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https://www.readbyqxmd.com/read/28149576/duration-of-antibiotic-therapy-in-the-intensive-care-unit
#1
REVIEW
Gabor Zilahi, Mary Aisling McMahon, Pedro Povoa, Ignacio Martin-Loeches
There are certain well defined clinical situations where prolonged therapy is beneficial, but prolonged duration of antibiotic therapy is associated with increased resistance, medicalising effects, high costs and adverse drug reactions. The best way to decrease antibiotic duration is both to stop antibiotics when not needed (sterile invasive cultures with clinical improvement), not to start antibiotics when not indicated (treating colonization) and keep the antibiotic course as short as possible. The optimal duration of antimicrobial treatment for ventilator-associated pneumonia (VAP) is unknown, however, there is a growing evidence that reduction in the length of antibiotic courses to 7-8 days can minimize the consequences of antibiotic overuse in critical care, including antibiotic resistance, adverse effects, collateral damage and costs...
December 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28068948/women-s-preferences-for-childbirth-experiences-in-the-republic-of-ireland-a-mixed-methods-study
#2
Patricia Larkin, Cecily M Begley, Declan Devane
BACKGROUND: How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women's preferences for the most important elements of their childbirth experiences. METHODS: A mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28052343/the-concept-of-medicalisation-reassessed
#3
Joan Busfield
Medicalisation has been an important concept in sociological discussions of medicine since its adoption by medical sociologists in the early 1970s. Yet it has been criticised by some sociologists, in part because it seems too negative about medicine, and modified or replaced by others with concepts deemed more relevant like biomedicalisation and pharmaceuticalisation. My aim in this paper is to reassess the concept and consider whether it still has value in exploring significant aspects of the role of medicine in present-day society...
January 4, 2017: Sociology of Health & Illness
https://www.readbyqxmd.com/read/28049522/paradox-of-the-institution-findings-from-a-hospital-labour-ward-ethnography
#4
Elizabeth C Newnham, Lois V McKellar, Jan I Pincombe
BACKGROUND: Interest in the influence of culture on birth practices is on the rise, and with it comes a sense of urgency to implement practices that aid the normalisation and humanisation of birth. This groundswell is occurring despite a broader cultural milieu of escalating technology-use and medicalisation of birth across the globe. Against this background, rates of epidural analgesia use by women in labour are increasing, despite the risk of side effects. Socio-cultural norms and beliefs are likely to influence pain relief choices but there is currently scant research on this topic...
January 3, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28012200/obesity-bodily-change-and-health-identities-a-qualitative-study-of-canadian-women
#5
Andrea E Bombak, Lee F Monaghan
Medicalised concerns about an obesity crisis persist yet more needs to be learnt about everyday orientations to weight (loss). This article reports and analyses data generated using qualitative methods, including repeated interviews and fieldwork conducted over one year in Canada with women (n = 13) identifying as (formerly) obese. Three ideal types are explored using empirical data: (1) hopeful narratives; (2) disordered eating distress; and (3) weight-cycling or stagnation. Core themes include women's desire to embody a thin(ner) future and the good life, the harms of intentional weight-loss, and resignation to living as a fat woman whilst nonetheless challenging stigma...
December 24, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27933146/operationalising-the-lean-principles-in-maternity-service-design-using-3p-methodology
#6
Iain Smith
The last half century has seen significant changes to Maternity services in England. Though rates of maternal and infant mortality have fallen to very low levels, this has been achieved largely through hospital admission. It has been argued that maternity services may have become over-medicalised and service users have expressed a preference for more personalised care. NHS England's national strategy sets out a vision for a modern maternity service that continues to deliver safe care whilst also adopting the principles of personalisation...
2016: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/27903957/medicalisation-smoking-and-e-cigarettes-evidence-and-implications
#7
Kylie Morphett, Adrian Carter, Wayne Hall, Coral Gartner
There is debate in the tobacco control literature about the value of a medical model in reducing smoking-related harm. The variety of medical treatments for smoking cessation has increased, health professionals are encouraged to use them to assist smoking cessation and tobacco dependence is being described as a 'chronic disease'. Some critics suggest that the medicalisation of smoking undermines the tobacco industry's responsibility for the harms of smoking. Others worry that it will lead smokers to deny personal responsibility for cessation, create beliefs in 'magic bullets' for smoking cessation, or erode smokers' confidence in their ability to quit...
