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Bedside ethics

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https://www.readbyqxmd.com/read/28651620/an-assessment-of-the-factors-affecting-the-commercialization-of-cell-based-therapeutics-a-systematic-review-protocol
#1
David Pettitt, Zeeshaan Arshad, Benjamin Davies, James Smith, Anna French, Doug Cole, Kim Bure, Sue Dopson, David DiGiusto, Jeff Karp, Brock Reeve, Richard Barker, Georg Holländer, David Brindley
BACKGROUND: Cellular-based therapies represent a platform technology within the rapidly expanding field of regenerative medicine and are distinct from conventional therapeutics-offering a unique approach to managing what were once considered untreatable diseases. Despite a significant increase in basic science activity within the cell therapy arena, alongside a growing portfolio of cell therapy trials and promising investment, the translation of cellular-based therapeutics from "bench to bedside" remains challenging, and the number of industry products available for widespread clinical use remains comparatively low...
June 26, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28645964/the-predictive-value-of-serial-changes-in-diaphragm-function-during-the-spontaneous-breathing-trial-for-weaning-outcome-a-study-protocol
#2
Pengmin Zhou, Zhongheng Zhang, Yucai Hong, Huabo Cai, Hui Zhao, Peifeng Xu, Yiming Zhao, Shengping Lin, Xuchang Qin, JiaWei Guo, Yun Pan, Junru Dai
INTRODUCTION: There is a variety of tools being used in clinical practice for the prediction of weaning success from mechanical ventilation. However, their diagnostic performances are less than satisfactory. The purpose of this study is to investigate the value of serial changes in diaphragm function measured by ultrasound during the spontaneous breathing trial (SBT) as a weaning predictor. METHODS AND ANALYSIS: This is a prospective observational study conducted in a 10-bed medical emergency intensive care unit (EICU) in a university-affiliated hospital...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644781/teaching-clinical-ethics-at-the-bedside-william-osler-and-the-essential-role-of-the-hospitalist
#3
Matthew William McCarthy, Joseph J Fins
As the field of hospital medicine celebrates its twenty-first anniversary, we believe it is time to expand its mission to play an even greater role in medical education. Given hospitalists' proximity to students and clinical material, members of this growing cohort of physicians are uniquely positioned to teach normative reasoning, professionalism, communication, and medical ethics in real time to trainees on the wards. But, to do so, we must reimagine the role of the hospitalist in graduate and postgraduate medical education...
June 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28612650/pediatric-nurses-ethical-difficulties-in-the-bedside-care-of-children
#4
Kwisoon Choe, Yoonjung Kim, Yoonseo Yang
BACKGROUND: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective. OBJECTIVES: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children. METHODS: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28594678/transplantation-of-bioprinted-tissues-and-organs-technical-and-clinical-challenges-and-future-perspectives
#5
Dino J Ravnic, Ashley N Leberfinger, Srinivas V Koduru, Monika Hospodiuk, Kazim K Moncal, Pallab Datta, Madhuri Dey, Elias Rizk, Ibrahim T Ozbolat
: Three-dimensional (3D) bioprinting is a revolutionary technology in building living tissues and organs with precise anatomic control and cellular composition. Despite the great progress in bioprinting research, there has yet to be any clinical translation due to current limitations in building human-scale constructs, which are vascularized and readily implantable. In this article, we review the current limitations and challenges in 3D bioprinting, including in situ techniques, which are one of several clinical translational models to facilitate the application of this technology from bench to bedside...
July 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28577552/determining-the-amount-of-training-needed-for-competency-of-anesthesia-trainees-in-ultrasonographic-identification-of-the-cricothyroid-membrane
#6
Katia F Oliveira, Cristian Arzola, Xiang Y Ye, Jefferson Clivatti, Naveed Siddiqui, Kong E You-Ten
BACKGROUND: Airway guidelines recommend the use of ultrasound to localize the cricothyroid membrane prior to airway manipulation in difficult airways. In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasound to identify the cricothyroid membrane. METHODS: This is a prospective non-randomized cohort study in the Department of Anesthesia at Mount Sinai Hospital (Toronto, Ontario, Canada)...
June 2, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28572102/complementary-health-practitioners-in-the-acute-and-critical-care-setting-nursing-considerations
#7
Debra Kramlich
In response to the rising demand by patients and their families for complementary health approaches, hospitals are increasingly integrating complementary health approaches with their conventional medical practices to create healing environments. Results of the 2010 Complementary and Alternative Medicine Survey of Hospitals indicated that the top 6 inpatient modalities included pet therapy, massage therapy, music or art therapy, guided imagery, relaxation therapy, and Reiki and therapeutic touch. Whether complementary health approaches are provided by complementary health practitioners through hospital-based integrative medicine programs, volunteer practitioners, or bedside nurses, the regulatory, legal, ethical, and safety concerns remain constant...
