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https://www.readbyqxmd.com/read/29151056/between-professional-values-social-regulations-and-patient-preferences-medical-doctors-perceptions-of-ethical-dilemmas
#1
Berit Bringedal, Karin Isaksson Rø, Morten Magelssen, Reidun Førde, Olaf Gjerløv Aasland
BACKGROUND: We present and discuss the results of a Norwegian survey of medical doctors' views on potential ethical dilemmas in professional practice. METHODS: The study was conducted in 2015 as a postal questionnaire to a representative sample of 1612 doctors, among which 1261 responded (78%). We provided a list of 41 potential ethical dilemmas and asked whether each was considered a dilemma, and whether the doctor would perform the task, if in a position to do so...
November 18, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/29151052/prevalence-of-health-services-usage-and-associated-factors-in-the-amazon-region-of-brazil-a-population-based-cross-sectional-study
#2
Maria Elizete A Araujo, Marcus T Silva, Tais F Galvao, Mauricio G Pereira
OBJECTIVES: To estimate the prevalence of healthcare use and associated factors in the Manaus metropolitan region and to describe the reasons for lack of access. DESIGN: Cross-sectional population-based study. SETTING: A survey conducted between May and August of 2015 in eight cities from Manaus metropolitan region, Amazonas, Brazil. PARTICIPANTS: 4001 adults ≥18 years of age. PRIMARY OUTCOMES MEASURES: Physician visits, dentist visits and hospitalisations in the last 12 months were the primary outcomes...
November 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150423/including-children-and-young-people-in-assessments-a-practical-guide
#3
Lydia M C Green, Amanda J Friend, Rebecca J M Bardgett, Jonathan C Darling
The ability to interact with children and young people (CYP), appropriately examine and competently interpret signs is an essential skill for many medical practitioners and allied healthcare professionals; yet, how do we ensure competence in our students and trainees? One method is to include CYP in both formative and summative assessments; this provides an invaluable opportunity for examiners not only to evaluate the clinical interaction but also to gain an understanding of the CYP experience and what characteristics they value in a 'good children's doctor'...
November 17, 2017: Archives of Disease in Childhood. Education and Practice Edition
https://www.readbyqxmd.com/read/29150251/validity-of-birth-certificate-and-hospital-discharge-data-reporting-of-labor-induction
#4
Kristen H Kjerulff, Laura B Attanasio
PURPOSE: To examine the concordance of labor induction measures derived from birth certificate and hospital discharge data with each other and with maternal report. METHODS: Birth certificate data were linked with hospital discharge data and structured interviews of 2,851 mothers conducted 1 month after first childbirth. Those who reported that a doctor or nurse tried to cause their labor to begin, and were not in labor before that event, were classified as undergoing labor induction...
November 14, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29149483/factors-influencing-the-quality-of-vital-signs-data-in-electronic-health-records-a-qualitative-study
#5
Jean E Stevenson, Johan Israelsson, Goran Petersson, Peter A Bath
AIMS AND OBJECTIVES: The purpose of this study was to investigate reasons for inadequate documentation of vital signs in an electronic health record. BACKGROUND: Monitoring vital signs is crucial to detecting and responding to patient deterioration. The ways in which vital signs are documented in electronic health records have received limited attention in the research literature. A previous study revealed that vital signs in an electronic health record were incomplete and inconsistent...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29149366/prescribing-of-noacs-has-outnumbered-warfarin-exploring-how-physicians-choose-anticoagulant-treatments
#6
Anne Katrine Eek, Erik Øie, Anne Gerd Granas
PURPOSE: The development of non-vitamin K-dependent oral anticoagulants (NOACs) is a new alternative to treatment with warfarin. The purpose of this study was to explore drug prescription decisions of NOACs or warfarin from hospital physicians in cardiovascular departments. METHODS: A qualitative study with focus group interviews was conducted in three different hospitals. The interview guide explored the background of prescribing anticoagulants (warfarin, dabigatran, rivaroxaban, and apixaban) and experiences with effect and side-effects they had observed in patients...
November 17, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29149335/liberty-in-health-care-a-comparative-study-between-hong-kong-and-mainland-china
#7
Jingxian Wu, Ying Mao
This essay contends that individual liberty, understood as the permissibility of making choices about one's own health care in support of one's own good and the good of one's family utilizing private resources, is central to the moral foundations of a health care system. Such individual freedoms are important not only because they often support more efficient and effective health care services, but because they permit individuals to fulfill important moral duties. A comparative study of the health care systems in Hong Kong and mainland China is utilized to illustrate the conceptual and moral concerns at stake...
