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https://www.readbyqxmd.com/read/29453006/illicit-and-prescription-drug-misuse-as-reported-to-the-maine-diversion-alert-program
#1
Brian J Piper, Michael J Suarez, John P Piserchio, Dipam T Shah, Olapeju M Simoyan, Kenneth L McCall, Clare E Desrosiers, Stephanie D Nichols
BACKGROUND: The opioid epidemic is rapidly evolving and new tools are needed to combat drug abuse. The Maine Diversion Alert Program (DAP) is an informational resource that facilitates communication about drug arrests between the criminal justice and healthcare fields. The objectives of this report were to: (1) describe the illegal and prescription pharmaceuticals reported to the DAP; (2) determine if the drugs implicated in arrests changed from the first to latter half of 2016; (3) identify the demographic and other characteristics of arrestees; and (4) outline the strengths and limitations of the DAP for other areas considering implementing similar programs...
February 6, 2018: Forensic Science International
https://www.readbyqxmd.com/read/29452563/code-red-the-essential-yet-neglected-role-of-emergency-care-in-health-law-reform
#2
Shaun Ossei-Owusu
The United States' health care system is mired in uncertainty. Public opinion on the Patient Protection and Affordable Care Act ("ACA") is undeniably mixed and politicized. The individual mandate, tax subsidies, and Medicaid expansion dominate the discussion. This Article argues that the ACA and reform discourse have given short shrift to a more static problem: the law of emergency care. The Emergency Medical Treatment and Active Labor Act of 1986 ("EMTALA") requires most hospitals to screen patients for emergency medical conditions and provide stabilizing treatment regardless of patients' insurance status or ability to pay...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452562/deciphering-the-sunshine-act-transparency-regulation-and-financial-conflicts-in-health-care
#3
Richard S Saver
The Physician Payments Sunshine Act ("Sunshine Act"), enacted to address financial conflicts in health care, is the first comprehensive federal legislation mandating public reporting of payments between drug companies, device manufacturers, and medicine. This article analyzes the Sunshine Act's uneven record, exploring how the law serves as an intriguing example of the uncertain case for transparency regulation in health care. The Sunshine Act's bumpy rollout demonstrates that commanding transparency through legislation can be arduous because of considerable implementation challenges...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29452560/health-care-efficiencies-consolidation-and-alternative-models-vs-health-care-and-antitrust-regulation-irreconcilable-differences
#4
Michael W King
Despite the U.S. substantially outspending peer high income nations with almost 18% of GDP dedicated to health care, on any number of statistical measurements from life expectancy to birth rates to chronic disease, 1 the U.S. achieves inferior health outcomes. In short, Americans receive a very disappointing return on investment on their health care dollars, causing economic and social strain. 2 Accordingly, the debates rage on: what is the top driver of health care spending? Among the culprits: poor communication and coordination among disparate providers, paperwork required by payors and regulations, well-intentioned physicians overprescribing treatments, drugs and devices, outright fraud and abuse, and medical malpractice litigation...
November 2017: American Journal of Law & Medicine
https://www.readbyqxmd.com/read/29451054/physician-under-supervision-uk-medical-students-perspectives
#5
Elinor Laws, Georgina Phillips
No abstract text is available yet for this article.
February 16, 2018: Medical Teacher
https://www.readbyqxmd.com/read/29448963/academic-medical-centers-as-innovation-ecosystems-to-address-population-omics-challenges-in-precision-medicine
#6
REVIEW
Patrick J Silva, Valerie M Schaibley, Kenneth S Ramos
While the promise of the Human Genome Project provided significant insights into the structure of the human genome, the complexities of disease at the individual level have made it difficult to utilize -omic information in clinical decision making. Some of the existing constraints have been minimized by technological advancements that have reduced the cost of sequencing to a rate far in excess of Moore's Law (a halving in cost per unit output every 18 months). The reduction in sequencing costs has made it economically feasible to create large data commons capturing the diversity of disease across populations...
