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Clinical ethics

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https://www.readbyqxmd.com/read/29676527/undergraduate-nursing-assistant-employment-in-aged-care-has-benefits-for-new-graduates
#1
Maricris Algoso, Lucie Ramjan, Leah East, Kath Peters
AIMS: To determine how undergraduate assistant in nursing employment in aged care helps to prepare new graduates for clinical work as a registered nurse. BACKGROUND: The amount and quality of clinical experience afforded by university programs has been the subject of constant debate in the nursing profession. New graduate nurses are often deemed inadequately prepared for clinical practice and so many nursing students seek employment as assistants in nursing whilst studying to increase their clinical experience...
April 20, 2018: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/29676031/treatment-of-recurrent-focal-segmental-glomerulosclerosis-post-kidney-transplantation-in-australian-and-new-zealand-children-a-retrospective-cohort-study
#2
Anna Francis, Madeleine Didsbury, Hugh McCarthy, Tonya Kara
Disease recurrence affects around a third of renal transplants for children with FSGS and is associated with poor graft outcomes. Unfortunately, there are no large trials guiding treatment for recurrent FSGS. We aimed to describe current therapies and treatment response for recurrent FSGS in 4 centres in Australia and New Zealand. Data were collected on children (age <18 years) with recurrent FSGS (1990-2015). We reviewed patient charts to obtain clinical information. Ethics approval was obtained from the relevant boards...
April 19, 2018: Pediatric Transplantation
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
#3
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/29674371/automation-of-ct-based-haemorrhagic-stroke-assessment-for-improved-clinical-outcomes-study-protocol-and-design
#4
Betty Chinda, George Medvedev, William Siu, Martin Ester, Ali Arab, Tao Gu, Sylvain Moreno, Ryan C N D'Arcy, Xiaowei Song
INTRODUCTION: Haemorrhagic stroke is of significant healthcare concern due to its association with high mortality and lasting impact on the survivors' quality of life. Treatment decisions and clinical outcomes depend strongly on the size, spread and location of the haematoma. Non-contrast CT (NCCT) is the primary neuroimaging modality for haematoma assessment in haemorrhagic stroke diagnosis. Current procedures do not allow convenient NCCT-based haemorrhage volume calculation in clinical settings, while research-based approaches are yet to be tested for clinical utility; there is a demonstrated need for developing effective solutions...
April 19, 2018: BMJ Open
https://www.readbyqxmd.com/read/29674362/implementation-of-an-evidence-based-model-of-care-for-low-back-pain-in-emergency-departments-protocol-for-the-sydney-health-partners-emergency-department-shaped-trial
#5
Gustavo C Machado, Bethan Richards, Chris Needs, Rachelle Buchbinder, Ian A Harris, Kirsten Howard, Kirsten McCaffery, Laurent Billot, James Edwards, Eileen Rogan, Rochelle Facer, David Lord Cowell, Chris G Maher
INTRODUCTION: Patients with low back pain often seek care in emergency departments, but the problem is that many patients receive unnecessary or ineffective interventions and at the same time miss out on the basics of care, such as advice on self-management. This pattern of care has important consequences for the healthcare system (expensive and inefficient) and for patients (poor health outcomes). We hypothesised that the implementation of an evidence-based model of care for low back pain will improve emergency care by reducing inappropriate overuse of tests and treatments and improving patient outcomes...
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
#6
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/29672984/views-of-cancer-patients-regarding-cardiopulmonary-resuscitation-in-greece
#7
N Miaris, E Samantas, I Siafaka, E Logothetis, N Iacovidou, A Chalkias, T Xanthos
Cardiopulmonary resuscitation (CPR) in patients with cancer is an ethical issue of worldwide interest. A questionnaire-based study was carried out in a Greek oncology hospital aiming to explore the attitude of Greek cancer patients towards CPR. Overall, 200 patients (94 male, 106 female) of a mean age of 62.8 years took part in the study. Only 42 (21%) patients indicated that they knew what CPR really involves and only 20 (10%) patients thought that CPR has serious side effects, while the mean estimated in-hospital CPR survival rate to hospital discharge was 56...
April 19, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29672392/the-effect-of-hyperoxygenated-fatty-acids-in-preventing-skin-lesions-caused-by-surgical-pneumatic-tourniquets
#8
Beatriz Castillo Martín, Juan Ignacio Castillo Martín, Jesús Lago Oliver, Jorge Diz Gómez
OBJECTIVES: To determine whether hyperoxygenated fatty acids (HOFAs) provide safe and effective protection against lesions caused by surgical pneumatic tourniquets (SPTs). METHODS: This was a nonrandomized, single-blind, 2-arm, prospective, comparative study. The study was approved by the Ethics and Clinical Research Commission of the Hospital Universitario Gregorio Marañón, in Madrid, Spain. Subjects in the intervention group were treated topically with HOFAs (Linovera; B...