November 15, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/29148907/impact-of-patients-expressed-wishes-on-their-surrogate-decision-makers-preferred-decision-making-roles-in-japan
#8
Shuji Tsuda, Mieko Nakamura, Shigeru Aoki, Hiroshi Ono, Mitsuru Takagi, Hiroki Ohashi, Junichiro Miyachi, Yoshinori Matsui, Toshiyuki Ojima
BACKGROUND: Home medical care (HMC) patients and their families are expected to prepare for end-of-life decision making. OBJECTIVE: We investigated the decision readiness of HMC patients and their family surrogates. DESIGN: Cross-sectional survey. SETTING/SUBJECTS: We collected data from dyads, consisting of a HMC patient aged 65 years or older and a family member of the patient, recruited at four Japanese primary care clinics from January 2016 to November 2016...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29148566/factors-that-influence-the-provision-of-intrapartum-and-postnatal-care-by-skilled-birth-attendants-in-low-and-middle-income-countries-a-qualitative-evidence-synthesis
#9
REVIEW
Susan Munabi-Babigumira, Claire Glenton, Simon Lewin, Atle Fretheim, Harriet Nabudere
BACKGROUND: In many low- and middle-income countries women are encouraged to give birth in clinics and hospitals so that they can receive care from skilled birth attendants. A skilled birth attendant (SBA) is a health worker such as a midwife, doctor, or nurse who is trained to manage normal pregnancy and childbirth. (S)he is also trained to identify, manage, and refer any health problems that arise for mother and baby. The skills, attitudes and behaviour of SBAs, and the extent to which they work in an enabling working environment, impact on the quality of care provided...
November 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29148421/a-validation-study-of-the-simple-psoriatic-arthritis-screening-sipas-questionnaire-to-screen-psoriasis-patients-for-psoriatic-arthritis
#10
Fausto Salaffi, Marco Di Carlo, Michele Maria Luchetti, Eleonora Di Donato, Anna Campanati, Devis Benfaremo, Massimiliano Nicolini, Marina Carotti, Alfredo Giacchetti, Giulia Ganzetti, Leonardo Bugatti, Armando Gabrielli, Anna Maria Offidani
OBJECTIVES: To validate in a multicentric cohort of patients a self-administered PsA screening tool, called Simple Psoriatic Arthritis Screening (SiPAS) questionnaire, to screen psoriasis patients for signs and symptoms of PsA. METHODS: The SiPAS questionnaire was validated in a multicentric Italian cohort of psoriasis patients referred to two rheumatological centres. RESULTS: A total of 202 psoriasis patients were screened with SiPAS in the validation study...
November 16, 2017: Clinical and Experimental Rheumatology
https://www.readbyqxmd.com/read/29148347/consumer-health-insurance-shopping-behavior-and-challenges-lessons-from-two-state-based-marketplaces
#11
Anna D Sinaiko, Jon Kingsdale, Alison A Galbraith
Selecting a health plan in a health insurance exchange is a critical decision, yet consumers are known to face challenges with health plan choice. We surveyed new enrollees in two state-based exchanges in 2015 to investigate how a nonelderly, primarily low-income population chose their health plans and the implications of shopping behavior for early experiences in their plans. Financial considerations were most important to enrollees. Prior Medicaid enrollees and the uninsured were more likely to have multiple shopping challenges (e...
July 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148346/increasing-the-use-of-comparative-quality-information-in-maternity-care-results-from-a-randomized-controlled-trial
#12
Maureen Maurer, Kristin L Carman, Manshu Yang, Kirsten Firminger, Judith Hibbard
This randomized controlled trial tested an intervention to increase uptake of hospital-level maternity care quality reports among 245 pregnant women in North Carolina (123 treatment; 122 control). The intervention included three enhancements to the quality report offered to the control: (a) biweekly text messages or e-mails directing women to the website, (b) videos and materials describing the relevance of quality measures to pregnant women's interests, and (c) tools to support discussions with clinicians...
