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https://www.readbyqxmd.com/read/28102466/the-care-of-the-ultra-orthodox-jewish-patient
#1
Ezra Gabbay, Matthew W McCarthy, Joseph J Fins
The Ultra-Orthodox Jewish community embraces a system of values and a rigorous behavioral code that are deeply rooted in religious tradition and history. Here we describe some of the unique challenges that stem from the encounter between modern medical practice and the Ultra-Orthodox world. Through examples of clinical and ethical scenarios ranging from prenatal care to end-of-life decisions, we illustrate problems related to observance of age-old practices in a modern hospital setting, balancing acceptance of Divine will with standard risk assessment, reconciliation of patient autonomy with deference to rabbinic authority and fear of stigma associated with mental illness in a traditional society...
January 19, 2017: Journal of Religion and Health
https://www.readbyqxmd.com/read/28101699/humanity-at-the-edge-the-moral-laboratory-of-feeding-precarious-lives
#2
Mette N Svendsen, Iben M Gjødsbøl, Mie S Dam, Laura E Navne
At the heart of anthropology and the social sciences lies a notion of human existence according to which humans and animals share the basic need for food, but only humans have the capacity for morality. Based on fieldwork in a pig laboratory, a neonatal intensive care unit (NICU), and a dementia nursing home, we follow practices of feeding precarious lives lacking most markers of human personhood, including the exercise of moral judgment. Despite the absence of such markers, laboratory researchers and caregivers in these three sites do not abstain from engaging in questions about the moral status of the piglets, infants, and people with dementia in their care...
January 18, 2017: Culture, Medicine and Psychiatry
https://www.readbyqxmd.com/read/28100560/prevalence-impact-and-cost-of-multimorbidity-in-a-cohort-of-people-with-chronic-pain-in-ireland-a-study-protocol
#3
Brian W Slattery, Laura O'Connor, Stephanie Haugh, Christopher P Dwyer, Siobhan O'Higgins, Line Caes, Jonathan Egan, Brian E McGuire
INTRODUCTION: Multimorbidity (MM) refers to the coexistence of two or more chronic conditions within one person, where no one condition is considered primary. As populations age and healthcare provision improves, MM is becoming increasingly common and poses a challenge to the single morbidity approach to illness management, usually adopted by healthcare systems. Indeed, recent research has shown that 66.2% of the people in primary care in Ireland are living with MM. Healthcare usage and cost is significantly associated with MM, and additional chronic conditions lead to exponential increases in service usage and financial costs, and decreases in physical and mental well-being...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28099676/development-of-nurses-professional-competence-early-in-their-career-a-longitudinal-study
#4
Olivia Numminen, Helena Leino-Kilpi, Hannu Isoaho, Riitta Meretoja
BACKGROUND: Research on newly graduated nurses' competence development and associated factors is relatively scarce. METHOD: Data for this longitudinal, descriptive, correlation study were collected during 2012-2014 from 318 Finnish nurses to explore their competence development during the first 3 years after graduation and to estimate the extent to which given work-related factors predicted change in competence. Data were analyzed using NCSS 10 statistical software...
January 1, 2017: Journal of Continuing Education in Nursing
https://www.readbyqxmd.com/read/28099661/pharmaceutical-lobbying-in-brazil-a-missing-topic-in-the-public-health-research-agenda
#5
Francisco José Roma Paumgartten
In the US, where registration of lobbyists is mandatory, the pharmaceutical industry and private health-care providers spend huge amounts of money seeking to influence health policies and government decisions. In Brazil, where lobbying lacks transparency, there is virtually no data on drug industry expenditure to persuade legislators and government officials of their viewpoints and to influence decision-making according to commercial interests. Since 1990, however, the Associação da Indústria Farmacêutica de Pesquisa (Interfarma - Pharmaceutical Research Industry Association), Brazilian counterpart of the Pharmaceutical Research and Manufacturers of America (PhRMA), main lobbying organization of the US pharmaceutical industry, has played a major role in the advocacy of interests of major drug companies...
