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Healthcare and Ethics

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https://www.readbyqxmd.com/read/28918550/advance-care-planning-challenges-at-the-emergency-department-of-a-cancer-care-center
#1
Maria T Cruz-Carreras, Patrick Chaftari, Jayne Viets-Upchurch
INTRODUCTION: Code status discussions form an important part of advance care planning (ACP) as it enables physicians to respect the patient's wishes for end-of-life care. However, in some cases, code status discussions can be challenging causing the physician to go against the patient's wishes and the code of medical ethics. This is especially true in an emergency setting. In this paper, we will discuss three cases of advanced cancer patients, where code status discussions posed challenges to healthcare providers...
September 16, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28914335/regulatory-experience-of-tops-an-internet-based-system-to-prevent-healthy-subjects-from-over-volunteering-for-uk-clinical-trials
#2
C Allen, G Francis, J Martin, M Boyce
PURPOSE: The aim was to review the use of The Over-volunteering Prevention System (TOPS) since the HRA began hosting it in 2013, and the Medicines and Healthcare products Regulatory Agency (MHRA) experience of monitoring its use by UK clinical research units. METHODS: The HRA searched the TOPS database for the number, type and location of units and the number of entries. The MHRA inspectors reviewed their findings from routine inspections. RESULTS: Twenty-two additional UK units registered to use TOPS during 2013-2016, making a total of 84 units since TOPS was established in 2002...
September 15, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28914185/power-potential-and-pitfalls-in-global-health-academic-partnerships-review-and-reflections-on-an-approach-in-nepal
#3
David Citrin, Stephen Mehanni, Bibhav Acharya, Lena Wong, Isha Nirola, Rekha Sherchan, Bikash Gauchan, Khem Bahadur Karki, Dipendra Raman Singh, Sriram Shamasunder, Phuoc Le, Dan Schwarz, Ryan Schwarz, Binod Dangal, Santosh Kumar Dhungana, Sheela Maru, Ramesh Mahar, Poshan Thapa, Anant Raut, Mukesh Adhikari, Indira Basnett, Shankar Prasad Kaluanee, Grace Deukmedjian, Scott Halliday, Duncan Maru
BACKGROUND: Global health academic partnerships are centered around a core tension: they often mirror or reproduce the very cross-national inequities they seek to alleviate. On the one hand, they risk worsening power dynamics that perpetuate health disparities; on the other, they form an essential response to the need for healthcare resources to reach marginalized populations across the globe. OBJECTIVES: This study characterizes the broader landscape of global health academic partnerships, including challenges to developing ethical, equitable, and sustainable models...
2017: Global Health Action
https://www.readbyqxmd.com/read/28914115/knowledge-attitudes-and-perspective-on-adverse-drug-reaction-reporting-in-a-public-sector-hospital-in-south-africa-baseline-analysis
#4
Antionette Terblanche, Johanna Catharina Meyer, Brian Godman, Robert Stanley Summers
BACKGROUND AND AIMS: Adverse drug reactions (ADRs) can cause significant harm in patients; however, ADRs are under-reported in many countries, including South Africa, where evidence of a pharmacovigilance (PV) system to monitor and manage ADRs is a requirement for compliance with norms and standards for quality healthcare delivery. We conducted an analysis amongst health care professionals (HCPs) at Sebokeng Hospital to assess the situation there. METHODS: Data were collected using a structured self-administered questionnaire, targeting all medical practitioners, nurses, pharmacists and pharmacist assistants in the hospital...
September 15, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28913595/health-professionals-make-their-choice-pharmaceutical-industry-leaders-understandings-of-conflict-of-interest
#5
Quinn Grundy, Lisa Tierney, Christopher Mayes, Wendy Lipworth
Conflicts of interest, stemming from relationships between health professionals and the pharmaceutical industry, remain a highly divisive and inflammatory issue in healthcare. Given that most jurisdictions rely on industry to self-regulate with respect to its interactions with health professionals, it is surprising that little research has explored industry leaders' understandings of conflicts of interest. Drawing from in-depth interviews with ten pharmaceutical industry leaders based in Australia, we explore the normalized and structural management of conflicts of interest within pharmaceutical companies...
