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https://www.readbyqxmd.com/read/29767375/strategies-to-guide-the-return-of-genomic-research-findings-an-australian-perspective
#1
Lisa Eckstein, Margaret Otlowski
In Australia, along with many other countries, limited guidance or other support strategies are currently available to researchers, institutional research ethics committees, and others responsible for making decisions about whether to return genomic findings with potential value to participants or their blood relatives. This lack of guidance results in onerous decision-making burdens-traversing technical, interpretative, and ethical dimensions-as well as uncertainty and inconsistencies for research participants...
May 16, 2018: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29766480/-the-therapeutic-alliance-in-community-mental-health-services
#2
A Groenendijk, J Van Hecke
The treatment of severe mental illnesses is increasingly taking place in a domiciliary setting due to the deinstitutionalisation.<br/> AIM: Theoretical reflection on the influence of home treatment on the therapeutic alliance.<br/> METHOD: Qualitative review of possible effects of home treatment based on own experiences, the scientific literature, and recent handbooks on community mental health.<br/> RESULTS: The therapeutic relationship appears to be an important general factor in the outcomes of community mental health approaches...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29764887/how-effective-and-cost-effective-are-behaviour-change-interventions-in-improving-the-prescription-and-use-of-antibiotics-in-low-income-and-middle-income-countries-a-protocol-for-a-systematic-review
#3
Neha Batura, Carla Cuevas, Mishal Khan, Virginia Wiseman
INTRODUCTION: Antibiotic resistance endangers effective prevention and treatment of infections, and places significant burden on patients, families, communities and healthcare systems. Low-income and middle-income countries (LMICs) are especially vulnerable to antibiotic resistance, owing to high infectious disease burden, and limited resources for treatment. High prevalence of antibiotic prescription and use due to lack of provider's knowledge, prescriber's habits and perceived patient needs further exacerbate the situation...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29751362/low-prevalence-of-palliative-care-and-ethics-consultations-for-children-with-chronic-critical-illness
#4
Renee D Boss, Alison Falck, Naomi Goloff, Nancy Hutton, Alison Miles, Miriam Shapiro, Elliott M Weiss, Pamela K Donohue
Medical advances over the past two decades have increased the numbers of children who survive serious conditions. Mortality from premature birth and genetic syndromes has improved such that more clinicians offer, and more families request, interventions to prolong their child's life. While some interventions promise cure, others result in chronic disease states that require ongoing medical care. This article is protected by copyright. All rights reserved.
May 11, 2018: Acta Paediatrica
https://www.readbyqxmd.com/read/29746009/evaluation-of-a-paediatric-clinical-ethics-service
#5
Melanie A Jansen, Luregn J Schlapbach, Helen Irving
AIM: To evaluate a paediatric clinical ethics service incorporating both normative and empirical analysis. METHODS: Section 1: Review of consensus guidelines to identify emerging standards for clinical ethics services (CES) and evaluation of the service in relation to these. Section 2: Description of service activity data. Section 3: Feedback from clinical staff involved in clinical ethics consultations was collected using a web-based survey. RESULTS: Four guideline documents were reviewed, and clear emerging consensus standards were identified...
May 10, 2018: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29745246/chaco-canyon-dig-unearths-ethical-concerns
#6
Katrina G Claw, Dorothy Lippert, Jessica Bardill, Anna Cordova, Keolu Fox, Joseph M Yracheta, Alyssa C Bader, Deborah A Bolnick, Ripan S Malhi, Kimberly TallBear, Nanibaa' A Garrison
The field of paleogenomics (the study of ancient genomes) is rapidly advancing, with more robust methods of isolating ancient DNA and increasing access to next-generation DNA sequencing technology. As these studies progress, many important ethical issues have emerged that should be considered when ancient Native American remains, whom we refer to as ancestors, are used in research. We highlight a 2017 article by Kennett et al., "Archaeogenomic evidence reveals prehistoric matrilineal dynasty," that brings to light several ethical issues that should be addressed in paleogenomics research...
July 2017: Human Biology
https://www.readbyqxmd.com/read/29743330/protocol-for-a-randomised-trial-of-higher-versus-lower-intensity-patient-provider-communication-interventions-to-reduce-antibiotic-misuse-in-two-paediatric-ambulatory-clinics-in-the-usa
#7
Kathy Goggin, Andrea Bradley-Ewing, Angela L Myers, Brian R Lee, Emily A Hurley, Kirsten B Delay, Sarah Schlachter, Areli Ramphal, Kimberly Pina, David Yu, Kirsten Weltmer, Sebastian Linnemayr, Christopher C Butler, Jason G Newland
INTRODUCTION: Children with acute respiratory tract infections (ARTIs) are prescribed up to 11.4 million unnecessary antibiotic prescriptions annually. Inadequate parent-provider communication is a chief contributor, yet efforts to reduce overprescribing have only indirectly targeted communication or been impractical. This paper describes our multisite, parallel group, cluster randomised trial comparing two feasible interventions for enhancing parent-provider communication on the rate of inappropriate antibiotic prescribing (primary outcome) and revisits, adverse drug reactions and parent-rated quality of shared decision-making, parent-provider communication and visit satisfaction (secondary outcomes)...