December 22, 2016: Revista de Saúde Pública
https://www.readbyqxmd.com/read/28098627/global-collaboration-in-acute-care-clinical-research-opportunities-challenges-and-needs
#6
John C Marshall
The most impactful research in critical care comes from trials groups led by clinician-investigators who study questions arising through the day-to-day care of critically ill patients. The success of this model reflects both "necessity"-the paucity of new therapies introduced through industry-led research-and "clinical reality"-nuanced modulation of standard practice can have substantial impact on clinically important outcomes. Success in a few countries has fueled efforts to build similar models around the world and to collaborate on an unprecedented scale in large international trials...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#7
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096704/neonatal-resuscitation-advances-in-training-and-practice
#8
REVIEW
Taylor Sawyer, Rachel A Umoren, Megan M Gray
Each year in the US, some four hundred thousand newborns need help breathing when they are born. Due to the frequent need for resuscitation at birth, it is vital to have evidence-based care guidelines and to provide effective neonatal resuscitation training. Every five years, the International Liaison Committee on Resuscitation (ILCOR) reviews the science of neonatal resuscitation. In the US, the American Heart Association (AHA) develops treatment guidelines based on the ILCOR science review, and the Neonatal Resuscitation Program (NRP) translates the AHA guidelines into an educational curriculum...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28096576/role-of-edaravone-in-managemant-of-septic-peritonitis
#9
Ghada Fouad Elbaradey, Nagat Sayed Elshmaa, Hossam Hodeib
BACKGROUND AND AIMS: Sepsis is a complex rapidly progressive infectious disease that remain a major cause of morbidity and mortality in surgical patients and trauma victims. Edaravone a novel free radical scavenger was approved in 2001 in Japan for treatment of acute cerebral and myocardial infarction. Hence, in this work we attempt to evaluate its role in cases of septic peritonitis (SP). MATERIAL AND METHODS: This is a prospective randomized observer-blinded study carried out in surgical Intensive Care Unit (ICU) after approval by Hospital Ethical Committee...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28096516/newborn-sequencing-in-genomic-medicine-and-public-health
#10
Jonathan S Berg, Pankaj B Agrawal, Donald B Bailey, Alan H Beggs, Steven E Brenner, Amy M Brower, Julie A Cakici, Ozge Ceyhan-Birsoy, Kee Chan, Flavia Chen, Robert J Currier, Dmitry Dukhovny, Robert C Green, Julie Harris-Wai, Ingrid A Holm, Brenda Iglesias, Galen Joseph, Stephen F Kingsmore, Barbara A Koenig, Pui-Yan Kwok, John Lantos, Steven J Leeder, Megan A Lewis, Amy L McGuire, Laura V Milko, Sean D Mooney, Richard B Parad, Stacey Pereira, Joshua Petrikin, Bradford C Powell, Cynthia M Powell, Jennifer M Puck, Heidi L Rehm, Neil Risch, Myra Roche, Joseph T Shieh, Narayanan Veeraraghavan, Michael S Watson, Laurel Willig, Timothy W Yu, Tiina Urv, Anastasia L Wise
The rapid development of genomic sequencing technologies has decreased the cost of genetic analysis to the extent that it seems plausible that genome-scale sequencing could have widespread availability in pediatric care. Genomic sequencing provides a powerful diagnostic modality for patients who manifest symptoms of monogenic disease and an opportunity to detect health conditions before their development. However, many technical, clinical, ethical, and societal challenges should be addressed before such technology is widely deployed in pediatric practice...
January 17, 2017: Pediatrics
https://www.readbyqxmd.com/read/28096255/sheppheartcabg-trial-comprehensive-early-rehabilitation-after-coronary-artery-bypass-grafting-a-protocol-for-a-randomised-clinical-trial
#11
Ida Elisabeth Højskov, Philip Moons, Niels Viggo Hansen, Søren La Cour, Peter Skov Olsen, Christian Gluud, Per Winkel, Jane Lindschou, Lau Caspar Thygesen, Ingrid Egerod, Selina Kikkenborg Berg
INTRODUCTION: Patients undergoing coronary artery bypass graft surgery often experience a range of symptoms. Studies indicate that non-pharmacological interventions such as exercise training and psychoeducation have a positive physiological and psychological effect in early outpatient rehabilitation. The SheppHeartCABG trial will investigate the effect of early comprehensive rehabilitation in early phase rehabilitation versus usual care. The aim of this paper is to present the protocol for the SheppHeartCABG trial...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28095946/electroconvulsive-therapy-ect-for-treating-agitation-in-dementia-major-neurocognitive-disorder-a-promising-option
#12
Oliver M Glass, Brent P Forester, Adriana P Hermida
BACKGROUND: Agitation in patients with dementia increases caretaker burden, increases healthcare costs, and worsens the patient's quality of life. Antipsychotic medications, commonly used for the treatment of agitation in patients with dementia have a box warning from the FDA for elevated mortality risk. Electroconvulsive therapy (ECT) has made significant advances over the past several years, and is efficacious in treating a wide range of psychiatric conditions. We provide a systematic review of published literature regarding the efficacy of ECT for the treatment of agitation in patients with dementia (major neurocognitive disorder)...
