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Healthcare and Ethics

Alberto Pilotto, Raffaella Boi, Jean Petermans
Recently, the interest of industry, government agencies and healthcare professionals in technology for aging people has increased. The challenge is whether technology may play a role in enhancing independence and quality of life and in reducing individual and societal costs of caring. Information and communication technologies, i.e. tools aimed at communicating and informing, assistive technologies designed to maintain older peoples' independence and increasing safety, and human-computer interaction technologies for supporting older people with motility and cognitive impairments as humanoid robots, exoskeletons, rehabilitation robots, service robots and companion-type are interdisciplinary topics both in research and in clinical practice...
March 13, 2018: Age and Ageing
Trisha M Prentice, Lynn Gillam
When healthcare professionals feel constrained from acting in a patient's best interests, moral distress ensues. The resulting negative sequelae of burnout, poor retention rates, and ultimately poor patient care are well recognized across healthcare providers. Yet an appreciation of how particular disciplines, including physicians, come to be "constrained" in their actions is still lacking. This paper will examine how the application of shared decision-making may contribute to the experience of moral distress for physicians and why such distress may go under-recognized...
March 14, 2018: Journal of Bioethical Inquiry
Nausheen Bakht
The social contract between medicine and society is being renegotiated and demands the reorientation of healthcare. Neither society nor doctors are happy with the way modern medicine is being practised. An obtuse focus on medical sciences and a myopic view of medical humanities (MH) has been incriminated. MH reflects on healthcare-related topics in the light of shared human experiences. It addresses the genuine concerns of patients and their attendants. It also helps inculcate humanistic values in doctors by enhancing ethical understanding, cultural sensitivity, mutual respect, empathy, communication skills and decision-making...
March 2018: JPMA. the Journal of the Pakistan Medical Association
Beatriz Paulina Ayala Quintanilla, Wendy E Pollock, Susan J McDonald, Angela J Taft
INTRODUCTION: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality...
March 14, 2018: BMJ Open
Jacqueline Murphy, Mark G Pritchard, Lok Yin Cheng, Roshni Janarthanan, José Leal
INTRODUCTION: Hip and knee replacement represents a significant burden to the UK healthcare system. 'Enhanced recovery' pathways have been introduced in the National Health Service (NHS) for patients undergoing hip and knee replacement, with the aim of improving outcomes and timely recovery after surgery. To support policymaking, there is a need to evaluate the cost-effectiveness of enhanced recovery pathways across jurisdictions. Our aim is to systematically summarise the published cost-effectiveness evidence on enhanced recovery in hip and knee replacement, both as a whole and for each of the various components of enhanced recovery pathways...
March 14, 2018: BMJ Open
Selene Cordeiro Vasconcelos, Iracema da Silva Frazão, Everton Botelho Sougey, Sandra Lopes de Souza, Tatiana de Paula Santana da Silva, Murilo Duarte da Costa Lima
INTRODUCTION: The abuse of alcohol and other drugs is a worldwide problem, the treatment of which poses a challenge to healthcare workers. OBJECTIVE: This study presents a proposal for a systematic review to analyse the psychometric properties of assessment tools developed to measure the self-efficacy of drug users with regard to resisting the urge to take drugs in high-risk situations. METHODS AND ANALYSIS: The guiding question was based on PICOS (Population Intervention Comparator Outcome Setting), and the report of the methods of review protocol was written in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P)...
March 14, 2018: BMJ Open
Christiana R Dallas, Curtis H Harris, Cham E Dallas
In the U.S., migration has been documented to affect the prevalence of infectious disease. As a mitigation entity, border security has been recorded by numerous scholarly works as being essential to the support of the health of the U.S. POPULATION: Consequently, the lack of current health care monitoring of the permeable U.S. border places the U.S. population at risk in the broad sectors of infectious disease and interpersonal violence. Visualizing border security in the context of public health mitigation has significant potential to protect migrant health as well as that of all populations on both sides of the border...
