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https://www.readbyqxmd.com/read/29334251/discussing-edaravone-with-the-als-patient-an-ethical-framework-from-a-u-s-perspective
#1
Crystal Jing Jing Yeo, Zachary Simmons
The recent approval of edaravone by the United States Food and Drug Administration has generated a mix of hope tempered by reality. The costs of the drug, both monetarily and with regard to intensity of treatment, are high. The benefits, while modest, will be viewed through a very different lens by individuals depending on their goals of care. By virtue of our training and experience, physicians are ideally suited to understand and explain new treatments to our patients. As healthcare providers with a fiduciary responsibility to our patients, we must make sure they are fully informed about both the costs and benefits of non-curative therapies such as edaravone, and be prepared to discuss these in the context of their goals of care and potential impact on quality of life...
January 15, 2018: Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration
https://www.readbyqxmd.com/read/29333495/integrating-prevention-and-health-promotion-in-a-london-prison
#2
Adam John Finnie
Many people enter prison with poor health from a background of deprivation and with unhealthy lifestyle habits, yet spending time in prisons is often actively detrimental to health. There is therefore a clear value in providing high-quality health promotion services in prisons that are effective at reaching those who need support to improve their lifestyle. The health promotion service at HMP Brixton provides a health trainers clinic to address lifestyle issues but found that it was sometimes challenging to identify appropriate patients and that the service was inefficient as a result...
2018: BMJ Open Quality
https://www.readbyqxmd.com/read/29333486/ethical-considerations-when-delivering-behavior-analytic-services-for-problem-behavior-via-telehealth
#3
Patrick W Romani, Kelly M Schieltz
Delivery of healthcare services via telehealth has been growing in popularity, and work completed by behavior analytic researchers and practitioners have supported this trend. Behavior analysts at the University of Iowa Children's Hospital (UICH) developed a telehealth model of service delivery to build upon their already established in-clinic and in-home services. Results from their telehealth studies showed positive effects. Social functions were identified for most children, and problem behavior decreased by an average of 94...
November 2017: Behavior Analysis (Washington, D.C.)
https://www.readbyqxmd.com/read/29333149/a-summary-of-worldwide-national-activities-in-chronic-kidney-disease-ckd-testing
#4
Roberto Ruiz-Arenas, Rosa Sierra-Amor, David Seccombe, Stella Raymondo, Maria Stella Graziani, Mauro Panteghini, Tewogbade A Adedeji, Shanthi Naidu Kamatham, Vanja Radišić Biljak
Chronic kidney disease (CKD) is a major public health issue worldwide and is associated with adverse health outcomes, especially in low- and middle-income countries. In a cash limited healthcare system, guidelines that improve the efficiency of health care free up resources needed for other healthcare services. This short review presents some examples from national acitivities in CKD testing, including countries throughout the globe: Mexico in North America, Uruguay in South America, Italy in Europe, Nigeria in Africa and India in Asia...
December 2017: EJIFCC
https://www.readbyqxmd.com/read/29332642/current-affairs-future-perspectives-of-tuberculosis-and-antitubercular-agents
#5
REVIEW
Jineetkumar Gawad, Chandrakant Bonde
Tuberculosis (TB) is the major threat for humans from past several decades. Even after advent of several antitubercular drugs, researchers are still struggling for the mycobacterial infections in humans are TB and leprosy. Chronic infections caused by Mycobacterium tuberculosis and Mycobacterium leprae. A particular problem with both of these organisms is that they can survive inside macrophages after phagocytosis, unless these cells are activated by cytokines produced by T-lymphocytes, because of this researchers are not yet succeeded in finding effective treatment on TB...
January 2018: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/29332219/desensitisation-strategies-in-high-risk-children-before-kidney-transplantation
#6
Ankit Sharma, Anne M Durkan
BACKGROUND: Transplantation is the preferred modality for renal replacement therapy in children. With increasing rates of re-transplantation within the paediatric population, there are more sensitised children on waiting lists. One issue with developing strategies to treat these children is the number of different definitions of sensitisation. and we would therefore recommend an immunological risk stratification approach. METHODS: We discuss methods of sensitisation prevention, assessment and management, including paired exchange programmes and desensitisation protocols...
