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https://www.readbyqxmd.com/read/29907553/development-and-evaluation-of-an-ethical-guideline-for-decisions-to-limit-life-prolonging-treatment-in-advanced-cancer-protocol-for-a-monocentric-mixed-method-interventional-study
#1
Katsiaryna Laryionava, Katja Mehlis, Elena Bierwirth, Friederike Mumm, Wolfgang Hiddemann, Pia Heußner, Eva C Winkler
BACKGROUND: Many patients with advanced cancer receive chemotherapy close to death and are referred too late to palliative or hospice care, and therefore die under therapy or in intensive care units. Oncologists still have difficulties in involving patients appropriately in decisions about limiting tumor-specific or life-prolonging treatment. OBJECTIVE: The aim of this Ethics Policy for Advanced Care Planning and Limiting Treatment Study is to develop an ethical guideline for end-of-life decisions and to evaluate the impact of this guideline on clinical practice regarding the following target goals: reduction of decisional conflicts, improvement of documentation transparency and traceability, reduction of distress of the caregiver team, and better knowledge and consideration of patients' preferences...
June 15, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29906317/essential-considerations-in-developing-attention-control-groups-in-behavioral-research
#2
Dawn M Aycock, Matthew J Hayat, Ashley Helvig, Sandra B Dunbar, Patricia C Clark
Attention control groups strengthen randomized controlled trials of behavioral interventions, but researchers need to give careful consideration to the attention control activities. A comparative effectiveness research framework provides an ideal opportunity for an attention control group as a supplement to standard care, so participants potentially receive benefit regardless of group assignment. The anticipated benefit of the control condition must be independent of the study outcome. Resources needed for attention control activities need to be carefully considered and ethical considerations carefully weighed...
June 2018: Research in Nursing & Health
https://www.readbyqxmd.com/read/29905632/an-ethical-claim-for-providing-medical-recommendations-in-pediatric-intensive-care
#3
Katie M Moynihan, Melanie A Jansen, Shih-Ning Liaw, Peta M A Alexander, Robert D Truog
The Declaration of Geneva was recently revised to emphasize patient autonomy and the importance of clinicians sharing medical knowledge. This reflects the welcome evolution of the doctor-patient relationship from one of paternalism to more informed, shared decision-making. Unfortunately, there is an increasing trend for clinicians to avoid making recommendations, instead providing a "menu" of care options from which patients and families must choose. This seems to be underpinned by the belief that it is unacceptably paternalistic to give guidance as to which course of action may be best to take...
June 13, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29905139/the-four-quadrant-approach-to-ethical-issues-in-burn-care
#4
Chad M Teven, Lawrence J Gottlieb
Burn injuries raise questions about decision-making capacity, informed consent, medical decision making, patient autonomy, the patient-physician relationship, and medical futility that must be acutely addressed. A commonly used approach to managing ethical challenges focuses on moral principles including respect for patient autonomy, beneficence, nonmaleficence, and justice. Another paradigm for ethical analysis is the "four-quadrant" approach, which poses questions for a given case regarding medical indications, patient preferences, quality of life, and contextual features...
June 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29905138/ask-me-about-my-pearls-burn-care-ethics-and-creative-writing
#5
Debra Ann Reilly, Steve Langan
Channeling feelings into the written word rather than the scalpel was at the heart of the creative writing challenge that the first author (DR) accepted when she joined the Seven Doctors Project at the University of Nebraska Medical Center in 2008. Burnout has become recognized as a factor undermining physicians' quality of life, and the practice of creative writing helps mitigate stress and sustain a successful practice. When physicians partner with and are mentored by a seasoned creative writer, creative writing can serve as an exercise in ethical reflection, which is particularly valuable at mid-career; this is the subject of the following dialogue between one physician writer and the facilitator of the Seven Doctors Project creative writing class...
June 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29905136/ethics-of-burn-wound-care-in-a-low-middle-income-country
#6
Shelley Wall, Nikki Allorto, Ross Weale, Victor Kong, Damian Clarke
This review focuses on burn care in low- and middle-income countries (LMICs). It attempts to put the burden of disease in perspective by showing that burn care is under-resourced across the spectrum of LMICs and by interrogating the ethical dilemmas and challenges that staff face in caring for burn patients in this environment, with a focus on South Africa. More specifically, it will attempt to address the following issues: the threshold for utilizing the intensive care unit (ICU), how to balance treatment against cost, the percentage burn considered survivable and how it should be determined, the use of skin from both cadavers and living related donors, and the appropriate ethical guidelines for LMICs...
June 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29905132/should-cosmetic-outcome-influence-discussions-about-goals-of-care-for-severely-burned-patients
#7
Yuk Ming Liu, Kathleen Skipton Romanowski
We focus on surrogate decision making and, specifically, the topic of cosmetic outcomes following burn injury in a case in which potential surrogates dispute what the patient would have wanted. In particular, we examine the choice and role of surrogate decision makers in light of ethical principles that guide surrogate decision making. We also examine whether and when cosmesis should enter into goals of care discussions and consider potential roles cosmetic outcomes could play in such discussions. Finally, we discuss how caregivers should respond when surrogate decision makers suggest cosmetic results as a reason for withdrawing care...
