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https://www.readbyqxmd.com/read/29352579/informed-consent-in-physiotherapy-practice-it-is-not-what-is-said-but-how-it-is-said
#1
G Copnell
This paper discusses the concept of informed consent in the context of contemporary biomedical ethics. A change in UK law regarding what information should be provided to patients has brought to the fore the role of physiotherapists in the process of gaining informed consent. It is important that physiotherapists are aware of how this change in the law will affect their practice. For an individual to consent, they need to have both the capacity and freedom to exercise rational thought. These concepts are challenged in contemporary biomedical ethics...
August 7, 2017: Physiotherapy
https://www.readbyqxmd.com/read/29350780/an-evolutionary-concept-analysis-of-futility-in-healthcare
#2
Lauren Morata
AIM: To report a concept analysis of futility in healthcare. BACKGROUND: Each member of the healthcare team, the physician, the nurse, the patient, the family and all others involved perceive futility differently. The current evidence and knowledge in regard to futility in healthcare manifest a plethora of definitions, meanings and interpretations without consensus. DESIGN: Concept analysis. DATA SOURCES: Databases searched included Medline, Cumulative Index of Nursing and Allied Health Literature, Academic Search Premier, Cochrane Database of Systematic Reviews and PsycINFO...
January 19, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29349856/self-responsibility-rationing-and-treatment-decision-making-managing-moral-narratives-alongside-fiscal-reality-in-the-obesity-surgery-clinic
#3
Amanda Owen-Smith, Joanna Coast, Jenny L Donovan
BACKGROUND: Addressing the prevalence of severe obesity and its concomitant morbidities is widely acknowledged as one of the most pressing global health priorities. Nevertheless, a paucity of effective interventions and universal pressure on health-care budgets means that access to obesity treatments is often limited. Although health-care rationing can be conceived as a socially constructed process, little is known about how decisions emerge within the context of face-to-face doctor-patient interactions...
January 19, 2018: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29349753/expensive-care-resource-based-thresholds-for-potentially-inappropriate-treatment-in-intensive-care
#4
Dominic Wilkinson, Stavros Petrou, Julian Savulescu
In intensive care, disputes sometimes arise when patients or surrogates strongly desire treatment, yet health professionals regard it as potentially inappropriate. While professional guidelines confirm that physicians are not always obliged to provide requested treatment, determining when treatment would be inappropriate is extremely challenging. One potential reason for refusing to provide a desired and potentially beneficial treatment is because (within the setting of limited resources) this would harm other patients...
January 18, 2018: Monash Bioethics Review
https://www.readbyqxmd.com/read/29342371/global-regional-and-country-level-economic-impacts-of-dental-diseases-in-2015
#5
A J Righolt, M Jevdjevic, W Marcenes, S Listl
Up-to-date information about the economic impact of dental diseases is essential for health care decision makers when seeking to make rational use of available resources. The purpose of this study was to provide up-to-date estimates for dental expenditures (direct costs) and productivity losses (indirect costs) due to dental diseases on the global, regional, and country level. Direct costs of dental diseases were estimated using a previously established systematic approach; indirect costs were estimated using an approach developed by the World Health Organization Commission on Macroeconomics and Health and factoring in 2015 values for gross domestic product and disability-adjusted life years from the Global Burden of Disease Study...
January 1, 2018: Journal of Dental Research
https://www.readbyqxmd.com/read/29322099/outbreaks-caused-by-vancomycin-resistant-enterococcus-faecium-in-hematology-and-oncology-departments-a-systematic-review
#6
Nikos Ulrich, Ralf-Peter Vonberg, Petra Gastmeier
Background: Vancomycin-resistance in Enterococcus faecium (VRE) poses a major threat in health care settings. It is well known that patients in hematology and oncology departments are especially at risk of nosocomial VRE acquisition. This systematic review of the literature provides data on the main sources, transmission modes and potential risk factors for VRE acquisition as well as appropriate infection control measures in order to terminate such nosocomial outbreaks. Methods: Data on nosocomial VRE outbreaks on hematology and oncology wards was retrieved from the Outbreak Database and PubMed...
December 2017: Heliyon
https://www.readbyqxmd.com/read/29318114/the-impact-of-the-national-essential-medicines-policy-on-rational-drug-use-in-primary-care-institutions-in-jiangsu-province-of-china
#7
Jianqian Chao, Jiangyi Gu, Hua Zhang, Huanghui Chen, Zhenchun Wu
Background: Essential medicine policy is a successful global health policy to promote rational drug use. The aim of this study was to evaluate the impact of the National Essential Medicines Policy (NEMP) on the rational drug use in primary care institutions in Jiangsu Province of China. Methods: In this exploratory study, a multistage, stratified, random sampling was used to select 3400 prescriptions from 17 primary care institutions who implemented the NEMP before (Jan 2010) and after the implementation of the NEMP (Jan 2014)...
