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Ethics of care

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https://www.readbyqxmd.com/read/28453985/realising-the-dream-of-becoming-a-nurse-underrepresented-bsc-nursing-students-experiences
#1
Brid O'Brien, Margaret M Graham, Deirdre O'Sullivan
BACKGROUND: This paper describes the experiences of underrepresented BSc nursing students in realising the dream of becoming a nurse in one university. In the past ten years, pre-registration nurse education has become established within higher education in Ireland. This development includes promoting access and inclusion of students from traditionally underrepresented groups in higher education. A third of nursing students currently access places on programmes through routes specifically designed for underrepresented groups...
April 18, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28453947/a-secondary-analysis-of-mistreatment-of-women-during-childbirth-in-health-care-facilities
#2
Cheryl Tatano Beck
OBJECTIVE: To conduct a secondary qualitative analysis of a phenomenological study of traumatic childbirth to identify the types and frequency of mistreatment of women during childbirth in high-income countries. DESIGN: Analytic expansion was the type of secondary analysis chosen to make further use of a primary qualitative data set to ask a new question that was not included the original study aims. SETTING: The primary data set of women's experiences of traumatic childbirth was obtained via the Internet...
April 25, 2017: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/28449382/current-use-of-chromosomal-microarray-by-australian-paediatricians-and-implications-for-the-implementation-of-next-generation-sequencing
#3
Victoria McKay, Daryl Efron, Elizabeth E Palmer, Susan M White, Chris Pearson, Margie Danchin
AIM: Chromosomal microarray (CMA) is an important diagnostic test for children with multiple congenital anomalies or certain developmental behavioural problems suggestive of an underlying genetic diagnosis. However, there are medical and ethical complexities to its use and few Australian policies to guide practice. We aimed to describe the current practice of Australian paediatricians in relation to CMA testing. We hypothesised that there are knowledge gaps in their use of CMA. METHODS: Online survey completed between September 2015 and January 2016 by paediatricians in secondary care settings...
April 27, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28448286/profile-iora-health-transactional-vs-relationship-based-care
#4
Michelle Howe
Last November, Nursing Management Congress2016 attendees experienced a one-of-a-kind keynote address when Zubin Damania, MD, took the stage. Through self-produced song and video, he explored the ethics of delivering compassionate care in our challenging healthcare system. Here, read about the Iora Health model that Dr. Damania celebrates as "having it right."
May 2017: Nursing Management
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#5
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28446164/core-information-sets-for-informed-consent-to-surgical-interventions-baseline-information-of-importance-to-patients-and-clinicians
#6
Barry G Main, Angus G K McNair, Richard Huxtable, Jenny L Donovan, Steven J Thomas, Paul Kinnersley, Jane M Blazeby
BACKGROUND: Consent remains a crucial, yet challenging, cornerstone of clinical practice. The ethical, legal and professional understandings of this construct have evolved away from a doctor-centred act to a patient-centred process that encompasses the patient's values, beliefs and goals. This alignment of consent with the philosophy of shared decision-making was affirmed in a recent high-profile Supreme Court ruling in England. The communication of information is central to this model of health care delivery but it can be difficult for doctors to gauge the information needs of the individual patient...
April 26, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28446119/neurobionics-and-the-brain-computer-interface-current-applications-and-future-horizons
#7
Jeffrey V Rosenfeld, Yan Tat Wong
The brain-computer interface (BCI) is an exciting advance in neuroscience and engineering. In a motor BCI, electrical recordings from the motor cortex of paralysed humans are decoded by a computer and used to drive robotic arms or to restore movement in a paralysed hand by stimulating the muscles in the forearm. Simultaneously integrating a BCI with the sensory cortex will further enhance dexterity and fine control. BCIs are also being developed to: provide ambulation for paraplegic patients through controlling robotic exoskeletons; restore vision in people with acquired blindness; detect and control epileptic seizures; and improve control of movement disorders and memory enhancement...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28443357/informed-consent-and-the-aftermath-of-cardiopulmonary-resuscitation-ethical-considerations
#8
Pamela Bjorklund, Denise M Lund
BACKGROUND: Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR. OBJECTIVE: A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28443132/disease-resistance-and-the-definition-of-genetic-enhancement
#9
Derek So, Erika Kleiderman, Seydina B Touré, Yann Joly
Recent gene editing experiments carried out in human embryos have raised the question of whether interventions like the introduction of a CCR5-Δ32 deletion, which could provide heritable resistance to HIV infection, ought to be considered enhancements. Many authors have used the term "enhancement" in different ways, some based on patients' biomedical outcomes and others on their social context. These classifications are often considered overly imprecise. Nevertheless, the concept of "enhancement" could affect the ways in which these applications are regulated in different jurisdictions, the availability of coverage by insurers or public health care, and the force of public opinion in shaping future policy on gene editing...
2017: Frontiers in Genetics
https://www.readbyqxmd.com/read/28442806/study-of-clinical-profile-of-herpes-zoster-in-human-immunodeficiency-virus-positive-and-negative-patients-at-a-rural-based-tertiary-care-center-gujarat
#10
Rita V Vora, Gopikrishnan Anjaneyan, Rahul Krishna S Kota, Abhishek P Pilani, Nilofar G Diwan, Nidhi N Patel
BACKGROUND: Herpes zoster usually presents with typically grouped vesicles on erythematous base involving single dermatome with self-limiting nature in immunocompetent individuals while it may present in extensive form involving multiple dermatomes involvement or disseminated form in immunocompromised, especially in human immunodeficiency virus (HIV). AIMS AND OBJECTIVES: The aim of this study was to study the prevalence of HIV in patients of herpes zoster, to compare the clinical presentation of herpes zoster in HIV-infected and noninfected patient...
