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https://www.readbyqxmd.com/read/28732477/a-web-based-clinical-decision-tool-to-support-treatment-decision-making-in-psychiatry-a-pilot-focus-group-study-with-clinicians-patients-and-carers
#1
Catherine Henshall, Lisa Marzano, Katharine Smith, Mary-Jane Attenburrow, Stephen Puntis, Jakov Zlodre, Kathleen Kelly, Matthew R Broome, Susan Shaw, Alvaro Barrera, Andrew Molodynski, Alastair Reid, John R Geddes, Andrea Cipriani
BACKGROUND: Treatment decision tools have been developed in many fields of medicine, including psychiatry, however benefits for patients have not been sustained once the support is withdrawn. We have developed a web-based computerised clinical decision support tool (CDST), which can provide patients and clinicians with continuous, up-to-date, personalised information about the efficacy and tolerability of competing interventions. To test the feasibility and acceptability of the CDST we conducted a focus group study, aimed to explore the views of clinicians, patients and carers...
July 21, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28730518/the-case-for-enrolling-high-cost-patients-in-an-aco
#2
Abraham Graber, Shane Carter, Asha Bhandary, Matthew Rizzo
Though accountable care organizations (ACOs) are increasingly important to American healthcare, ethical inquiry into ACOs remains in its nascent stages. Several articles have raised the concern that ACOs have an incentive to avoid enrolling high-cost patients and, thereby, have an incentive to deny care to those who need it the most. This concern is borne out by the reports of consultants working with newly formed ACOs. This paper argues that, contra initial appearances, there is no financial incentive for ACOs to avoid enrolling high-cost patients...
July 20, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28729310/socioeconomic-inequalities-in-caries-experience-care-level-and-dental-attendance-in-primary-school-children-in-belgium-a-cross-sectional-survey
#3
Martijn J Lambert, Jacques S N Vanobbergen, Luc C Martens, Luc M J De Visschere
OBJECTIVES: Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce. AIMS: To explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children. METHODS: Data collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28727733/a-new-methodology-for-sampling-blackflies-for-the-entomological-surveillance-of-onchocerciasis-in-brazil
#4
Érika S do Nascimento-Carvalho, Raquel de Andrade Cesário, Vladimir Fazito do Vale, Arion Tulio Aranda, Ana Carolina Dos Santos Valente, Marilza Maia-Herzog
The effectiveness of the MosqTent® trap was evaluated in endemic area to onchocerciasis in Brazil. This study seeks to provide subsidies for the monitoring of the onchocerciasis transmission in the country. The study was carried out at the Homoxi and Thirei villages, located in the Yanomami Indigenous Land, in the state of Roraima. This area presents hyperendemicity, high blackflies densities, large population migrations and mining activities. The Homoxi and Thirei villages are assisted by the Brazilian Ministry of Health...
2017: PloS One
https://www.readbyqxmd.com/read/28727695/where-to-from-here-posthumous-healthcare-data-digital-e-lectronic-mortality-and-new-zealand-s-healthcare-future
#5
Katie Hoeksema, Richman Wee, Alastair Macdonald, Parry Guilford, Jesse Wall, Jon Cornwall
Ongoing improvements in digital data acquisition and storage has led to the phenomenon of e(lectronic)-mortality, where digital data can now exist for a potentially infinite period. Globally, many countries are facilitating the acquisition and researcher-led access to large-scale, population-based digitised healthcare data sets. Their utilisation has led to numerous positive advances in healthcare. New Zealand's medical record system is becoming increasingly digitised, and as a consequence there will be an ever-increasing resource of posthumous healthcare data stored digitally, including genomic information...
July 21, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28720615/assessment-of-the-effectiveness-and-safety-of-ethosuximide-in-the-treatment-of-abdominal-pain-related-to-irritable-bowel-syndrome-ibset-protocol-of-a-randomised-parallel-controlled-double-blind-and-multicentre-trial
#6
Nicolas Kerckhove, Julien Scanzi, Bruno Pereira, Denis Ardid, Michel Dapoigny
INTRODUCTION: Irritable bowel syndrome (IBS) is characterised by the association of abdominal chronic pain with bowel habit disorders in the absence of identifiable organic disease. This is the first reason for consultation in gastroenterology, with an estimated prevalence of 10%-15% in industrialised countries. Although this is a benign gastrointestinal disease, its chronicity profoundly impacts the patient's quality of life and causes considerable health spending. Actual medical treatments are poorly efficient on IBS-related abdominal pain, making it a major public health concern...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716082/efficacy-of-hormonal-and-mental-treatments-with-mmpi-in-ftm-individuals-cross-sectional-and-longitudinal-studies
#7
Hiroyuki Oda, Toshihiko Kinoshita
BACKGROUND: Cross-sex hormone treatment (CSHT) is an important option for gender dysphoria (GD) individuals to improve the quality of life. However, in Japan, sex reassignment surgery (SRS) and CSHT for GD had been discontinued until 1998 (over 30 years). After resumption, the number of GD individuals wishing treatment rapidly increased. On the other hand, the number of medical institutions available for evaluation was limited. For this reason, hormonal treatment has been administered to GD individuals requiring the prompt start of CSHT in the absence of mental health assessment by specialists...
