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https://www.readbyqxmd.com/read/28324205/levels-of-intervention-how-are-they-used-in-quebec-hospitals
#1
Marjolaine Frenette, Jocelyne Saint-Arnaud, Karim Serri
In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered...
March 21, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28323612/from-particularities-to-context-refining-our-thinking-on-illness-narratives
#2
Annie Le, Kara Miller, Juliet McMullin
This paper examines how illness narratives are used in medical education and their implications for clinicians' thinking and care of patients. Ideally, collecting and reading illness narratives can enhance clinicians' sensitivity and contextual thinking. And yet these narratives have become part of institutionalizing cultural competency requirements in ways that tend to favor standardization. Stereotyping and reductionistic thinking can result from these pedagogic approaches and obscure structural inequities...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323611/the-role-of-universal-health-literacy-precautions-in-minimizing-medspeak-and-promoting-shared-decision-making
#3
Lara Killian, Margo Coletti
Shared decision making (SDM), a collaborative process whereby patients and professionals make health care decisions together, is a cornerstone of ethical patient care. The patient-clinician communication necessary to achieve SDM depends on many factors, not the least of which is a shared language (sometimes with the aid of a medical interpreter). However, even when a patient and clinician are speaking the same mother tongue, the use of medical jargon can pose a large and unnecessary barrier. This article discusses how health care professionals can use "universal health literacy precautions" as a legal, practical, and ethical means to enhance SDM and improve health care outcomes...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323608/from-doctors-stories-to-doctors-stories-and-back-again
#4
Marcia Day Childress
Stories have always been central to medicine, but during the twentieth century bioscience all but eclipsed narrative's presence in medical practice. In Doctors' Stories, published in 1991, Kathryn Montgomery excavated medicine's narrative foundations and functions to reveal new possibilities for how to conceive and characterize medicine. Physicians' engagement with stories has since flourished, especially through the narrative medicine movement, although in the twenty-first century this has been challenged by the health care industry's business-minded and data-driven clinical systems...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28323603/how-medicine-may-save-the-life-of-us-immigration-policy-from-clinical-and-educational-encounters-to-ethical-public-policy
#5
Mark G Kuczewski
Medicine has a conceptual contribution to make to the immigration debate. Our nation has been unable to move forward with meaningful immigration reform because many citizens seem to assume that immigrants are in the United States to access benefits to which they are not entitled. In contrast, when medicine encounters undocumented immigrants in the health care or medical education setting, it is obvious that their contributions to our health care system are denied by exclusionary laws. When the system is amended to be inclusive, immigrants become contributors to the systems that they access...
March 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28320024/-therapeutic-decisions-concerning-severe-neurological-diseases-and-at-the-end-of-life
#6
Christoph Burkhard Lücking
Modern medicine increasingly enables survival of life-threatening diseases. On the other side, however, especially in Neurology, the questions have to be addressed how intensive the initial treatment should be and how to deal with residual states when severe functional or cognitive deficits are expected. In these cases, it is not only important to decide which medical measures are appropriate for the patient, but also whether, given the prognosis, the patient would agree with the suggested measures. This article first describes the basis for each medical action, i...
March 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28319987/practitioner-application-perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#7
Jason Lesandrini, John A Brennan
No abstract text is available yet for this article.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319986/perceived-ethics-dilemmas-among-pioneer-accountable-care-organizations
#8
Craig R Westling, Thom Walsh, William A Nelson
This study of Pioneer accountable care organizations (ACOs) suggests that the ACO model is creating moral distress for physicians and business leaders in seven critical ways:Despite an overall sense of optimism associated with the ACO model, our research identified an underlying sense of moral distress at most sites. A clear opportunity exists for ACOs to use a more comprehensive, coordinated approach to proactively resolving ethical dilemmas while continuing the march toward risk-based contracts.