February 15, 2018: Journal of Translational Medicine
https://www.readbyqxmd.com/read/29446644/an-algorithm-for-managing-adults-who-refuse-medical-treatment-in-new-south-wales
#7
Kylie Cheng, Anne Wand, Christopher Ryan, Sascha Callaghan
OBJECTIVES: The assessment and management of a patient who refuses medical treatment requires clinical skill, and consideration of the relevant law and the patient's decision-making capacity. Psychiatrists are often asked to advise in these situations. We aimed to develop an algorithm describing the relevant legal pathways to assist clinicians, especially psychiatrists, working in New South Wales (NSW), Australia. METHODS: We reviewed the academic literature on treatment refusal, relevant legislation, judicial rulings and NSW Health policy directives and guidelines...
February 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29446214/new-developments-in-india-concerning-the-policy-of-passive-euthanasia
#8
Scaria Kanniyakonil
Euthanasia and assisted dying are illegal in India according to Sections 306 and 309 of the Indian Penal Code (IPC), and Article 21 of the Constitution of India. There have been a number of cases where the Indian High Courts and Indian Supreme Court issued differing verdicts concerning the right to life and the right to die. Nevertheless, on 7 March 2011, a paradigm shift happened as a result of the Indian Supreme Court's judgment on involuntary passive euthanasia in the case of Aruna Shanbaug. In its judgment, the Supreme Court requested the government to prepare a law on euthanasia...
February 15, 2018: Developing World Bioethics
https://www.readbyqxmd.com/read/29445453/the-european-falsified-medicines-directive-in-poland-background-implementation-and-potential-recommendations-for-pharmacists
#9
Piotr Merks, Damian Swieczkowski, Michal Byliniak, Mariola Drozd, Katarzyna Krupa, Milosz Jaguszewski, David A Brindley, Bernard D Naughton
By February 2019, the Polish pharmaceutical industry, community and hospital pharmacies, wholesalers and parallel traders must all comply with the EU-wide Falsified Medicines Directive (FMD) legislation (2011/62/EU), to ensure that no medicinal product is dispensed to a patient without proper tracking and authentication. Here we describe how Poland is complying with the new EU regulations, the actions that have been taken to incorporate the FMD into Polish Pharmaceutical Law and whether or not these actions are sufficient...
January 2018: European Journal of Hospital Pharmacy. Science and Practice
https://www.readbyqxmd.com/read/29444707/percutaneous-transhepatic-vs-endoscopic-retrograde-biliary-drainage-for-suspected-malignant-hilar-obstruction-study-protocol-for-a-randomized-controlled-trial
#10
Firas Al-Kawas, Harry Aslanian, John Baillie, Filip Banovac, Jonathan M Buscaglia, James Buxbaum, Amitabh Chak, Bradford Chong, Gregory A Coté, Peter V Draganov, Kulwinder Dua, Valerie Durkalski, B Joseph Elmunzer, Lydia D Foster, Timothy B Gardner, Brian S Geller, Priya Jamidar, Laith H Jamil, Rajesh N Keswani, Mouen A Khashab, Gabriel D Lang, Ryan Law, David Lichtenstein, Simon K Lo, Sean McCarthy, Silvio Melo, Daniel Mullady, Jose Nieto, J Bayne Selby, Vikesh K Singh, Rebecca L Spitzer, Brian Strife, Paul Tarnaksy, Jason R Taylor, Jeffrey Tokar, Andrew Y Wang, April Williams, Field Willingham, Patrick Yachimski
BACKGROUND: The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO). METHODS: The INTERCPT trial is a multi-center, comparative effectiveness, randomized, superiority trial of PTBD vs. ERC for decompression of suspected MHO...
