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https://www.readbyqxmd.com/read/28074588/care-under-the-influence
#1
Joseph J Fins, Samantha F Knowlton
A forty-year-old man is brought to the emergency room by his wife at five in the morning, two hours after he fell down the stairs at home, hitting his head and injuring his arm. He tells the ER physician that he got up to get a drink of water and tripped in the dark. His speech is slurred, and he smells strongly of alcohol. Lab results reveal elevated liver enzymes, and his blood alcohol level is 0.1. His medical history is unremarkable. When asked about his alcohol consumption, he says he usually has one or two drinks a night with dinner but that he drinks more on holidays and special occasions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28074587/after-the-dnr-surrogates-who-persist-in-requesting-cardiopulmonary-resuscitation
#2
Ellen M Robinson, Wendy Cadge, Angelika A Zollfrank, M Cornelia Cremens, Andrew M Courtwright
Some health care organizations allow physicians to withhold cardiopulmonary resuscitation from a patient, despite patient or surrogate requests that it be provided, when they believe it will be more harmful than beneficial. Such cases usually involve patients with terminal diagnoses whose medical teams argue that aggressive treatments are medically inappropriate or likely to be harmful. Although there is state-to-state variability and a considerable judicial gray area about the conditions and mechanisms for refusals to perform CPR, medical teams typically follow a set of clearly defined procedures for these decisions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28064252/philosophical-provocation-the-lifeblood-of-clinical-ethics
#3
Laurence B McCullough
The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28062965/patient-satisfaction-and-clinical-outcomes-following-414-breast-reductions-application-of-breast-q
#4
A Cogliandro, M Barone, G Cassotta, S Tenna, B Cagli, P Persichetti
BACKGROUND: The aim of this study was to measure breast satisfaction and quality of life using the BREAST-Q Reduction Module in a large sample of postoperative patients having breast reduction using the inverted T technique. METHODS: With due approval from the ethics committee of our university, 414 patients who were seen in consultation for breast reduction surgery between 2005 and 2015 performed by the same team were asked to fill out BREAST-Q surveys. The patient factors collected for all those undergoing breast reduction included age, body mass index, incision pattern, areola complex pedicle used, amount of tissue resected, concurrent procedures, and complications...
January 7, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28048387/mo-a-brc-00-tg167-clinical-recommendations-for-innovative-brachytherapy-devices-and-applicators
#5
Ravinder Nath
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28048159/mo-a-brc-02-tg167-report-detailed-description
#6
M Rivard
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046775/mo-a-brc-01-tg167-report-introduction
#7
R Nath
: Although a multicenter, Phase III, prospective, randomized trial is the gold standard for evidence-based medicine, it is rarely used to evaluate innovative radiotherapy devices because of many practical and ethical reasons. It is usually sufficient to compare the dose distributions and dose rates for determining equivalence of the innovative device to an existing one. Thus, quantitative evaluation of the dosimetric characteristics of an innovative brachytherapy device or application is a critical part in which physicists are actively involved...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28031617/knowledge-awareness-and-practice-of-ethics-among-doctors-in-tertiary-care-hospital
#8
Surjit Singh, Pramod Kumar Sharma, Bharti Bhandari, Rimplejeet Kaur
INTRODUCTION: With the advancement of healthcare and medical research, doctors need to be aware of the basic ethical principles. This cross-sectional study is an attempt to assess the knowledge, awareness, and practice of health-care ethics among health-care professionals. MATERIALS AND METHODS: After taking written informed consent, a standard questionnaire was administered to 117 doctors. No personal information was recorded on the questionnaire so as to ensure the confidentiality and anonymity of participants...