January 2017: Journal of Healthcare Management / American College of Healthcare Executives
https://www.readbyqxmd.com/read/28319151/ethical-problems-in-an-era-where-disasters-have-become-a-part-of-daily-life-a-qualitative-study-of-healthcare-workers-in-turkey
#9
M Murat Civaner, Kevser Vatansever, Kayihan Pala
BACKGROUND: Natural disasters, armed conflict, migration, and epidemics today occur more frequently, causing more death, displacement of people and economic loss. Their burden on health systems and healthcare workers (HCWs) is getting heavier accordingly. The ethical problems that arise in disaster settings may be different than the ones in daily practice, and can cause preventable harm or the violation of basic human rights. Understanding the types and the determinants of ethical challenges is crucial in order to find the most benevolent action while respecting the dignity of those affected people...
2017: PloS One
https://www.readbyqxmd.com/read/28318398/health-and-identity-related-interactions-between-lesbian-bisexual-queer-and-pansexual-women-and-their-healthcare-providers
#10
Aleta Baldwin, Brian Dodge, Vanessa Schick, Debra Herbenick, Stephanie Sanders, Roshni Dhoot, Dennis Fortenberry
Disclosure of sexual identity among sexual minority women is related to better outcomes and improved quality of care. The existing literature on sexual minority women's experiences of identity disclosure and related interactions with healthcare providers draws little distinction between different groups of sexual minority women, despite the different barriers, stigma and health outcomes that exist between them. This paper presents factors influencing identity disclosure and describes the characteristics of interactions that sexual minority women have with their healthcare providers around sexual identity and health...
March 20, 2017: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/28317143/role-of-pharmaceutical-care-for-self-administered-pulmonary-tuberculosis-treatment-in-thailand
#11
P Tanvejsilp, E Pullenayegum, M Loeb, J Dushoff, F Xie
WHAT IS KNOWN AND OBJECTIVE: With resource constraints in Thailand, directly observed therapy (DOT) for treating tuberculosis (TB) may not be feasible to implement. To improve patients' adherence, hospitals either modify DOT or adopt different approaches: pharmaceutical care or home visit. Our objective was to assess pulmonary TB treatment success rate of pharmaceutical care compared to home visit and modified DOT in Thailand. METHODS: We conducted a retrospective cohort study using data collected in adult pulmonary TB patients starting treatment between October 2010 and September 2013 in three hospitals in Thailand...
March 19, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28314493/beyond-visas-and-vaccines-preparing-students-for-domestic-and-global-health-engagement
#12
EDITORIAL
Lisa V Adams, Anne N Sosin
At campuses across the United States, scores of students are embarking on global health experiences in low- and middle-income countries. The desire to improve the health of poor communities while preparing for future health careers is often the main driver. The spotlight on domestic health issues also has fueled a resurgence of interest in underserved communities in the United States. Regardless of the destination, rigorous preparation is needed to ensure that the students' presence benefits the communities they aim to serve...
November 2016: Annals of Global Health
https://www.readbyqxmd.com/read/28304117/planning-focus-group-interviews-with-asylum-seekers-factors-related-to-the-researcher-interpreter-and-asylum-seekers
#13
Niina Eklöf, Maija Hupli, Helena Leino-Kilpi
The aim of this article was to discuss factors related to the researcher, interpreter and asylum seekers when planning focus group interviews with asylum seekers. Focus group interview is one of the basic data collection methods in descriptive nursing and health research. It has been used in multicultural research, allowing an opportunity to participate without literacy and to have linguistic and cultural support from other participants. Asylum seekers form a specific, vulnerable group, and the growing number of asylum seekers increases the need for research related to them...
March 17, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28303815/prevalence-and-characterization-of-rotaviruses-in-children-hospitalized-for-diarrheal-disease-in-a-tertiary-care-hospital-pune
#14
Sae Satish Pol, Ashwini Kacharu Dedwal, Sujata Sudhir Ranshing, Shobha Dattatray Chitambar, Sushma Narayan Pednekar, Renu Satish Bharadwaj
BACKGROUND: Diarrhoea remains the second most common cause of death among children below 5 years globally. Among various enteric pathogens, rotavirus appears to be the most important aetiological agent of acute gastroenteritis in infants and young children. Increased understanding of epidemiology of rotavirus infections is needed to improve the vaccine efficacy. AIM: This study aims to determine prevalence rotavirus infection and prevalent circulating strains of rotavirus in and around Pune...