May 9, 2018: BMJ Open
https://www.readbyqxmd.com/read/29740194/opinions-of-israeli-neonatologists-about-life-and-death-decisions-in-neonates
#8
Moshe Y Kasirer, Francis B Mimouni, Alona Bin-Nun, Michael S Schimmel
BACKGROUND: In 2005, the Israeli parliament passed the "law of dying patients" legalizing life and death decisions (do not resuscitate) in patients with life expectancy less than 6 months. OBJECTIVE: To determine whether ethnic and religious backgrounds (both religion and religiosity) influence neonatologists' attitudes in simulated clinical situations and opinions about the new law. DESIGN/METHODS: Prospective design, using standard questionnaire sent to all 155 board-certified practising Israeli Neonatologists...
May 8, 2018: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/29730877/evaluation-of-the-decision-making-capacity-of-two-cases-planning-to-undergo-uterine-evacuation
#9
Ali Ercan Altınöz, Altan Eşsizoğlu, Mustafa Sercan, Didem Yiğit, Sinan Yıldız
Psychiatric disorders in the perinatal period can lead to a deterioration in one's judgment and decision-making ability. These disorders may cause sensitive and complex legal and ethical issues relating to psychiatric, obstetric, and neonatal care. Clinicians should ethically respect the autonomy of the individual, but at the same time, they must assess the individual's decision-making process with the use of forensic psychiatric and consultation-liaison psychiatric practice. While the literature related to mental disorders in pregnancy has been increasing, there is limited information regarding the medico-legal and ethical aspects of this topic...
2018: Türk Psikiyatri Dergisi, Turkish Journal of Psychiatry
https://www.readbyqxmd.com/read/29726067/readability-of-endoscopy-information-leaflets-implications-for-informed-consent
#10
Matthew C Mason, James M L Williamson
INTRODUCTION: Valid consent for gastrointestinal endoscopy is required for ethical and legal reasons. Patients are frequently met by an endoscopist for the first time on the day of their procedure. For valid consent to be possible, the patient needs to have received and understood generic information regarding endoscopy in advance. Patient information leaflets (PILs) need to be easily understood by the majority of the population. METHOD: PILs from 14 secondary care institutions and a sample PIL from the British Society of Gastroenterology were analysed using an online readability tool...
May 3, 2018: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/29725893/moral-conflicts-and-religious-convictions-what-role-for-clinical-ethics-consultants
#11
John C Moskop
Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, and the ethics facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach...
May 3, 2018: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/29724252/synthetic-versus-autologous-reconstruction-syn-var-of-the-medial-patellofemoral-ligament-a-study-protocol-for-a-randomised-controlled-trial
#12
Adam Tucker, Sam McMahon, Bronwyn McArdle, Bridgeen Rutherford, Danny Acton
BACKGROUND: Recurrent patellar instability incidence is 5.8/100,000 population, and recurrent dislocations are reported in the range of 15-80%. Recurrent instability is multifactorial and can be associated with disorder of limb alignment, osseous development, congruity of the patella in the trochlea and soft tissue static and dynamic constraints. The multifactorial aetiology makes management challenging, and a lack studies in a heterogeneous population with robust clinical outcomes compounds this further...
May 3, 2018: Trials
https://www.readbyqxmd.com/read/29723341/impact-of-discharge-medication-counseling-in-the-cardiology-unit-of-a-tertiary-hospital-in-brazil-a-randomized-controlled-trial
#13
Aline F Bonetti, Bruna Q Bagatim, Antonio M Mendes, Inajara Rotta, Renata C Reis, Maria Luiza D Fávero, Fernando Fernandez-Llimós, Roberto Pontarolo
OBJECTIVES: This study aimed to evaluate the impact of pharmacist-provided discharge counseling on mortality rate, hospital readmissions, emergency department visits, and medication adherence at 30 days post discharge. METHODS: This randomized controlled trial was approved by the local ethics committee and included patients aged 18 years or older admitted to the cardiology ward of a Brazilian tertiary hospital. The intervention group received a pharmacist-led medication counseling session at discharge and a telephone follow-up three and 15 days after discharge...
2018: Clinics
https://www.readbyqxmd.com/read/29713346/preferred-source-and-perceived-need-of-more-information-about-dental-implants-by-the-undergraduate-dental-students-of-nepal-all-nepal-survey
#14
Arati Sharma, Bidhan Shrestha, Bijay Kumar Chaudhari, Pramita Suwal, Raj Kumar Singh, Surya Raj Niraula, Prakash Kumar Parajuli
Objectives: This study was conducted to know the preferred source and perceived need of more information about dental implants by the undergraduate students of Nepal and their association with academic levels and gender. Materials and Methods: It was conducted in all the dental colleges of Nepal from June 2016 to June 2017 after taking ethical clearance and approval from the research committee of BPKIHS. It included all those who were present at the time of survey...
