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Value judgement

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https://www.readbyqxmd.com/read/27878797/choosing-wisely-at-the-end-of-life-the-crucial-role-of-medical-indication
#1
Gian Domenico Borasio, Ralf J Jox
At the end of life, several treatments are administered routinely that lack medical indication and may cause significant harm to patients. Examples include artificial hydration and oxygen therapy in the dying phase, as well as enteral nutrition in advanced dementia. Medical indication is defined as the appropriateness of a therapeutic or diagnostic measure in the patient's concrete clinical situation, in light of the best available evidence. The decision about the absence or presence of a medical indication is a core competence of physicians...
2016: Swiss Medical Weekly
https://www.readbyqxmd.com/read/27874210/cost-effectiveness-of-using-cognitive-screening-tests-for-detecting-dementia-and-mild-cognitive-impairment-in-primary-care
#2
Thaison Tong, Praveen Thokala, Brian McMillan, Rob Ghosh, John Brazier
INTRODUCTION: We estimated the cost effectiveness of different cognitive screening tests for use by General Practitioners (GPs) to detect cognitive impairment in England. METHODS: A patient-level cost-effectiveness model was developed using a simulated cohort that represents the elderly population in England (65 years and older). Each patient was followed over a lifetime period. Data from published sources were used to populate the model. The costs include government funded health and social care, private social care and informal care...
November 22, 2016: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/27869930/-assessment-of-service-to-verify-the-cause-of-death-implementation-in-pernambuco-state-brazil-2012-multiple-case-study
#3
Barbara Araújo Silva de Azevedo, Lygia Carmen de Moraes Vanderlei, Roberto José Vieira de Mello, Paulo Germano de Frias
OBJECTIVE: to evaluate the implementation of Death Verification Services in Pernambuco State, Brazil, in 2012. METHODS: this was an implementation analysis evaluation study; we constructed a logical framework and judgement matrix were prepared; primary data (direct observation and interviews) and secondary data were used; assessment of the level of Death Verification Services implementation was based on outcome-related structure and process indicators which were compared with the logical framework...
July 2016: Epidemiologia e Servicos de Saude: Revista do Sistema Unico de Saude do Brasil
https://www.readbyqxmd.com/read/27832830/-it-depends-on-the-consultation-revisiting-use-of-family-members-as-interpreters-for-general-practice-consultations-when-and-why
#4
Jo Hilder, Ben Gray, Anthony Dowell, Lindsay Macdonald, Rachel Tester, Maria Stubbe
Family members continue to be used as interpreters in medical consultations despite the well-known risks. This paper examines participant perceptions of this practice in three New Zealand clinics chosen for their frequent use of interpreters and their skill in using them. It is based on a detailed study of 17 video-recorded interpreted consultations and 48 post-consultation interviews with participants (5 doctors, 16 patients and 12 interpreters, including 6 family members). All participants expressed satisfaction with the communication...
November 11, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27829041/cognitive-bias-in-ambiguity-judgements-using-computational-models-to-dissect-the-effects-of-mild-mood-manipulation-in-humans
#5
Kiyohito Iigaya, Aurelie Jolivald, Wittawat Jitkrittum, Iain D Gilchrist, Peter Dayan, Elizabeth Paul, Michael Mendl
Positive and negative moods can be treated as prior expectations over future delivery of rewards and punishments. This provides an inferential foundation for the cognitive (judgement) bias task, now widely-used for assessing affective states in non-human animals. In the task, information about affect is extracted from the optimistic or pessimistic manner in which participants resolve ambiguities in sensory input. Here, we report a novel variant of the task aimed at dissecting the effects of affect manipulations on perceptual and value computations for decision-making under ambiguity in humans...