July 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28706092/development-of-an-intervention-to-support-patients-and-clinicians-with-advanced-lung-cancer-when-considering-systematic-anticancer-therapy-protocol-for-the-pact-study
#8
Despina Anagnostou, Stephanie Sivell, Simon Noble, Jason Lester, Anthony Byrne, Catherine Sampson, Mirella Longo, Annmarie Nelson
INTRODUCTION: Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28688910/burden-of-palliative-care-issues-encountered-by-radiation-oncologists-caring-for-patients-with-advanced-cancer
#9
Gregory M Parker, Virginia T LeBaron, Monica Krishnan, Ron Y Shiloh, Alexander Spektor, Lauren Hertan, Tracy A Balboni
PURPOSE: Radiation oncologists frequently provide care for patients with advanced cancer who are in their last months or weeks of life. This study examined the previously not well-characterized types and frequencies of palliative care issues encountered in consultations for palliative radiation therapy (PRT). METHODS AND MATERIALS: This prospective, survey-based study assessed consecutive consults for PRT from May 19, 2014, to September 26, 2014 at 3 Boston-area community and academic, hospital-based centers...
May 25, 2017: Practical Radiation Oncology
https://www.readbyqxmd.com/read/28674939/the-care-dialog-the-ethics-of-care-approach-and-its-importance-for-clinical-ethics-consultation
#10
Patrick Schuchter, Andreas Heller
Ethics consultation in institutions of the healthcare system has been given a standard form based on three pillars: education, the development of guidelines and concrete ethics consultation in case conferences. The spread of ethics committees, which perform these tasks on an organizational level, is a remarkable historic achievement. At the same time it cannot be denied that modern ethics consultation neglects relevant aspects of care ethics approaches. In our essay we present an "ethics of care" approach as well as an empirical pilot project-"Ethics from the bottom up"-which organizes ethics consultation based on this focus...
July 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28674135/mechanism-evaluation-of-a-lifestyle-intervention-for-patients-with-musculoskeletal-pain-who-are-overweight-or-obese-protocol-for-a-causal-mediation-analysis
#11
Hopin Lee, John Wiggers, Steven J Kamper, Amanda Williams, Kate M O'Brien, Rebecca K Hodder, Luke Wolfenden, Sze Lin Yoong, Elizabeth Campbell, Robin Haskins, Emma K Robson, James H McAuley, Christopher M Williams
INTRODUCTION: Low back pain (LBP) and knee osteoarthritis (OA) are highly prevalent and disabling conditions that cause societal and economic impact worldwide. Two randomised controlled trials (RCTs) will evaluate the effectiveness of a multicomponent lifestyle intervention for patients with LBP and knee OA who are overweight or obese. The key targets of this intervention are to improve physical activity, modify diet and correct pain beliefs. These factors may explain how a lifestyle intervention exerts its effects on key patient-relevant outcomes: pain, disability and quality of life...
July 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28674123/dietary-and-physical-activity-strategies-to-prevent-type-2-diabetes-in-south-asian-adults-protocol-for-a-systematic-review
#12
Mirthe Muilwijk, Karien Stronks, Samera Azeem Qureshi, Erik Beune, Carlos Celis-Morales, Jason Gill, Aziz Sheikh, Anne Karen Jenum, Irene Gm van Valkengoed
INTRODUCTION: Type 2 diabetes (T2D) is a major health concern among populations of South Asian ethnicity. Although dietary and physical activity interventions may reduce the risk of T2D, the effectiveness has been moderate among South Asians. This might (in part) be because this subgroup follows strategies that were originally developed for interventions among other populations. Therefore, this review aims to assess the evidence for the current dietary and physical activity strategies recommended in T2D prevention intervention studies and guidelines for South Asians...
July 2, 2017: BMJ Open
https://www.readbyqxmd.com/read/28667211/criteria-for-return-to-sport-after-anterior-cruciate-ligament-reconstruction-with-lower-reinjury-risk-cr-stal-study-protocol-for-a-prospective-observational-study-in-france
#13
Alexandre J M Rambaud, Bertrand Semay, Pierre Samozino, Jean-Benoît Morin, Rodolphe Testa, Rémi Philippot, Jérémy Rossi, Pascal Edouard
INTRODUCTION: The decision regarding when to return to sport after an anterior cruciate ligament reconstruction (ACLR) is an important one. Using a variety of subjective and objective parameters, various attempts have been made to determine an optimal timeline for a return to sport after ACLR, but none have been validated.The aim of the present study is therefore to determine which criteria or combination of criteria could allow to return to sport with the lowest possible risk of reinjury...