November 30, 2016: Tobacco Control
https://www.readbyqxmd.com/read/27885958/articulating-reproductive-justice-through-reparative-justice-case-studies-of-abortion-in-great-britain-and-south-africa
#8
Catriona Ida Macleod, Siân Beynon-Jones, Merran Toerien
Public health and rights-based approaches to abortion advocacy are well established. Feminists are, however, increasingly using a broader framework of 'reproductive justice', which considers the intersecting conditions that serve to enhance or hinder women's reproductive freedoms, including their capacities to decide about the outcome of their pregnancies. Nonetheless, reproductive justice approaches to abortion are, conceptually, relatively under-developed. We introduce a reparative justice approach as a method of further articulating the concept of reproductive justice...
November 25, 2016: Culture, Health & Sexuality
https://www.readbyqxmd.com/read/27862331/the-concept-of-fragile-skin-a-case-of-disease-mongering-in-dermatology
#9
Peter Elsner
"Disease mongering" is a term proposed by medical journalist Lynn Payer in 1992 as "trying to convince essentially well people that they are sick, or slightly sick people that they are very ill" [1]. Scientifically, it has been defined as the "selling of sickness that widens the boundaries of illness in order to grow markets for those who sell and deliver treatments" [2]. While the promotion of medical products to physicians is a legal right of manufacturers that may serve a legitimate purpose, i.e. informing physicians on innovative treatment options for their patients, disease mongering refers to the medicalisation of conditions that do not fulfil the definition of disease...
November 11, 2016: Journal of the European Academy of Dermatology and Venereology: JEADV
https://www.readbyqxmd.com/read/27862018/what-is-wrong-with-being-a-pill-taker-the-special-case-of-statins
#10
Louisa Polak
In an interview study of decision-making about statins, many participants said they took pills regularly, yet described themselves as 'not really pill-takers'. This paper explores this paradox and its implications. The practice of pill-taking itself can constitute a challenge to the presentation of moral adequacy, beyond the potential for rendering stigmatised illnesses visible. Meeting this challenge involves a complex process of calibrating often-conflicting moral imperatives: to be concerned, but not too concerned, over one's health; to be informed, but not over-informed; and deferential but not over-deferential to medical expertise...
November 16, 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27857243/medicinal-cannabis-moving-the-debate-forward
#11
Giles Newton-Howes, Sam McBride
There has been increased interest in cannabis as a medicine both nationally and internationally. Internationally, cannabis is accepted as a medication for a variety of purposes in a variety of legal guises and this, associated with anecdotes of the utility of cannabis as medication has led for calls for it to be 'medicalised' in New Zealand. This viewpoint discusses the issues associated with this approach to accessing cannabis and some of the difficulties that may be associated with it. It is important doctors are at the forefront of the debate surrounding medicalised cannabis...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27826684/victims-of-disaster-can-ethical-debriefings-be-of-help-to-care-for-their-suffering
#12
Ignaas Devisch, Stijn Vanheule, Myriam Deveugele, Iskra Nola, Murat Civaner, Peter Pype
Victims of disaster suffer, not only at the very moment of the disaster, but also years after the disaster has taken place, they are still in an emotional journey. While many moral perspectives focus on the moment of the disaster itself, a lot of work is to be done years after the disaster. How do people go through their suffering and how can we take care of them? Research on human suffering after a major catastrophe, using an ethics of care perspective, is scarce. People suffering from disasters are often called to be in distress and their emotional difficulties 'medicalised'...
November 8, 2016: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/27801356/medicalisation-and-overdiagnosis-what-society-does-to-medicine
#13
Wieteke van Dijk, Marjan J Faber, Marit A C Tanke, Patrick P T Jeurissen, Gert P Westert
The concept of overdiagnosis is a dominant topic in medical literature and discussions. In research that targets overdiagnosis, medicalisation is often presented as the societal and individual burden of unnecessary medical expansion. In this way, the focus lies on the influence of medicine on society, neglecting the possible influence of society on medicine. In this perspective, we aim to provide a novel insight into the influence of society and the societal context on medicine, in particularly with regard to medicalisation and overdiagnosis...
August 31, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/27780116/-we-re-giving-you-something-so-we-get-something-in-return-perspectives-on-research-participation-and-compensation-among-people-living-with-hiv-who-use-drugs
#14
Alexandra B Collins, Carol Strike, Adrian Guta, Rosalind Baltzer Turje, Patrick McDougall, Surita Parashar, Ryan McNeil
BACKGROUND: Compensation for participating in research has been a fundamental element of the research apparatus despite concerns about its impact on incentivising participation. Researchers and research ethics boards acknowledge that compensation may prompt structurally vulnerable populations, such as people who use drugs (PWUD), to engage in research primarily out of financial need. Thus, institutional restrictions around compensation have been implemented. This study explores the ethical implications of compensation practices aimed at 'protecting' structurally vulnerable people living with HIV (PLHIV) who use drugs within the context of individuals' lived realities...