June 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29903852/transplants-for-non-lethal-conditions-a-case-against-hand-transplantation-in-minors
#8
Charles E Hedges, Philip M Rosoff
Human allografts for life-threatening organ failure have been demonstrated to be lifesaving and are now considered to be standard of care for many conditions. Transplantation of non-vital anatomic body parts has also been accomplished. Hand transplantation after limb loss in adults has been shown to offer some promising benefits in both functional and psychological measures in preliminary studies. It has been suggested to expand eligibility criteria to include minors, with one such operation having already been performed...
June 14, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29903795/hepatitis-c-virus-infection-and-hospital-related-outcomes-a-systematic-review-protocol
#9
Lianping Ti, Michelle Ng, Lindila Awendila, Patrizia Maria Carrieri
INTRODUCTION: People living with hepatitis C virus (HCV) infection are disproportionately over-represented in the healthcare system due to various individual and contextual circumstances, including comorbidities and socioeconomic marginalisation. With growing trends in morbidity and mortality related to HCV infection, HCV is becoming a significant health and financial burden on the healthcare system, particularly in acute hospital settings. It is noteworthy that with the advent of direct-acting antiviral therapy the increasing number of patients who are cured of HCV could potentially result in different patterns of hospital-related outcomes over time...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903794/child-and-adolescent-musculoskeletal-pain-cam-pain-feasibility-study-testing-a-method-of-identifying-recruiting-and-collecting-data-from-children-and-adolescents-who-consult-about-a-musculoskeletal-condition-in-uk-general-practice
#10
Zoe A Michaleff, Paul Campbell, Alastair D Hay, Louise Warburton, Kate M Dunn
OBJECTIVES: Test a method of identifying, recruiting and collecting data from children and adolescents who consult their general practitioner about a musculoskeletal condition. DESIGN: Prospective cohort feasibility study. SETTING: 13 general practices in West Midlands of England. PARTICIPANTS: Patients aged 8-19 years who consult their general practice about a musculoskeletal condition. Patients were identified via a relevant musculoskeletal Read code entered at the point of consultation...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29903792/realist-evaluation-of-the-use-of-patient-experience-data-to-improve-the-quality-of-inpatient-mental-health-care-euripides-in-england-study-protocol
#11
Scott Weich, Sarah-Jane Hannah Fenton, Kamaldeep Bhui, Sophie Staniszewska, Jason Madan, Michael Larkin, Elizabeth Newton, David Crepaz-Keay, Alastair Canaway, Charlotte Croft, Frances Griffiths
INTRODUCTION: Inpatient mental healthcare continues to be an area of high risk and where patients report negative experiences. To ensure the patient voice is heard, National Health Service (NHS) Trusts are required to collect feedback from patients routinely. We do not know what kinds of feedback are most important or what management processes are needed to translate this into effective action plans. Further, we do not know if this makes any difference to the patients themselves. This study seeks to explore which of the many different approaches to collecting and using patient experience data are the most useful for supporting improvements in inpatient mental healthcare...
June 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29900849/-health-data
#12
Dominique Polton
Healthcare is considered as one of the most promising areas where big data can be applied to foster innovation for the benefit of patients and of the whole system. Healthcare analytics have the potential to accelerate R&D, increase knowledge on diseases and risk factors, improve treatments, develop personalised medicine, help physicians with decision support systems… The access to data is also a driving force for patients' empowerment and for the democratic debate. However, there are also concerns about the societal, economic and ethic impacts of this wave of digitization and of the growing use of data, algorithms and artificial intelligence...
May 2018: Médecine Sciences: M/S
https://www.readbyqxmd.com/read/29900801/biobanking-in-the-pediatric-critical-care-setting-adolescent-young-adult-perspectives
#13
Erin D Paquette, Sabrina F Derrington, Avani Shukla, Neha Sinha, Sarah Oswald, Lauren Sorce, Kelly N Michelson
Biorepository research in children raises numerous ethical questions that are heightened in the pediatric intensive care unit (PICU) setting. We conducted a cross-sectional, interview-based study of 20 adolescent/young adult (A/YA) PICU patients and 75 parents of PICU patients to elucidate perspectives on biorepository research. A/YAs had a positive attitude toward biobanking. In young adults, comprehension was higher for knowledge of a choice to withdraw and participate in the research and lower for purpose, procedures, risks, and benefits of participation...
June 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
https://www.readbyqxmd.com/read/29899014/a-surrogate-s-secrets-are-n-t-safe-with-me-patient-confidentiality-in-the-care-of-a-gestational-surrogate
#14
Claire Horner, Paul Burcher
Gestational surrogacy relies on a legal agreement between the surrogate and the intended parents to define the roles and responsibilities of the parties, including explicit consent by the surrogate to allow the physician to release all pregnancy-related medical information to the intended parents. In the event of surrogate misconduct, however, physicians may feel conflicted if the surrogate asks the physician to withhold information about potentially dangerous behaviour in pregnancy from the intended parents...