January 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28095908/limiting-treatment-and-shortening-of-life-data-from-a-cross-sectional-survey-in-germany-on-frequencies-determinants-and-patients-involvement
#13
Birte Malena Dahmen, Jochen Vollmann, Stephan Nadolny, Jan Schildmann
BACKGROUND: Limiting treatment forms part of practice in many fields of medicine. There is a scarcity of robust data from Germany. Therefore, in this paper, we report results of a survey among German physicians with a focus on frequencies, aspects of decision making and determinants of limiting treatment with expected or intended shortening of life. METHODS: Postal survey among a random sample of physicians working in the area of five German state chambers of physicians using a modified version of the questionnaire of the EURELD Consortium...
January 17, 2017: BMC Palliative Care
https://www.readbyqxmd.com/read/28095761/the-caring-encounter-in-nursing
#14
Gunilla Holopainen, Lisbet Nyström, Anne Kasén
BACKGROUND: The concept 'encounter' occurs in caring literature as a synonym for dialogue and relation describing deeper levels of interaction between patient and nurse. In nursing and caring research, the concept 'caring encounter' is often used without further reflection on the meaning of the concept. Encounters are, however, continuously taking place in the world of caring, which calls for a clarification of the concept. OBJECTIVES: This study is an analysis of the concept of caring encounter in nursing from the patients' and nurses' point of view...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28095759/living-with-end-stage-renal-disease
#15
Karen Schipper, Elleke Landeweer, Tineke A Abma
BACKGROUND: Living with a renal disease often reduces quality of life because of the stress it entails. No attention has been paid to the moral challenges of living with renal disease. OBJECTIVES: To explore the moral challenges of living with a renal disease. RESEARCH DESIGN: A case study based on qualitative research. We used Walker's ethical framework combined with narrative ethics to analyse how negotiating care responsibilities lead to a new perspective on moral issues...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28095758/ethical-difficulties-in-healthcare
#16
Cinzia Leuter, Carmen La Cerra, Santina Calisse, Danila Dosa, Cristina Petrucci, Loreto Lancia
BACKGROUND: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity. OBJECTIVE: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians. METHODS: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28093938/capacity-and-consent
#17
Scott Lamont, Cameron Stewart, Mary Chiarella
INTRODUCTION: Healthcare practitioners have a legal, ethical and professional obligation to obtain patient consent for all healthcare treatments. There is increasing evidence which suggests dissonance and variation in practice in assessment of decision-making capacity and consent processes. AIMS: This study explores healthcare practitioners' knowledge and practices of assessing decision-making capacity and obtaining patient consent to treatment in the acute generalist setting...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28093443/impact-of-advanced-autonomous-non-medical-practitioners-in-emergency-care-protocol-for-a-scoping-study
#18
Mark Sujan, Hannah Howard-Franks, Garry Swann, Kirsti Soanes, Catherine Pope, Robert Crouch, Sophie Staniszewska, Elaine Maxwell, Huayi Huang, Matthew Cooke
INTRODUCTION: Emergency care services are looking for new models of care delivery to deal with changing patient demographics and increased pressures. It has been suggested that advanced non-medical practitioners might be valuable for delivering such new models of care. However, it is not clear what the impact of the deployment of advanced non-medical practitioners in emergency care is. This scoping study addresses the following research question: What is known from the literature about the different types of impact of the deployment of advanced (autonomous) non-medical practitioners in emergency care? METHODS AND ANALYSIS: A scoping study will be undertaken to examine and map the impact of the deployment of advanced non-medical practitioners in emergency care...
January 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/28092316/expanded-newborn-screening-challenges-to-nicu-nurses
#19
Rachel A Joseph
BACKGROUND: Newborn screening programs provide testing for all newborns born in this country for conditions that can potentially cause death or disability. Currently each state is responsible for its programs and the number of disorders screened varies from state to state. The current universal recommended metabolic screening panel may include 32 to 58 disorders. Expansion of the programs has impacted the role of nurses in the neonatal intensive care units (NICUs). Nurses are responsible for facilitating the screening process, educating the family, and assisting with follow-up...
January 12, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/28090077/clinical-and-biological-insights-from-viral-genome-sequencing
#20
Charlotte J Houldcroft, Mathew A Beale, Judith Breuer
Whole-genome sequencing (WGS) of pathogens is becoming increasingly important not only for basic research but also for clinical science and practice. In virology, WGS is important for the development of novel treatments and vaccines, and for increasing the power of molecular epidemiology and evolutionary genomics. In this Opinion article, we suggest that WGS of viruses in a clinical setting will become increasingly important for patient care. We give an overview of different WGS methods that are used in virology and summarize their advantages and disadvantages...
January 16, 2017: Nature Reviews. Microbiology
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