February 14, 2018: Trials
https://www.readbyqxmd.com/read/29443781/unexpected-custodial-death-due-to-acute-epiglottitis-a-rare-autopsy-case-report
#11
Shifan Wu, Luo Zhuo, Xingang Qiu, Zijiao Ding, Mingzhen Yang, Meichen Pan, Qian Liu
RATIONALE: Acute epiglottitis is a potentially life-threaten disease, which makes it more challenging to save the life for doctors. Unexpected deaths in custody are a primary cause of concern for the forensic community and doctor worldwide. PATIENT CONCERNS: We present a case of a 44-year-old male detainee who was clinically suspected of dying of acute epiglottitis. The man experienced failure of resuscitation and died after admitted to a hospital. DIAGNOSES: The autopsy, toxicological testing, the test of immunoglobulin E and bacterial culture suggested the patient died of acute epiglottitis...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29443634/national-health-expenditure-projections-2017-26-despite-uncertainty-fundamentals-primarily-drive-spending-growth
#12
Gigi A Cuckler, Andrea M Sisko, John A Poisal, Sean P Keehan, Sheila D Smith, Andrew J Madison, Christian J Wolfe, James C Hardesty
Under current law, national health spending is projected to grow 5.5 percent annually on average in 2017-26 and to represent 19.7 percent of the economy in 2026. Projected national health spending and enrollment growth over the next decade is largely driven by fundamental economic and demographic factors: changes in projected income growth, increases in prices for medical goods and services, and enrollment shifts from private health insurance to Medicare that are related to the aging of the population. The recent enactment of tax legislation that eliminated the individual mandate is expected to result in only a small reduction to insurance coverage trends...
February 14, 2018: Health Affairs
https://www.readbyqxmd.com/read/29441963/do-patients-with-diabetes-type-2-or-chronic-heart-failure-understand-a-medication-plan
#13
L Botermann, A Wachter, K Monzel, K Krueger, S Ewen, F Mahfoud, N Griese-Mammen, M Schulz, U Laufs
A standardized medication plan (MP) was recently enacted into German law (§ 31a SGB V). The purpose of our study was to assess if patients with chronic diseases requiring polymedication understand the standardized MP and can transfer the given information into practice. 100 patients who took at least five medicines regularly were prospectively included in a cross-sectional study: 50 patients with the primary diagnosis chronic heart failure (CHF), and 50 with diabetes mellitus type 2 (DMT2). We performed a structured test-scenario studying the handling of a provided MP then evaluated the execution of the information on the MP by filling pill boxes and requested patients' opinion...
December 1, 2017: Die Pharmazie
https://www.readbyqxmd.com/read/29440320/left-of-bang-interventions-in-trauma-some-legal-implications-of-military-medical-prophylaxis
#14
Rain Liivoja
In the context of military medical care, Eisenstein and colleagues have introduced the notion 'left of bang intervention in trauma', which refers to interventions administered before trauma to reduce morbidity and mortality after injury. This paper responds to Eisenstein and colleagues' ethical analysis of such interventions, highlighting the difficulty in distinguishing between purely prophylactic and enhancing interventions. This response also addresses legal issues that arise from left of bang interventions under human rights law and the law of armed conflict, in particular the questions as to whether the consent of service members would need to be obtained and whether the adversary would as a consequence be authorised to resort to more injurious weapons...
February 13, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29440236/the-consequences-of-patient-charges-for-prescription-drugs-in-canada-a-cross-sectional-survey
#15
Michael R Law, Lucy Cheng, Ashra Kolhatkar, Laurie J Goldsmith, Steven G Morgan, Anne M Holbrook, Irfan A Dhalla
BACKGROUND: Many Canadians face substantial out-of-pocket charges for prescription drugs. Prior work suggests that this causes some patients to not take their medications as prescribed; however, we have little understanding of whether charges for prescription medicines lead patients to forego basic needs or to use more health care services. Our study aimed to quantify the consequences of patient charges for medicines in Canada. METHODS: As part of the 2016 Canadian Community Health Survey, we designed and fielded cross-sectional questions to 28 091 Canadians regarding prescription drug affordability, consequent use of health care services and trade-offs with other expenditures...