2018: International Journal of Dentistry
https://www.readbyqxmd.com/read/29703859/characteristics-of-value-based-health-and-social-care-from-organisations-perspectives-orgvalue-a-mixed-methods-study-protocol
#15
Lena Ansmann, Hendrik Ansgar Hillen, Ludwig Kuntz, Stephanie Stock, Vera Vennedey, Kira Isabelle Hower
INTRODUCTION: Health and social care systems are under pressure to organise care around patients' needs with constrained resources. Several studies reveal that care is constantly challenged by balancing economic requirements against individual patients' preferences and needs. Therefore, value-based health and social care aims to facilitate patient-centredness while taking the resources spent into consideration. The OrgValue project examines the implementation of patient-centredness while considering the health and social care organisations' resource orientation in the model region of the city of Cologne, Germany...
April 27, 2018: BMJ Open
https://www.readbyqxmd.com/read/29681639/effectiveness-of-surgical-treatment-in-chronic-migraine
#16
Francisco Javier Amaya-Blas, Gabriel A Mecott, Alejandro Marfil-Rivera, María de Lourdes Tamayo-Esquivel, Mauricio Manuel García-Pérez, Hernán Chacón-Moreno, Sergio Pérez-Porras, Rosa Coutiño, Yanko Castro-Góvea
Objective: Migraine affects more than 35 million people in the United States of America, and 10% of the population in the world. The purpose of this study was to evaluate the effectiveness of surgical treatment in chronic migraine with frontal or occipital trigger areas. Methods: We designed a pilot, proof of concept, and prospective study to analyze the effectiveness of surgical release of trigger nerves in severe frontal or occipital chronic migraines. The study was approved by the Ethics and Investigation Committee of Hospital Universitario Dr...
2018: Cirugia y Cirujanos
https://www.readbyqxmd.com/read/29679443/a-20-year-review-the-use-of-exception-from-informed-consent-and-waiver-of-informed-consent-in-emergency-research
#17
Lauren Klein, Johanna Moore, Michelle Biros
BACKGROUND: Due to the acuity and time sensitive needs of their clinical condition, patients presenting with certain emergent pathologies may lack capacity to provide meaningful prospective informed consent to participate in clinical research. For these reasons, these populations have often been excluded from research investigations. To mitigate this, regulations allowing Exception from Informed Consent (EFIC) (21 CFR 50.24) or Waiver of Informed Consent (WIC) (45 CFR 46.101) were developed in 1996...
April 21, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29674373/study-protocol-quantitative-fibronectin-to-help-decision-making-in-women-with-symptoms-of-preterm-labour-quids-part-2-uk-prospective-cohort-study
#18
Sarah Jane Stock, Lisa M Wotherspoon, Kathleen Anne Boyd, Rachel K Morris, Jon Dorling, Lesley Jackson, Manju Chandiramani, Anna L David, Asma Khalil, Andrew Shennan, Victoria Hodgetts Morton, Tina Lavender, Khalid Khan, Susan Harper-Clarke, Ben Mol, Richard D Riley, John Norrie, Jane Norman
INTRODUCTION: The aim of the QUIDS study is to develop a decision support tool for the management of women with symptoms and signs of preterm labour, based on a validated prognostic model using quantitative fetal fibronectin (fFN) concentration, in combination with clinical risk factors. METHODS AND ANALYSIS: The study will evaluate the Rapid fFN 10Q System (Hologic, Marlborough, Massachusetts, USA) which quantifies fFN in a vaginal swab. In QUIDS part 2, we will perform a prospective cohort study in at least eight UK consultant-led maternity units, in women with symptoms of preterm labour at 22+0  to 34+6 weeks gestation to externally validate a prognostic model developed in QUIDS part 1...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29673278/doing-what-s-right-a-grounded-theory-of-ethical-decision-making-in-occupational-therapy
#19
Sandra VanderKaay, Lori Letts, Bonny Jung, Sandra E Moll
BACKGROUND: Ethical decision-making is an important aspect of reasoning in occupational therapy practice. However, the process of ethical decision-making within the broader context of reasoning is yet to be clearly explicated. OBJECTIVE: The purpose of this study was to advance a theoretical understanding of the process by which occupational therapists make ethical decisions in day-to-day practice. METHOD: A constructivist grounded theory approach was adopted, incorporating in-depth semi-structured interviews with 18 occupational therapists from a range of practice settings and years of experience...
April 20, 2018: Scandinavian Journal of Occupational Therapy
https://www.readbyqxmd.com/read/29671189/intrafamilial-oocyte-donation-in-classic-galactosemia-ethical-and-societal-aspects
#20
M Haskovic, W J Poot, R J T van Golde, S H Benneheij, E Oussoren, G M W R de Wert, A Krumeich, M Estela Rubio-Gozalbo
Classic galactosemia is a rare inherited disorder of galactose metabolism. Primary ovarian insufficiency (POI) with subfertility affects > 80% of female patients and is an important concern for patients and their parents. Healthcare providers are often consulted for subfertility treatment possibilities. An option brought up by the families is intrafamilial oocyte donation (mother-to-daughter or sister-to-sister). In addition to POI, galactosemia patients can also present varying cognitive and neurological impairments, which may not be fully clear at the time when mother-to-daughter oocyte donation is considered...
April 18, 2018: Journal of Inherited Metabolic Disease
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