May 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148341/the-affordable-care-act-appears-to-have-narrowed-racial-and-ethnic-disparities-in-insurance-coverage-and-access-to-care-among-young-adults
#13
Brandy J Lipton, Sandra L Decker, Benjamin D Sommers
Prior to the Affordable Care Act, one in three young adults aged 19 to 25 years were uninsured, with substantial racial/ethnic disparities in coverage. We analyzed the separate and cumulative changes in racial/ethnic disparities in coverage and access to care among young adults after implementation of the Affordable Care Act's 2010 dependent coverage provision and 2014 Medicaid and Marketplace expansions. We find that the dependent coverage provision was associated with similar gains across racial/ethnic groups, but the 2014 expansion was associated with larger gains in coverage among Hispanics and Blacks relative to Whites...
April 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148311/for-which-clinical-rules-do-doctors-want-decision-support-and-why-a-survey-of-dutch-general-practitioners
#14
Stephanie Medlock, Saeid Eslami, Marjan Askari, Derk L Arts, Esther M van de Glind, Henk J Brouwer, Henk C van Weert, Sophia E de Rooij, Ameen Abu-Hanna
Despite the promise of decision support for improving care, alerts are often overridden or ignored. We evaluated Dutch general practitioners' intention to accept decision support in a proposed implementation based on clinical rules regarding care for elderly patients, and their reasons for wanting or not wanting support. We developed a survey based on literature and structured interviews and distributed it to all doctors who would receive support in the proposed implementation (n = 43), of which 65 percent responded...
November 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/29148172/quality-of-handwritten-surgical-operative-notes-from-surgical-trainees-a-noteworthy-issue
#15
Tatenda C Nzenza, Todd Manning, Simeon Ngweso, Marlon Perera, Shomik Sengupta, Damien Bolton, Nathan Lawrentschuk
BACKGROUND: Surgical operation notes are crucial for medical record keeping and information flow in continued patient care. In addition to inherent medical implications, the quality of operative notes also has important economic and medico-legal ramifications. Further, well-documented records can also be useful for audit purposes and propagation of research, facilitating the improvement of delivery of care to patients. We aimed to assess the quality of surgical operation notes written by junior doctors and trainees against a set standard, to ascertain whether these standards were met...
November 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29148154/incident-reporting-behaviours-following-the-francis-report-a-cross-sectional-survey
#16
Gareth Archer, Alison Colhoun
RATIONALE, AIMS, AND OBJECTIVES: Previous studies have shown a lack of engagement in the reporting process. There is limited evidence about whether attitudes and behaviours of doctors in the UK towards incident reporting have changed following the events at Mid Staffordshire National Health Service Foundation Trust and the recommendations that followed. We conducted a relatively large survey of doctors, aiming to assess whether doctors recognised incidents and reported them accordingly, along with their behaviours towards reporting and their suggestions of how incident reporting may be improved...
November 17, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29147950/mental-health-consultation-among-ontario-s-immigrant-populations
#17
Farah Islam, Nazilla Khanlou, Alison Macpherson, Hala Tamim
To determine the prevalence rates and characteristics of past-year mental health consultation for Ontario's adult (18 + years old) immigrant populations. The Canadian Community Health Survey (CCHS) 2012 was used to calculate the prevalence rates of past-year mental health consultation by service provider type. Characteristics associated with mental health consultation were determined by carrying out multivariable logistic regression analysis on merged CCHS 2008-2012 data. Adult immigrant populations in Ontario (n = 3995) had lower estimated prevalence rates of past-year mental health consultation across all service provider types compared to Canadian-born populations (n = 14,644)...
November 16, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/29146824/doctors-in-india-still-carry-out-two-finger-test-on-rape-victims
#18
Sanjeet Bagcchi
No abstract text is available yet for this article.
November 16, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/29146680/the-association-between-patient-experience-factors-and-likelihood-of-30-day-readmission-a-prospective-cohort-study
#19
Jocelyn Carter, Charlotte Ward, Deborah Wexler, Karen Donelan
OBJECTIVE: Hospital readmissions comprise nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29146646/cross-sectional-study-of-the-financial-cost-of-training-to-the-surgical-trainee-in-the-uk-and-ireland
#20
John O'Callaghan, Helen M Mohan, Anna Sharrock, Vimal Gokani, J Edward Fitzgerald, Adam P Williams, Rhiannon L Harries
OBJECTIVES: Applications for surgical training have declined over the last decade, and anecdotally the costs of training at the expense of the surgical trainee are rising. We aimed to quantify the costs surgical trainees are expected to cover for postgraduate training. DESIGN: Prospective, cross-sectional, questionnaire-based study. SETTING/PARTICIPANTS: A non-mandatory online questionnaire for UK-based trainees was distributed nationally...
November 15, 2017: BMJ Open
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