September 14, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28912289/using-best-interests-meetings-for-people-in-a-prolonged-disorder-of-consciousness-to-improve-clinical-and-ethical-management
#6
Derick T Wade
Current management of people with prolonged disorders of consciousness is failing patients, families and society. The causes include a general lack of concern, knowledge and expertise; a legal and professional framework which impedes timely and appropriate decision-making and/or enactment of the decision; and the exclusive focus on the patient, with no legitimate means to consider the broader consequences of healthcare decisions. This article argues that a clinical pathway based on the principles of (a) the English Mental Capacity Act 2005 and (b) using time-limited treatment trials could greatly improve patient management and reduce stress on families...
September 14, 2017: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28899291/ethics-and-reverence-for-the-discipline-of-nursing
#7
Constance L Milton
Healthcare disciplines, including nursing, are emerging sciences that contain discipline-specific theories that guide the activities of research, practice, and education. The term nursing science calls forth meaning that has long been accepted and referred to as the extant nursing theories undergirded with philosophy of science. Recent writings dispute the purposes and future usage of nursing theoretical frameworks in the science of nursing. The author of this article proposes new thinking about the importance of reverence and ethical implications for the future of formal inquiry in nursing science...
January 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28899280/ethics-and-discovering-new-meanings-with-metaphors
#8
Constance L Milton
Metaphors are widely understood concepts or structures of human understanding undergirded with transformational creativity. The usages of metaphors are ubiquitous; they are used to convey unique meaning messages in healthcare disciplines. This article begins an ethical straight-thinking discussion of the defining aspects of metaphors and their usage in the discipline of nursing. The humanbecoming paradigm is used to discover new meanings of the metaphor hands-on and its ethical implications for understanding in the discipline of nursing...
July 2017: Nursing Science Quarterly
https://www.readbyqxmd.com/read/28894546/nurses-perception-of-the-strategies-to-gaining-professional-power-a-qualitative-study
#9
Rana Rezai Sepasi, Fariba Borhani, Abbas Abbaszadeh
BACKGROUND: Power in nursing is a broad concept that has a determining effect on the achievement of professional goals. Gaining power is essential for promoting the roles of nurses, improving their professional image and the consistent improvement of healthcare systems. OBJECTIVES: This study was conducted to identify and clarify strategies for gaining power in the nursing profession through the experiences of Iranian nurses. METHODS: The present qualitative grounded theory study was conducted on fifteen participants selected through purposive sampling...
July 2017: Electronic Physician
https://www.readbyqxmd.com/read/28893073/challenges-faced-by-caregivers-of-children-on-antiretroviral-therapy-at-mutale-municipality-selected-healthcare-facilities-vhembe-district-limpopo-province
#10
Rhudzani V Mafune, Rachel T Lebese, Livhuwani H Nemathaga
BACKGROUND: Children depend solely on caregivers who can be either parents or guardians for drug administration to enhance adherence to antiretroviral treatment (ART), which might pose any number of challenges. PURPOSE: The purpose of this study was to explore and describe the challenges faced by caregivers of children on ART at Mutale Municipality, Vhembe District, Limpopo Province. RESEARCH DESIGN AND METHOD: The research design was qualitative, explorative, descriptive and contextual in nature...
August 28, 2017: Curationis
https://www.readbyqxmd.com/read/28889935/sociocultural-determinants-of-us-women-s-ethical-views-on-various-fertility-treatments
#11
Stephen C Collins, Esther Chan
Ethical concerns over treatments for infertility can discourage patients from pursuing fertility healthcare. This study aims to evaluate the sociocultural factors that influence the ethical views of reproductive-aged women regarding various fertility treatments. A publicly available cross-sectional survey of 4792 nationally representative US women aged 25-52 years was analysed to identify the frequency of ethical concerns over such interventions. Concerns were most common for treatments that increase the chance of twins (54%), followed by third-party reproductive strategies (48-51%), IVF (30%) and partner insemination (14%)...
