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https://www.readbyqxmd.com/read/29166693/-the-biased-expert-an-unknown-quantity
#1
Wolfgang Meins
Academic publications have so far hardly paid any attention to the topic of biased medical experts or expert opinions. This is the first attempt to systematically describe and analyze the issue, drawing on the author's many years of giving expert opinions as a neuropsychiatrist on matters relating to social legislation and civil law. In addition to dealing with questions of definition, this article outlines the features of biased expert opinions, particularly focusing on the role of insurance and private experts...
November 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/29164916/age-and-gender-differences-in-medical-adherence-after-myocardial-infarction-women-do-not-receive-optimal-treatment-the-netherlands-claims-database
#2
Daniëlle C Eindhoven, Alexander D Hilt, Thomas C Zwaan, Martin J Schalij, C Jan Willem Borleffs
Background Following myocardial infarction, medication is, besides lifestyle interventions, the cornerstone treatment to improve survival and minimize the occurrence of new cardiovascular events. Still, data on nationwide medication adherence are scarce. This study assesses medical adherence during one year following myocardial infarction, stratifying per type of infarct, age and gender. Design Retrospective cohort study. Methods In The Netherlands, all inhabitants are by law obliged to have health insurance and all claims data are centrally registered...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29158993/antimicrobial-consumption-on-austrian-dairy-farms-an-observational-study-of-udder-disease-treatments-based-on-veterinary-medication-records
#3
Clair L Firth, Annemarie Käsbohrer, Corina Schleicher, Klemens Fuchs, Christa Egger-Danner, Martin Mayerhofer, Hermann Schobesberger, Josef Köfer, Walter Obritzhauser
Background: Antimicrobial use in livestock production is an important contemporary issue, which is of public interest worldwide. Antimicrobials are not freely available to Austrian farmers and can only be administered to livestock by veterinarians, or by farmers who are trained members of the Animal Health Service. Since 2015, veterinarians have been required by law to report antimicrobials dispensed to farmers for use in food-producing animals. The study presented here went further than the statutory framework, and collected data on antimicrobials dispensed to farmers and those administered by veterinarians...
2017: PeerJ
https://www.readbyqxmd.com/read/29158769/physicians-duty-to-recontact-and-update-genetic-advice
#4
Yvonne A Stevens, Grant D Senner, Gary E Marchant
This perspective addresses whether physicians have a duty to recontact former or current patients to update clinical advice based on newly discovered genomic information. Genetic information is unique compared with other medical data in that the underlying data do not appreciably change during the patients' lifetime, but the clinical significance of that information will continue to evolve. Based on relevant case law and guidelines, there is no general, established legal duty for physicians to affirmatively recontact former or current patients to update clinical advice based on newly discovered genetic information...
2017: Personalized Medicine
https://www.readbyqxmd.com/read/29157510/euthanasia-requests-in-a-canadian-psychiatric-emergency-room-a-case-series-part-1-of-the-mcgill-university-euthanasia-in-psychiatry-case-series
#5
David Benrimoh, Antoine Perreault, Frederique Van Den Eynde
Euthanasia was decriminalized in Quebec in December 2015, and Canada-wide in June 2016. Both the Provincial and Federal legislation have limited the right to medical assistance in dying (MAID) to end-of-life cases; which makes MAID inaccessible to most patients solely suffering from psychiatric illness. While some end-stage anorexia nervosa or elderly patients may meet the end-of-life criterion because of their medical comorbidities or their age (Kelly et al., 2003), repeated suicide attempts or psychotic disorganization would not qualify since they would not be seen as elements of an illness leading to a foreseeable "natural death" (Canada, 2016)...