January 2017: Indian Journal of Sexually Transmitted Diseases
https://www.readbyqxmd.com/read/28438584/strategies-for-enhancing-family-participation-in-research-in-the-icu-findings-from-a-qualitative-study
#11
Danae Dotolo, Elizabeth L Nielsen, J Randall Curtis, Ruth A Engelberg
CONTEXT: Family members of critically ill patients who participate in research focused on palliative care issues have been found to be systematically different from those who do not. These differences threaten the validity of research and raise ethical questions about worsening disparities in care by failing to represent diverse perspectives. OBJECTIVES: This study's aims were to explore: 1) barriers and facilitators influencing family members' decisions to participate in palliative care research; and 2) potential methods to enhance research participation...
April 21, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28438479/family-presence-during-resuscitation-fpdr-observational-case-studies-of-emergency-personnel-in-victoria-australia
#12
Joanne E Porter, Nareeda Miller, Anita Giannis, Nicole Coombs
INTRODUCTION: Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28438182/forced-fluid-removal-versus-usual-care-in-intensive-care-patients-with-high-risk-acute-kidney-injury-and-severe-fluid-overload-ffaki-study-protocol-for-a-randomised-controlled-pilot-trial
#13
Rasmus E Berthelsen, Theis Itenov, Anders Perner, Jens-Ulrik Jensen, Michael Ibsen, Andreas Emil Kryger Jensen, Morten Bestle
BACKGROUND: Intravenous administration of fluids is an essential part of critical care. While some fluid administration is likely beneficial, there is increasing observational evidence that the development of fluid overload is associated with increased mortality. There are no randomised trials to confirm this association in patients with acute kidney injury. We aim to perform a pilot trial to test the feasibility of forced fluid removal compared to standard care in patients with acute kidney injury and severe fluid overload, the FFAKI trial...
April 24, 2017: Trials
https://www.readbyqxmd.com/read/28438074/the-value-of-metaphorical-reasoning-in-bioethics-an-empirical-ethical-study
#14
Erik Olsman, Bert Veneberg, Claudia van Alfen, Dorothea Touwen
BACKGROUND: Metaphors are often used within the context of ethics and healthcare but have hardly been explored in relation to moral reasoning. OBJECTIVE: To describe a central set of metaphors in one case and to explore their contribution to moral reasoning. METHOD: Semi-structured interviews were conducted with 16 parents of a child suffering from the neurodegenerative disease CLN3. The interviews were recorded, transcribed, and metaphors were analyzed...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28437573/using-internal-and-external-reviewers-can-help-to-optimise-neonatal-mortality-and-morbidity-conferences
#15
Michael-Andrew Assaad, Annie Janvier, Anie Lapointe
AIM: This study determined if there was a difference in the conclusions reached by paediatricians in morbidity and mortality conferences based on their level of involvement in a case. METHODS: All neonatal deaths occurring between August 2014 and September 2015 at Sainte-Justine Hospital, Montreal, Quebec, Canada, were reviewed by internal physicians involved in the case and external physicians who were not. The reviewers were asked to identify positive and negative clinical practice items and provide written recommendations...
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
#16
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/28437367/-effective-requesting-a-scoping-review-of-the-literature-on-asking-families-to-consent-to-organ-and-tissue-donation
#17
Jennifer A Chandler, Matthew Connors, Giles Holland, Sam D Shemie
BACKGROUND: Families are often asked to consent to the donation of their deceased relative's organs or tissues. These end-of-life conversations are important because they affect consent rates as well as the psychological impact of the decision for families. This scoping review of the literature on requesting family consent was prepared to support of the development of leading practice recommendations for end-of-life conversations with families of potential donors. A scoping review maps research activity in a field across a range of commentary and empirical study designs but does not attempt meta-synthesis of empirical data or quality assessment...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28436929/when-not-to-rescue-an-ethical-analysis-of-best-practices-for-cardiopulmonary-resuscitation-and-emergency-cardiac-care
#18
Nancy S Jecker, Arthur R Derse
It is now a default obligation to provide cardiopulmonary resuscitation (CPR), in the absence of knowledge of a patient's or surrogate's wishes to the contrary. We submit that it is time to re-evaluate this position. Attempting CPR should be subject to the same scrutiny demanded of other medical interventions that involve balancing a great benefit against grievous harms.
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28435691/interrupting-antiretroviral-treatment-in-hiv-cure-research-scientific-and-ethical-considerations
#19
EDITORIAL
Samual A Garner, Stuart Rennie, Jintanat Ananworanich, Karine Dube, David M Margolis, Jeremy Sugarman, Randall Tressler, Adam Gilbertson, Liza Dawson
Over the past several years there has been intense activity directed at the possibility of achieving remission or eradication of HIV infection. Current assays for the measurement of latent HIV are insufficient to demonstrate complete clearance of replication-competent HIV. Therefore, the ultimate test for assessing whether investigational interventions have resulted in HIV remission or eradication is to interrupt standard antiretroviral therapy (ART) in a carefully controlled clinical trial setting. These procedures, known as analytic treatment interruptions (ATIs), raise important scientific and ethical questions...
April 1, 2017: Journal of Virus Eradication
https://www.readbyqxmd.com/read/28433757/surgical-volunteerism-or-voluntourism-are-we-doing-more-harm-than-good
#20
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
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