August 25, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28889403/do-paediatric-investigation-plans-pips-advance-paediatric-healthcare
#12
Klaus Rose, Philip D Walson
Since 2007, new drugs need a paediatric investigation plan (PIP) for EU registration. The PIPs' justifications can be traced back to concerns expressed by Shirkey that label warnings against paediatric use made children "therapeutic orphans", and the American Academy of Pediatrics' claim that all children differ considerably from adults. US legislation first encouraged, then also required, separate, adult-style safety and efficacy studies in all paediatric subpopulations. This triggered paediatric regulatory studies by the pharmaceutical industry...
September 9, 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28886735/sustainability-in-health-care-by-allocating-resources-effectively-share-9-conceptualising-disinvestment-in-the-local-healthcare-setting
#13
Claire Harris, Sally Green, Wayne Ramsey, Kelly Allen, Richard King
BACKGROUND: This is the ninth in a series of papers reporting a program of Sustainability in Health care by Allocating Resources Effectively (SHARE) in a local healthcare setting. The disinvestment literature has broadened considerably over the past decade; however there is a significant gap regarding systematic, integrated, organisation-wide approaches. This debate paper presents a discussion of the conceptual aspects of disinvestment from the local perspective. DISCUSSION: Four themes are discussed: Terminology and concepts, Motivation and purpose, Relationships with other healthcare improvement paradigms, and Challenges to disinvestment...
September 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28885219/recognition-of-possible-risk-factors-for-clinically-significant-drug-drug-interactions-among-indian-people-living-with-hiv-receiving-highly-active-antiretroviral-therapy-and-concomitant-medications
#14
Poka Siva Sai Lakshmi Priyanka, Danturulu Muralidhar Varma, Kavyasri Immadisetti, Radhakrishnan Rajesh, Sudha Vidyasagar, Vasudeva Guddattu
BACKGROUND: Greatest challenges for clinician is to recognize risk factors for clinically significant drug interactions (CSDIs). There is a lack of awareness about CSDIs among healthcare professionals in India. OBJECTIVE: To recognize all possible risk factors for drug-drug interactions (DDIs) and to identify clinically significant drug interactions (CSDIs), the prevalence, pattern of occurrence of DDIs in People Living with HIV (PLW-HIV) receiving highly active antiretroviral therapy (HAART) and concomitant medications...
2017: International Journal of Risk & Safety in Medicine
https://www.readbyqxmd.com/read/28882923/-reframing-healthcare-services-through-the-lens-of-co-production-rhelaunch-a-study-protocol-for-a-mixed-methods-evaluation-of-mechanisms-by-which-healthcare-and-social-services-impact-the-health-and-well-being-of-patients-with-copd-and-chf-in-the-usa-and-the
#15
Gijs Hesselink, Julie Johnson, Paul Batalden, Michelle Carlson, Wytske Geense, Stef Groenewoud, Sylvester Jones, Brita Roy, Christina Sansone, Judith R L M Wolf, Bradley Bart, Hub Wollersheim
INTRODUCTION: The USA lags behind other high-income countries in many health indicators. Outcome differences are associated with differences in the relative spending between healthcare and social services at the national level. The impact of the ratio and delivery of social and healthcare services on the individual patient's health is however unknown. 'Reframing Healthcare Services through the Lens of Co-Production' (RheLaunCh) will be a cross-Atlantic comparative study of the mechanisms by which healthcare and social service delivery may impact patient health with chronic conditions...
September 7, 2017: BMJ Open
https://www.readbyqxmd.com/read/28882150/care-managers-professional-choices-ethical-dilemmas-and-conflicting-expectations
#16
Siri Tønnessen, Gøril Ursin, Berit Støre Brinchmann
BACKGROUND: Care-managers are responsible for the public administration of individual healthcare decisions and decide on the volume and content of community healthcare services given to a population. The purpose of this study was to investigate the conflicting expectations and ethical dilemmas these professionals encounter in their daily work with patients and to discuss the clinical implications of this. METHODS: The study had a qualitative design. The data consisted of verbatim transcripts from 12 ethical reflection group meetings held in 2012 at a purchaser unit in a Norwegian city...
