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Ethics of care

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https://www.readbyqxmd.com/read/29782631/reflections-on-end-of-life-dialysis
#1
Manuel Carlos Martins Castro
The world population is aging and diseases such as diabetes mellitus and systemic arterial hypertension are increasing the risk of patients developing chronic kidney disease, leading to an increase in the prevalence of patients on dialysis. The expansion of health services has made it possible to offer dialysis treatment to an increasing number of patients. At the same time, dialysis survival has increased considerably in the last two decades. Thus, patients on dialysis are becoming more numerous, older and with greater number of comorbidities...
May 17, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29781783/clinical-and-radiological-outcome-of-non-surgical-management-of-thoracic-and-lumbar-spinal-fracture-dislocations-a-historical-analysis-in-the-era-of-modern-spinal-surgery
#2
Andrei Fernandes Joaquim, Gregory D Schroeder, Alpesh A Patel, Alexander R Vaccaro
CONTEXT: It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. OBJECTIVE: Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries...
May 21, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29781680/provision-of-antiretroviral-therapy-for-children-in-nelson-mandela-bay-health-care-professionals-challenges
#3
Margaret Williams, Dalena R M Van Rooyen, Esmeralda J Ricks
BACKGROUND:  The human immunodeficiency virus and/or acquired immune deficiency syndrome (HIV/AIDS) pandemic continues to increase in prevalence worldwide, particularly in South Africa, and includes the often overlooked paediatric population. The provision of paediatric antiretroviral treatment (ART) is as essential for children as for adults, and has numerous obstacles, not least of which is lack of decentralisation of facilities to provide essential treatment. Optimising ART, care and support for HIV-positive children, and their caregivers, at public sector primary health care (PHC) clinics is crucial to improve morbidity and mortality rates in children...
March 12, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29780034/improving-predictive-asthma-algorithms-with-modelled-environment-data-for-scotland-an-observational-cohort-study-protocol
#4
Ireneous N Soyiri, Aziz Sheikh, Stefan Reis, Kimberly Kavanagh, Massimo Vieno, Tom Clemens, Edward J Carnell, Jiafeng Pan, Abby King, Rachel C Beck, Hester J T Ward, Chris Dibben, Chris Robertson, Colin R Simpson
INTRODUCTION: Asthma has a considerable, but potentially, avoidable burden on many populations globally. Scotland has some of the poorest health outcomes from asthma. Although ambient pollution, weather changes and sociodemographic factors have been associated with asthma attacks, it remains unclear whether modelled environment data and geospatial information can improve population-based asthma predictive algorithms. We aim to create the afferent loop of a national learning health system for asthma in Scotland...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29778990/health-out-of-foster-care-as-young-adults-age-out-of-foster-care-a-phenomenological-exploration-of-seeking-healthcare-services-after-aging-out-of-the-us-foster-care-system
#5
Jennifer L Collins, Rosalinda Jimenez, Laura J Thomas
Some adolescents in the United States who have been abused and/or neglected by caregivers and placed in permanent custody of the state leave, or "age out" of foster care at 18 years of age. Poor health outcomes among individuals who age out are notable, yet few studies describe the phenomenon of seeking healthcare services after leaving foster care. The investigators specifically queried the phenomenon of seeking healthcare services after foster care drawing from the Phenomenology of Practice approach...
May 17, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29776979/ethical-challenges-raised-by-opennotes-for-pediatric-and-adolescent-patients
#6
Fabienne C Bourgeois, Catherine M DesRoches, Sigall K Bell
Sharing clinic notes online with patients and parents may yield many potential benefits to patients and providers alike, but the unprecedented transparency and accessibility to notes afforded by patient portals has also raised a number of unique ethical and legal concerns. As the movement toward transparent notes (OpenNotes) grows, clinicians and health care organizations caring for pediatric and adolescent patients wrestle with how to document confidential and sensitive information, including issues such as reproductive health, misattributed paternity, or provider and parent disagreements...