January 2018: Iranian Journal of Public Health
https://www.readbyqxmd.com/read/29304796/referral-gynecological-ambulatory-clinic-principal-diagnosis-and-distribution-in-health-services
#8
Adna Thaysa Marcial da Silva, Camila Lohmann Menezes, Edige Felipe de Sousa Santos, Paulo Francisco Ramos Margarido, José Maria Soares, Edmund Chada Baracat, Luiz Carlos de Abreu, Isabel Cristina Esposito Sorpreso
BACKGROUND: The association between gynecological diagnoses and their distribution in the health sectors provides benefits in the field of women's health promotion and in medical and interdisciplinary education, along with rationalization according to level of care complexity. Thus, the objective is analyze the clinical-demographic characteristics, main diagnoses in gynecological ambulatory care, and their distribution in health services. METHOD: This is a research project of retrospective audit study design with a chart review of data from 428 women treated at University Ambulatory Clinic of Women's Health, the facility in gynecology and training for Family and Community Medical Residents, São Paulo, Brazil, from 2012 to 2014...
January 5, 2018: BMC Women's Health
https://www.readbyqxmd.com/read/29294693/providing-health-care-in-the-shadow-of-violence-does-emotion-regulation-vary-among-hospital-workers-from-different-professions
#9
Hadass Goldblatt, Anat Freund, Anat Drach-Zahavy, Guy Enosh, Ilana Peterfreund, Neomi Edlis
Research into violence against health care staff by patients and their families within the health care services shows a rising frequency of incidents. The potentially damaging effects on health care staff are extensive, including diverse negative psychological and physical symptoms. The aim of this qualitative study was to examine how hospital workers from different professions reacted to patients' and visitors' violence against them or their colleagues, and how they regulated their emotional reactions during those incidents...
March 1, 2017: Journal of Interpersonal Violence
https://www.readbyqxmd.com/read/29280167/from-applied-ethics-to-empirical-ethics-to-contextual-ethics
#10
Barry Hoffmaster
Bioethics became applied ethics when it was assimilated to moral philosophy. Because deduction is the rationality of moral philosophy, subsuming facts under moral principles to deduce conclusions about what ought to be done became the prescribed reasoning of bioethics, and bioethics became a theory comprised of moral principles. Bioethicists now realize that applied ethics is too abstract and spare to apprehend the specificity, particularity, complexity and contingency of real moral issues. Empirical ethics and contextual ethics are needed to incorporate these features into morality, not just bioethics...
December 27, 2017: Bioethics
https://www.readbyqxmd.com/read/29261502/-a-pragmatic-approach-to-managing-expensive-therapies
#11
Bertrand Jordan
Inflated drug prices necessarily raise the issue of rational allocation of health care resources. The system operated by the NICE agency in the UK attempts to do this by calculating the cost per quality-adjusted life year gained (QALY) and recommending funding only for drugs whose cost per QALY falls under a certain threshold. The whole process is documented in detail and easily accessible, and often results in significant discounts on drug prices. Given that some kind of rationing of health care is inevitable, the rational and transparent process followed by NICE has a number of positive features...
December 2017: Médecine Sciences: M/S
https://www.readbyqxmd.com/read/29243947/multiple-target-based-pharmacophore-design-from-active-site-structures
#12
P Kumar, R Kaalia, A Srinivasan, I Ghosh
Health care systems have benefitted from rational drug discovery processes like vHTS, virtual high throughput screening pharmacophores and quantitative structure-activity relationships, and many challenges have been explored using such techniques: decisions on specificity and selectivity are made after screening millions of molecules for multiple targets. Recent challenges in drug research emphasize the design of drugs that bind with more than one target of interest (multi-target) and do not bind with undesirable targets...
December 15, 2017: SAR and QSAR in Environmental Research
https://www.readbyqxmd.com/read/29233505/outcome-measurement-in-plastic-surgery
#13
REVIEW
Justin C R Wormald, Jeremy N Rodrigues
Outcome measurement in plastic surgery is often surgeon-centred, and clinician-derived. Greater emphasis is being placed on patient-reported outcomes (PROs), in which the patients' perspective is measured directly from them. Numerous patient-reported outcome measures (PROMs) have been developed in a range of fields, with a number of good quality PROMs in plastic surgery. They can be deployed to support diagnosis, disease severity determination, referral pathways, treatment decision-making, post-operative care and in determining cost-effectiveness...