May 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29671734/instrumental
#9
Ryoko Hamaguchi
Incorporating classmates' unique one-word reflections on human anatomy and the experience of engaging with the bodies of our anatomical donors, this series captures a diverse spectrum of human emotions surrounding anatomical dissection. Grappling with the humanity of our varied reactions, we related ourselves-ethically and clinically, individually and collectively-to our first "patients" and their critical role in our education and growth as physicians.
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29671727/how-should-trainee-autonomy-and-oversight-be-managed-in-the-setting-of-overlapping-surgery
#10
Jean-Nicolas Gallant, Alexander Langerman
This case highlights an attending surgeon's conflicts between duty to care for individual patients, train independent surgeons, and serve a patient population in an efficient manner. Although oversight of surgical residents and multiple operating room scenarios can be conducted in an ethical manner, patients might not understand the realities of surgical training and clinical logistics without explicit disclosure. Central to the ethical concerns of the case are the attending surgeon's obfuscation of resident involvement and her insufficient oversight of two concurrent procedures...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29671726/what-about-learners-roles-in-the-operating-room-should-be-disclosed-to-patients
#11
Michael J Kirsch, Steven J Kasten
This case commentary primarily focuses on properly disclosing the participation of medical trainees when obtaining informed consent in the educational health care environment, particularly in relation to the development of institutional standardization of informed consent processes. The article addresses what it means to obtain informed consent, the elements thereof, and how ethical principles can be better applied to clinical practice in order to ensure truly informed consent. Concepts of capacity, disclosure of information, patient understanding, voluntary decision making, and consent are discussed as they relate to the case...
April 1, 2018: AMA Journal of Ethics
https://www.readbyqxmd.com/read/29671037/-geriatric-intensive-care-patients-perspectives-and-limits-of-geriatric-intensive-care-medicine
#12
REVIEW
U Müller-Werdan, H-J Heppner, G Michels
Critically ill geriatric patients are vitally endangered due to the aging processes of organs, the frequently existing multimorbidity with subsequent polypharmacy and the typical geriatric syndrome of functional impairments. Aging processes in organs lower the clinical threshold for organ dysfunction and organ failure. Physiological organ aging processes with practical consequences for intensive care medicine are atypical manifestion of sepsis in immunosenescence, altered pharmacokinetics, reduced tolerance to hypovolemia due to proportionally reduced water compartment of the body in old age, the frequently only apparently normal function of the kidneys and the continuous reduction in pulmonary function in old age...
April 18, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29670897/searching-for-clinically-relevant-biomarkers-in-geriatric-oncology
#13
REVIEW
Theodora Katsila, George P Patrinos, Dimitrios Kardamakis
Ageing, which is associated with a progressive decline and functional deterioration in multiple organ systems, is highly heterogeneous, both inter- and intraindividually. For this, tailored-made theranostics and optimum patient stratification become fundamental, when decision-making in elderly patients is considered. In particular, when cancer incidence and cancer-related mortality and morbidity are taken into account, elderly patient care is a public health concern. In this review, we focus on oncogeriatrics and highlight current opportunities and challenges with an emphasis on the unmet need of clinically relevant biomarkers in elderly cancer patients...
2018: BioMed Research International
https://www.readbyqxmd.com/read/29670338/preference-for-anonymity-in-sperm-donation-for-artificial-insemination-an-experience-from-low-resource-settings-in-nigeria
#14
Euzebus Chinonye Ezugwu, George U Eleje, Chukwuemeka A Iyoke, Sunday G Mba, Henry C Nnaji, Chukwunonso I Enechukwu, Peter O Nkwo
Objective: Anonymous sperm donation is a common practice in Nigeria with its associated legal and ethical challenges. This study aimed to investigate infertile couples' opinions about issues of sperm donor anonymity and to determine factors that might influence their preferences. Methods: A cross-sectional, multicentered, questionnaire-based study was conducted among infertile couples attending infertility clinics in three tertiary hospitals in the south-eastern region of Nigeria over a period of 6 months...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29669685/nurses-views-on-legalising-assisted-dying-in-new-zealand-a-cross-sectional-study
#15
Michael Wilson, Pam Oliver, Phillipa Malpas
AIMS: This study investigated New Zealand nurses' views on legalising assisted dying across a range of clinical conditions, nurses' willingness to engage in legal assisted dying, potential deterrents and enablers to such engagement, and nurses' perceptions of the proper role of their professional bodies in relation to legalising assisted dying. BACKGROUND: A Bill for legalising assisted dying is currently before the New Zealand parliament. Of the 16 jurisdictions where assisted dying has been specifically legislated, only the Canadian federal statute provides nurses with explicit legal protection for their performance of assisted dying-related tasks...