May 18, 2018: Pediatrics
https://www.readbyqxmd.com/read/29776973/challenges-in-end-of-life-dementia-care
#7
REVIEW
Anne A Fetherston, Grace Rowley, Charlotte L Allan
Dementia is a chronic, progressive disease that is now much more widely recognised and treated. Patients with dementia may require palliative care when they reach the end stage of their illness, or they may have mild-moderate cognitive symptoms comorbid with a life-limiting illness. The variety of presentations necessitates a highly individual approach to care planning, and patients should be encouraged to set their own goals and contribute to advanced care planning where possible. Assessment and management of distressing symptoms at the end of life can be greatly helped by a detailed knowledge of the individuals' prior wishes, interdisciplinary communication and recognition of changes in presentation that may result from new symptoms, for example, onset of pain, nutritional deficits and infection...
May 18, 2018: Evidence-based Mental Health
https://www.readbyqxmd.com/read/29773528/a-digital-app-to-aid-detection-monitoring-and-management-of-dyslexia-in-young-children-dimmand-protocol-for-a-digital-health-and-education-solution
#8
Mariam R Sood, Annet Toornstra, Martin I Sereno, Mark Boland, Daniele Filaretti, Anuj Sood
BACKGROUND: Dyslexia, a specific learning difficulty and a disability as defined in the Equality Act 2010, is a lifelong condition that affects a child from the start of education. Dyslexia is characterized by difficulties in language processing (reading, spelling, and writing) which do not correspond with the child's general intellectual abilities. Although dyslexia cannot be cured, there is a consensus that interventions are more effective and have greater impact the earlier they are administered...
May 17, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29773480/must-i-respond-if-my-health-is-at-risk
#9
Kenneth V Iserson
BACKGROUND: Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION: It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29772961/contrasts-in-older-persons-experiences-and-significant-others-perceptions-of-existential-loneliness
#10
Helena Larsson, Anna-Karin Edberg, Ingrid Bolmsjö, Margareta Rämgård
BACKGROUND: As frail older people might have difficulties in expressing themselves, their needs are often interpreted by others, for example, by significant others, whose information health care staff often have to rely on. This, in turn, can put health care staff in ethically difficult situations, where they have to choose between alternative courses of action. One aspect that might be especially difficult to express is that of existential loneliness. We have only sparse knowledge about whether, and in what way, the views of frail older persons and their significant others concerning existential loneliness are in concordance...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29771188/handbook-of-primary-care-ethics
#11
David E Cunningham, Kay Mohanna, Patrick Wills
No abstract text is available yet for this article.
May 17, 2018: Education for Primary Care
https://www.readbyqxmd.com/read/29771160/effects-of-an-intervention-program-for-pomoting-ethical-practices-among-pediatric-nurses
#12
Naomi Matsumori
The Japanese nursing education system only requires a general nursing qualification. After graduation, many Japanese nurses work within pediatric departments where they receive specialized training in pediatric care. An intervention program for promoting ethical nursing practices among patients and their families was implemented for pediatric nurses with 0-5 years pediatric nursing experience. The objective of this study was to clarify changes in nurses' recognition and behaviors, as well as the intervention's post-initiation durability...
May 17, 2018: Comprehensive child and adolescent nursing
https://www.readbyqxmd.com/read/29771103/-an-introduction-to-the-thought-of-emmanuel-levinas-the-care-or-irreducible-worry-of-infinite-responsibility
#13
Philippe Svandra
Despite a particularly difficult approach, Emmanuel Levinas remains a philosopher who « speaks » quite naturally to caregivers. The reason is simple ; he is interested in an issue that has long been hidden in philosophy, but that directly affects care : vulnerability.However, it seems that his thinking has too often been watered down. By presenting it as a form of benevolent altruism, the radical, even subversive, aspect of the approach that he proposes to us is erased. Indeed, Levinassian responsibility is experienced first of all as a rupture, a violence that makes me the « hostage of others...
March 2018: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/29769257/optimum-hospice-at-home-services-for-end-of-life-care-protocol-of-a-mixed-methods-study-employing-realist-evaluation
#14
Claire Butler, Charlotte Brigden, Heather Gage, Peter Williams, Laura Holdsworth, Kay Greene, Bee Wee, Stephen Barclay, Patricia Wilson
INTRODUCTION: Hospice at home (HAH) services aim to enable patients to be cared for and die in their place of choice, if that is at home, and to achieve a 'good death'. There is a considerable range of HAH services operating in England. The published evidence focuses on evaluations of individual services which vary considerably, and there is a lack of consistency in terms of the outcome measures reported. The evidence, therefore, does not provide generalisable information, so the question 'What are the features of hospice at home service models that work, for whom, and under what circumstances?' remains unanswered...
