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https://www.readbyqxmd.com/read/29457248/duty-hours-restriction-for-our-surgical-trainees-an-ethical-obligation-or-a-bad-idea
#1
REVIEW
Christopher A Adin, Callie A Fogle, Steven L Marks
To ensure patient safety and protect the well-being of interns and residents, the Accreditation Council for Graduate Medical Education (ACGME) issued guidelines in 2003 limiting the working hours of physician trainees. Although many supported the goals of the ACGME, institutions struggled to restructure their programs and hire staff required by this unfunded mandate. Numerous studies have analyzed the effects of duty hours restrictions on patient outcomes and physician training over the past 15 years. Most agree that duty hours restrictions improved well-being of house officers, but these improvements came at the expense of continuity, and patient hand-offs led to medical errors...
February 19, 2018: Veterinary Surgery: VS
https://www.readbyqxmd.com/read/29457241/can-rationing-through-inconvenience-be-ethical
#2
Nir Eyal, Paul L Romain, Christopher Robertson
In this article, we provide a comprehensive analysis and a normative assessment of rationing through inconvenience as a form of rationing. By "rationing through inconvenience" in the health sphere, we refer to a nonfinancial burden (the inconvenience) that is either intended to cause or has the effect of causing patients or clinicians to choose an option for health-related consumption that is preferred by the health system for its fairness, efficiency, or other distributive desiderata beyond assisting the immediate patient...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457239/patient-care-to-public-health-to-synthetic-biology
#3
EDITORIAL
(no author information available yet)
The January-February 2018 issue of the Hastings Center Report includes pieces addressing patient care concerns that lie at the original core of bioethics and pieces that reflect the field's growing breadth. Among the pieces getting at the original core is an article by philosopher Daniel Brudney on the moral values underpinning surrogate decision-making. The article and the two commentaries that follow it contribute to the debate on the moral authority of surrogate decision-makers. Several items in the issue take up matters of public health and health policy...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29457238/rationing-care-through-collaboration-and-shared-values
#4
James E Sabin
Although "rationing" continues to be a dirty word for the public in health policy discourse, Nir Eyal and colleagues handle the concept exactly right in their article in this issue of the Hastings Center Report. They correctly characterize rationing as an ethical requirement, not a moral abomination. They identify the key health policy question as how rationing can best be done, not whether it should be done at all. They make a cogent defense of what they call "rationing through inconvenience" as a justifiable allocational technique...
January 2018: Hastings Center Report
https://www.readbyqxmd.com/read/29455169/positron-emission-tomography-pet-for-prediction-of-glioma-histology-protocol-for-an-individual-level-data-meta-analysis-of-test-performance
#5
Nikolaos A Trikalinos, Takashi Nihashi, Evangelos Evangelou, Teruhiko Terasawa
INTRODUCTION: Gliomas, the most commonly diagnosed primary brain tumours, are associated with varied survivals based, in part, on their histological subtype. Therefore, accurate pretreatment tumour grading is essential for patient care and clinical trial design. METHODS AND ANALYSIS: We will perform an individual-level data meta-analysis of published studies to evaluate the ability of different types of positron emission tomography (PET) to differentiate high from low-grade gliomas...
February 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29455166/the-development-of-an-online-intervention-care-assist-to-support-male-caregivers-of-women-with-breast-cancer-a-protocol-for-a-mixed-methods-study
#6
Janelle V Levesque, Martha Gerges, Afaf Girgis
INTRODUCTION: It is projected that 17 730 women will be diagnosed with breast cancer in Australia in 2017, with 3114 of these predicted to be fatal. Caregiving for a person with cancer can significantly impact caregivers' physical and mental health. Many caregivers feel ill-prepared for this role, especially when care involves complex medical needs accompanied by the psychological challenges experienced following a cancer diagnosis. METHODS AND ANALYSIS: This study employs a convergent, parallel, mixed methods design combining an online survey with an optional interview...
February 17, 2018: BMJ Open
https://www.readbyqxmd.com/read/29453548/-big-data-from-clinical-routine
#7
REVIEW
U Mansmann
BACKGROUND: Over the past 100 years, evidence-based medicine has undergone several fundamental changes. Through the field of physiology, medical doctors were introduced to the natural sciences. Since the late 1940s, randomized and epidemiological studies have come to provide the evidence for medical practice, which led to the emergence of clinical epidemiology as a new field in the medical sciences. Within the past few years, big data has become the driving force behind the vision for having a comprehensive set of health-related data which tracks individual healthcare histories and consequently that of large populations...