November 28, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/29212630/clarifying-the-concept-of-adherence-to-ehealth-technology-systematic-review-on-when-usage-becomes-adherence
#14
REVIEW
Floor Sieverink, Saskia M Kelders, Julia Ewc van Gemert-Pijnen
BACKGROUND: In electronic health (eHealth) evaluations, there is increasing attention for studying the actual usage of a technology in relation to the outcomes found, often by studying the adherence to the technology. On the basis of the definition of adherence, we suggest that the following three elements are necessary to determine adherence to eHealth technology: (1) the ability to measure the usage behavior of individuals; (2) an operationalization of intended use; and (3) an empirical, theoretical, or rational justification of the intended use...
December 6, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29206942/understanding-decision-making-in-cardiac-imaging-determinants-of-appropriate-use
#15
Ricardo Fonseca, Kim Jose, Thomas H Marwick
Aims: Appropriate Use Criteria (AUC) for echocardiography were developed in 2007 to facilitate decision-making, reduce variability in test utilization, and encourage rational use of imaging. However, there is little evidence that the AUC have favourably influenced ordering behaviour. This study explores the factors that contribute to clinicians requesting echocardiograms with a focus on appropriate use. Methods and results: Semi-structured face-to-face interviews with cardiologists and non-cardiologists who had requested echocardiograms were conducted at an Australian tertiary hospital...
November 30, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#16
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29204852/european-antibiotic-awareness-day-2017-training-the-next-generation-of-health-care-professionals-in-antibiotic-stewardship
#17
Lenneke Schrier, Adamos Hadjipanayis, Stefano Del Torso, Tom Stiris, Marieke Emonts, Hans Juergen Dornbusch
Antimicrobial stewardship (AMS) aims to optimise treatment, minimise the risk of adverse effects and reduce health care costs. In addition, it is recognised as a key component to stop the current spread of antimicrobial resistance in Europe. Educational programmes are particularly important for the successful implementation of AMS. Training should start during medical school, continue during clinical training and be reinforced throughout postgraduate training. National core curricula for paediatric training should include passive and active training of competencies needed for AMS and future paediatricians should be skilled in taking leadership roles in AMS initiatives...
December 5, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29202714/improving-quality-of-care-for-maternal-and-newborn-health-a-pre-post-evaluation-of-the-safe-childbirth-checklist-at-a-hospital-in-bangladesh
#18
Herfina Y Nababan, Rubana Islam, Shabnam Mostari, Md Tariqujjaman, Malabika Sarker, Mohammad Tajul Islam, Corrina Moucheraud
BACKGROUND: Bangladesh has achieved major gains in maternal and newborn survival, facility childbirth and skilled birth attendance between 1991 and 2010, but excess maternal mortality persists. High-quality maternal health care is necessary to address this burden. Implementation of WHO Safe Childbirth Checklist (SCC), whose items address the major causes of maternal deaths, is hypothesized to improve adherence of providers to essential childbirth practices. METHOD: The SCC was adapted for the local context through expert consultation meetings, creating a total of 27 checklist items...
December 4, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29199253/-effects-of-pharmacist-intervention-on-the-treatment-of-infectious-diseases-in-critically-ill-patients
#19
Masaharu Imaura
 The pathological conditions of patients who require intensive care are usually complex and extremely severe; their health and life are in a critical state. Therefore, correct, rapid treatment of these conditions is indispensable. Furthermore, the selection of drugs and adjustment of their dosage for an immediate effect are important. Moreover, most patients are immunocompromised and present an extremely high level of risk for complications involving infectious diseases. Since such complications may lead to life-threatening outcomes, a rational dosage regimen to achieve sufficient antimicrobial activity from the initial stage of treatment is essential...
2017: Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan
https://www.readbyqxmd.com/read/29194876/rational-decision-making-in-medicine-implications-for-overuse-and-underuse
#20
Benjamin Djulbegovic, Shira Elqayam, William Dale
In spite of substantial spending and resource utilization, today's health care remains characterized by poor outcomes, largely due to overuse (overtesting/overtreatment) or underuse (undertesting/undertreatment) of health services. To a significant extent, this is a consequence of low-quality decision making that appears to violate various rationality criteria. Such suboptimal decision making is considered a leading cause of death and is responsible for more than 80% of health expenses. In this paper, we address the issue of overuse or underuse of health care interventions from the perspective of rational choice theory...
December 1, 2017: Journal of Evaluation in Clinical Practice
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