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decision making capacity

Denice Kamugumya, Jill Olivier
BACKGROUND: Public-private partnership (PPP) has been suggested as a tool to assist governments in lower to middle income countries fulfil their responsibilities in the efficient delivery of health services. In Tanzania, although the idea of PPP has existed for many years in the health sector, there has been limited coordination, especially at a district level - which has contributed to limited health gains or systems strengthening obviously seen as a result of PPP. METHODS: This case study was conducted in the Bagamoyo district of Tanzania, and employed in-depth interviews, document reviews, and observations methods...
October 21, 2016: BMC Health Services Research
Samia A Hurst, Alex Mauron
Assisting suicide is legal in Switzerland if it is offered without selfish motive to a person with decision-making capacity. Although the 'Swiss model' for suicide assistance has been extensively described in the literature, the formally and informally protected liberties and claims of assistors and recipients of suicide assistance in Switzerland are incompletely captured in the literature. In this article, we describe the package of rights involved in the 'Swiss model' using the framework of Hohfeldian rights as modified by Wenar...
October 21, 2016: Bioethics
Maria Agapova, Brian B Bresnahan, Mitchell Higashi, Larry Kessler, Louis P Garrison, Beth Devine
The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating...
October 19, 2016: Journal of Evaluation in Clinical Practice
Ahmad Reza Hosseinpoor, Devaki Nambiar, Anne Schlotheuber, Daniel Reidpath, Zev Ross
BACKGROUND: It is widely recognised that the pursuit of sustainable development cannot be accomplished without addressing inequality, or observed differences between subgroups of a population. Monitoring health inequalities allows for the identification of health topics where major group differences exist, dimensions of inequality that must be prioritised to effect improvements in multiple health domains, and also population subgroups that are multiply disadvantaged. While availability of data to monitor health inequalities is gradually improving, there is a commensurate need to increase, within countries, the technical capacity for analysis of these data and interpretation of results for decision-making...
October 19, 2016: BMC Medical Research Methodology
Y Krylova, V Polyakova, I Kvetnoy, I Kogan, L Dzhemlikhanova, D Niauri, A Gzgzyan, E Ailamazyan
: Abstracts Background: Implantation failure of in vitro fertilization (IVF) cycles is recognized as one of key problems in contemporary reproductive medicine. Implantation itself is a multifactorial process and one can hardly expect to find a single criterion for the endometrium receptivity. Endometrium biopsy still remains the most applicable technique to diagnose abnormalities causing decrease or complete loss of endometrial receptivity. MATERIALS AND METHODS: We have studied 95 endometrial biopsy samples from 45 patient with I/II stage endometriosis and 40 controls from October 2014 to December 2015...
October 2016: Gynecological Endocrinology
Felice N van Erning, Maryska L G Janssen-Heijnen, Johannes A Wegdam, Gerrit D Slooter, Jan H Wijsman, Art Vreugenhil, Tonneke A J M Beijers, Lonneke V van de Poll-Franse, Valery E P P Lemmens
INTRODUCTION: Among the elderly, the impairment of functional capacities due to neuropathy can have a significant impact. The aim of the present study was to investigate the course of neuropathic symptoms among elderly patients with stage III colon cancer treated with CAPOX (capecitabine, oxaliplatin), capecitabine monotherapy, or no adjuvant chemotherapy. MATERIALS AND METHODS: The Netherlands Cancer Registry was used to select patients with stage III colon cancer and aged ≥ 70 years...
September 17, 2016: Clinical Colorectal Cancer
Hui Min Lim, Lee Gan Goh, T Thirumoorthy
Medical reports are required to support court applications to appoint a deputy to make decisions on behalf of a person who has lost mental capacity. The doctor writing such a medical report needs to be able to systematically assess the mental capacity of the person in question, in order to gather the necessary evidence for the Court to make a decision. If the medical report is not adequate, the application will be rejected and the appointment of the deputy delayed. This article sets out the best practices for performing the assessment, and the common errors, issues of concern and best practices in writing the medical report...
October 18, 2016: Singapore Medical Journal
Tomas L Griebling
No abstract text is available yet for this article.
November 2016: Journal of Urology
Douglas MacKay, Alexandra Robinson
Governments must determine the legal procedures by which their residents are registered, or can register, as organ donors. Provided that governments recognize that people have a right to determine what happens to their organs after they die, there are four feasible options to choose from: opt-in, opt-out, mandated active choice, and voluntary active choice. We investigate the ethics of these policies' use of nudges to affect organ donor registration rates. We argue that the use of nudges in this context is morally problematic...
November 2016: American Journal of Bioethics: AJOB
Anne C Grunseit, Samantha Rowbotham, Melanie Pescud, Devon Indig, Sonia Wutzke
Issue addressed: The Australian National Partnership Agreement on Preventive Health (NPAPH) charged states and territories with the development and implementation of the Healthy Workers Initiative (HWI) to improve workplace health promotion. Most evaluation efforts focus on the setting (micro) level. In the present study the HWI at the meso-level (state program development) was examined to understand how jurisdictions navigated theoretical, practical, and political priorities to develop their programs, and the programmatic choices that support or hinder perceived success...
October 13, 2016: Health Promotion Journal of Australia
Debjani Mueller, Iñaki Gutiérrez-Ibarluzea, Tara Schuller, Marco Chiumente, Jeonghoon Ahn, Andres Pichon-Riviere, Sebastian García-Martí, David Grainger, Elizabeth Cobbs, Marco Marchetti
OBJECTIVES: Health technology assessment (HTA) yields information that can be ideally used to address deficiencies in health systems and to create a wider understanding of the impact of different policy considerations around technology reimbursement and use. The structure of HTA programs varies across different jurisdictions according to decision-maker needs. Moreover, conducting HTA requires specialized skills. Effective decision making should include multiple criteria (medical, economic, technical, ethical, social, legal, and cultural) and requires multi-disciplinary teams of experts working together to produce these assessments...