June 2017: Critical Care Nurse
https://www.readbyqxmd.com/read/28553902/how-situational-diagnosis-helps-disentangle-ethical-and-psychological-features-of-complex-cases
#8
Jerry Joseph Ignatius, Walter Baile
We review Marguerite S. Lederberg's 1999 Acta Oncologica article entitled "Disentangling Ethical and Psychological Issues: A Guide for Oncologists," in which she introduces a method of analysis that facilitates clarification of ethical and psychological aspects of complex cases. Based on her understanding of the dynamics at play in patients', family members', and physicians' experiences, Lederberg formulated what she calls "situational diagnosis," a guide on how to distinguish ethical from psychological issues at the bedside or when an ethics consultation is requested...
May 1, 2017: AMA Journal of Ethics
https://www.readbyqxmd.com/read/28301693/the-clue
#9
Tyler Tate
As I stood outside of Carlos's room, I felt caught on the horns of a dilemma. It seemed impossible to truly "be there" for Carlos without sacrificing my other intern duties. This tension pervaded much of my residency training, as I often found myself spending more time completing chart notes, answering pages, and giving sign out than I did at the bedside with my patients. I knew I had a duty to "do my job"-I could not let my team down. But what about my duty to Carlos, a duty to act on my intuition and try to "get to the bottom" of his illness, if that was even possible? And what about my thirteen other patients? Wasn't I was their doctor as well? I have spent countless hours studying the ethical frameworks for medical rationing...
March 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28298480/antimicrobial-stewardship-programmes-bedside-rationing-by-another-name
#10
Simon Oczkowski
Antimicrobial therapy is a cornerstone of therapy in critically ill patients; however, the wide use of antibiotics has resulted in increased antimicrobial resistance and outbreaks of resistant disease. To counter this, many hospitals have instituted antimicrobial stewardship programmes as a way to reduce the inappropriate use of antibiotics. However, uptake of antimicrobial stewardship programmes has been variable, as many clinicians fear that they may put individual patients at risk of treatment failure. In this paper, I argue that antimicrobial stewardship programmes are indeed a form of bedside rationing, and explore the risks and benefits of such programmes for individual patients in the intensive care unit, and the critically ill population in general...
March 15, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28279999/simplified-mortality-score-for-the-intensive-care-unit-sms-icu-protocol-for-the-development-and-validation-of-a-bedside-clinical-prediction-rule
#11
Anders Granholm, Anders Perner, Mette Krag, Peter Buhl Hjortrup, Nicolai Haase, Lars Broksø Holst, Søren Marker, Marie Oxenbøll Collet, Aksel Karl Georg Jensen, Morten Hylander Møller
INTRODUCTION: Mortality prediction scores are widely used in intensive care units (ICUs) and in research, but their predictive value deteriorates as scores age. Existing mortality prediction scores are imprecise and complex, which increases the risk of missing data and decreases the applicability bedside in daily clinical practice. We propose the development and validation of a new, simple and updated clinical prediction rule: the Simplified Mortality Score for use in the Intensive Care Unit (SMS-ICU)...
March 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28264826/computer-determined-dosage-of-insulin-in-the-management-of-neonatal-hyperglycaemia-hint2-protocol-of-a-randomised-controlled-trial
#12
Jane Alsweiler, Kathryn Williamson, Frank Bloomfield, Geoffrey Chase, Jane Harding
INTRODUCTION: Neonatal hyperglycaemia is frequently treated with insulin, which may increase the risk of hypoglycaemia. Computer-determined dosage of insulin (CDD) with the STAR-GRYPHON program uses a computer model to predict an effective dose of insulin to treat hyperglycaemia while minimising the risk of hypoglycaemia. However, CDD models can require more frequent blood glucose testing than common clinical protocols. The aim of this trial is to determine if CDD using STAR-GRYPHON reduces hypoglycaemia in hyperglycaemic preterm babies treated with insulin independent of the frequency of blood glucose testing...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28182811/overcoming-ethical-challenges-of-bedside-medical-education
#13
EDITORIAL
Duu Wen Sewa, Devanand Anantham
No abstract text is available yet for this article.
