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Healthcare and Ethics

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https://www.readbyqxmd.com/read/28100560/prevalence-impact-and-cost-of-multimorbidity-in-a-cohort-of-people-with-chronic-pain-in-ireland-a-study-protocol
#1
Brian W Slattery, Laura O'Connor, Stephanie Haugh, Christopher P Dwyer, Siobhan O'Higgins, Line Caes, Jonathan Egan, Brian E McGuire
INTRODUCTION: Multimorbidity (MM) refers to the coexistence of two or more chronic conditions within one person, where no one condition is considered primary. As populations age and healthcare provision improves, MM is becoming increasingly common and poses a challenge to the single morbidity approach to illness management, usually adopted by healthcare systems. Indeed, recent research has shown that 66.2% of the people in primary care in Ireland are living with MM. Healthcare usage and cost is significantly associated with MM, and additional chronic conditions lead to exponential increases in service usage and financial costs, and decreases in physical and mental well-being...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100067/race-based-experiences-of-ethnic-minority-health-professionals-arab-physicians-and-nurses-in-israeli-public-healthcare-organizations
#2
Yael Keshet, Ariela Popper-Giveon
: Increasing workforce diversity was found to contribute to the narrowing of disparities in health. However, racism toward ethnic minority health professionals has not been adequately researched. In Israel, public healthcare organizations that serve a mixed Jewish-Arab population employ Arab minority healthcare professionals. Instances of prejudice and manifestations of racism toward them, which frequently surface in public discussion and the media, have unfortunately gained little scholarly attention...
January 19, 2017: Ethnicity & Health
https://www.readbyqxmd.com/read/28098627/global-collaboration-in-acute-care-clinical-research-opportunities-challenges-and-needs
#3
John C Marshall
The most impactful research in critical care comes from trials groups led by clinician-investigators who study questions arising through the day-to-day care of critically ill patients. The success of this model reflects both "necessity"-the paucity of new therapies introduced through industry-led research-and "clinical reality"-nuanced modulation of standard practice can have substantial impact on clinically important outcomes. Success in a few countries has fueled efforts to build similar models around the world and to collaborate on an unprecedented scale in large international trials...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#4
Ewan C Goligher, E Wesley Ely, Daniel P Sulmasy, Jan Bakker, John Raphael, Angelo E Volandes, Bhavesh M Patel, Kate Payne, Annmarie Hosie, Larry Churchill, Douglas B White, James Downar
OBJECTIVE: Many patients are admitted to the ICU at or near the end of their lives. Consequently, the increasingly common debate regarding physician-assisted suicide and euthanasia holds implications for the practice of critical care medicine. The objective of this article is to explore core ethical issues related to physician-assisted suicide and euthanasia from the perspective of healthcare professionals and ethicists on both sides of the debate. SYNTHESIS: We identified four issues highlighting the key areas of ethical tension central to evaluating physician-assisted suicide and euthanasia in medical practice: 1) the benefit or harm of death itself, 2) the relationship between physician-assisted suicide and euthanasia and withholding or withdrawing life support, 3) the morality of a physician deliberately causing death, and 4) the management of conscientious objection related to physician-assisted suicide and euthanasia in the critical care setting...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28096252/understanding-the-importance-of-therapeutic-relationships-in-the-development-of-self-management-behaviours-during-cancer-rehabilitation-a-qualitative-research-protocol
#5
Wendy M Wilkinson, Jaynie Rance, Deborah Fitzsimmons
INTRODUCTION: Cancer is a growing health, social and economic problem. 1 in 3 people in the UK will develop cancer in their lifetime. With survival rates rising to over 50%, the long-term needs of cancer survivors are of growing importance. Cancer rehabilitation is tailored to address the physical or psychosocial decline in ability to engage in daily activities. Its use is supported by high-quality international, multicentre research. Incorporating strategies for self-management behaviour development into rehabilitation can prepare individuals for cancer survivorship...
January 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28095946/electroconvulsive-therapy-ect-for-treating-agitation-in-dementia-major-neurocognitive-disorder-a-promising-option
#6
Oliver M Glass, Brent P Forester, Adriana P Hermida
BACKGROUND: Agitation in patients with dementia increases caretaker burden, increases healthcare costs, and worsens the patient's quality of life. Antipsychotic medications, commonly used for the treatment of agitation in patients with dementia have a box warning from the FDA for elevated mortality risk. Electroconvulsive therapy (ECT) has made significant advances over the past several years, and is efficacious in treating a wide range of psychiatric conditions. We provide a systematic review of published literature regarding the efficacy of ECT for the treatment of agitation in patients with dementia (major neurocognitive disorder)...