October 17, 2016: International Journal of Technology Assessment in Health Care
Bethany L Strong, Sarah-Blythe Ballard, Wendy Braund
The American College of Preventive Medicine Policy Committee makes policy guidelines and recommendations on preventive medicine and public health topics for public health decision makers. After a review of the current evidence available in 2016, the College is providing a consensus-based set of policy recommendations designed to reduce firearm-related morbidity and mortality in the U.S. These guidelines address seven general areas pertaining to the public health threat posed by firearms: gun sales and background checks, assault weapons and high-capacity weapons, mental health, research funding, gun storage laws, and physician counseling...
October 12, 2016: American Journal of Preventive Medicine
Michael Parker, Patricia Kingori
There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives...
2016: PloS One
Ronni Hayon
Transgender and gender-nonconforming individuals experience significant health disparities. They are more likely to use drugs and alcohol, smoke, be diagnosed with HIV infection or other sexually transmitted infections, and experience depression or attempt suicide. Many also experience discrimination within the health care system. Office-level strategies to create a safe and affirming space for gender-expansive patients include posting of a nondiscrimination statement, use of intake forms that ask about current gender identity and birth-assigned sex, provision of gender-neutral restrooms, and staff training in use of appropriate language...
October 2016: FP Essentials
Suzette C Brémault-Phillips, Jasneet Parmar, Steven Friesen, Laura G Rogers, Ashley Pike, Bryan Sluggett
BACKGROUND: The Decision-Making Capacity Assessment (DMCA) Model includes a best-practice process and tools to assess DMCA, and implementation strategies at the organizational and assessor levels to support provision of DMCAs across the care continuum. A Developmental Evaluation of the DMCA Model was conducted. METHODS: A mixed methods approach was used. Survey (N = 126) and focus group (N = 49) data were collected from practitioners utilizing the Model. RESULTS: Strengths of the Model include its best-practice and implementation approach, applicability to independent practitioners and inter-professional teams, focus on training/mentoring to enhance knowledge/skills, and provision of tools/processes...
September 2016: Canadian Geriatrics Journal: CGJ
Marco Gipponi, Piero Fregatti, Alessandro Garlaschi, Federica Murelli, Cecilia Margarino, Francesca Depaoli, Paola Baccini, Maurizio Gallo, Daniele Friedman
OBJECTIVE: A prospective observational clinical study was undertaken to assess the accuracy of preoperative Axillary Ultrasound (AUS) plus Fine-Needle Aspiration Cytology (FNAC) as well as and its clinical utility, that is the capacity of the information supplied by the test to guide the clinical decision-making. MATERIALS AND METHODS: from January 2013 to August 2015, 400 female patients with pT1-3 cN0 operable breast cancer underwent AUS with FNAC at the Breast Unit of the "IRCCS San Martino-IST" in Genoa (Italy)...
October 8, 2016: Breast: Official Journal of the European Society of Mastology
Amelia Barwise, Lisbeth Garcia-Arguello, Yue Dong, Manasi Hulyalkar, Marija Vukoja, Marcus J Schultz, Neill K J Adhikari, Benjamin Bonneton, Oguz Kilickaya, Rahul Kashyap, Ognjen Gajic, Christopher N Schmickl
BACKGROUND: The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. One of CERTAIN's key features is clinical decision support providing point-of-care information about common acute illness syndromes, procedures, and medications in an index card format...
October 3, 2016: BMC Medical Informatics and Decision Making
F Reed Johnson, Mo Zhou
Demands for greater transparency in US regulatory assessments of benefits and risks, together with growing interest in engaging patients in Food and Drug Administration regulatory decision making, have resulted in several recent regulatory developments. Although Food and Drug Administration's Center for Drug Evaluation and Research (CDER) and Center for Devices and Radiological Health (CDRH) have established patient-engagement initiatives, CDRH has proposed guidelines for considering quantitative data on patients' benefit-risk perspectives, while CDER has focused on a more qualitative approach...
September 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
Danielle Magaldi, Leora Trub
OBJECTIVE: Spiritual/religious/non-religious (S/R/N) identity development is often neglected in psychotherapy training and represents an area where psychotherapists feel they lack competence. Such feelings can become even more pronounced when it comes to S/R/N self-disclosure. This study explores the decisions therapists make regarding self-disclosure, which impacts the psychotherapy process. METHOD: This grounded theory study explores psychotherapists' S/R/N self-disclosure based on qualitative interviews with 21 psychotherapists representing varied theoretical orientations and spiritual, religious, atheist, and agnostic backgrounds...
October 6, 2016: Psychotherapy Research: Journal of the Society for Psychotherapy Research
Aizhan Tursunbayeva, Raluca Bunduchi, Massimo Franco, Claudia Pagliari
OBJECTIVE: This systematic review aimed to: (1) determine the prevalence and scope of existing research on human resource information systems (HRIS) in health organizations; (2) analyze, classify, and synthesize evidence on the processes and impacts of HRIS development, implementation, and adoption; and (3) generate recommendations for HRIS research, practice, and policy, with reference to the needs of different stakeholders. METHODS: A structured search strategy was used to interrogate 10 electronic databases indexing research from the health, social, management, technology, and interdisciplinary sciences, alongside gray literature sources and reference lists of qualifying studies...
October 5, 2016: Journal of the American Medical Informatics Association: JAMIA
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