January 13, 2018: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/29331967/understanding-frailty-a-qualitative-study-of-european-healthcare-policy-makers-approaches-to-frailty-screening-and-management
#7
Holly Gwyther, Rachel Shaw, Eva-Amparo Jaime Dauden, Barbara D'Avanzo, Donata Kurpas, Maria Bujnowska-Fedak, Tomasz Kujawa, Maura Marcucci, Antonio Cano, Carol Holland
OBJECTIVE: To elicit European healthcare policy-makers' views, understanding and attitudes about the implementation of frailty screening and management strategies and responses to stakeholders' views. DESIGN: Thematic analysis of semistructured qualitative interviews. SETTING: European healthcare policy departments. PARTICIPANTS: Seven European healthcare policy-makers representing the European Union (n=2), UK (n=2), Italy (n=1), Spain (n=1) and Poland (n=1)...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331530/a-qualitative-synthesis-of-pharmacist-other-health-professional-and-lay-perspectives-on-the-role-of-community-pharmacy-in-facilitating-care-for-people-with-long-term-conditions
#8
N J Hall, G Donovan, S Wilkes
BACKGROUND: There is increasing interest in an enhanced role for community pharmacy (CP) in facilitating care for people with long-term conditions (LTCs). It is important to understand the perspectives of stakeholders in order to identify key issues that may impact on future development of the role and related services. OBJECTIVES: Explore pharmacist, other health professional and lay perspectives on the role of CP in facilitating care for people with LTCs. METHODS: Synthesis of qualitative research from UK based studies published between 2007 and January 2017 using a meta-ethnographic interpretative approach...
January 4, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29331259/public-and-physician-s-expectations-and-ethical-concerns-about-electronic-health-record-benefits-outweigh-risks-except-for-information-security
#9
Eleni Entzeridou, Evgenia Markopoulou, Vasiliki Mollaki
INTRODUCTION: Electronic Health Record systems (EHRs) offer numerous benefits in health care but also pose certain risks. As we progress toward the implementation of EHRs, a more in-depth understanding of attitudes that influence overall levels of EHR support is required. OBJECTIVES: To record public and physicians' awareness, expectations for, and ethical concerns about the use of EHRs. METHODS: A convenience sample was surveyed for both the public and physicians...
February 2018: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29330835/international-guidelines-for-groin-hernia-management
#10
(no author information available yet)
INTRODUCTION: Worldwide, more than 20 million patients undergo groin hernia repair annually. The many different approaches, treatment indications and a significant array of techniques for groin hernia repair warrant guidelines to standardize care, minimize complications, and improve results. The main goal of these guidelines is to improve patient outcomes, specifically to decrease recurrence rates and reduce chronic pain, the most frequent problems following groin hernia repair. They have been endorsed by all five continental hernia societies, the International Endo Hernia Society and the European Association for Endoscopic Surgery...
January 12, 2018: Hernia: the Journal of Hernias and Abdominal Wall Surgery
https://www.readbyqxmd.com/read/29329535/measurement-of-the-potential-geographic-accessibility-from-call-to-definitive-care-for-patient-with-acute-stroke
#11
J Freyssenge, F Renard, A M Schott, L Derex, N Nighoghossian, K Tazarourte, C El Khoury
BACKGROUND: The World Health Organization refers to stroke, the second most frequent cause of death in the world, in terms of pandemic. Present treatments are only effective within precise time windows. Only 10% of thrombolysis patients are eligible. Late assessment of the patient resulting from admission and lack of knowledge of the symptoms is the main explanation of lack of eligibility. METHODS: The aim is the measurement of the time of access to treatment facilities for stroke victims, using ambulances (firemen ambulances or EMS ambulances) and private car...
January 12, 2018: International Journal of Health Geographics
https://www.readbyqxmd.com/read/29329530/design-and-evaluation-of-a-mobile-application-to-assist-the-self-monitoring-of-the-chronic-kidney-disease-in-developing-countries
#12
Alvaro Sobrinho, Leandro Dias da Silva, Angelo Perkusich, Maria Eliete Pinheiro, Paulo Cunha
BACKGROUND: The chronic kidney disease (CKD) is a worldwide critical problem, especially in developing countries. CKD patients usually begin their treatment in advanced stages, which requires dialysis and kidney transplantation, and consequently, affects mortality rates. This issue is faced by a mobile health (mHealth) application (app) that aims to assist the early diagnosis and self-monitoring of the disease progression. METHODS: A user-centered design (UCD) approach involving health professionals (nurse and nephrologists) and target users guided the development process of the app between 2012 and 2016...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29327409/cultural-aspects-of-pain-a-study-of-indian-asian-women-in-the-uk
#13
Stephanie Holt, Jackie Waterfield
OBJECTIVES: Culture and ethnicity are acknowledged as important factors in the context of the biopsychosocial model. They may contribute to explaining the experience of pain, therapeutic encounters within healthcare, and the strategies that individuals use to cope with pain. The present study explored these issues in a sample of Indian Asian women in the UK. METHODS: Based on a phenomenological approach, 17 women participated in five semi-structured group interviews...
