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https://www.readbyqxmd.com/read/28444477/ethical-conflicts-in-the-treatment-of-fasting-muslim-patients-with-diabetes-during-ramadan
#1
Ilhan Ilkilic, Hakan Ertin
BACKGROUND: For an effective treatment of patients, quality-assured safe implementation of drug therapy is indispensable. Fasting during Ramadan, an essential religious practice for Muslims, affects Muslim diabetics' drug use in a number of different ways. OBJECTIVES: Ethical problems arising from fasting during the month of Ramadan for practicing Muslim patients are being discussed on the basis of extant research literature. Relevant conflicts of interest originating in this situation are being analysed from an ethical perspective...
April 25, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28439962/balancing-task-focus-and-relationship-building-asking-sleepy-patients-about-traffic-risk-in-treatment-initiation-consultations
#2
Clara Iversen, Anders Broström, Martin Ulander
BACKGROUND: The use of traffic risk assessment questions is an understudied area in nursing research. Obstructive sleep apnoea is associated with an increased risk of traffic accidents. Therefore, traffic safety authorities demand adherent continuous positive airway pressure use. Nurses act as coaches to achieve treatment adherence, but they are also obliged to act as state agents by prohibiting obstructive sleep apnoea patients from drowsy driving. OBJECTIVE: To examine how nurses and obstructive sleep apnoea patients manage traffic risk assessment questions in the relation-building context of treatment initiation consultations...
April 24, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#3
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28421331/two-troubling-trends-in-the-conversation-over-whether-clinical-ethics-consultants-have-ethics-expertise
#4
Abram Brummett, Christopher J Ostertag
In a recent issue of the Journal of Medicine and Philosophy, several scholars wrote on the topic of ethics expertise in clinical ethics consultation. The articles in this issue exemplified what we consider to be two troubling trends in the quest to articulate a unique expertise for clinical ethicists. The first trend, exemplified in the work of Lisa Rasmussen, is an attempt to define a role for clinical ethicists that denies they have ethics expertise. Rasmussen cites the dependence of ethical expertise on irresolvable meta-ethical debates as the reason for this move...
April 18, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28420063/patients-experiences-of-lupus-related-foot-problems-a-qualitative-investigation
#5
A E Williams, A Blake, L Cherry, B Alcacer-Pitarch, C J Edwards, N Hopkinson, E M J Vital, L S Teh
Background Systemic lupus erythematosus (SLE) can present with a variety of symptoms. Previous research has shown there is a high prevalence of lower limb and foot problems in patients with SLE associated with the musculoskeletal, vascular and neurological changes. Furthermore, there is a high prevalence of infections affecting the feet and a range of common skin and nail problems. However, it is not known how these foot problems impact upon people's lives. Therefore, we aimed to explore this using a qualitative approach...
January 1, 2017: Lupus
https://www.readbyqxmd.com/read/28417519/methodological-reflections-on-the-contribution-of-qualitative-research-to-the-evaluation-of-clinical-ethics-support-services
#6
Sebastian Wäscher, Sabine Salloch, Peter Ritter, Jochen Vollmann, Jan Schildmann
This article describes a process of developing, implementing and evaluating a clinical ethics support service intervention with the goal of building up a context-sensitive structure of minimal clinical-ethics in an oncology department without prior clinical ethics structure. Scholars from different disciplines have called for an improvement in the evaluation of clinical ethics support services (CESS) for different reasons over several decades. However, while a lot has been said about the concepts and methodological challenges of evaluating CESS up to the present time, relatively few empirical studies have been carried out...
May 2017: Bioethics
https://www.readbyqxmd.com/read/28417516/discovering-what-matters-interrogating-clinician-responses-to-ethics-consultation
#7
Stuart G Finder, Virginia L Bartlett
Against the background assumptions that (a) knowing what clinical ethics consultation represents to those with whom ethics consultants work most closely is a necessary component for being responsible in the practice of ethics consultation, and (b) the complexities of soliciting and understanding colleague evaluations require another inherent responsibility for the methods by which ethics consultations are evaluated, in this article we report our experience soliciting, analyzing, and trying to understand retrospective evaluations of our Clinical Ethics Consultation Service...
