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Healthcare and Ethics

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https://www.readbyqxmd.com/read/28727818/prep-in-italy-the-time-may-be-ripe-but-who-s-paying-the-bill-a-nationwide-survey-on-physicians-attitudes-towards-using-antiretrovirals-to-prevent-hiv-infection
#1
Antonio Di Biagio, Niccolò Riccardi, Alessio Signori, Renato Maserati, Silvia Nozza, Andrea Gori, Stefano Bonora, Marco Borderi, Diego Ripamonti, Maria Cristina Rossi, Giancarlo Orofino, Tiziana Quirino, Giuseppe Nunnari, Benedetto Maurizio Celesia, Salvatore Martini, Caterina Sagnelli, Giovanni Mazzola, Pietro Colletti, Dario Bartolozzi, Teresa Bini, Nicoletta Ladisa, Filippo Castelnuovo, Annalisa Saracino, Sergio Lo Caputo
Several studies have demonstrated the efficacy of the oral pre-exposure prophylaxis (PrEP) with tenofovir (with or without emtricitabine) on preventing HIV-negative partners of HIV infected patients to become infected through sexual contacts. PrEP is already available in the United States and now is approved by European Medicine Agency. In this setting we would like to gauge physicians' knowledge, acquaintance with and attitude to include PrEP in their clinical practice. A cross sectional survey was conducted among Italian physicians expert on antiretroviral therapy...
2017: PloS One
https://www.readbyqxmd.com/read/28727695/where-to-from-here-posthumous-healthcare-data-digital-e-lectronic-mortality-and-new-zealand-s-healthcare-future
#2
Katie Hoeksema, Richman Wee, Alastair Macdonald, Parry Guilford, Jesse Wall, Jon Cornwall
Ongoing improvements in digital data acquisition and storage has led to the phenomenon of e(lectronic)-mortality, where digital data can now exist for a potentially infinite period. Globally, many countries are facilitating the acquisition and researcher-led access to large-scale, population-based digitised healthcare data sets. Their utilisation has led to numerous positive advances in healthcare. New Zealand's medical record system is becoming increasingly digitised, and as a consequence there will be an ever-increasing resource of posthumous healthcare data stored digitally, including genomic information...
July 21, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28726532/local-to-global-working-together-to-meet-the-needs-of-vulnerable-communities
#3
Anne Dressel, Lucy Mkandawire-Valhmu, Ann Dietrich, Ellen Chirwa, Florence Mgawadere, Sylvia Kambalametore, Peninnah Kako
Since 2012, the University of Wisconsin-Milwaukee (UWM) faculty from nursing and physical therapy (PT) have been working together towards a common goal: to meet the healthcare needs of vulnerable populations in Malawi and Milwaukee. Sharing valuable knowledge and understanding one another's professions have allowed us to develop interprofessional education (IPE) learning experiences for students to help identify how quality of life could be improved or enhanced for children and their families across two different geographic spaces, one in rural Malawi and the other in urban Milwaukee...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28724031/methodological-challenges-in-the-use-of-focus-groups-with-people-with-severe-mental-illness
#4
Rosana Teresa Onocko-Campos, Alberto Rodolfo Giovanello Díaz, Catarina Magalhães Dahl, Erotildes Maria Leal, Octavio Domont de Serpa
This study addresses the practical, methodological and ethical challenges that were found in three studies that used focus groups with people with severe mental illness, in the context of community mental health services in Brazil. Focus groups are a powerful tool in health research that need to be better discussed in research with people with severe mental illness, in the context of community mental health facilities. This study is based on the authors' experience of conducting and analyzing focus groups in three different cities - Campinas, Rio de Janeiro and Salvador - between 2006-2010...
July 13, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28723997/access-to-health-care-as-a-human-right-in-international-policy-critical-reflections-and-contemporary-challenges
#5
Camilo Hernán Manchola Castillo, Volnei Garrafa, Thiago Cunha, Fernando Hellmann
Using the United Nations (UN) and its subordinate body, the World Health Organization (WHO), as a frame of reference, this article explores access to healthcare as a human right in international intergovernmental policies. First, we look at how the theme of health is treated within the UN, focusing on the concept of global health. We then discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions...