January 18, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28095758/ethical-difficulties-in-healthcare
#7
Cinzia Leuter, Carmen La Cerra, Santina Calisse, Danila Dosa, Cristina Petrucci, Loreto Lancia
BACKGROUND: Advances in biomedical sciences, technologies and care practices have resulted in an increase in ethical problems and a resulting growth of difficulties encountered by health workers in their professional activity. OBJECTIVE: The main objective of this study was to analyse knowledge in the ethical field and experience with and the propensity for using ethics consultations by nurses and physicians. METHODS: Between March and June 2014, a cross-sectional observational study was conducted on a sample of 351 nurses and 128 physicians in four central Italian hospitals...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28095757/ethical-leadership-outcomes-in-nursing
#8
Maasoumeh Barkhordari-Sharifabad, Tahereh Ashktorab, Foroozan Atashzadeh-Shoorideh
BACKGROUND: Leadership style adopted by nursing managers is a key element in progress and development of nursing and quality of healthcare services received by the patients. In this regard, the role of ethical leadership is of utmost importance. OBJECTIVES: The objective of the study was to elaborate on the ethical leadership and its role in professional progress and growth of nurses in the light of work condition in health providing institutes. METHODS: The study was carried out as a qualitative study following conventional content analysis method...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28093938/capacity-and-consent
#9
Scott Lamont, Cameron Stewart, Mary Chiarella
INTRODUCTION: Healthcare practitioners have a legal, ethical and professional obligation to obtain patient consent for all healthcare treatments. There is increasing evidence which suggests dissonance and variation in practice in assessment of decision-making capacity and consent processes. AIMS: This study explores healthcare practitioners' knowledge and practices of assessing decision-making capacity and obtaining patient consent to treatment in the acute generalist setting...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28078766/lost-in-transformation-reviving-ethics-of-care-in-hospital-cultures-of-evidence-based-healthcare
#10
Annelise Norlyk, Anita Haahr, Pia Dreyer, Bente Martinsen
Drawing on previous empirical research, we provide an exemplary narrative to illustrate how patients have experienced hospital care organized according to evidence-based fast-track programmes. The aim of this paper was to analyse and discuss if and how it is possible to include patients' individual perspectives in an evidence-based practice as seen from the point of view of nursing theory. The paper highlights two conflicting courses of development. One is a course of standardization founded on evidence-based recommendations, which specify a set of rules that the patient must follow rigorously...
January 12, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28077414/implementation-of-a-consumer-focused-ehealth-intervention-for-people-with-moderate-to-high-cardiovascular-disease-risk-protocol-for-a-mixed-methods-process-evaluation
#11
Genevieve M Coorey, Lis Neubeck, Timothy Usherwood, David Peiris, Sharon Parker, Annie Y S Lau, Clara Chow, Kathryn Panaretto, Mark Harris, Nicholas Zwar, Julie Redfern
INTRODUCTION: Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understanding how, why and among whom such strategies have an effect can help determine the requirements for implementing them at a scale. This paper aims to detail a process evaluation that will (1) assess implementation fidelity of a multicomponent eHealth intervention; (2) determine its effective features; (3) explore contextual factors influencing and maintaining user engagement; and (4) describe barriers, facilitators, preferences and acceptability of such interventions...
January 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28069627/what-aspects-of-intentional-rounding-work-in-hospital-wards-for-whom-and-in-what-circumstances-a-realist-evaluation-protocol
#12
Ruth Harris, Sarah Sims, Ros Levenson, Stephen Gourlay, Fiona Ross Cbe, Nigel Davies, Sally Brearley, Giampiero Favato, Robert Grant
INTRODUCTION: Intentional rounding (IR) is a structured process whereby nurses in hospitals carry out regular checks, usually hourly, with individual patients using a standardised protocol to address issues of positioning, pain, personal needs and placement of items. The widespread implementation of IR across the UK has been driven by the recommendations of the Francis Inquiry although empirical evidence of its effectiveness is poor. This paper presents a protocol of a multimethod study using a realist evaluation approach to investigate the impact and effectiveness of IR in hospital wards on the organisation, delivery and experience of care from the perspective of patients, their family members and staff...
January 9, 2017: BMJ Open
https://www.readbyqxmd.com/read/28063105/the-moral-of-the-tale-stories-trust-and-public-engagement-with-clinical-ethics-via-radio-and-theatre
#13
Deborah Bowman
Trust is frequently discussed with reference to the professional-patient relationship. However, trust is less explored in relation to the ways in which understanding of, and responses to, questions of ethics are discussed by both the "public" and "experts." Public engagement activity in healthcare ethics may invoke "trust" in analysing a moral question or problem but less frequently conceives of trust as integral to "public engagement" itself. This paper explores the relationship between trust and the ways in which questions of healthcare ethics are identified and negotiated by both "experts" and the public...