March 15, 2018: Disaster Medicine and Public Health Preparedness
Jong-In Kim, Hee-Jung Kim, Jung Ju Lee, Ji Hee Jun, Tae-Young Choi, Myeong Soo Lee
BACKGROUND: The ability of acupuncture to successfully control pain has been reported in the past. However, currently no systematic reviews exist regarding the effect of acupuncture on trigeminal neuralgia (TN). This proposed review aims to evaluate the current evidence on the efficacy of acupuncture for the management of pain in TN. METHODS: A total of 11 databases were searched from their inception. These include MEDLINE, AMED, EMBASE, the Cochrane Library, 6 Korean medical databases, and 1 Chinese Medical Database...
March 2018: Medicine (Baltimore)
Norita Hussein, Stephen F Weng, Joe Kai, Jos Kleijnen, Nadeem Qureshi
BACKGROUND: Globally, about five per cent of children are born with congenital or genetic disorders. The most common autosomal recessive conditions are thalassaemia, sickle cell disease, cystic fibrosis and Tay-Sachs disease, with higher carrier rates in specific patient populations. Identifying and counselling couples at genetic risk of the conditions before pregnancy enables them to make fully informed reproductive decisions, with some of these choices not being available if genetic counselling is only offered in an antenatal setting...
March 14, 2018: Cochrane Database of Systematic Reviews
Caroline Fertleman, Phoebe Aubugeau-Williams, Carmel Sher, Ai-Nee Lim, Sophie Lumley, Sylvie Delacroix, Xueni Pan
Background: Virtual reality technology is an exciting and emerging field with vast applications. Our study sets out the viewpoint that virtual reality software could be a new focus of direction in the development of training tools in medical education. We carried out a panel discussion at the Center for Behavior Change 3rd Annual Conference, prompted by the study, "The Responses of Medical General Practitioners to Unreasonable Patient Demand for Antibiotics--A Study of Medical Ethics Using Immersive Virtual Reality" (1)...
2018: Frontiers in Public Health
Marlysa B Sullivan, Matt Erb, Laura Schmalzl, Steffany Moonaz, Jessica Noggle Taylor, Stephen W Porges
Yoga therapy is a newly emerging, self-regulating complementary and integrative healthcare (CIH) practice. It is growing in its professionalization, recognition and utilization with a demonstrated commitment to setting practice standards, educational and accreditation standards, and promoting research to support its efficacy for various populations and conditions. However, heterogeneity of practice, poor reporting standards, and lack of a broadly accepted understanding of the neurophysiological mechanisms involved in yoga therapy limits the structuring of testable hypotheses and clinical applications...
2018: Frontiers in Human Neuroscience
Stephanie Stiel, Mareike Nurnus, Christoph Ostgathe, Carsten Klein
BACKGROUND: Clinical practice of Palliative Sedation (PS) varies between institutions worldwide and sometimes includes problematic practices. Little available research points at different definitions and frameworks which may contribute to uncertainty of healthcare professionals in the application of PS. This analysis investigates what demographic factors and characteristics of treatment practices differ between institutions with high versus low sedation rates estimates in Palliative and Hospice Care in Germany...
March 13, 2018: BMC Palliative Care
Gwendolien Vanderschaeghe, Kris Dierickx, Rik Vandenberghe
BACKGROUND: Today, many healthcare or dementia organizations, clinicians, and companies emphasize the importance of detection of Alzheimer's disease in an early phase. This idea has gained considerable momentum due to the development of biomarkers, the recent FDA and EMA approval of three amyloid tracers, and the failure of a number of recent therapeutic trials conducted in the early dementia phase. On the one hand, an early etiological diagnosis can lead to early and more efficacious intervention...