July 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28720617/protocol-for-an-online-randomised-controlled-trial-to-evaluate-the-clinical-and-cost-effectiveness-of-a-peer-supported-self-management-intervention-for-relatives-of-people-with-psychosis-or-bipolar-disorder-relatives-education-and-coping-toolkit-react
#6
Fiona Lobban, Heather Robinson, Duncan Appelbe, Johanna Barraclough, Emma Bedson, Lizzie Collinge, Susanna Dodd, Sue Flowers, Mahsa Honary, Sonia Johnson, Ceu Mateus, Barbara Mezes, Valerie Minns, Elizabeth Murray, Andrew Walker, Paula Williamson, Catherine Wintermeyer, Steven Jones
INTRODUCTION: Despite clinical guidelines recommendations, many relatives of people with psychosis or bipolar disorder do not currently receive the support they need. Online information and support may offer a solution. METHODS AND ANALYSIS: This single-blind, parallel, online randomised controlled trial will determine clinical and cost-effectiveness of the Relatives Education And Coping Toolkit (REACT) (including an online resource directory (RD)), compared with RD only, for relatives of people with psychosis or bipolar disorder...
July 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716785/imbuing-medical-professionalism-in-relation-to-safety-a-study-protocol-for-a-mixed-methods-intervention-focused-on-trialling-an-embedded-learning-approach-that-centres-on-the-use-of-a-custom-designed-board-game
#7
Marie Ward, Eilish McAuliffe, Éidín Ní Shé, Ann Duffy, Una Geary, Una Cunningham, Catherine Holland, Nick McDonald, Karen Egan, Christian Korpos
INTRODUCTION: Healthcare organisations have a responsibility for ensuring that the governance of workplace settings creates a culture that supports good professional practice. Encouraging such a culture needs to start from an understanding of the factors that make it difficult for health professionals to raise issues of concern in relation to patient safety. The focus of this study is to determine whether a customised education intervention, developed as part of the study, with interns and senior house officers (SHOs) can imbue a culture of medical professionalism in relation to patient safety and support junior doctors to raise issues of concern, while shaping a culture of responsiveness and learning...
July 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28716621/healthcare-professionals-attitudes-about-physician-assisted-death-an-analysis-of-their-justifications-and-the-roles-of-terminology-and-patient-competency
#8
Derek W Braverman, Brian S Marcus, Paul G Wakim, Mark R Mercurio, Gary S Kopf
CONTEXT: Healthcare professionals (HCPs) are crucial to physician-assisted death (PAD) provision. OBJECTIVES: To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views, and their support for three forms of PAD. METHODS: Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia...
July 14, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28716504/series-pragmatic-trials-and-real-world-evidence-paper-8-data-collection-and-management-data-collection-in-pragmatic-trials
#9
Anna-Katharina Meinecke, Paco Welsing, George Kafatos, Des Burke, Sven Trelle, Maria Kubin, Gaelle Nachbaur, Matthias Egger, Mira Zuidgeest
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice...
July 14, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28714147/communication-of-information-about-genetic-risks-putting-families-at-the-center
#10
Álvaro Mendes, Alison Metcalfe, Milena Paneque, Liliana Sousa, Angus J Clarke, Jorge Sequeiros
Genetic information is a family affair. With the expansion of genomic technologies, many new causal genes and variants have been established and the potential for molecular diagnoses increased, with implications not only for patients but also their relatives. The need for genetic counseling and intrafamilial circulation of information on genetic risks grew accordingly. Also, the amount and, particularly, the complexity of the information to convey multiplied. Sharing information about genetic risks with family members, however, has never been an easy matter and often becomes a source of personal and familial conflicts and distress...