January 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28155594/pbpk-modeling-a-predictive-eco-friendly-bio-waiver-tool-for-drug-research
#14
Baishakhi De, Koushik Bhandari, Ranjan Mukherjee, Prakash Katakam, Shanta K Adiki, Rohit Gundamaraju, Analava Mitra
BACKGROUND: The world has witnessed growing complexities in disease scenario influenced by the drastic changes in host-pathogen- environment triadic relation. Pharmaceutical R&Ds are in constant search of novel therapeutic entities to hasten transition of drug molecules from lab bench to patient bedside. Extensive animal studies and human pharmacokinetics are still the "gold standard" in investigational new drug research and bio-equivalency studies. Apart from cost, time and ethical issues on animal experimentation, burning questions arise relating to ecological disturbances, environmental hazards and biodiversity issues...
February 1, 2017: Current Drug Discovery Technologies
https://www.readbyqxmd.com/read/27989237/modernising-epidemic-science-enabling-patient-centred-research-during-epidemics
#15
EDITORIAL
Amanda M Rojek, Peter W Horby
BACKGROUND: Emerging and epidemic infectious disease outbreaks are a significant public health problem and global health security threat. As an outbreak begins, epidemiological investigations and traditional public health responses are generally mounted very quickly. However, patient-centred research is usually not prioritised when planning and enacting the response. Instead, the clinical research response occurs subsequent to and separate from the public health response, and is inadequate for evidence-based decision-making at the bedside or in the offices of public health policymakers...
December 19, 2016: BMC Medicine
https://www.readbyqxmd.com/read/27923150/an-analysis-of-alumni-performance-a-study-of-the-quality-of-nursing-education
#16
Serap Altuntaş, Ülkü Baykal
BACKGROUND: The professional performance level of their alumni is one of the quality indicators of educational institutions. Nursing education institutions can use their alumni's performance analysis results to enhance their curricula, eliminate deficiencies, improve the quality of education and graduate more highly qualified nurses. OBJECTIVE AND DESIGN: This is a descriptive, cross-sectional and comparative study, which aimed to determine the professional performances of nurses who graduated from the same nursing faculty...
February 2017: Nurse Education Today
https://www.readbyqxmd.com/read/27738255/feasibility-of-conducting-prospective-observational-research-on-critically-ill-dying-patients-in-the-intensive-care-unit
#17
Amanda van Beinum, Laura Hornby, Sonny Dhanani, Roxanne Ward, Jane Chambers-Evans, Kusum Menon
Studying patients during the end of life is important, as it has the potential to lead to improvements in care for the dying. For patients who die after a controlled withdrawal of life-sustaining therapies in the intensive care unit, information about the natural history of death and the process of removing life support has additionally led to advances in practice for deceased organ donation. However, this unique population of severely critically ill and imminently dying patients has been difficult to study, largely due to assumptions made by research teams and ethics boards alike about the logistical difficulties of obtaining consent and completing research procedures before or during the process of withdrawal of life-sustaining therapies...
January 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27716629/ethical-considerations-in-the-translation-of-regenerative-biofabrication-technologies-into-clinic-and-society
#18
I A Otto, C C Breugem, J Malda, A L Bredenoord
Biofabrication technologies have the potential to improve healthcare by providing highly advanced and personalized biomedical products for research, treatment and prevention. As the combining of emerging techniques and integrating various biological and synthetic components becomes increasingly complex, it is important that relevant stakeholders anticipate the translation of biofabricated 3D tissue products into patients and society. Ethics is sometimes regarded as a brake on scientific progress, yet from our perspective, ethics in parallel with research anticipates societal impacts of emerging technologies and stimulates responsible innovation...
October 7, 2016: Biofabrication
https://www.readbyqxmd.com/read/27649916/creating-a-culture-of-ethical-practice-in-health-care-delivery-systems
#19
Cynda Hylton Rushton
Undisputedly, the United States' health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty-five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances...
September 2016: Hastings Center Report
https://www.readbyqxmd.com/read/27613475/feasibility-of-monomodal-analgesia-with-iv-alfentanil-during-burn-dressing-changes-at-bedside-in-spontaneously-breathing-non-intubated-patients
#20
Mathieu Fontaine, Jacques Latarjet, Jacqueline Payre, Jean-Charles Poupelin, François Ravat
INTRODUCTION: The severe pain related to repeated burn dressing changes at bedside is often difficult to manage. However these dressings can be performed at bedside on spontaneously breathing non-intubated patients using powerful intravenous opioids with a quick onset and a short duration of action such as alfentanil. The purpose of this study is to demonstrate the efficacy and safety of the protocol which is used in our burn unit for pain control during burn dressing changes. PATIENTS AND METHODS: Cohort study began after favorable opinion from local ethic committee has been collected...
March 2017: Burns: Journal of the International Society for Burn Injuries
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