed to ensure positive outcomes for all parties involved...
April 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28431546/health-care-public-reporting-utilization-user-clusters-web-trails-and-usage-barriers-on-germany-s-public-reporting-portal-weisse-liste-de
#10
Christoph Pross, Lars-Henrik Averdunk, Josip Stjepanovic, Reinhard Busse, Alexander Geissler
BACKGROUND: Quality of care public reporting provides structural, process and outcome information to facilitate hospital choice and strengthen quality competition. Yet, evidence indicates that patients rarely use this information in their decision-making, due to limited awareness of the data and complex and conflicting information. While there is enthusiasm among policy makers for public reporting, clinicians and researchers doubt its overall impact. Almost no study has analyzed how users behave on public reporting portals, which information they seek out and when they abort their search...
April 21, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28431190/higher-levels-of-submissive-behaviors-at-the-onset-of-the-pairing-process-of-rhesus-macaques-macaca-mulatta-are-associated-with-lower-risk-of-wounding-following-introduction
#11
Ori Pomerantz, Kate C Baker
Social housing of rhesus macaques (Macaca mulatta) is considered to be the cornerstone of behavioral management programs in biomedical facilities. However, it also involves the risk of socially inflicted trauma. The ability to avoid such trauma would contribute to the animals' well-being and alleviate staff's concerns, thus paving the path for more introductions. Here, we sought to address the conflict between the need to socially house rhesus macaques and the need to bring social wounding to a minimum by identifying behaviors expressed early in social introductions, that may serve as predictors of later wounding events...
April 21, 2017: American Journal of Primatology
https://www.readbyqxmd.com/read/28431025/1h-magnetic-resonance-spectroscopy-of-live-human-sperm
#12
S Reynolds, S J Calvert, M N Paley, A A Pacey
STUDY QUESTION: Can 1H Magnetic Resonance Spectroscopy (MRS) be used to obtain information about the molecules and metabolites in live human spermatozoa? SUMMARY ANSWER: Percoll-based density gradient centrifugation (DGC) followed by a further two washing steps, yielded enough sperm with minimal contamination (<0.01%) from seminal fluid to permit effective MRS which detected significant differences (p < 0.05) in the choline/glycerophosphocholine, lipid and lactate regions of the 1H MRS spectrum between sperm in the pellet and those from the 40/80% interface...
April 18, 2017: Molecular Human Reproduction
https://www.readbyqxmd.com/read/28430068/caring-for-patients-or-organs-new-therapies-raise-new-dilemmas-in-the-emergency-department
#13
Arjun Prabhu, Lisa S Parker, Michael A DeVita
Two potentially lifesaving protocols, emergency preservation and resuscitation (EPR) and uncontrolled donation after circulatory determination of death (uDCDD), currently implemented in some U.S. emergency departments (EDs), have similar eligibility criteria and initial technical procedures, but critically different goals. Both follow unsuccessful cardiopulmonary resuscitation and induce hypothermia to "buy time": one in trauma patients suffering cardiac arrest, to enable surgical repair, and the other in patients who unexpectedly die in the ED, to enable organ donation...
May 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28428815/service-user-and-care-giver-involvement-in-mental-health-system-strengthening-in-nepal-a-qualitative-study-on-barriers-and-facilitating-factors
#14
Dristy Gurung, Nawaraj Upadhyaya, Jananee Magar, Nir Prakash Giri, Charlotte Hanlon, Mark J D Jordans
BACKGROUND: Service user and caregiver involvement has become an increasingly common strategy to enhance mental health outcomes, and has been incorporated in the mental healthpolicies of many developed nations. However, this practice is non-existent or fragmented in low and middle income countries (LMICs). Instances of service user and caregiver involvement have been rising slowly in a few LMICs, but are rarely described in the literature. Very little is known about the context of user and caregiver participation in mental health system strengthening processes in a low-income, disaster- and conflict-affected state such as Nepal...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28427509/efficacy-and-safety-of-bortezomib-thalidomide-and-lenalidomide-in-multiple-myeloma-an-overview-of-systematic-reviews-with-meta-analyses
#15
REVIEW
Patricia Melo Aguiar, Tácio de Mendonça Lima, Gisele Wally Braga Colleoni, Sílvia Storpirtis
This overview summarizes evidence for the efficacy and safety of bortezomib, thalidomide, and lenalidomide in patients with multiple myeloma. We searched the Medline, Scopus, and LILACS databases through August 2016, including systematic reviews with meta-analyses of randomized controlled trials assessing the efficacy and/or safety of bortezomib, thalidomide, or lenalidomide in patients with multiple myeloma. Two authors performed study selection, data extraction, and quality assessment using AMSTAR and GRADE instruments...