January 2017: Indian Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28303207/management-strategies-for-neoplastic-and-vascular-brain-lesions-presenting-during-pregnancy-a-series-of-29-patients
#15
Celestino Esteves Pereira, Jose Carlos Lynch
BACKGROUND: The occurrence of a brain tumor or intracranial vascular lesion during pregnancy is a rare event, but when it happens, it jeopardizes the lives of both the mother and infant. It also creates challenges of a neurosurgical, obstetric, and ethical nature. A multidisciplinary approach should be used for their care. METHODS: Between 1986 and 2015, 12 pregnant women diagnosed with brain tumors and 17 women with intracranial vascular lesion underwent treatment at the Neurosurgery Department of the Servidores do Estado Hospital and Rede D'Or/São Luis...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28302637/protocol-for-determining-primary-healthcare-practice-characteristics-models-of-practice-and-patient-accessibility-using-an-exploratory-census-survey-with-linkage-to-administrative-data-in-nova-scotia-canada
#16
Emily Gard Marshall, Richard J Gibson, Beverley Lawson, Frederick Burge
INTRODUCTION: There is little evidence on how primary care providers (PCPs) model their practices in Nova Scotia (NS), Canada, what services they offer or what accessibility is like for the average patient. This study will create a database of all family physicians and primary healthcare nurse practitioners in NS, including information about accessibility and the model of care in which they practice, and will link the survey data to administrative health databases. METHODS AND ANALYSIS: 3 census surveys of all family physicians, primary care nurse practitioners (ie, PCPs) and their practices in NS will be conducted...
March 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28301699/coercion-and-access-to-health-care
#17
Keramet Reiter
In this issue of the Hastings Center Report, Paul Christopher and colleagues describe a study of why prisoners choose to enroll in clinical research. The article represents an important methodological and policy contribution to the literature on prisoner participation in research and medical experimentation. Given the methodological and ethical debates to which this research seeks to make an empirical contribution, the careful manner in which the study was conducted and the transparency with which the authors describe the research is especially noteworthy...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28301696/toward-an-ethically-sensitive-implementation-of-noninvasive-prenatal-screening-in-the-global-context
#18
Jessica Mozersky, Vardit Ravitsky, Rayna Rapp, Marsha Michie, Subhashini Chandrasekharan, Megan Allyse
Noninvasive prenatal screening using cell-free DNA, which analyzes placental DNA circulating in maternal blood to provide information about fetal chromosomal disorders early in pregnancy and without risk to the fetus, has been hailed as a potential "paradigm shift" in prenatal genetic screening. Commercial provision of cell-free DNA screening has contributed to a rapid expansion of the tests included in the screening panels. The tests can include screening for sex chromosome anomalies, rare subchromosomal microdeletions and aneuploidies, and most recently, the entire fetal genome...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28301695/justifying-clinical-nudges
#19
Moti Gorin, Steven Joffe, Neal Dickert, Scott Halpern
The shift away from paternalistic decision-making and toward patient-centered, shared decision-making has stemmed from the recognition that in order to practice medicine ethically, health care professionals must take seriously the values and preferences of their patients. At the same time, there is growing recognition that minor and seemingly irrelevant features of how choices are presented can substantially influence the decisions people make. Behavioral economists have identified striking ways in which trivial differences in the presentation of options can powerfully and predictably affect people's choices...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28299591/dealing-with-the-other-between-the-ethical-and-the-moral-albinism-on-the-african-continent
#20
Elvis Imafidon
Albinism is a global public health issue but it assumes a peculiar nature in the African continent due, in part, to the social stigma faced by persons with albinism (PWAs) in Africa. I argue that there are two essential reasons for this precarious situation. First, in the African consciousness, albinism is an alterity or otherness. The PWA in Africa is not merely a physical other but also an ontological other in the African community of beings, which provides a hermeneutic for the stigmatising separateness or difference of the PWA...
March 15, 2017: Theoretical Medicine and Bioethics
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