July 16, 2017: Family Process
https://www.readbyqxmd.com/read/28713128/introduction-community-academic-partnerships-in-research-and-public-health
#11
Emily E Anderson, Kevin J Valadares
This symposium includes twelve personal narratives from individuals and teams who have been engaged in community-academic partnerships in research and public health. This issue also includes four commentaries on these narratives by experts in patient and research subject advocacy, healthcare and biomedical ethics, social science, and health education funding. While much has been written about community-academic partnerships, what appears in the literature does not include in-depth, personal reflection on the challenges and obstacles faced in these partnerships...
2017: Narrative Inquiry in Bioethics
https://www.readbyqxmd.com/read/28710222/a-developmental-evaluation-to-enhance-stakeholder-engagement-in-a-wide-scale-interactive-project-disseminating-quality-improvement-data-study-protocol-for-a-mixed-methods-study
#12
Alison Laycock, Jodie Bailie, Veronica Matthews, Frances Cunningham, Gillian Harvey, Nikki Percival, Ross Bailie
INTRODUCTION: Bringing together continuous quality improvement (CQI) data from multiple health services offers opportunities to identify common improvement priorities and to develop interventions at various system levels to achieve large-scale improvement in care. An important principle of CQI is practitioner participation in interpreting data and planning evidence-based change. This study will contribute knowledge about engaging diverse stakeholders in collaborative and theoretically informed processes to identify and address priority evidence-practice gaps in care delivery...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28710220/let-s-talk-about-children-evaluation-ltce-study-in-northern-finland-a-multiple-group-ecological-study-of-children-s-health-promotion-activities-with-a-municipal-and-time-trend-design
#13
Veikko Kujala, Jaana Jokinen, Hanna Ebeling, Anneli Pohjola
INTRODUCTION: Making change towards child and family-based and coordinated services is critical to improve quality, outcomes and value. The Let's Talk about Children (LTC) approach, which consists of brief psychoeducational discussions with parents of kindergarten-aged and school-aged children, has been launched as a municipality-specific programme in the Council of Oulu Region. The aim of this paper is to present a protocol of an ecological study evaluating the group-specific effects of an intervention about LTC activities in a geographically defined population...
July 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28707845/clinical-ethics-what-the-anaesthesiologist-and-the-intensivist-need-to-know
#14
Marco Vergano, Emma Magavern, Nereo Zamperetti
Clinical ethics if often perceived as an intuitive understanding of what is right versus wrong. This is insufficient for healthcare workers in general, but particularly for anesthesiologists and intensivists, who often must weigh up complex and emergent life or death decisions and subsequently justify these decisions to their team and patients, as well as patient's families. Articulating the rationale for such decisions is an arduous task. Thus, a brief introduction to the basic conceptual framework and vocabulary of clinical ethics may be useful to this population of physicians...
July 12, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28706104/use-of-a-mobile-social-networking-intervention-for-weight-management-a-mixed-methods-study-protocol
#15
Liliana Laranjo, Annie Y S Lau, Paige Martin, Huong Ly Tong, Enrico Coiera
INTRODUCTION: Obesity and physical inactivity are major societal challenges and significant contributors to the global burden of disease and healthcare costs. Information and communication technologies are increasingly being used in interventions to promote behaviour change in diet and physical activity. In particular, social networking platforms seem promising for the delivery of weight control interventions.We intend to pilot test an intervention involving the use of a social networking mobile application and tracking devices (Fitbit Flex 2 and Fitbit Aria scale) to promote the social comparison of weight and physical activity, in order to evaluate whether mechanisms of social influence lead to changes in those outcomes over the course of the study...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706101/low-value-clinical-practices-in-injury-care-a-scoping-review-protocol
#16
Lynne Moore, Khadidja Malloum Boukar, Pier-Alexandre Tardif, Henry T Stelfox, Howard Champion, Peter Cameron, Belinda Gabbe, Natalie Yanchar, John Kortbeek, François Lauzier, France Légaré, Patrick Archambault, Alexis F Turgeon