May 2017: Bioethics
https://www.readbyqxmd.com/read/28412971/appraising-the-holistic-value-of-lenvatinib-for-radio-iodine-refractory-differentiated-thyroid-cancer-a-multi-country-study-applying-pragmatic-mcda
#8
Monika Wagner, Hanane Khoury, Liga Bennetts, Patrizia Berto, Jenifer Ehreth, Xavier Badia, Mireille Goetghebeur
BACKGROUND: The objective of the study was to reveal through pragmatic MCDA (EVIDEM) the contribution of a broad range of criteria to the value of the orphan drug lenvatinib for radioiodine refractory differentiated thyroid cancer (RR-DTC) in country-specific contexts. METHODS: The study was designed to enable comprehensive appraisal (12 quantitative, 7 qualitative criteria) in the current disease context (watchful waiting, sorafenib) of France, Italy and Spain...
April 17, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28396369/the-one-in-a-million-study-creating-a-database-of-uk-primary-care-consultations
#9
Marcus Jepson, Chris Salisbury, Matthew J Ridd, Chris Metcalfe, Ludivine Garside, Rebecca K Barnes
BACKGROUND: Around 1 million primary care consultations happen in England every day. Despite this, much of what happens in these visits remains a 'black box'.Aim To create an archive of videotaped consultations and linked data based on a large sample of routine face-to-face doctor-patient consultations with consent for use in future research and training.Design and setting Cross-sectional study in 12 general practices in the west of England, UK. METHOD: Up to two GPs from each practice took part in the study...
April 10, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28391236/study-on-the-utility-of-a-statewide-counselling-programme-for-improving-mortality-outcomes-of-patients-with-staphylococcus-aureus-bacteraemia-in-thuringia-support-a-study-protocol-of-a-cluster-randomised-crossover-trial
#10
S Weis, S Hagel, R P H Schmitz, A Scherag, F M Brunkhorst, C Forstner, B Löffler, M W Pletz
INTRODUCTION: Staphylococcus aureus bacteraemia (SAB) is a frequent infection with high mortality rates. It requires specific diagnostic and therapeutic management such as prolonged intravenous administration of antibiotics and aggressive search for and control of infectious sources. Underestimation of disease severity frequently results in delayed or inappropriate management of patients with SAB leading to increased mortality rates. According to observational studies, patient counselling by infectious disease consultants (IDC) improves survival and reduces the length of hospital stay as well as complication rates...
April 8, 2017: BMJ Open
https://www.readbyqxmd.com/read/28385913/the-weekend-effect-in-acute-medicine-a-protocol-for-a-team-based-ethnography-of-weekend-care-for-medical-patients-in-acute-hospital-settings
#11
Carolyn Tarrant, Elizabeth Sutton, Emma Angell, Cassie P Aldridge, Amunpreet Boyal, Julian Bion
INTRODUCTION: It is now well-recognised that patients admitted to hospital on weekends are at higher risk of death than those admitted during weekdays. However, the causes of this 'weekend effect' are poorly understood. Some contend that there is a deficit of medical staff on weekends resulting in poorer quality care, whereas others find that patients admitted to hospital on weekends are sicker and therefore at higher risk of adverse outcomes. Clarifying the causal pathway is clearly important in order to identify effective solutions...
April 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28384104/development-of-bioethics-and-clinical-ethics-in-bulgaria
#12
Silviya S Aleksandrova-Yankulovska
BACKGROUND: Bioethics and clinical ethics emerged from the classical medical ethics in the 1970s of the 20th century. Both fields are new for the Bulgarian academic tradition. AIM: The aims of this paper were to demarcate the subject fields of medical ethics, bioethics, and clinical ethics, to present the developments in the field of medical ethics in Bulgaria, to delineate the obstacles to effective ethics education of medical professionals, and to present the results of the application of an adapted bottom-up methodology for clinical ethics consultation in several clinical units in Bulgaria...
March 1, 2017: Folia Medica
https://www.readbyqxmd.com/read/28377393/does-a-brief-behavioural-intervention-delivered-by-paediatricians-or-psychologists-improve-sleep-problems-for-children-with-adhd-protocol-for-a-cluster-randomised-translational-trial
#13
E Sciberras, M Mulraney, H Heussler, N Rinehart, T Schuster, L Gold, N Hayes, H Hiscock
INTRODUCTION: Up to 70% of children with attention-deficit/hyperactivity disorder (ADHD) experience sleep problems. We have demonstrated the efficacy of a brief behavioural intervention for children with ADHD in a large randomised controlled trial (RCT) and now aim to examine whether this intervention is effective in real-life clinical settings when delivered by paediatricians or psychologists. We will also assess the cost-effectiveness of the intervention. METHODS AND ANALYSIS: Children aged 5-12 years with ADHD (n=320) are being recruited for this translational cluster RCT through paediatrician practices in Victoria and Queensland, Australia...