October 2016: Indian Journal of Pharmacology
https://www.readbyqxmd.com/read/28001140/cultivating-administrative-support-for-a-clinical-ethics-consultation-service
#9
Courtney R Bruce, Mary A Majumder, Ashley Stephens, Janet Malek, Amy McGuire
Hospital administrators may lack familiarity with what clinical ethicists do (and do not do), and many clinical ethicists report receiving inadequate financial support for their clinical ethics consultation services (CECSs). Ethics consultation is distinct in that it is not reimbursable by third parties, and its financial benefit to the hospital may not be quantifiable. These peculiarities make it difficult for clinical ethicists to resort to tried-and-true outcome-centered evaluative strategies, like cost reduction or shortened length of stay for patients, to show a "need" for ethics consultation...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28001139/the-evolution-of-american-hospital-ethics-committees-a-systematic-review
#10
Andrew Courtwright, Martha Jurchak
During the 1970s and 1980s, legal precedent, governmental recommendations, and professional society guidelines drove the formation of hospital ethics committees (HECs). The Joint Commission on Accreditation of Health Care Organization's requirements in the early 1990s solidified the role of HECs as the primary mechanism to address ethical issues in patient care. Because external factors drove the rapid growth of HECs on an institution-by-institution basis, however, no initial consensus formed around the structure and function of these committees...
2016: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/27992278/definition-of-compassion-in-healthcare-a-systematic-literature-review
#11
Encarnación Perez-Bret, Rogelio Altisent, Javier Rocafort
AIM: To reflect on the definition of compassion and analyse the concepts encompassed by the term. BACKGROUND: A large number of authors have defined compassion, with certain nuances that differ from case to case. This raises the need for specificity in the definition of the term. DATA SOURCES: First, a systematic search was conducted of scientific databases. Second, a selection of experts were consulted and a request made to them for specific articles...
December 2016: International Journal of Palliative Nursing
https://www.readbyqxmd.com/read/27981776/lyme-disease-why-the-controversy
#12
M H Beaman
Some Australians have become convinced of the existence of locally acquired Lyme disease (LD). The history of LD, since its recognition in the early 1970s, is reviewed as a model for investigative approaches to unknown syndromes. Australian Management Guidelines for LD include the requirement for diagnostic testing by National Association of Testing Authorities-accredited laboratories using Therapeutic Goods Administration-licensed tests, which result in the efficient diagnosis of LD in overseas travellers...
December 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27960129/researcher-and-institutional-review-board-perspectives-on-the-benefits-and-challenges-of-reporting-back-biomonitoring-and-environmental-exposure-results
#13
Jennifer Liss Ohayon, Elicia Cousins, Phil Brown, Rachel Morello-Frosch, Julia Green Brody
As the number of personal exposure studies expands and trends favor greater openness and transparency in the health sciences, ethical issues arise around reporting back individual results for contaminants without clear health guidelines. Past research demonstrates that research participants want their results even when the health implications are not known. The experiences of researchers and institutional review boards (IRBs) in studies that have reported personal chemical exposures can provide insights about ethical and practical approaches while also revealing areas of continued uncertainty...
December 10, 2016: Environmental Research
https://www.readbyqxmd.com/read/27940784/parental-refusal-of-surgery-in-an-infant-with-tricuspid-atresia
#14
Alexander A Kon, Angira Patel, Steven Leuthner, John D Lantos
We present a case of a fetal diagnosis of tricuspid atresia (TA). The pregnant woman and her husband requested that the baby be treated with only palliative care. The cardiologist did not think it would be appropriate to withhold life-prolonging surgery once the infant was born. The neonatologist argued that outcomes for TA are similar to those for hypoplastic left heart syndrome, and the standard practice at the institution was to allow parents to choose surgery or end-of-life care for those infants. The team requested an ethics consultation to assist in determining whether forgoing life-prolonging interventions in this case would be ethically supportable...
November 2016: Pediatrics
https://www.readbyqxmd.com/read/27936288/staple-crops-biofortified-with-increased-vitamins-and-minerals-considerations-for-a-public-health-strategy
#15
Maria Nieves Garcia-Casal, Juan Pablo Peña-Rosas, Boitshepo Giyose
Biofortification of staple crops has been proposed as a strategy to address micronutrient malnutrition, particularly with respect to insufficient intake of vitamin A, iron, zinc, and folate. The World Health Organization, in collaboration with the Food and Agriculture Organization of the United Nations and the Sackler Institute for Nutrition Science at the New York Academy of Sciences, convened a technical consultation entitled "Staple Crops Biofortified with Vitamins and Minerals: Considerations for a Public Health Strategy" in April 2016...