2016: PloS One
https://www.readbyqxmd.com/read/27819401/-clinical-usefulness-and-psychometric-properties-of-the-cambridge-behavioural-inventory
#6
R Fernandez-Martinez, E Kokoulina, E Carballido-Araujo, I Garcia-Fuertes, O Gutierrez-Martinez, F Santiago-Lopez, P Vazquez-Batan
INTRODUCTION: An important area in neuropsychological assessment is that of psychological and behavioural symptoms. The Cambridge Behavioural Inventory (CBI) is a self-report measure aimed at relatives which takes account of a wide range of behavioural symptoms that may occur during the course of neurological diseases. The main objective of the study is to test the clinical usefulness of its Spanish adaptation. SUBJECTS AND METHODS: The CBI was completed by 215 members of kin of patients referred from neurology and psychiatry services...
November 16, 2016: Revista de Neurologia
https://www.readbyqxmd.com/read/27816667/correlation-between-brain-damage-associated-biomarkers-and-medication-in-psychiatric-inpatients-a-cross-sectional-study
#7
Madoka Yoshida, Tetsuto Kanzaki, Mutsumi Mizoi, Mizuho Nakamura, Takeshi Uemura, Seisuke Mimori, Yoriyasu Uju, Keisuke Sekine, Yukihiro Ishii, Taro Yoshimi, Reiko Yasui, Asuka Yasukawa, Mamoru Sato, Seiko Okamoto, Tetsuya Hisaoka, Masafumi Miura, Shun Kusanishi, Kanako Murakami, Chieko Nakano, Yasuhiko Mizuta, Shunichi Mishima, Tatsuro Hayakawa, Kazumi Tsukada, Keiko Kashiwagi, Kazuei Igarashi
BACKGROUND: We clarified the correlation between brain damage, associated biomarkers and medication in psychiatric patients, because patients with schizophrenia have an increased risk of stroke. METHODS: The cross-sectional study was performed from January 2013 to December 2015. Study participants were 96 hospitalized patients (41 men and 55 women) in the Department of Psychiatry at Kohnodai Hospital, National Center for Global Health and Medicine, Ichikawa, Chiba, Japan...
November 3, 2016: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/27793481/a-new-approach-to-the-identification-of-landscape-quality-objectives-lqos-as-a-set-of-indicators
#8
Barbara Natalia Sowińska-Świerkosz, Tadeusz J Chmielewski
The objective of the paper is threefold: (1) to introduce Landscape Quality Objectives (LQOs) as a set of indicators; (2) to present a method of linking social and expert opinion in the process of the formulation of landscape indicators; and (3) to present a methodological framework for the identification of LQOs. The implementation of these goals adopted a six-stage procedure based on the use of landscape units: (1) GIS analysis; (2) classification; (3) social survey; (4) expert value judgement; (5) quality assessment; and (6) guidelines formulation...
October 25, 2016: Journal of Environmental Management
https://www.readbyqxmd.com/read/27762022/game-theory-and-strategy-in-medical-training
#9
Amy Blake, Bryan T Carroll
OBJECTIVE: This paper analyses how game theory can provide a framework for understanding the strategic decision-making that occurs in everyday scenarios in medical training and practice, and ultimately serves as a tool for improving the work environment and patient care. Game theory has been applied to a variety of fields outside of its native economics, but has not been thoroughly studied in the context of health care provision. METHODS: The paper discusses four of the most common 'games' and applies each to a scenario in medicine to provide new insight on the incentives and drivers for certain types of behaviour and a deeper understanding of why certain results are valued more strongly than others...
November 2016: Medical Education
https://www.readbyqxmd.com/read/27733437/rationing-conscience
#10
Dominic Wilkinson
Decisions about allocation of limited healthcare resources are frequently controversial. These decisions are usually based on careful analysis of medical, scientific and health economic evidence. Yet, decisions are also necessarily based on value judgements. There may be differing views among health professionals about how to allocate resources or how to evaluate existing evidence. In specific cases, professionals may have strong personal views (contrary to professional or societal norms) that treatment should or should not be provided...