January 6, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28062971/cost-equivalence-and-pluralism-in-publicly-funded-health-care-systems
#14
Dominic Wilkinson, Julian Savulescu
Clinical guidelines summarise available evidence on medical treatment, and provide recommendations about the most effective and cost-effective options for patients with a given condition. However, sometimes patients do not desire the best available treatment. Should doctors in a publicly-funded healthcare system ever provide sub-optimal medical treatment? On one view, it would be wrong to do so, since this would violate the ethical principle of beneficence, and predictably lead to harm for patients. It would also, potentially, be a misuse of finite health resources...
January 6, 2017: Health Care Analysis: HCA: Journal of Health Philosophy and Policy
https://www.readbyqxmd.com/read/28060434/participatory-bioethics-research-and-its-social-impact-the-case-of-coercion-reduction-in-psychiatry
#15
Tineke A Abma, Yolande Voskes, Guy Widdershoven
In this article we address the social value of bioethics research and show how a participatory approach can achieve social impact for a wide audience of stakeholders, involving them in a process of joint moral learning. Participatory bioethics recognizes that research co-produced with stakeholders is more likely to have impact on healthcare practice. These approaches aim to engage multiple stakeholders and interested partners throughout the whole research process, including the framing of ideas and research questions, so that outcomes are tailored to the interests and context, and the type of impact stakeholders envisage...
February 2017: Bioethics
https://www.readbyqxmd.com/read/28057389/-priority-setting-of-health-interventions-review-of-criteria-approaches-and-role-of-assessment-agencies
#16
Leonor Varela-Lema, Gerardo Atienza-Merino, Marisa López-García
OBJECTIVE: This study was carried out to develop an explicit health priority setting methodology to support decision-making regarding the technologies to be assessed for inclusion in the National Health Service service portfolio. The primary objective is to identify and analyse the criteria, approaches and conceptual frameworks used for national/international priority setting. METHOD: An exhaustive review of the literature was carried out. For this purpose, a search of the main biomedical databases was performed and assessment agency websites were reviewed, among other sources...
January 2, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28047960/tu-b-206-02-on-the-algorithmic-approach-to-ethical-conduct
#17
G Sherouse
PURPOSE: To reacquaint the participant with foundational aspects of educational, healthcare and research ethics as they relate to the Medical Physicist day to day role. METHODS: Presenting recognized best practice guidelines and tenants applied to hypothetical scenarios and medical physics related occupations. RESULTS: The application of recognized standards of ethical behavior result in beneficial outcomes for all involved CONCLUSION: Ethics is multi-faceted in its manifestation application; most facets are applicable to any avenue a medical physicist may pursue in their career...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28047387/tu-b-206-00-do-the-right-thing
#18
Jeffrey Limmer
PURPOSE: To reacquaint the participant with foundational aspects of educational, healthcare and research ethics as they relate to the Medical Physicist day to day role. METHODS: Presenting recognized best practice guidelines and tenants applied to hypothetical scenarios and medical physics related occupations. RESULTS: The application of recognized standards of ethical behavior result in beneficial outcomes for all involved CONCLUSION: Ethics is multi-faceted in its manifestation application; most facets are applicable to any avenue a medical physicist may pursue in their career...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046817/su-g-206-13-validating-dose-split-a-method-to-image-the-same-patient-at-multiple-doses-with-a-single-ct-acquisition
#19
J Solomon, Y Zhang, D Marin, E Samei
PURPOSE: Dose optimization studies in CT have a need for images acquired at multiple dose levels. This presents ethical and logistical challenges for performing such research with human subjects. As a result, most studies rely on phantom data. The purpose of this study was to perform a physics-based validation of a method to obtain images of the same patient at multiple dose levels using a single CT acquisition on a dual-source CT system. METHODS: The Dose Split (DS) method relies on acquiring raw projection data simultaneously from two separate sources/detectors (denoted Tube A and Tube B) on a dual-source system...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28046722/tu-b-206-01-navigating-the-black-white-and-gray
#20
J Limmer
PURPOSE: To reacquaint the participant with foundational aspects of educational, healthcare and research ethics as they relate to the Medical Physicist day to day role. METHODS: Presenting recognized best practice guidelines and tenants applied to hypothetical scenarios and medical physics related occupations. RESULTS: The application of recognized standards of ethical behavior result in beneficial outcomes for all involved CONCLUSION: Ethics is multi-faceted in its manifestation application; most facets are applicable to any avenue a medical physicist may pursue in their career...
June 2016: Medical Physics
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