December 9, 2016: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/27927660/effect-of-prehabilitation-in-gastro-oesophageal-adenocarcinoma-study-protocol-of-a-multicentric-randomised-control-trial-the-prehab-study
#16
Bertrand Le Roy, Bruno Pereira, Corinne Bouteloup, Frédéric Costes, Ruddy Richard, Marie Selvy, Caroline Pétorin, Johan Gagnière, Emmanuel Futier, Karem Slim, Bernard Meunier, Jean-Yves Mabrut, Christophe Mariette, Denis Pezet
INTRODUCTION: Perioperative chemotherapy is the gold standard treatment of the resectable gastro-oesophageal adenocarcinoma. However, 70% of patients cannot receive the complete sequence because of a postoperative complication or a decrease in functional and nutritional reserves. Recently, a new concept appeared in digestive surgery: prehabilitation. This interventional process consists of patient preparation, between surgical consultation and surgery, and is based on 3 components: (1) physical management, (2) nutritional care and (3) psychological care...
December 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27927488/the-accuracy-of-interpretation-of-emergency-abdominal-ct-in-adult-patients-who-present-with-non-traumatic-abdominal-pain-results-of-a-uk-national-audit
#17
D C Howlett, K Drinkwater, C Frost, A Higginson, C Ball, G Maskell
AIM: To evaluate major/minor discrepancy rates for provisional (initial) and addendum (supplementary senior review) emergency computed tomography (CT) reports in patients presenting with non-traumatic abdominal pain. MATERIALS AND METHODS: Ethical approval for this type of study is not required in the UK. All radiology departments with an approved lead for audit registered with the Royal College of Radiologists were invited to participate in this retrospective audit...
January 2017: Clinical Radiology
https://www.readbyqxmd.com/read/27925381/doctors-use-of-mobile-devices-in-the-clinical-setting-a-mixed-methods-study
#18
Arany Nerminathan, Amanda Harrison, Megan Phelps, Karen M Scott
AIM: To explore how doctors use mobile devices in the clinical setting and understand drivers for use. METHODS: A mixed methods study was used with doctors in a paediatric and adult teaching hospital in 2013. A paper based survey examined mobile device usage data by doctors in the clinical setting. Focus groups explored doctors' reasons for using or refraining from using mobile devices in the clinical setting, and their attitudes about others' use. RESULTS: The survey, completed by 109 doctors, showed that 91% owned a smartphone and 88% used their mobile devices frequently in the clinical setting...
December 7, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27923340/-decision-support-for-the-therapy-planning-for-young-refugees-and-asylum-seekers-with-posttraumatic-disorders
#19
Cornelia Reher, Franka Metzner
Decision Support for the Therapy Planning for Young Refugees and Asylum-Seekers with Posttraumatic Disorders Due to the Convention on the Rights of the Child and § 6 of the Asylum Seekers' Benefit Act, there are legal and ethical obligations for the care of minor refugees suffering from trauma-related disorders. In Germany, psychotherapeutic care of adolescent refugees is provided by specialized treatment centers and Child and Adolescent psychiatries with specialized consultation-hours for refugees. Treatment of minor refugees is impeded by various legal and organizational barriers...
December 2016: Praxis der Kinderpsychologie und Kinderpsychiatrie
https://www.readbyqxmd.com/read/27922202/current-practices-for-screening-consent-and-care-of-related-donors-in-france-haematopoietic-stem-cell-transplantation-coordinator-nurses-perceptions
#20
A Polomeni, C Bompoint, A Gomez, E Brissot, A Ruggeri, R Belhocine, M Mohty
Haematopoietic stem cell transplantation-coordinating nurses (HSCT-CNs) play an important role in informing related donors (RDs) and in organising human leucocyte antigen (HLA) tests, pre-donation workup and stem cells collection. Our pilot study aimed to explore French HSCT-CNs' perceptions of RD care issues. Twenty-nine French HSCT adult units were sent a questionnaire on the subject of donation procedures, HSCT-CNs' data and their professional experience of related donation issues. Twenty-two HSCT-CNs returned a completed questionnaire, and 90% of HSCT units were involved to some degree in both patient and donor care...
December 6, 2016: European Journal of Cancer Care
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