June 13, 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29898914/physician-alert-the-legal-risks-associated-with-on-call-duties-in-the-usa
#15
Zachary R Paterick, Nachiket J Patel, Timothy Edward Paterick
On-call physicians encounter a diverse aggregate of interfaces with sundry persons concerning patient care that may surface potential legal peril. The duties and obligations of an on-call physician, who must act as a fiduciary to all patients, create a myriad of circumstances where there is a risk of falling prey to legal ambiguities. The understanding of the doctor-patient relationship, the obligations of physicians under the Emergency Medical Treatment and Labor Act, the meaning of medical informed consent and the elements of negligence will help physicians avoid the legal risk associated with the various encounters of being on call...
June 13, 2018: Postgraduate Medical Journal
https://www.readbyqxmd.com/read/29898620/nurses-patients-and-family-caregivers-perceptions-of-compassionate-nursing-care
#16
Banafsheh Tehranineshat, Mahnaz Rakhshan, Camellia Torabizadeh, Mohammad Fararouei
BACKGROUND: Compassion is the core of nursing care and the basis of ethical codes. Due to the complex and abstract nature of this concept, there is a need for further investigations to explore the meaning and identify compassionate nursing care. OBJECTIVES: The purpose of this study was to identify and describe compassionate nursing care based on the experiences of nurses, patients, and family caregivers. RESEARCH DESIGN: This was a qualitative exploratory study...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29897882/a-radical-rn-bs-nursing-class-outcomes-from-an-integrative-yoga-elective
#17
Carey S Clark
With the knowledge of psychoneuroimmunological responses and the known high stress levels of nursing students, as caring nurse educators, we have become ethically obligated to revise and re-vision our current nursing educational practices. Nurse educators should be motivated to create innovative and radical caring science curricular approaches, so that our nurses of the future are in turn supported in creating caring- healing sustainable bedside practices. This paper details the outcomes from an upper level yoga elective in an RN- BSN program...
June 13, 2018: International Journal of Nursing Education Scholarship
https://www.readbyqxmd.com/read/29895853/genome-wide-sequencing-in-acutely-ill-infants-genomic-medicine-s-critical-application
#18
Jan M Friedman, Yvonne Bombard, Martina C Cornel, Conrad V Fernandez, Anne K Junker, Sharon E Plon, Zornitza Stark, Bartha Maria Knoppers
Diagnostic genome-wide sequencing (exome or genome sequencing and data analysis for high-penetrance disease-causing variants) in acutely ill infants appears to be clinically useful, but the value of this diagnostic test should be rigorously demonstrated before it is accepted as a standard of care. This white paper was developed by the Paediatric Task Team of the Global Alliance for Genomics and Health's Regulatory and Ethics Work Stream to address the question of how we can determine the clinical value of genome-wide sequencing in infants in an intensive care setting...
June 12, 2018: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/29895651/telemedicine-for-the-management-of-neuropsychiatric-symptoms-in-long-term-care-facilities-the-detect-study-methods-of-a-cluster-randomised-controlled-trial-to-assess-feasibility
#19
Antoine Piau, Fati Nourhashemi, Adélaïde De Mauléon, Achille Tchalla, Claude Vautier, Bruno Vellas, Maryline Duboue, Nadège Costa, Pierre Rumeau, Benoit Lepage, Maria Soto Martin
INTRODUCTION: Neuropsychiatric symptoms (NPSs) in elderly patients with dementia are frequent in long-term care facilities (LTCFs) and are associated with adverse events. Telemedicine is an emerging way to provide consultation and care to dependent LTCF residents who may not have easy access to specialty services. Several studies have evaluated telemedicine for dementia care but to date, no study has evaluated its impact in the management of NPS in patients with dementia living in LTCF...
June 12, 2018: BMJ Open
https://www.readbyqxmd.com/read/29895523/the-collaborative-role-of-north-american-departments-of-pediatrics-in-global-child-health
#20
REVIEW
Sophia P Gladding, Patrick T McGann, Andrea Summer, Christiana M Russ, Omolara T Uwemedimo, Martha Matamoros Aguilar, Rana Chakraborty, Molly Moore, Mary Lieh-Lai, Robert Opoka, Cynthia Howard, Chandy C John
Appeals for health equity call for departments of pediatrics to improve the health of all children including those from underserved communities in North America and around the world. Consequently, North American (NA) departments of pediatrics have a role in global child health (GCH) which focuses on providing health care to underserved children worldwide. In this review, we describe how NA departments of pediatrics can collaboratively engage in GCH education, clinical practice, research, and advocacy and summarize best practices, challenges, and next steps for engaging in GCH in each of these areas...
June 12, 2018: Pediatrics
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