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Healthcare and Ethics

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https://www.readbyqxmd.com/read/28636455/the-role-of-the-healthcare-chaplain-a-literature-review
#1
Fiona Timmins, Sílvia Caldeira, Maryanne Murphy, Nicolas Pujol, Greg Sheaf, Elizabeth Weathers, Jacqueline Whelan, Bernadette Flanagan
Healthcare chaplains operate in many healthcare sites internationally and yet their contribution is not always clearly understood by medical and healthcare staff. This review aims to explore the chaplains' role in healthcare, with a view to informing best practice in future healthcare chaplaincy. Overall the extent of the provision and staffing of chaplaincy service internationally is unclear. From this review, several key spiritual and pastoral roles in healthcare emerge including a potential contribution to ethical decision making at the end of life...
June 21, 2017: Journal of Health Care Chaplaincy
https://www.readbyqxmd.com/read/28635570/quality-dementia-care-prerequisites-and-relational-ethics-among-multicultural-healthcare-providers
#2
Gerd Sylvi Sellevold, Veslemøy Egede-Nissen, Rita Jakobsen, Venke Sørlie
BACKGROUND: Many nursing homes appear as multicultural workplaces where the majority of healthcare providers have an ethnic minority background. This environment creates challenges linked to communication, interaction and cultural differences. Furthermore, the healthcare providers have varied experiences and understanding of what quality care of patients with dementia involves. PURPOSE: The aim of this study is to illuminate multi-ethnic healthcare providers' lived experiences of their own working relationship, and its importance to quality care for people with dementia...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28635528/clinical-social-and-ethical-issues-associated-with-non-invasive-prenatal-testing-for-aneuploidy
#3
Blanche Griffin, Samantha Edwards, Lyn S Chitty, Celine Lewis
Non-invasive prenatal testing (NIPT), based on analysis of cell-free foetal DNA, is rapidly becoming a preferred method to screen for chromosomal aneuploidy with the technology now available in over 90 countries. This review provides an up-to-date discussion of the key clinical, social and ethical implications associated with this revolutionary technology. Stakeholders are positive about a test that is highly accurate, safe, can be perfomed early in pregnancy, identifies affected pregnancies that might otherwise have been missed and reduces the need for invasive testing...
February 9, 2017: Journal of Psychosomatic Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/28634768/futile-treatment-a-review
#4
Lenko Šarić, Ivana Prkić, Marko Jukić
The main goal of intensive care medicine is helping patients survive acute threats to their lives, while preserving and restoring life quality. Because of medical advancements, it is now possible to sustain life to an extent that would previously have been difficult to imagine. However, the goals of medicine are not to preserve organ function or physiological activity but to treat and improve the health of a person as a whole. When dealing with medical futilities, physicians and other members of the care team should be aware of some ethical principles...
June 20, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28631537/sustainability-in-care-through-an-ethical-practice-model
#5
Linda Nyholm, Susanne Salmela, Lisbet Nyström, Camilla Koskinen
BACKGROUND: While sustainability is a key concept in many different domains today, it has not yet been sufficiently emphasized in the healthcare sector. Earlier research shows that ethical values and evidence-based care models create sustainability in care practice. OBJECTIVE: The aim of this study was to gain further understanding of the ethical values central to the realization of sustainability in care and to create an ethical practice model whereby these basic values can be made perceptible and active in care practice...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28625147/adverse-drug-reactions-related-to-drug-administration-in-hospitalized-patients
#6
Luca Gallelli, Antonio Siniscalchi, Caterina Palleria, Laura Mumoli, Orietta Staltari, Aida Squillace, Francesca Maida, Emilio Russo, Santo Gratteri, Giovambattista De Sarro
INTRODUCTION: Drug treatment may be related with the development of adverse drug reactions (ADRs). AIM: Here, we evaluated the ADRs in patients admitted to Catanzaro Hospital. METHODS: After we obtained the approval by local Ethical Committee, we performed a retrospective study on clinical records from March 01, 2013 to April30, 2015. The association between drug and ADR or between drug and drug-drug-interactions (DDIs) was evaluated using the Naranjo's probability scale and Drug Interaction Probability Scale (DIPS), respectively...
June 15, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28624760/how-do-smoking-cessation-medicines-compare-with-respect-to-their-neuropsychiatric-safety-a-protocol-for-a-systematic-review-network-meta-analysis-and-cost-effectiveness-analysis
#7
Kyla H Thomas, Deborah Caldwell, Michael N Dalili, David Gunnell, Marcus R Munafò, Matt Stevenson, Nicky J Welton
INTRODUCTION: Cigarette smoking is one of the leading causes of early death in the UK and worldwide. Public health guidance recommends the use of varenicline, bupropion and nicotine replacement therapy (NRT) as smoking cessation aids in the UK. Additionally, the first electronic cigarette has been licensed for use as a smoking cessation medicine. However, there are ongoing concerns about the safety of these medicines. We present a protocol for a systematic review and network meta-analysis (NMA) to determine how these smoking cessation medicines compare to each other with respect to their neuropsychiatric safety in adult smokers...