February 16, 2018: Zeitschrift Für Rheumatologie
https://www.readbyqxmd.com/read/29453507/interprofessional-education-opportunities-and-challenges-for-psychology
#8
Wendy Ward, Alexandra Zagoloff, Cortney Rieck, William Robiner
This manuscript is an outgrowth of an invited panel presentation at the national Association for Psychologists in Academic Health Centers Conference in 2017 on Interprofessional Education (IPE). IPE is a structured and transformative educational strategy designed to provide active learning experiences where trainees from diverse healthcare professions gain shared content knowledge plus collaboration skills as they learn about, from, and with each other. Collaboration skills include understanding professional role distinctions and overlap, effective team-based communication, shared values/ethics and respect for each other's expertise, and teamwork dynamics...
February 16, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29453477/effects-of-bilateral-nasal-packing-on-oxygen-saturation-and-blood-pressure
#9
Meera Bista
INTRODUCTION: Nasal packing is one of the most common rhinological procedures in ENT practice exerting local in nose and systemic effects. Systemic effects may be due to poor sleep quality, respiratory difficulty, decreased oxygen saturation, circulatory problems and toxic shock syndrome which can threaten the life of a person.The study was done to investigate the effect on bilateral nasal packing on blood oxygen saturation and blood pressure changes. METHODS: A cross-sectional prospective study was undertaken in Kathmandu Medical College from January 2017 to June 2017...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453469/demographic-and-clinical-profile-in-patients-with-liver-cirrhosis-in-a-tertiary-care-hospital-in-central-nepal
#10
Subash Bhattarai, Merina Gyawali, Khus Raj Dewan, Gaurav Shrestha
INTRODUCTION: Liver cirrhosis is an important health problem worldwide and is a common disease in Nepal. The profile of cirrhosis may vary due to different factors. This study was undertaken to see the demographic and clinical profiles of patients with cirrhosis of liver attending a tertiary care hospital in Central Nepal. METHODS: Six hundred patients with clinical features, laboratory and sonological findings suggestive of chronic liver dysfunction and endoscopic evidence of portal hypertension were included in the study...
October 2017: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/29453304/protocol-investigating-the-clinical-utility-of-an-objective-measure-of-attention-impulsivity-and-activity-qbtest-for-optimising-medication-management-in-children-and-young-people-with-adhd-qbtest-utility-for-optimising-treatment-in-adhd-quota-a-feasibility
#11
Charlotte L Hall, Marilyn James, Sue Brown, Jennifer L Martin, Nikki Brown, Kim Selby, Julie Clarke, Hena Vijayan, Boliang Guo, Kapil Sayal, Chris Hollis, Madeleine J Groom
INTRODUCTION: Attention-deficit hyperactivity disorder (ADHD) is characterised by symptoms of inattention, hyperactivity and impulsivity. To improve outcomes, the National Institute for Health and Care Excellence ADHD guidelines recommend regular monitoring of symptoms when children commence medication. However, research suggests that routine monitoring rarely happens, and clinicians often rely on subjective information such as reports from parents and teachers to ascertain improvement...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29452958/brca1-mutation-spectrum-functions-and-therapeutic-strategies-the-story-so-far
#12
REVIEW
Babita Sharma, Raman Preet Kaur, Sonali Raut, Anjana Munshi
BRCA1 gene mutations account for about 25-28% of hereditary Breast Cancer as BRCA1 is included in the category of high penetrance genes. Except for few commonmutations, there is a heterogenous spectrum of BRCA1 mutations in various ethnic groups. 185AGdel and 5382ins Care the most common BRCA1 alterations (founder mutations) which have been identified in most of the population. This review has been compiled with an aim to consolidate the information on genetic variants reported in BRCA1 found in various ethnic groups, their functional implications if known; involvement of BRCA1 in various cellular pathways/processes and potential BRCA1 targeted therapies...
January 8, 2018: Current Problems in Cancer
https://www.readbyqxmd.com/read/29452625/knowledge-regarding-noncytotoxic-medication-extravasation-among-registered-nurses-working-in-western-saudi-arabia
#13
Mo'men Sisan, Ahmad Rayan, Soha Elmorsy, Hamza Elyan, Mosab Salahat
Extravasation and infiltration are among the most common intravenous therapy complications. For noncytotoxic agents, the incidence of extravasation remains unknown. There has been little research into extravasation due to ethical considerations limiting controlled research; most evidences are based on small, uncontrolled trials or case reports. The purpose of this study was to assess the knowledge level regarding noncytotoxic medications extravasation and its associated factors among staff nurses.A descriptive correlational design using self-administered questionnaire was employed...
March 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/29450795/ethics-and-confidentiality-for-psychologists-in-academic-health-centers
#14
Kathleen Ashton, Amy Sullivan
Psychologists in academic health centers (AHC) face important ethical issues including confidentiality when working with a multidisciplinary team, sharing of information through the electronic health record, obtaining informed consent in a fast-paced healthcare environment, cultural competency in the medical setting, and issues related to supervision and training. The goal of this paper is to describe ethical issues for psychologists in AHCs in the context of case examples, and to consider ethical decision-making tools to enhance clinical care...