March 12, 2018: Journal of Bioethical Inquiry
Guowei Li, Meha Bhatt, Mei Wang, Lawrence Mbuagbaw, Zainab Samaan, Lehana Thabane
Evidence from a well-designed randomized controlled trial (RCT) is generally considered to be the gold standard that can inform clinical practice and guide decision-making. However, several deficiencies in the reporting of RCTs have frequently been identified, including incomplete, selective, and biased or inconsistent reporting. Such suboptimal reporting may lead to irreproducible results, substantial waste of resources, impaired study validity, erosion of public trust in science, and a high risk of research misconduct...
March 13, 2018: Proceedings of the National Academy of Sciences of the United States of America
Cecilia Bartholdson, Bert Molewijk, Kim Lützén, Klas Blomgren, Pernilla Pergert
BACKGROUND: In previous research on ethics case reflection (ECR) sessions about specific cases, healthcare professionals in childhood cancer care were clarifying their perspectives on the ethical issue to resolve their main concern of consolidating care. When perspectives were clarified, consequences in the team included 'increased understanding', 'group strengthening' and 'decision grounding'. Additional analysis of the data was needed on conditions that could contribute to the quality of ECR sessions...
March 2018: Nursing Ethics
Linda Rainey, Daniëlle van der Waal, Anna Jervaeus, Yvonne Wengström, D Gareth Evans, Louise S Donnelly, Mireille J M Broeders
BACKGROUND: Increased knowledge of breast cancer risk factors provides opportunities to shift from a one-size-fits-all screening programme to a personalised approach, where screening and prevention is based on a woman's risk of developing breast cancer. However, potential implementation of this new paradigm could present considerable challenges which the present review aims to explore. METHODS: Bibliographic databases were searched to identify studies evaluating potential implications of the implementation of personalised risk-based screening and primary prevention for breast cancer...
March 9, 2018: Breast: Official Journal of the European Society of Mastology
Swetha Narayanan, Bruce Blumberg, Marla L Clayman, Vivian Pan, Catherine Wicklund
Exome sequencing is a clinical diagnostic test offered primarily for children and adults with suspected genetic conditions. The purpose of this study was to explore issues related to exome sequencing in a reproductive clinical setting. This was a qualitative study using semi-structured interviews. Participants were professionals drawn from four key stakeholder groups-healthcare providers, laboratory/industry, ethics, and government. Transcribed interviews were analyzed for emergent themes. Most participants saw potential clinical utility in offering prenatal exome sequencing for diagnostic purposes as opposed to screening...
March 10, 2018: Journal of Genetic Counseling
Sandra C Buttigieg, Joost van Hoof
Lehoux et al provide a highly valid contribution in conceptualizing value in value propositions for new health technologies and developing an analytic framework that illustrates the interplay between health innovation supply-side logic (the logic of emergence) and demand-side logic (embedding in the healthcare system). This commentary brings forth several considerations on this article. First, a detailed stakeholder analysis provides the necessary premonition of potential hurdles in the development, implementation and dissemination of a new technology...
July 3, 2017: International Journal of Health Policy and Management
Peter D Young, Dawei Xie, Harald Schmidt
Financial conflicts of interest exist between industry and physicians, and these relationships have the power to influence physicians' medical practice. Transparency about conflicts matters for ensuring adequate informed consent, controlling healthcare expenditure, and encouraging physicians' reflection on professionalism. The US Centers for Medicare & Medicaid Services (CMS) launched the Open Payments Program (OPP) to publicly disclose and bring transparency to the relationships between industry and physicians in the United States...
October 29, 2017: International Journal of Health Policy and Management
Chaplain John D Connolly
Healthcare ethics committees, physicians, surgeons, nurses, families, and patients themselves are constantly under pressure to make appropriate medically ethical decisions concerning patient care. Various models for healthcare ethics decisions have been proposed throughout the years, but by and large they are focused on making the initial ethical decision. What follows is a proposed model for healthcare ethics that considers the most appropriate decisions before, during, and after any intervention. The Just War Tradition is a model that is thorough in its exploration of the ethics guiding a nation to either engage in or refuse to engage in combatant actions...
March 8, 2018: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
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