January 12, 2018: Musculoskeletal Care
https://www.readbyqxmd.com/read/29326195/why-do-gps-leave-direct-patient-care-and-what-might-help-to-retain-them-a-qualitative-study-of-gps-in-south-west-england
#14
Anna Sansom, Rohini Terry, Emily Fletcher, Chris Salisbury, Linda Long, Suzanne H Richards, Alex Aylward, Jo Welsman, Laura Sims, John L Campbell, Sarah G Dean
OBJECTIVE: To identify factors influencing general practitioners' (GPs') decisions about whether or not to remain in direct patient care in general practice and what might help to retain them in that role. DESIGN: Qualitative, in-depth, individual interviews exploring factors related to GPs leaving, remaining in and returning to direct patient care. SETTING: South West England, UK. PARTICIPANTS: 41 GPs: 7 retired; 8 intending to take early retirement; 11 who were on or intending to take a career break; 9 aged under 50 years who had left or were intending to leave direct patient care and 6 who were not intending to leave or to take a career break...
January 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29326038/a-qualitative-meta-synthesis-of-emergency-department-staff-experiences-of-violence-and-aggression
#15
REVIEW
Rebecca Angharad Ashton, Lucy Morris, Ian Smith
INTRODUCTION: Patient and visitor violence or aggression against healthcare workers in the Emergency Department (ED) is a significant issue worldwide. This review synthesises existing qualitative studies exploring the first-hand experiences of staff working in the ED to provide insight into preventing this issue. METHOD: A meta-ethnographic approach was used to review papers. RESULTS: Four concepts were identified: 'The inevitability of violence and aggression'; 'Staff judgments about why they face violence and aggression'; 'Managing in isolation'; and 'Wounded heroes'...
January 8, 2018: International Emergency Nursing
https://www.readbyqxmd.com/read/29325569/the-relevance-of-clinical-ethnography-reflections-on-10%C3%A2-years-of-a-cultural-consultation-service
#16
Melissa Dominicé Dao, Sophie Inglin, Sarah Vilpert, Patricia Hudelson
BACKGROUND: Training health professionals in culturally sensitive medical interviewing has been widely promoted as a strategy for improving intercultural communication and for helping clinicians to consider patients' social and cultural contexts and improve patient outcomes. Clinical ethnography encourages clinicians to explore the patient's explanatory model of illness, recourse to traditional and alternative healing practices, healthcare expectations and social context, and to use this information to negotiate a mutually acceptable treatment plan...
January 11, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29325536/autonomy-and-couples-joint-decision-making-in-healthcare
#17
Pauline E Osamor, Christine Grady
BACKGROUND: Respect for autonomy is a key principle in bioethics. However, respecting autonomy in practice is complex because most people define themselves and make decisions influenced by a complex network of social relationships. The extent to which individual autonomy operates for each partner within the context of decision-making within marital or similar relationships is largely unexplored. This paper explores issues related to decision-making by couples (couples' joint decision-making) for health care and the circumstances under which such a practice should be respected as compatible with autonomous decision-making...
January 11, 2018: BMC Medical Ethics
https://www.readbyqxmd.com/read/29325495/management-of-cancer-associated-venous-thromboembolism-a-case-based-practical-approach
#18
Minna Voigtlaender, Florian Langer
In patients with solid tumours or haematological malignancies, venous thromboembolism (VTE) is a leading cause of death and significantly contributes to morbidity and healthcare resource utilization. Current practice guidelines recommend long-term anticoagulation with low-molecular-weight heparin (LMWH) as the treatment of choice for cancer-associated VTE, based on clinical trial data showing an overall improved safety and efficacy profile of LMWH compared to vitamin K antagonists. However, several open questions remain, e...
January 12, 2018: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/29325410/personalisation-an-emergent-institutional-logic-in-healthcare-comment-on-re-making-the-procrustean-bed-standardization-and-customization-as-competing-logics-in-healthcare
#19
Ewan Ferlie
This commentary on the recent think piece by Mannion and Exworthy reviews their core arguments, highlighting their suggestion that recent forces for personalization have emerged which may counterbalance the strong standardization wave which has been evident in many healthcare settings and systems over the last two decades. These forces for personalization can take very different forms. The commentary explores the authors' suggestion that these themes can be fruitfully examined theoretically through an institutional logics (ILs) literature, which has recently been applied by some scholars to healthcare settings...
June 20, 2017: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/29325401/performance-based-financing-to-strengthen-the-health-system-in-benin-challenging-the-mainstream-approach
#20
Elisabeth Paul, Mohamed Lamine Dramé, Jean-Pierre Kashala, Armand Ekambi Ndema, Marcel Kounnou, Julien Codjovi Aïssan, Karel Gyselinck
BACKGROUND: Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach - especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness - and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects...
April 15, 2017: International Journal of Health Policy and Management
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