June 30, 2017: BMJ Open
https://www.readbyqxmd.com/read/28666762/the-impact-of-baseline-edmonton-symptom-assessment-scale-scores-on-treatment-and-survival-in-patients-with-advanced-non-small-cell-lung-cancer
#14
Sharon F McGee, Tinghua Zhang, Hannah Jonker, Scott A Laurie, Glen Goss, Garth Nicholas, Khalid Albaimani, Paul Wheatley-Price
BACKGROUND: Palliative systemic therapy is frequently underutilized in patients with advanced non-small-cell lung cancer (NSCLC), for many reasons. The aim of this study was to identify patient-reported factors that may predict for treatment decisions and survival in advanced NSCLC, using the Edmonton Symptom Assessment Scale (ESAS), which is a self-reported questionnaire that quantifies symptom burden by asking patients to rate the severity of 9 common symptoms. PATIENTS AND METHODS: With ethics approval, we analyzed ESAS scores at initial oncology consultation for 461 patients with advanced NSCLC seen at The Ottawa Hospital Cancer Centre from 2009 to 2012...
June 8, 2017: Clinical Lung Cancer
https://www.readbyqxmd.com/read/28666533/the-ethics-consultant
#15
Ana Zapatero Ferrándiz, Gerard Colomar Pueyo, Irene Dot Jordana, José Felipe Solsona Durán
No abstract text is available yet for this article.
June 27, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28661743/law-is-not-enough-the-importance-of-ethics-consultation-in-complex-cases
#16
Joan M Henriksen, Megan S Remtema, Kevin Whitford
No abstract text is available yet for this article.
July 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28661281/informed-consent-is-the-essence-of-capacity-assessment
#17
Jeffrey P Spike
Informed consent is the single most important concept for understanding decision-making capacity. There is a steady pull in the clinical world to transform capacity into a technical concept that can be tested objectively, usually by calling for a psychiatric consult. This is a classic example of medicalization. In this article I argue that is a mistake, not just unnecessary but wrong, and explain how to normalize capacity assessment. Returning the locus of capacity assessment to the attending, the primary care doctor, and even to ethics consultation in today's environment will require a substantial effort to undo a strong but illusory impression of capacity assessment...
March 2017: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/28651650/ethics-review-of-studies-during-public-health-emergencies-the-experience-of-the-who-ethics-review-committee-during-the-ebola-virus-disease-epidemic
#18
Emilie Alirol, Annette C Kuesel, Maria Magdalena Guraiib, Vânia de la Fuente-Núñez, Abha Saxena, Melba F Gomes
BACKGROUND: Between 2013 and 2016, West Africa experienced the largest ever outbreak of Ebola Virus Disease. In the absence of registered treatments or vaccines to control this lethal disease, the World Health Organization coordinated and supported research to expedite identification of interventions that could control the outbreak and improve future control efforts. Consequently, the World Health Organization Research Ethics Review Committee (WHO-ERC) was heavily involved in reviews and ethics discussions...
June 26, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/28649428/the-uk-me-cfs-biobank-for-biomedical-research-on-myalgic-encephalomyelitis-chronic-fatigue-syndrome-me-cfs-and-multiple-sclerosis
#19
Eliana M Lacerda, Erinna W Bowman, Jacqueline M Cliff, Caroline C Kingdon, Elizabeth C King, Ji-Sook Lee, Taane G Clark, Hazel M Dockrell, Eleanor M Riley, Hayley Curran, Luis Nacul
The UK ME/CFS Biobank was launched in August 2011 following extensive consultation with professionals and patient representatives. The bioresource aims to enhance research on myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), related to pathophysiology, biomarkers and therapeutic approaches. The cohort includes 18-60 year olds, encompassing 284 clinically-confirmed ME/CFS cases, 60 neurologist-diagnosed multiple sclerosis (MS) cases, and 135 healthy individuals. The Biobank contains blood samples, aliquoted into serum, plasma, peripheral blood mononuclear cells (PBMC), red blood cells/granulocyte pellet, whole blood, and RNA (totalling 29,863 aliquots)...
2017: Open J Bioresour
https://www.readbyqxmd.com/read/28644789/what-is-the-role-of-ethics-consultation-in-the-moral-habitability-of-health-care-environments
#20
Wendy Austin
Ethics consultation has traditionally focused on the provision of expert guidance to health care professionals when challenging quandaries arise in clinical cases. Its role, however, is expanding as demands on health care organizations are negatively impacting their moral habitability. A sign of this impact can be seen in the moral distress experienced by staff and administrators, such that some leave their positions and their organizations. Ethics consultation, more broadly conceived, can be a major asset in ensuring that ethical practice is meaningfully supported, that moral distress is mitigated, and that the organizational environment is morally habitable...
June 1, 2017: AMA Journal of Ethics
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