April 15, 2018: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29669657/using-docudrama-in-a-new-graduate-nurse-residency-program-stepping-into-the-lives-of-families-experiencing-dementia
#16
Jeanne Merkle Sorrell, Christine Szweda
Hospitals are increasingly implementing residencies to help ensure that new graduate nurses are prepared to provide safe and effective care. At the Cleveland Clinic, a docudrama focused on ethical concerns in living with dementia was implemented into a 6-month pilot new graduate nurse residency program. Outcomes suggest that the docudrama helped nurse residents gain empathy and understanding through stepping into the lives of families experiencing dementia.
April 1, 2018: Creative Nursing
https://www.readbyqxmd.com/read/29668641/comparison-of-10-year-overall-survival-between-patients-with-g1-and-g2-grade-ta-bladder-tumors
#17
Daniel Balan, Orsolya Martha, Calin Bogdan Chibelean, Sabin Tataru, Septimiu Voidezan, Anca Sin, Victor Deliu Matei, Mihai Dorin Vartolomei, Giuseppe Lucarelli, Antonio Cioffi, Francesco Del Giudice, Ettore De Berardinis, Angela Borda, Gian Maria Busetto, Matteo Ferro, Akos Pytel, Daniel Porav-Hodade
To compare long-term overall survival (OS) in patients with G1 and G2 grade Ta bladder cancer after transurethral resection of bladder tumors (TURBTs). Secondary aim was to investigate clinical and pathologic prognostic factors for OS of Ta patients, except G3/high grade (HG).A total of 243 patients, retrospectively selected, with Ta nonmuscle invasive bladder cancer (NMIBC) underwent TURBT between January 2006 and December 2008 (median follow-up 109 months). Inclusion criteria were: Ta at first manifestation, G1 or G2 grade with no associated carcinoma in situ (CIS)...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29668467/the-effect-of-rectus-sheath-block-as-a-supplement-of-general-anesthesia-on-postoperative-analgesia-in-adult-patient-undergoing-umbilical-hernia-repair
#18
Andrijan Kartalov, Nikola Jankulovski, Biljana Kuzmanovska, Milka Zdravkovska, Mirjana Shosholcheva, Marija Tolevska, Filip Naumovski, Marija Srceva, Aleksandra Panovska Petrusheva, Rexhep Selmani, Atanas Sivevski
BACKGROUND: Ultrasound guided rectus sheath block can block the ventral rami of the 7th to 12th thoracolumbar nerves by injection of local anesthetic into the space between the rectus muscle and posterior rectus sheath. The aim of this randomized double-blind study was to evaluate the analgesic effect of the bilateral ultrasound guided rectus sheath block as supplement of general anesthesia on patents undergoing elective umbilical hernia repair. METHODS: After the hospital ethics committee approval, 60 (ASA I-II) adult patients scheduled for umbilical hernia repair were included in this study...
December 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/29667794/body-dysmorphic-disorder-in-the-cosmetic-practice
#19
Helena Kuhn, Paulo R Cunha, Natalie H Matthews, George Kroumpouzos
Body dysmorphic disorder (BDD) is a preoccupation with a slight or imagined flaw in appearance that causes significant distress and impairment in daily functioning. The disease is more prevalent among patients who seek aesthetic procedures as compared with population standards or individuals that are not interested in aesthetic surgery. Several studies have indicated that BDD symptoms typically worsen after an aesthetic procedure because the preoccupation shifts to a different body area. This article discusses the demographic and clinical features, psychiatric comorbidity, assessment, differential diagnosis, and management of BDD...
April 18, 2018: Giornale Italiano di Dermatologia e Venereologia: Organo Ufficiale, Società Italiana di Dermatologia e Sifilografia
https://www.readbyqxmd.com/read/29667543/assessment-of-parents-guardians-initial-comprehension-and-1-day-recall-of-elements-of-informed-consent-within-a-mozambican-study-of-pediatric-bacteremia
#20
Ezequiel B Ossemane, Troy D Moon, Jahit Sacarlal, Esperança Sevene, Darlene Kenga, Wu Gong, Elizabeth Heitman
Participants' understanding of key elements of a research protocol is essential to their ethical enrollment in the study. Ongoing participation should be based on continued comprehension and consent, which presumes a high degree of recall. Many obstacles can prevent full understanding of information about the research protocol. This study's aim was to evaluate the comprehension and 1-day recall of the elements of informed consent by the parents/guardians of children enrolled in a clinical study in Mozambique...
April 1, 2018: Journal of Empirical Research on Human Research Ethics: JERHRE
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