June 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28619604/clinical-implementation-of-pharmacogenomics-for-personalized-precision-medicine-barriers-and-solutions
#8
REVIEW
Michelle Elizabeth Klein, Md Masud Parvez, Jae-Gook Shin
Clinical implementation of pharmacogenomics (PGx) leads to personalized medicine, which improves the efficacy, safety, and cost-effectiveness of treatments. Although PGx-based research has been conducted for more than a decade, several barriers have slowed down its widespread implementation in clinical practice. Globally, there is an imbalance in programs and solutions required to empower the clinical implementation of PGx between countries. Therefore, we aimed to review these issues comprehensively, determine the major barriers, and find the best solutions...
June 12, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28618112/older-patients-with-late-stage-copd-their-illness-experiences-and-involvement-in-decision-making-regarding-mechanical-ventilation-and-noninvasive-ventilation
#9
Heidi Jerpseth, Vegard Dahl, Per Nortvedt, Kristin Halvorsen
Older patients with late-stage COPD: their illness experiences and involvement in decision-making regarding mechanical ventilation and noninvasive ventilation AIMS AND OBJECTIVES: The aim of this study was twofold: first, to explore the illness experiences of older patients' with late-stage chronic obstructive pulmonary disease; and second, to develop knowledge about how patients perceive their preferences to be taken into account in decision-making processes concerning mechanical ventilation and /or non-invasive ventilation...
June 15, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28618087/telephone-nursing-in-sweden-a-narrative-literature-review
#10
REVIEW
Elenor Kaminsky, Marta Röing, Annica Björkman, Inger K Holmström
Telephone nursing services are expanding globally. Swedish Healthcare Direct is the largest healthcare provider in Sweden. This paper provides a comprehensive understanding of telephone nursing, as reflected by research on Swedish national telephone nursing, and discusses the findings in relation to international literature. A descriptive, mixed-studies literature review was conducted. Twenty-four articles from January 2003 to April 2015 were identified from PubMed, Scopus, and CINAHL, and included. The issues explored in this study are how telephone nursing is perceived by callers, telephone nurses, and managers, and what characterizes such calls...
June 15, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28617193/are-contact-precautions-ethically-justifiable-in-contemporary-hospital-care
#11
Joanna Harris, Kenneth Walsh, Susan Dodds
Hospital infection control practices known as Contact Precautions are recommended for the management of people with pathogens such as methicillin-resistant Staphylococcus aureus or vancomycin-resistant Enterococci. BACKGROUND: The patient is isolated, and staff are required to wear gloves, and a gown or apron when providing care. A notice is displayed to remind staff of these requirements and an 'alert' message is placed in the patient's medical record. OBJECTIVE: The aim of this article is to discuss and explore whether practices used in hospitals to reduce the transmission of endemic antibiotic-resistant organisms are ethically justified in today's healthcare environment in the developed world...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28615754/telepsychiatry-in-india-where-do-we-stand-a-comparative-review-between-global-and-indian-telepsychiatry-programs
#12
REVIEW
Subrata Naskar, Robin Victor, Himabrata Das, Kamal Nath
A wide discrepancy exists in India between the existing mental healthcare repertoire and the alarmingly high burden of individuals requiring immediate attention from requisite mental healthcare services. Providing equitable mental healthcare across a vast country characterized by profound cultural variations and territorial caveats has remained a major public health concern. Against this gloomy backdrop, the emergence of distant communications technology offers solace and optimism as an ingenious approach to bridge the existing gap between clients and mental health professionals...
May 2017: Indian Journal of Psychological Medicine
https://www.readbyqxmd.com/read/28614079/do-not-resuscitate-with-no-surrogate-and-no-advance-directive-an-ethics-case-study
#13
Jamie Diamond, Umesh Gidwani, Rosamond Rhodes
Do-not-resuscitate (DNR) orders are typically signed by physicians in conjunction with patients or their surrogate decision makers in order to instruct healthcare providers not to perform cardiopulmonary resuscitation (CPR). Both the medical literature and CPR guidelines fail to address when it is appropriate for physicians to sign DNR orders without any knowledge of a patient's wishes. We explore the ethical issues surrounding instituting a two-physician DNR for a dying patient with multiple comorbidities and no medical record on file, no advance directives, and no surrogate decision maker...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28611089/protocol-for-a-randomised-controlled-trial-evaluating-the-effects-of-providing-essential-medicines-at-no-charge-the-carefully-selected-and-easily-accessible-at-no-charge-medicines-clean-meds-trial
#14
Nav Persaud, Taehoon Lee, Haroon Ahmad, Winny Li, Michael Sergio Taglione, Yathavan Rajakulasingam, Norman Umali, Andrew Boozary, Richard H Glazier, Tara Gomes, Stephen W Hwang, Peter Jüni, Michael Law, Muhammad M Mamdani, Braden Manns, Danielle Martin, Steve Morgan, Paul Oh, Andrew David Pinto, Baiju R Shah, Frank M Sullivan, Kevin E Thorpe, Karen Tu, Andreas Laupacis
INTRODUCTION: Cost-related non-adherence to medicines is common in low-income, middle-income and high-income countries such as Canada. Medicine non-adherence is associated with poor health outcomes and increased mortality. This randomised trial will test the impact of a carefully selected list of essential medicines at no charge (compared with usual medicine access) in primary care patients reporting cost-related non-adherence. METHODS AND ANALYSIS: This is an open-label, parallel two-arm, superiority, individually randomised controlled trial conducted in three primary care sites (one urban, two rural) in Ontario, Canada, that was codesigned by a community guidance panel...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28608971/the-experiences-of-pregnant-women-in-an-interventional-clinical-trial-research-in-pregnancy-ethics-ripe-study
#15
Angela Ballantyne, Susan Pullon, Lindsay Macdonald, Christine Barthow, Kristen Wickens, Julian Crane
There is increasing global pressure to ensure that pregnant women are responsibly and safely included in clinical research in order to improve the evidence base that underpins healthcare delivery during pregnancy. One supposed barrier to inclusion is the assumption that pregnant women will be reluctant to participate in research. There is however very little empirical research investigating the views of pregnant women. Their perspective on the benefits, burdens and risks of research is a crucial component to ensuring effective recruitment...