September 7, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28872923/implementing-and-evaluating-an-interprofessional-minority-health-conference-for-social-work-and-healthcare-professionals
#17
Tiffany R Washington, Trina Salm Ward, Henry N Young, Pamela Orpinas, Llewellyn J Cornelius
Interprofessional education (IPE) is one strategy for addressing health inequities; however, little attention has been paid to continuing IPE for practicing social work and healthcare professionals. This article offers guidance to faculty in social work and health-related academic units on offering continuing IPE on the topic of minority health. An interprofessional group of faculty offered a day-long conference on minority health, ethics, and social justice. The conference goal was to promote interprofessional communication in a co-learning environment and promote dialogue on social determinants of health and health equity in the state...
September 5, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28871027/case-management-in-primary-care-among-frequent-users-of-healthcare-services-with-chronic-conditions-protocol-of-a-realist-synthesis
#18
Catherine Hudon, Maud-Christine Chouinard, Kris Aubrey-Bassler, Nazeem Muhajarine, Fred Burge, Pierre Pluye, Paula L Bush, Vivian R Ramsden, France Legare, Line Guenette, Paul Morin, Mireille Lambert, Antoine Groulx, Martine Couture, Cameron Campbell, Margaret Baker, Lynn Edwards, Véronique Sabourin, Claude Spence, Gilles Gauthier, Mike Warren, Julie Godbout, Breanna Davis, Norma Rabbitskin
INTRODUCTION: A common reason for frequent use of healthcare services is the complex healthcare needs of individuals suffering from multiple chronic conditions, especially in combination with mental health comorbidities and/or social vulnerability. Frequent users (FUs) of healthcare services are more at risk for disability, loss of quality of life and mortality. Case management (CM) is a promising intervention to improve care integration for FU and to reduce healthcare costs. This review aims to develop a middle-range theory explaining how CM in primary care improves outcomes among FU with chronic conditions, for what types of FU and in what circumstances...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28871024/telemedicine-guided-education-on-secondary-stroke-and-fall-prevention-following-inpatient-rehabilitation-for-texas-patients-with-stroke-and-their-caregivers-a-feasibility-pilot-study
#19
Mansi M Jhaveri, Ruby Benjamin-Garner, Nahid Rianon, Mark Sherer, Gerard Francisco, Farhaan Vahidy, Kayta Kobayashi, Mary Gaber, Paige Shoemake, Kim Vu, Alyssa Trevino, James Grotta, Sean Savitz
INTRODUCTION: The aftermath of stroke leaves many consequences including cognitive deficits and falls due to imbalance. Stroke survivors and families struggle to navigate the complex healthcare system with little assistance posthospital discharge, often leading to early hospital readmission and worse stroke outcomes. Telemedicine Guided Education on Secondary Stroke and Fall Prevention Following Inpatient Rehabilitation feasibility study examines whether stroke survivors and their caregivers find value in telerehabilitation (TR) home visits that provide individualised care and education by a multidisciplinary team after discharge from inpatient rehabilitation...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28871022/perceived-effects-of-the-economic-recession-on-population-mental-health-well-being-and-provision-of-care-by-primary-care-users-and-professionals-a-qualitative-study-protocol-in-portugal
#20
Ana Antunes, Diana Frasquilho, Graça Cardoso, Nádia Pereira, Manuela Silva, José Miguel Caldas-de-Almeida, João Ferrão
INTRODUCTION: Economic recession periods can pose accentuated risks to population's mental health and well-being as well as additional threats to health systems. Users and health professionals are key stakeholders in care delivery; however, little attention has been given to their experiences of the crisis. This paper presents a qualitative study protocol to assess users' and health professionals' perceptions about the effects of the post-2008 economic recession on mental health and care delivery in the Lisbon Metropolitan Area, Portugal...
September 3, 2017: BMJ Open
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