May 16, 2018: BMJ Open
https://www.readbyqxmd.com/read/29768326/chronic-constipation-a-review-of-literature
#15
Mojgan Forootan, Nazila Bagheri, Mohammad Darvishi
BACKGROUND: Chronic constipation is described as a common complication determined by difficult and/or rare passage of stool or both. The difference in definition of constipation has led to a wide range of reported prevalence (i.e., between 1% and 80%). Various factors are involved in the pathogenesis of the disease, including type of diet, genetic predisposition, colonic motility, absorption, social economic status, daily behaviors, and biological and pharmaceutical factors. Diagnostic and therapeutic options play a key role in the treatment of chronic constipation...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29768072/an-integrated-developmental-four-year-medical-school-curriculum-in-palliative-care-a-longitudinal-content-evaluation-based-on-national-competency-standards
#16
Erin M Denney-Koelsch, Robert Horowitz, Timothy Quill, Constance D Baldwin
BACKGROUND: While palliative care (PC) competencies for medical school graduates have been defined, the lack of established curriculum models and assessment tools hampers curricular evaluation. OBJECTIVE: To describe the scope and content of the University of Rochester's longitudinal, integrated four-year PC curriculum after 17 years of implementation, review student evaluative responses, and compare the curriculum to national competency standards. DESIGN AND SETTING: Combining and reorganizing a published PC curriculum assessment tool and a list of medical school PC competencies, we created a novel nine-topic framework to assess the content coverage of our curriculum...
May 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29767828/a-digitally-facilitated-citizen-science-driven-approach-accelerates-participant-recruitment-and-increases-study-population-diversity
#17
Milo A Puhan, Nina Steinemann, Christian P Kamm, Stephanie Müller, Jens Kuhle, Roland Kurmann, Pasquale Calabrese, Jürg Kesselring, Viktor von Wyl, Swiss Multiple Sclerosis Registry Smsr
QUESTION UNDER STUDY: Our aim was to assess whether a novel approach of digitally facilitated, citizen-science research, as followed by the Swiss Multiple Sclerosis Registry (Swiss MS Registry), leads to accelerated participant recruitment and more diverse study populations compared with traditional research studies where participants are mostly recruited in study centres without the use of digital technology. METHODS: The Swiss MS Registry is a prospective, longitudinal, observational study covering all Switzerland...
May 16, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#18
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29766747/a-seat-around-the-table-participatory-data-analysis-with-people-living-with-dementia
#19
Charlotte L Clarke, Heather Wilkinson, Julie Watson, Jane Wilcockson, Lindsay Kinnaird, Toby Williamson
The involvement of "people with experience" in research has developed considerably in the last decade. However, involvement as co-analysts at the point of data analysis and synthesis has received very little attention-in particular, there is very little work that involves people living with dementia as co-analysts. In this qualitative secondary data analysis project, we (a) analyzed data through two theoretical lenses: Douglas's cultural theory of risk and Tronto's Ethic of Care, and (b) analyzed data in workshops with people living with dementia...
May 1, 2018: Qualitative Health Research
https://www.readbyqxmd.com/read/29766353/how-ethical-is-our-current-delivery-of-care-to-patients-with-severe-and-complicated-obesity
#20
REVIEW
Hilary Craig, Carel le Roux, Fiona Keogh, Francis M Finucane
Despite overwhelming evidence that bariatric interventions reduce morbidity and mortality and are cost-effective, access for affected patients is limited. We sought to describe the extent to which health policy makers and publically funded health services have an ethical obligation to provide bariatric care. We conducted a narrative review of the literature pertaining to the efficacy, safety, and cost-effectiveness of bariatric surgical interventions, in the context of the core principles of medical ethics...
May 15, 2018: Obesity Surgery
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