November 2017: International Journal of Law and Psychiatry
https://www.readbyqxmd.com/read/29155288/investigation-of-the-practices-legislation-supply-chain-and-regulation-of-opioids-for-clinical-pain-management-in-southern-africa-a-multi-sectoral-cross-national-mixed-methods-study
#6
Eve Namisango, Matthew J Allsop, Richard A Powell, Stefan J Friedrichsdorf, Emmanuel Bk Luyirika, Fatia Kiyange, Edward Mukooza, Chris Ntege, Eunice Garanganga, Mavis Ntombifuthi Ginindza-Mdluli, Faith Mwangi-Powell, Lidia Justino Mondlane, Richard Harding
CONTEXT: Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. OBJECTIVES: To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29150824/legislation-of-direct-to-consumer-genetic-testing-in-europe-a-fragmented-regulatory-landscape
#7
L Kalokairinou, H C Howard, S Slokenberga, E Fisher, M Flatscher-Thöni, M Hartlev, R van Hellemondt, J Juškevičius, J Kapelenska-Pregowska, P Kováč, L Lovrečić, H Nys, A de Paor, A Phillips, L Prudil, E Rial-Sebbag, C M Romeo Casabona, J Sándor, A Schuster, S Soini, K H Søvig, D Stoffel, T Titma, T Trokanas, P Borry
Despite the increasing availability of direct-to-consumer (DTC) genetic testing, it is currently unclear how such services are regulated in Europe, due to the lack of EU or national legislation specifically addressing this issue. In this article, we provide an overview of laws that could potentially impact the regulation of DTC genetic testing in 26 European countries, namely Austria, Belgium, Cyprus, the Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Ireland, Italy, Latvia, Lithuania, Luxembourg, Norway, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, the Netherlands and the United Kingdom...
November 18, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/29148351/opioid-prescribing-by-nurse-practitioners-in-medicare-part-d-impact-of-state-scope-of-practice-legislation
#8
Elissa Ladd, Casey Fryer Sweeney, Anthony Guarino, Alex Hoyt
Many state legislatures restrict nurse practitioner (NP) scope of practice as a way of addressing patient safety concerns. The purpose of this study was to investigate the influence of state NP scope of practice laws on the prescription of oxycodone and hydrocodone containing medications by NP and MD/DO/PA prescribers to Medicare Part D beneficiaries. Using the Medicare Part D public use file, we analyzed oxycodone and hydrocodone containing prescriptions per Medicare Part D beneficiary by prescriber type, NP state scope of practice, and geographic variables...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148320/the-extraregulatory-effect-of-nurse-practitioner-scope-of-practice-laws-on-physician-malpractice-rates
#9
Benjamin J McMichael, Barbara J Safriet, Peter I Buerhaus
Patients can hold physicians directly or vicariously liable for the malpractice of nurse practitioners under their supervision. Restrictive scope-of-practice laws governing nurse practitioners can ease patients' legal burdens in establishing physician liability. We analyze the effect of restrictive scope-of-practice laws on the number of malpractice payments made on behalf of physicians between 1999 and 2012. Enacting less restrictive scope-of-practice laws decreases the number of payments made by physicians by as much as 31%, suggesting that restrictive scope-of-practice laws have a salient extraregulatory effect on physician malpractice rates...
January 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148218/new-solutions-to-reduce-wrong-route-medication-errors
#10
REVIEW
Ronald S Litman, Victoria I Smith, Phoebe Mainland
Wrong route medication errors due to tubing misconnections are potentially life-threatening complications that have been made possible by the universal use of the Luer connector. The new International Organization of Standardization standards for small bore connectors, ISO 80369 series, have been developed to reduce the risk of these types of erroneous connections. Tubing connectors for different routes of clinical application will contain differently designed connectors that are physically incompatible. However, design and manufacturing standards have progressed slowly, and clinical roll-outs have been delayed, despite the implementation of California laws to promote their use...
November 17, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29146826/social-preferences-of-future-physicians
#11
Jing Li, William H Dow, Shachar Kariv
We measure the social preferences of a sample of US medical students and compare their preferences with those of the general population sampled in the American Life Panel (ALP). We also compare the medical students with a subsample of highly educated, wealthy ALP subjects as well as elite law school students and undergraduate students. We further associate the heterogeneity in social preferences within medical students to the tier ranking of their medical schools and their expected specialty choice. Our experimental design allows us to rigorously distinguish altruism from preferences regarding equality-efficiency tradeoffs and accurately measure both at the individual level rather than pooling data or assuming homogeneity across subjects...