October 12, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27732744/grammaticality-acceptability-and-probability-a-probabilistic-view-of-linguistic-knowledge
#11
Jey Han Lau, Alexander Clark, Shalom Lappin
The question of whether humans represent grammatical knowledge as a binary condition on membership in a set of well-formed sentences, or as a probabilistic property has been the subject of debate among linguists, psychologists, and cognitive scientists for many decades. Acceptability judgments present a serious problem for both classical binary and probabilistic theories of grammaticality. These judgements are gradient in nature, and so cannot be directly accommodated in a binary formal grammar. However, it is also not possible to simply reduce acceptability to probability...
October 12, 2016: Cognitive Science
https://www.readbyqxmd.com/read/27698247/the-impact-of-multiple-sclerosis-severity-on-health-state-utility-values-evidence-from-australia
#12
Hasnat Ahmad, Bruce V Taylor, Ingrid van der Mei, Sam Colman, Beth A O'Leary, Monique Breslin, Andrew J Palmer
BACKGROUND: The measurement of health state utility values (HSUVs) for a representative sample of Australian people with multiple sclerosis (MS) has not previously been performed. OBJECTIVES: Our main aim was to quantify the HSUVs for different levels of disease severities in Australian people with MS. METHOD: HSUVs were calculated by employing a 'judgement-based' method that essentially creates EQ-5D-3L profiles based on WHOQOL-100 responses and then applying utility weights to each level in each dimension...
October 3, 2016: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/27694678/uk-and-twenty-comparable-countries-gdp-expenditure-on-health-1980-2013-the-historic-and-continued-low-priority-of-uk-health-related-expenditure
#13
Andrew J E Harding, Colin Pritchard
It is well-established that for a considerable period the United Kingdom has spent proportionally less of its gross domestic product (GDP) on health-related services than almost any other comparable country. Average European spending on health (as a % of GDP) in the period 1980 to 2013 has been 19% higher than the United Kingdom, indicating that comparable countries give far greater fiscal priority to its health services, irrespective of its actual fiscal value or configuration. While the UK National Health Service (NHS) is a comparatively lean healthcare system, it is often regarded to be at a 'crisis' point on account of low levels of funding...
July 10, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/27686835/equity-in-disease-prevention-vaccines-for-the-older-adults-proceedings-of-a-workshop-melbourne-australia-20-june-2014
#14
C Raina MacIntyre, Robert Menzies, Elizabeth Kpozehouen, Michael Chapman, Joanne Travaglia, Michael Woodward, Lisa Jackson Pulver, Christopher J Poulos, David Gronow, Timothy Adair
On the 20th June, 2014 the National Health and Medical Research Council's Centre for Research Excellence in Population Health "Immunisation in under Studied and Special Risk Populations", in collaboration with the Public Health Association of Australia, hosted a workshop "Equity in disease prevention: vaccines for the older adults". The workshop featured international and national speakers on ageing and vaccinology. The workshop was attended by health service providers, stakeholders in immunisation, ageing, primary care, researchers, government and non-government organisations, community representatives, and advocacy groups...
September 26, 2016: Vaccine
https://www.readbyqxmd.com/read/27666338/exploring-uses-of-the-uk-clinical-aptitude-test-situational-judgement-test-in-a-dental-student-selection-process
#15
P Lambe, E Kay, D Bristow
AIM: In 2013 the UKCAT included a non-cognitive situational judgement test in addition to the four cognitive subtests commonly used by UK dental schools to select students. However, little is known about the situational judgement test's psychometric properties and relationship to other selection tools. This study's aim was explore these issues to inform decisions about the inclusion of the UKCAT SJT in the dental student selection process. METHOD: The sample comprised a cohort of applicants to a Bachelor of Dental Surgery programme, at a UK dental school, which does not use achievement in the UKCAT SJT in its selection process...