INTRODUCTION: Preventable injuries lead to 200 000 hospital stays, 60 000 disabilities, and 13 000 deaths per year in Canada with direct costs of $20 billion. Overall, potentially unnecessary medical interventions are estimated to consume up to 30% of healthcare resources and may expose patients to avoidable harm. However, little is known about overuse for acute injury care. We aim to identify low-value clinical practices in injury care. METHODS AND ANALYSIS: We will perform a scoping review of peer-reviewed and non-peer-reviewed literature to identify research articles, reviews, recommendations and guidelines that identify at least one low-value clinical practice specific to injury populations...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706092/development-of-an-intervention-to-support-patients-and-clinicians-with-advanced-lung-cancer-when-considering-systematic-anticancer-therapy-protocol-for-the-pact-study
#17
Despina Anagnostou, Stephanie Sivell, Simon Noble, Jason Lester, Anthony Byrne, Catherine Sampson, Mirella Longo, Annmarie Nelson
INTRODUCTION: Patient-centred care is essential to the delivery of healthcare; however, this necessitates direct patient involvement in clinical decision-making and can be challenging for patients diagnosed with advanced non-small cell lung cancer where there may be misunderstanding of the extent of disease, prognosis and aims of treatment. In this context, decisions are complex and there is a need to balance the risks and benefits, including treatment with palliative intent. The aim of the PACT study is to identify the information and decision support needs of patients, leading to the development of an intervention to support patients with advanced lung cancer when considering treatment options...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28706091/predict-cp-study-protocol-of-implementation-of-comprehensive-surveillance-to-predict-outcomes-for-school-aged-children-with-cerebral-palsy
#18
Roslyn N Boyd, Peter Sw Davies, Jenny Ziviani, Stewart Trost, Lee Barber, Robert Ware, Stephen Rose, Koa Whittingham, Leanne Sakzewski, Kristie Bell, Christopher Carty, Steven Obst, Katherine Benfer, Sarah Reedman, Priya Edwards, Megan Kentish, Lisa Copeland, Kelly Weir, Camilla Davenport, Denise Brooks, Alan Coulthard, Rebecca Pelekanos, Andrea Guzzetta, Simona Fiori, Meredith Wynter, Christine Finn, Andrea Burgess, Kym Morris, John Walsh, Owen Lloyd, Jennifer A Whitty, Paul A Scuffham
OBJECTIVES: Cerebral palsy (CP) remains the world's most common childhood physical disability with total annual costs of care and lost well-being of $A3.87b. The PREDICT-CP (NHMRC 1077257 Partnership Project: Comprehensive surveillance to PREDICT outcomes for school age children with CP) study will investigate the influence of brain structure, body composition, dietary intake, oropharyngeal function, habitual physical activity, musculoskeletal development (hip status, bone health) and muscle performance on motor attainment, cognition, executive function, communication, participation, quality of life and related health resource use costs...
July 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28700416/mandatory-influenza-vaccination-for-all-healthcare-personnel-a-review-on-justification-implementation-and-effectiveness
#19
Tiffany L Wang, Ling Jing, Joseph A Bocchini
PURPOSE OF REVIEW: As healthcare-associated influenza is a serious public health concern, this review examines legal and ethical arguments supporting mandatory influenza vaccination policies for healthcare personnel, implementation issues and evidence of effectiveness. RECENT FINDINGS: Spread of influenza from healthcare personnel to patients can result in severe harm or death. Although most healthcare personnel believe that they should be vaccinated against seasonal influenza, the Centers for Disease Control and Prevention (CDC) report that only 79% of personnel were vaccinated during the 2015-2016 season...
July 11, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28700382/mandatory-reporting-of-intimate-partner-violence-an-ethical-dilemma-for-forensic-nurses
#20
Rosalyn M Walker
Nearly all states and provinces have laws mandating licensed healthcare professionals to report to law enforcement suspicions and allegations of the abuse of children, older adults, and disabled persons and all incidents of violence by a deadly weapon. However, a few states in the United States additionally mandate providers to report all injuries resultant from reported or suspected domestic/intimate partner violence. This can present a challenge to forensic nurses seeking to protect patient confidentiality and autonomy...
July 11, 2017: Journal of Forensic Nursing
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