November 16, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/29143236/the-making-of-informed-choice-in-midwifery-a-feminist-experiment-in-care
#12
Margaret E MacDonald
This paper is about the clinical principle of informed choice-the hallmark feature of the midwifery model of care in Ontario, Canada. Drawing on ethnographic history interviews with midwives, I trace the origins of the idea of informed choice to its roots in the social movement of midwifery in North America in the late 1960s and 1970s. At that time informed choice was not the distinctive feature of midwifery but was deeply embedded what I call midwifery's feminist experiment in care. But as midwifery in Ontario transitioned from a social movement to a full profession within the formal health care system, informed choice was strategically foregrounded in order to make the midwifery model of care legible and acceptable to a skeptical medical profession, conservative law makers, and a mainstream clientele...
November 15, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/29140654/proposed-industry-best-practices-in-development-and-marketing-of-medical-foods-for-the-management-of-chronic-conditions-and-diseases-while-awaiting-regulation
#13
Bruce Burnett, Robert M Levy
Ideal therapeutics have low toxicity and can effectively manage condition(s) or disease(s). The Food & Drug Administration (FDA) marketing category of therapeutics called “medical foods” (MFs) meets such a definition. Medical foods have existed in Federal law since passage the Orphan Drug Act in 1988, which created a category of nutritional therapeutics separate from drugs. Unfortunately, MFs are not widely understood by the medical community or utilized in all patients who need them due to lack of a FDA-approval process, unclear and contradictory guidance especially with regard for need for an investigational new drug (IND) application, and no clear regulations regarding their development and marketing...
2017: Food and Drug Law Journal
https://www.readbyqxmd.com/read/29140477/when-can-the-child-speak-for-herself-the-limits-of-parental-consent-in-data-protection-law-for-health-research
#14
Mark J Taylor, Edward S Dove, Graeme Laurie, David Townend
Draft regulatory guidance suggests that if the processing of a child's personal data begins with the consent of a parent, then there is a need to find and defend an enduring consent through the child's growing capacity and on to their maturity. We consider the implications for health research of the UK Information Commissioner's Office's (ICO) suggestion that the relevant test for maturity is the Gillick test, originally developed in the context of medical treatment. Noting the significance of the welfare principle to this test, we examine the implications for the responsibilities of a parent to act as proxy for their child...
November 13, 2017: Medical Law Review
https://www.readbyqxmd.com/read/29138650/evaluation-of-antibiotic-self-medication-among-outpatients-of-the-state-university-hospital-of-port-au-prince-haiti-a-cross-sectional-study
#15
Kenny Moise, Joseph Junior Bernard, Jean Hugues Henrys
In Haiti, where all drugs are available over the counter, self-medication with antibiotics appears as a common practice. Inappropriate use of beta-lactams and macrolides is likely to contribute to the development of antimicrobial resistance. This study aimed to (i) assess the extent of self-medication with antibiotics, (ii) explore the contributing factors (age, gender and educational background) and (iii) identify specific antibiotic drug classes used among patients attending the outpatient clinic of the State University Hospital of Port-au-Prince...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/29138205/long-term-prognosis-of-young-breast-cancer-patients-%C3%A2-40-years-who-did-not-receive-adjuvant-systemic-treatment-protocol-for-the-paradigm-initiative-cohort-study
#16
Gwen Mhe Dackus, Natalie D Ter Hoeve, Mark Opdam, Willem Vreuls, Zsuzsanna Varga, Esther Koop, Stefan M Willems, Carolien Hm Van Deurzen, Emilie J Groen, Alicia Cordoba, Jos Bart, Antien L Mooyaart, Jan G van den Tweel, Vicky Zolota, Jelle Wesseling, Anna Sapino, Ewa Chmielik, Ales Ryska, Frederic Amant, Annegien Broeks, Ron Kerkhoven, Nikolas Stathonikos, Mitko Veta, Adri Voogd, Katarzyna Jozwiak, Michael Hauptmann, Marlous Hoogstraat, Marjanka K Schmidt, Gabe Sonke, Elsken van der Wall, Sabine Siesling, Paul J van Diest, Sabine C Linn
INTRODUCTION: Currently used tools for breast cancer prognostication and prediction may not adequately reflect a young patient's prognosis or likely treatment benefit because they were not adequately validated in young patients. Since breast cancers diagnosed at a young age are considered prognostically unfavourable, many treatment guidelines recommend adjuvant systemic treatment for all young patients. Patients cured by locoregional treatment alone are, therefore, overtreated. Lack of prognosticators for young breast cancer patients represents an unmet medical need and has led to the initiation of the PAtients with bReAst cancer DIaGnosed preMenopausally (PARADIGM) initiative...