January 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/27778465/improving-the-health-and-well-being-of-adults-with-conditions-of-a-genetic-origin-views-from-professionals-syndrome-support-groups-and-parents
#15
Marcus Redley, Merel Pannebakker, Anthony Holland
BACKGROUND: Advances in medical genetics herald the possibility that health and social care services could be more responsive to the needs arising from a person's genotype. This development may be particularly important for those men and women whose learning disability (known internationally as intellectual disability) is linked to a neurodevelopmental condition of genetic origin. METHOD: This possibility is tested through interviews with samples of (i) professional 'opinion former' with nationally recognised clinical and/or academic interests in learning disabilities and genetics; (ii) representatives of syndrome organisations prompting the interests of families where someone has a neurodevelopmental condition, and parent-members of these same organisations...
October 24, 2016: Journal of Applied Research in Intellectual Disabilities: JARID
https://www.readbyqxmd.com/read/27768995/non-medical-use-of-prescription-drugs-among-illicit-drug-users-a-case-study-on-an-online-drug-forum
#16
Sanna Rönkä, Anu Katainen
BACKGROUND: The non-medical use of prescription drugs is a growing phenomenon associated with increasing health-related harms. However, little is known about the drivers of this process among illicit drug users. Our aim is to show how the qualities of pharmaceutical drugs, pharmaceutical related knowledge, online communities sharing this knowledge and medical professionals mediate and transform the consumption behaviour related to pharmaceutical drugs. METHODS: The data consist of discussion threads from an online drug use forum...
January 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/27729353/development-of-guidance-on-the-timeliness-in-response-to-acute-kidney-injury-warning-stage-test-results-for-adults-in-primary-care-an-appropriateness-ratings-evaluation
#17
Tom Blakeman, Kathryn Griffith, Dan Lasserson, Berenice Lopez, Jung Y Tsang, Stephen Campbell, Charles Tomson
OBJECTIVES: Tackling the harm associated with acute kidney injury (AKI) is a global priority. In England, a national computerised AKI algorithm is being introduced across the National Health Service (NHS) to drive this change. The study sought to maximise its clinical utility and minimise the potential for burden on clinicians and patients in primary care. DESIGN: An appropriateness ratings evaluation using the RAND/UCLA Appropriateness Method. SETTING: Clinical scenarios were developed to test the timeliness in (1) communication of AKI warning stage test results from clinical pathology services to primary care, and (2) primary care clinician response to an AKI warning stage test result...
October 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27715138/diagnosis-and-management-of-lipoedema-in-the-community
#18
Marie Todd
Lipoedema is a chronic progressive adipose disorder that affects mainly women and presents as symmetrical enlargement of the buttocks and legs. It is commonly misdiagnosed as obesity or lymphoedema, but careful assessment will reveal a disproportionate enlargement below the waist which is resistant to dieting, sparing of the feet, legs are tender or painful to touch and bruise easily, there is occasional orthostatic oedema, and there is often significant psychological morbidity. Lipoedema is a oestrogen-regulated condition with onset around puberty in 78% of women, and there is often a strong family history...
October 2016: British Journal of Community Nursing
https://www.readbyqxmd.com/read/27707557/where-the-thread-of-home-births-never-broke-an-interview-with-susanne-houd
#19
Mário J D S Santos
BACKGROUND: The option of a planned home birth defies medical and social normativity across countries. In Denmark, despite the dramatic decline in the home birth rates between 1960 and 1980, the right to choose the place of birth was preserved. Little has been produced documenting this process. AIM: To present and discuss Susanne Houd's reflection on the history and social dynamics of home birth in Denmark, based in an in-depth interview. METHODS: This paper is part of wider Short Term Scientific Mission (STSM), in which this interview was framed as oral history...
October 1, 2016: Women and Birth: Journal of the Australian College of Midwives
https://www.readbyqxmd.com/read/27703068/hospital-incidence-and-annual-rates-of-hospitalization-for-venous-thromboembolic-disease-in-france-and-the-usa
#20
François-André Allaert, Eric Benzenine, Catherine Quantin
OBJECTIVE: The study was designed to describe the hospital incidences and annual hospitalization rates for venous thromboembolic disease by age and sex in France and the United States on the closest possible methodological bases. METHODS: French statistics are from the PMSI MCO (Programme de médicalisation des système d'information de médecine, chirurgie et obstétrique (French national hospital discharge register)) national database. These are compiled for each calendar year by collating résumé de sortie anonymisé (RSA, anonymous discharge summary) files forwarded and validated by health establishments with admissions in medicine, surgery, obstetrics, and odontology...
October 4, 2016: Phlebology
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