September 26, 2016: European Journal of Dental Education: Official Journal of the Association for Dental Education in Europe
https://www.readbyqxmd.com/read/27660184/reasoning-about-truth-telling-in-end-of-life-care-of-patients-with-acute-stroke
#16
Åsa Rejnö, Gunilla Silfverberg, Britt-Marie Ternestedt
BACKGROUND: Ethical problems are a universal phenomenon but rarely researched concerning patients dying from acute stroke. These patients often have a reduced consciousness from stroke onset and thereby lack ability to convey their needs and could be described as 'incompetent' decision makers regarding their own care. OBJECTIVE: The aim of the study was to deepen the understanding of stroke team members' reasoning about truth-telling in end-of-life care due to acute stroke...
September 22, 2016: Nursing Ethics
https://www.readbyqxmd.com/read/27649686/eliciting-the-level-of-health-inequality-aversion-in-england
#17
Matthew Robson, Miqdad Asaria, Richard Cookson, Aki Tsuchiya, Shehzad Ali
Health inequality aversion parameters can be used to represent alternative value judgements about policy concern for reducing health inequality versus improving total health. In this study, we use data from an online survey of the general public in England (n = 244) to elicit health inequality aversion parameters for both Atkinson and Kolm social welfare functions. We find median inequality aversion parameters of 10.95 for Atkinson and 0.15 for Kolm. These values suggest substantial concern for health inequality among the English general public which, at current levels of quality adjusted life expectancy, implies weighting health gains to the poorest fifth of people in society six to seven times as highly as health gains to the richest fifth...
September 20, 2016: Health Economics
https://www.readbyqxmd.com/read/27646845/pharmacological-neuroenhancement-teachers-knowledge-and-attitudes-results-from-a-survey-study-among-teachers-in-germany
#18
Andreas G Franke, Sophie Lehmberg, Michael Soyka
BACKGROUND: Pharmacological neuroenhancement (PN) is a topic of increasing importance. Its prevalence rates range from 1 % to more than 20 %. Students are a group that shows exceptionally high prevalence rates. However, little is known about teachers' knowledge, management, attitudes and ethical judgements regarding PN. METHODS: A web-based survey containing 40 closed questions was developed. All teachers working at all private and public schools in Mecklenburg-Vorpommern, a state in northeastern Germany, were invited to participate after their respective school offices were contacted by telephone, email and mail...
2016: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/27614962/parental-views-on-otitis-media-systematic-review-of-qualitative-studies
#19
REVIEW
Shingisai Chando, Christian Young, Jonathan C Craig, Hasantha Gunasekera, Allison Tong
UNLABELLED: This study aims to describe parental experiences and perspectives of caring for a child with otitis media. We conducted a systematic review of qualitative studies on parental perspectives on caring for a child with otitis media. We searched electronic databases to July 2015. Seventeen studies involving 284 participants from six countries were included. We identified seven themes: diminishing competency (guilt over failure to identify symptoms, helpless and despairing, fear of complications, disempowered and dismissed); disrupting life schedules (disturbing sleep, interfering with work, burden on family); social isolation (stigma and judgement, sick consciousness); threatening normal development (delaying growth milestones, impairing interpersonal skills, impeding education); taking ownership (recognising symptoms, diagnostic closure, working the system, protecting against physical trauma, contingency planning); valuing support (needing respite, depending on community, clinician validation); and cherishing health (relief with treatment success, inspiring resilience)...
October 2016: European Journal of Pediatrics
https://www.readbyqxmd.com/read/27608488/ethical-erosion-in-newly-qualified-doctors-perceptions-of-empathy-decline
#20
Emily C Stratta, David M Riding, Paul Baker
OBJECTIVES: This study sought to understand whether UK Foundation doctors perceived the phenomena of ethical erosion and empathy decline during their initial period of clinical practice, and if so, why this occurred. METHODS: This qualitative study used semi-structured interviews with nine doctors in their first year of clinical practice at Royal Bolton Hospital, UK. Participants were invited to discuss the definition of empathy, how individuals acquire and maintain empathic ability, perceptions of ethical erosion in the self and others, and how clinical experiences have influenced their empathic ability...
2016: International Journal of Medical Education
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