February 5, 2018: CMAJ Open
https://www.readbyqxmd.com/read/29440163/severity-and-management-of-postabortion-complications-among-women-in-zimbabwe-2016-a-cross-sectional-study
#16
Mugove Gerald Madziyire, Chelsea B Polis, Taylor Riley, Elizabeth A Sully, Onikepe Owolabi, Tsungai Chipato
OBJECTIVES: Abortion complications cause significant morbidity and mortality. We aimed to assess the severity and factors associated with abortion complications (induced or spontaneous), and the management of postabortion care (PAC) in Zimbabwe. DESIGN: Prospective, facility-based 28 day survey among women seeking PAC and their providers. SETTING: 127 facilities in Zimbabwe with the capacity to provide PAC, including all central and provincial hospitals, and a sample of primary health centres (30%), district/general/mission hospitals (52%), private (77%) and non-governmental organisation (NGO) (68%) facilities...
February 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29438111/comparison-of-transplant-waitlist-outcomes-for-pediatric-candidates-supported-by-ventricular-assist-devices-versus-medical-therapy
#17
Sabrina P Law, Assaf P Oron, Mariska S Kemna, Erin L Albers, D Michael McMullan, Jonathan M Chen, Yuk M Law
OBJECTIVES: Ventricular assist devices have gained popularity in the management of refractory heart failure in children listed for heart transplantation. Our primary aim was to compare the composite endpoint of all-cause pretransplant mortality and loss of transplant eligibility in children who were treated with a ventricular assist device versus a medically managed cohort. DESIGN: This was a retrospective cohort analysis. SETTINGS: Data were obtained from the Scientific Registry of Transplant Recipients...
February 12, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29436805/la-vision-des-soins-port%C3%A3-e-par-l%C3%A3-onie-chaptal%C3%A2-une-erreur-strat%C3%A3-gique-dans-le-d%C3%A3-veloppement-de-la-discipline-des-sciences-infirmi%C3%A3-res-en-france
#18
Jean-Marie Januel
The issue of the development of the discipline displayed by nursing sciences in France is crucial, especially since the Law of Modernization of the Health System has established a legal framework for advanced practice since 2016. This article presents a discussion on the important role that Léonie Chaptal has played in the development of nursing care in France, based on a purely professional vision, guaranteeing the subordination of the nurses to the medical physicians the in the spirit of the law of November 30, 1892 which had established a stranglehold of medical profession on health...
February 2, 2018: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29433953/affordable-care-act-impact-on-medicaid-coverage-of-smoking-cessation-treatments
#19
Sara B McMenamin, Sara W Yoeun, Helen A Halpin
INTRODUCTION: Four sections of the Affordable Care Act address the expansion of Medicaid coverage for recommended smoking-cessation treatments for: (1) pregnant women (Section 4107), (2) all enrollees through a financial incentive (1% Federal Medical Assistance Percentage increase) to offer comprehensive coverage (Section 4106), (3) all enrollees through Medicaid formulary requirements (Section 2502), and (4) Medicaid expansion enrollees (Section 2001). The purpose of this study is to document changes in Medicaid coverage for smoking-cessation treatments since the passage of the Affordable Care Act and to assess how implementation has differentially affected Medicaid coverage policies for: pregnant women, enrollees in traditional Medicaid, and Medicaid expansion enrollees...
February 9, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29433013/workplace-assimilation-and-professional-jurisdiction-how-nurses-learn-to-blur-the-nursing-medical-boundary
#20
Lars E F Johannessen
In theorising 'the system of professions', Andrew Abbott emphasised how jurisdictional boundaries in the workplace are far fuzzier than those specified in law. A key reason for this fuzziness is the process he characterised as 'workplace assimilation', involving on the job learning of a craft version of another profession's knowledge system. However, despite its centrality, workplace assimilation remains poorly elaborated in the scholarly literature. To address this shortcoming, this study explores the workplace assimilation of nurses in a Norwegian emergency primary care clinic...
February 7, 2018: Social Science & Medicine
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