July 2017: Bioethics
https://www.readbyqxmd.com/read/28601920/human-dignity-as-a-basis-for-providing-post-trial-access-to-healthcare-for-research-participants-a-south-african-perspective
#16
Pamela Andanda, Jane Wathuta
This paper discusses the need to focus on the dignity of human participants as a legal and ethical basis for providing post-trial access to healthcare. Debate about post-trial benefits has mostly focused on access to products or interventions proven to be effective in clinical trials. However, such access may be modelled on a broad fair benefits framework that emphasises both collateral benefits and interventional products of research, instead of prescribed post-trial access alone (Legal and ethical regulation of biomedical research in developing countries p...
June 10, 2017: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/28601833/targeted-simplification-versus-antipseudomonal-broad-spectrum-beta-lactams-in-patients-with-bloodstream-infections-due-to-enterobacteriaceae-simplify-a-study-protocol-for-a-multicentre-open-label-phase-iii-randomised-controlled-non-inferiority-clinical-trial
#17
Luis Eduardo López-Cortés, Clara Rosso-Fernández, María Núñez-Núñez, Lucía Lavín-Alconero, José Bravo-Ferrer, Ángel Barriga, Mercedes Delgado, Carmen Lupión, Pilar Retamar, Jesús Rodríguez-Baño
INTRODUCTION: Within the context of antimicrobial stewardship programmes, de-escalation of antimicrobial therapy is one of the proposed strategies for reducing the unnecessary use of broad-spectrum antibiotics (BSA). The empirical treatment of nosocomial and some healthcare-associated bloodstream infections (BSI) frequently includes a beta-lactam with antipseudomonal activity as monotherapy or in combination with other drugs, so there is a great opportunity to optimise the empirical therapy based on microbiological data...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28601832/global-prevalence-of-diabetes-mellitus-in-patients-with-tuberculosis-a-systematic-review-and-meta-analysis-protocol
#18
Aurel T Tankeu, Jean Joël Bigna, Jobert Richie Nansseu, Francky Teddy A Endomba, Guy Sadeu Wafeu, Arnaud D Kaze, Jean Jacques Noubiap
INTRODUCTION: Diabetes mellitus (DM) is an important risk factor for active tuberculosis (TB), which also adversely affect TB treatment outcomes. The escalating global DM epidemic is fuelling the burden of TB and should therefore be a major target in the strategy for ending TB. This review aims to estimate the global prevalence of DM in patients with TB. METHODS AND ANALYSIS: This systematic review will include cross-sectional, case-control or cohort studies of populations including patients diagnosed with TB that have reported the prevalence of DM using one of the fourth standard recommendations for screening and diagnosis...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28601828/colorectal-cancer-with-synchronous-liver-limited-metastases-the-protocol-of-an-inception-cohort-study-cosmic
#19
Ajith K Siriwardena, Anthony K C Chan, Agnieszka M Ignatowicz, James M Mason
INTRODUCTION: Colorectal cancer is the fourth most common cancer in the UK and an important cause of cancer-related death. In 20% of patients, there is metastasis to the liver or beyond at the time of diagnosis. The management of synchronous disease is complex. Conventional surgery removes the colorectal primary first, followed by chemotherapy, with resection of liver metastases as a final step. Advances in the availability and safety of liver surgery, anaesthesia and critical care have made two alternative options feasible...
June 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28600658/clinical-ethics-support-for-healthcare-personnel-an-integrative-literature-review
#20
Dara Rasoal, Kirsti Skovdahl, Mervyn Gifford, Annica Kihlgren
This study describes which clinical ethics approaches are available to support healthcare personnel in clinical practice in terms of their construction, functions and goals. Healthcare personnel frequently face ethically difficult situations in the course of their work and these issues cover a wide range of areas from prenatal care to end-of-life care. Although various forms of clinical ethics support have been developed, to our knowledge there is a lack of review studies describing which ethics support approaches are available, how they are constructed and their goals in supporting healthcare personnel in clinical practice...
June 9, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
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