April 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28374104/understanding-patient-needs-without-understanding-the-patient-the-need-for-complementary-use-of-professional-interpreters-in-end-of-life-care
#14
Demi Krystallidou, Ignaas Devisch, Dominique Van de Velde, Peter Pype
High-quality doctor-patient communication in end-of-life care results in better quality of life for patients. In linguistically and culturally diverse societies, language discordant consultations become daily practice, leading to difficulties in eliciting patient preferences toward end-of-life care. Although family members invariably act as informal interpreters, this may cause some ethical dilemmas. We present a case of a palliative patient whose son acted as an interpreter. This case generated a triple- layered ethical dilemma: (i) how to safeguard patient autonomy against paternalistic interventions by family members, (ii) how to respect the relational context in which patient autonomy can be realized, and (iii) how to respect the ethno-cultural values of the patient and his family...
April 3, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28351386/midwife-led-maternity-care-in-ireland-a-retrospective-cohort-study
#15
Anna Dencker, Valerie Smith, Colette McCann, Cecily Begley
BACKGROUND: Midwife-led maternity care is shown to be safe for women with low-risk during pregnancy. In Ireland, two midwife-led units (MLUs) were introduced in 2004 when a randomised controlled trial (the MidU study) was performed to compare MLU care with consultant-led care (CLU). Following study completion the two MLUs have remained as a maternity care option in Ireland. The aim of this study was to evaluate maternal and neonatal outcomes and transfer rates during six years in the larger of the MLU sites...
March 28, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28348532/ethical-implications-of-the-mild-encephalitis-hypothesis-of-schizophrenia
#16
Rita Riedmüller, Sabine Müller
Schizophrenia is a serious mental disease with a high mortality rate and severe social consequences. Due to insufficient knowledge about its etiopathogenesis, curative treatments are not available. One of the most promising new research concepts is the mild encephalitis hypothesis of schizophrenia, developed mainly by Karl Bechter and Norbert Müller. According to this hypothesis, a significant subgroup of schizophrenia patients suffer from a mild, but chronic, form of encephalitis with markedly different etiologies ranging from viral infections, traumas to autoimmune diseases...
2017: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/28340011/evaluation-of-the-impact-of-physical-exercise-in-reducing-pain-in-women-undergoing-mammography-a-randomized-clinical-trial
#17
Tadeu Cardoso de Almeida, Luane Marques de Mello, Jacó Saraiva de Castro Mattos, Anderson Soares da Silva, Altacílio Aparecido Nunes
Objective. : To evaluate the efficacy of exercise prior to mammography in reducing perceived postexamination pain. Methods. : An open, randomized, and controlled clinical trial was conducted. The interventions consisted of warm-up and stretching exercises of the upper or lower limbs of women who consulted at Barretos Cancer Hospital, São Paulo State, Brazil. The women were divided into three groups based on the intervention and its location: upper limbs (group 1), lower limbs (group 2), and no intervention (group 0)...
March 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28328379/participation-of-citizen-scientists-in-clinical-research-and-access-to-research-ethics-consultation
#18
Elaine Collier, Marion Danis
No abstract text is available yet for this article.
April 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/28327852/-person-centered-clinical-care-principles-and-strategies
#19
Juan Enrique Mezzich, Alberto Perales
The development of person-centered clinical care is inscribed within an international programmatic movement towards a medicine focused on the totality of the person. This movement, with broad historical bases, has been maturing since 2008 through conferences among global health institutions, research projects and academic publications. This paper is aimed at elucidating the conceptual principles of person-centered medicine (PCM) and to delineate strategies for the practical application of such principles in clinical care services...
October 2016: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28324205/levels-of-intervention-how-are-they-used-in-quebec-hospitals
#20
Marjolaine Frenette, Jocelyne Saint-Arnaud, Karim Serri
In order to promote better practices and communication around end-of-life decision-making, several Canadian hospitals in the province of Quebec have developed a tool called "Levels of Intervention" (LOI). No work to date has been published demonstrating improvement since these forms were implemented. The purpose of the present study was to obtain information about the use of LOI forms across Quebec hospitals and to identify gaps in practice as well as areas for improvement. A retrospective study was undertaken of 299 charts of patients who had died in three Quebec hospitals with a LOI ordered...
March 21, 2017: Journal of Bioethical Inquiry
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