February 15, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29450782/-is-the-refusal-of-invasive-or-noninvasive-ventilation-in-a-child-with-spinal-muscular-atrophy-ethically-justified
#15
Martina Radner, Annette Henry
We report about an infant who was diagnosed with spinal muscular atrophy type 1 (Werdnig-Hoffmann) at the age of 7 weeks. In a detailed discussion with the physicians the parents decided against mechanical ventilation in the event of either acute or chronical respiratory failure. During care at home all palliative actions were taken to optimize the quality of life for the child. The boy died at the age of 7 months at home. Whether continuous mechanical ventilation in a child with spinal muscular atrophy type 1 should be the individual decision of the parents or whether it should never be offered by the physicians is discussed controversially in the present medical literature...
February 15, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29449297/delivering-safe-and-effective-test-result-communication-management-and-follow-up-a-mixed-methods-study-protocol
#16
Maria R Dahm, Andrew Georgiou, Johanna I Westbrook, David Greenfield, Andrea R Horvath, Denis Wakefield, Ling Li, Ken Hillman, Patrick Bolton, Anthony Brown, Graham Jones, Robert Herkes, Robert Lindeman, Michael Legg, Meredith Makeham, Daniel Moses, Dauda Badmus, Craig Campbell, Rae-Anne Hardie, Julie Li, Euan McCaughey, Gorkem Sezgin, Judith Thomas, Nasir Wabe
INTRODUCTION: The failure to follow-up pathology and medical imaging test results poses patient-safety risks which threaten the effectiveness, quality and safety of patient care. The objective of this project is to: (1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility and accountability; (2) harness health information technology (IT) to inform and monitor test-result management; (3) enhance the contribution of consumers to the establishment of safe and effective test-result management systems...
February 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29446789/medical-advancements-emergency-contraception-ec-medico-legal-implications-of-ec-on-adolescents
#17
F Signore, S Napoletano, V Bruti, N M di Luca
The article's main focus is documenting what the best options are in order to make sure that minors are allowed to play a key role in the management of issues arising from the use of emergency contraception. In that regard, there is a lack of clean-cut legislative measures and, although there are several legal and ethical norms designed to get parents or legal guardians involved in such decisions, there seems to be an increasingly widespread tendency to give weight to the minor's will, thus acknowledging her decision-making capacity...
January 2018: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29445722/genetic-testing-between-private-and-public-interests-some-legal-and-ethical-reflections
#18
REVIEW
Judit Sándor
In Europe, there is a wide variety of genetic tests that various private companies offer to patients or to consumers. More and more people have become curious about their genetic predisposition and susceptibility. Most public health-care systems, however, are not adequately prepared for responding to these new demands and to the results of these genetic tests as, quite often, there is no available therapy for the identified genetic condition. This discrepancy between the newly emerging expectations and the insufficient responses contributes to a further rift between the public and private sectors of health care...
2018: Frontiers in Public Health
https://www.readbyqxmd.com/read/29444786/task-sharing-to-improve-the-prevention-diagnosis-and-management-of-rheumatic-heart-disease-a-systematic-review-protocol
#19
Leila Hussein Abdullahi, Inge Smit, Mark E Engel, David A Watkins, Liesl Joanna Zühlke
INTRODUCTION: Rheumatic heart disease (RHD) remains an important cause of cardiovascular morbidity and mortality globally due to weak health systems in many countries. RHD can be effectively prevented and managed; however, RHD-related interventions have not been widely adopted in countries with severe human resource constraints. Task sharing is a recognised approach to personnel shortages that could prove effective for RHD and has, anecdotally, been attempted in a few settings. We propose a systematic review and meta-analysis protocol to assess models that use non-physician workers to expand access to, and quality of, RHD-related healthcare...
February 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29444712/physical-activity-as-treatment-for-alcohol-use-disorders-fitforchange-study-protocol-for-a-randomized-controlled-trial
#20
Mats Hallgren, Victoria Andersson, Örjan Ekblom, Sven Andréasson
BACKGROUND: Help-seeking for alcohol use disorders (AUDs) is low and traditional treatments are often perceived as stigmatizing. Physical activity has positive effects on mental and physical health which could benefit this population. We propose to compare the effects of aerobic training, yoga, and usual care for AUDs in physically inactive Swedish adults. METHODS: This is a three-group, parallel, single-blind, randomized controlled trial (RCT). In total, 210 adults (aged 18-75 years) diagnosed with an AUD will be invited to participate in a 12-week intervention...
February 14, 2018: Trials
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