May 2017: Critical Reviews in Oncology/hematology
https://www.readbyqxmd.com/read/28427303/values-based-practice-a-framework-for-thinking-with
#16
Kay Mohanna
Values are those principles that govern behaviours, and values-based practice has been described as a theory and skills base for effective healthcare decision-making where different (and hence potentially conflicting) values are in play. The emphasis is on good process rather than pre-set right outcomes, aiming to achieve balanced decision-making. In this article we will consider the utility of this model by looking at leadership development, a current area of much interest and investment in healthcare. Copeland points out that 'values based leadership behaviors are styles with a moral, authentic and ethical dimension', important qualities in healthcare decision-making...
April 21, 2017: Education for Primary Care
https://www.readbyqxmd.com/read/28426697/perceived-conflict-of-interest-in-health-science-partnerships
#17
John C Besley, Aaron M McCright, Nagwan R Zahry, Kevin C Elliott, Norbert E Kaminski, Joseph D Martin
University scientists conducting research on topics of potential health concern often want to partner with a range of actors, including government entities, non-governmental organizations, and private enterprises. Such partnerships can provide access to needed resources, including funding. However, those who observe the results of such partnerships may judge those results based on who is involved. This set of studies seeks to assess how people perceive two hypothetical health science research collaborations...
2017: PloS One
https://www.readbyqxmd.com/read/28425578/survival-comparisons-of-intensive-vs-conventional-hemodialysis-pitfalls-and-lessons
#18
REVIEW
Amanda J Miller, Jeff Perl, Karthik K Tennankore
The optimal dose of hemodialysis (HD) has not yet been established. As a means of better approximating the physiology of native kidney function, there has been a growing interest in intensive HD (an increase in dialysis frequency and/or duration). Although many studies have demonstrated a survival benefit with intensive dialysis, results have been conflicting. This controversy stems from the challenges of randomizing patients to conventional vs. intensive HD modalities and, therefore, the reliance on observational comparisons that have been limited by varying definitions for intensive dialysis, differences in dialysis location and prescription, unavoidable treatment selection bias, and a potential lack of generalizability...
April 20, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28425153/nursing-students-preferences-for-clinical-placements-in-the-residential-aged-care-setting
#19
Emma Lea, Annette Marlow, Erika Altmann, Helen Courtney-Pratt
AIMS AND OBJECTIVES: To examine nursing student placement preferences submitted as online comments to a university's placement management system, to inform strategies for positive residential aged care experiences. BACKGROUND: There are predicted shortages of nurses to service an ageing population. Clinical placements undertaken by undergraduate nursing students help shape their attitudes and are a key determinant of career decision-making, yet there is little research about why students prefer particular placement areas...
April 20, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28424380/-schizotypy-detachment-or-magical-fusion
#20
János Kállai, Mária Simon, István Hartung, Béla Birkás, Róbert Herold
Nowadays, both in the clinical population, and in general communities, we tend to encounter an increasing number of personality disorder patients, whose social adjustment, partnerships and efficient life management is made difficult by the disorder. The ideas of borderline personality disorder patients, who fluctuate between farfetched expectations and fears of their selves being demolished, schizoid patients, who close their selves in their own alienating prison, avoidant patients, who try to escape difficulties, which would enhance their self-esteem, OCD patients, who build their own mythic superstitious world, and antisocial patients who tend to ignore and aggressively override others' interests are all important in the development of cultures with insecure identities...
2017: Psychiatria Hungarica: A Magyar Pszichiátriai Társaság Tudományos Folyóirata
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