November 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29137561/mental-health-spending-and-intensity-of-service-use-among-individuals-with-diagnoses-of-eating-disorders-following-federal-parity
#17
Haiden A Huskamp, Hillary Samples, Scott E Hadland, Emma E McGinty, Teresa B Gibson, Howard H Goldman, Susan H Busch, Elizabeth A Stuart, Colleen L Barry
OBJECTIVE: The Mental Health Parity and Addiction Equity Act (MHPAEA) was intended to eliminate differences in insurance coverage for mental health and substance use disorder services and medical-surgical care. No studies have examined mental health service use after federal parity implementation among individuals with diagnoses of eating disorders, for whom financial access to care has often been limited. This study examined whether MHPAEA implementation was associated with changes in use of mental health services and spending in this population...
November 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29136148/legal-but-limited-abortion-service-availability-and-readiness-assessment-in-nepal
#18
Suzanne O Bell, Linnea Zimmerman, Yoonjoung Choi, Michelle J Hindin
The government of Nepal revised its law in 2002 to allow women to terminate a pregnancy up to 12 weeks gestation for any indication on request, and up to 18 weeks if certain conditions are met. We evaluated the readiness of facilities in Nepal to provide three abortion services, manual vacuum aspiration (MVA), medication abortion (MA) and post-abortion care (PAC), using the service availability and readiness assessment (SARA) framework. The framework consists broadly of three domains; service availability, general service readiness and service readiness specific to individual services (i...
November 10, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29132060/traditional-beliefs-and-practices-in-pregnancy-childbirth-and-postpartum-a-review-of-the-evidence-from-asian-countries
#19
Mellissa Withers, Nina Kharazmi, Esther Lim
INTRODUCTION: Asian women suffer the largest proportion of the world's maternal deaths. To reduce this, policymakers and healthcare providers must encourage women with traditionally low rates of maternal health care utilization to access services. OBJECTIVE: The purpose of this study is to provide a comprehensive review of the most common traditional practices in Asia relating to pregnancy, childbirth and the postpartum period. DESIGN: We conducted a literature search of articles: a) focusing on Asia; b) relating to pregnancy, childbirth or postpartum, c) relating to traditional beliefs and/or cultural practices; and 4) published in English in the year 2000 or more recently...
November 10, 2017: Midwifery
https://www.readbyqxmd.com/read/29130271/the-impact-of-state-medical-malpractice-reform-on-individual-level-health-care-expenditures
#20
Hao Yu, Michael Greenberg, Amelia Haviland
BACKGROUND: Past studies of the impact of state-level medical malpractice reforms on health spending produced mixed findings. Particularly salient is the evidence gap concerning the effect of different types of malpractice reform. This study aims to fill the gap. It extends the literature by examining the general population, not a subgroup or a specific health condition, and controlling for individual-level sociodemographic and health status. METHODS: We merged the Database of State Tort Law Reforms with the Medical Expenditure Panel Survey between 1996 and 2012...
December 2017: Health Services Research
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