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ethics triage

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https://www.readbyqxmd.com/read/28279257/approaches-for-triaging-women-who-test-positive-for-human-papillomavirus-in-cervical-cancer-screening
#1
Joseph E Tota, James Bentley, Jennifer Blake, François Coutlée, Máire A Duggan, Alex Ferenczy, Eduardo L Franco, Michael Fung-Kee-Fung, Walter Gotlieb, Marie-Hélène Mayrand, Meg McLachlin, Joan Murphy, Gina Ogilvie, Sam Ratnam
Substantial evidence exists to support the introduction of molecular testing for human papillomavirus (HPV) as the primary technology in cervical cancer screening. While HPV testing is much more sensitive than cytology for detection of high-grade precancerous lesions, it is less specific. To improve efficiency, it is therefore recommended that a specific test (like cytology) be used in triaging HPV positive women to colposcopy. A number of studies have been conducted that support the use of cytology alone or in conjunction with HPV genotyping for triage...
May 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28264831/head-to-head-comparison-of-procalcitonin-and-presepsin-for-the-diagnosis-of-sepsis-in-critically-ill-adult-patients-a-protocol-for-a-systematic-review-and-meta-analysis
#2
Kei Hayashida, Yutaka Kondo, Yoshitaka Hara, Morio Aihara, Kazuma Yamakawa
INTRODUCTION: Early diagnosis and immediate therapeutic intervention, including appropriate antibiotic therapy and goal-directed resuscitation, are necessary to reduce mortality in patients with sepsis. However, a single clinical or biological marker indicative of sepsis has not been adopted unanimously. Although procalcitonin and presepsin are promising biomarkers that can effectively differentiate between sepsis/infection and systemic inflammatory response syndrome of non-infectious origin, little is known about which marker is superior...
March 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28180119/nonemergent-patients-in-the-emergency-department-an-ethnographic-study
#3
Amir Mirhaghi, Abbas Heydari, Mohsen Ebrahimi, Mohsen Noghani Dokht Bahmani
BACKGROUND: Triage in the interactive atmosphere of the emergency department (ED) has been described as complex and challenging. Nonemergent ED visits have been accompanied by ethical and legal conflicts. OBJECTIVES: The aim of this study was to gain an understanding of ED nurses' practice regarding triage of nonemergent patients. PATIENTS AND METHODS: Focused micro-ethnography based on Spradley's developmental research sequence (DRS) was used...
September 2016: Trauma Monthly
https://www.readbyqxmd.com/read/28150265/-ethical-debates-related-to-the-allocation-of-medical-resources-during-the-response-to-the-mass-casualty-incident-at-formosa-fun-coast-water-park
#4
Jing-Shia Tang, Chia-Jung Chen, Mei-Chih Huang
Disasters are unpredictable and often result in mass casualties. Limited medical resources often affect the response to mass casualty incidents, undermining the ability of responders to adequately protect all of the casualties. Thus, the injuries of casualties are classified in hopes of fully utilizing medical resources efficiently in order to save the maximum possible number of people. However, as opinions on casualty prioritization are subjective, disagreements and disputes often arise regarding allocating medical resources...
February 2017: Hu Li za Zhi the Journal of Nursing
https://www.readbyqxmd.com/read/28104707/improving-care-standards-for-patients-with-spinal-trauma-combining-a-modified-e-delphi-process-and-stakeholder-interviews-a-study-protocol
#5
Lisa N Sharwood, Ralph Stanford, James W Middleton, Brian Burns, Anthony Joseph, Oliver Flower, Oran Rigby, Jonathon Ball, Shelly Dhaliwal
INTRODUCTION: Around 300 people sustain a new traumatic spinal cord injury (TSCI) in Australia each year; a relatively low incidence injury with extremely high long-term associated costs. Care standards are inconsistent nationally, lacking in consensus across important components of care such as prehospital spinal immobilisation, timing of surgery and timeliness of transfer to specialist services. This study aims to develop 'expertly defined' and agreed standards of care across the majority of disciplines involved for these patients...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28026705/a-screening-mechanism-to-recognize-and-support-at-risk-aboriginal-children
#6
Nancy L Young, Diane Jacko, Mary Jo Wabano, Lauren Hawthorne, Sarah Seabrook, Sheri Wabanosse, Koyo Usuba
OBJECTIVES: The Aboriginal Children's Health and Well-Being Measure© (ACHWM) was developed to assess health from the perspectives of Aboriginal children. The purpose of this paper is to document the screening process, embedded within the ACHWM, and assess its effectiveness. METHODS: The ACHWM was implemented in 2014/2015 with children 8 to 18 years of age living on the Wiikwemkoong Unceded Territory. Survey responses were screened to identify potential risk, using an automated algorithm run on computer tablets...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/27968852/doctor-outpatient-communications-in-chinese-public-hospitals-a-cross-sectional-survey
#7
Guanping Wang, Jinzhu Xie, Yinhuan Hu
BACKGROUND: Communication can be seen as the important component in medical care. The improvement of doctor-outpatient communication can improve not only the doctor-patient relationship, but also the quality of health care. In this study, we aimed to estimate whether the doctor-outpatient communication experience is satisfactory in Chinese public hospitals and how various factors affect this experience. METHODS: In this cross-sectional study, we used a typical sampling survey...
October 2016: Lancet
https://www.readbyqxmd.com/read/27797986/ambulance-smartphone-tool-for-field-triage-of-ruptured-aortic-aneurysms-filtr-study-protocol-for-a-prospective-observational-validation-of-diagnostic-accuracy
#8
Thomas L Lewis, Rachael T Fothergill, Alan Karthikesalingam
INTRODUCTION: Rupture of an abdominal aortic aneurysm (rAAA) carries a considerable mortality rate and is often fatal. rAAA can be treated through open or endovascular surgical intervention and it is possible that more rapid access to definitive intervention might be a key aspect of improving mortality for rAAA. Diagnosis is not always straightforward with up to 42% of rAAA initially misdiagnosed, introducing potentially harmful delay. There is a need for an effective clinical decision support tool for accurate prehospital diagnosis and triage to enable transfer to an appropriate centre...
October 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27735929/international-variations-in-application-of-the-best-interest-standard-across-the-age-spectrum
#9
N Laventhal, A A E Verhagen, T W R Hansen, E Dempsey, P G Davis, G A Musante, A Wiles, W Meadow, A Janvier
OBJECTIVE: Ethically and legally, assertions that resuscitation is in a patient's best interest should be inversely correlated with willingness to forego intensive care (and accept comfort care) at the surrogate's request. Previous single country studies have demonstrated a relative devaluation of neonates when compared with other critically ill patients. STUDY DESIGN: In this international study, physicians in Argentina, Australia, Canada, Ireland, The Netherlands, Norway and the United States were presented with eight hypothetical vignettes of incompetent critically ill patients of different ages...
October 13, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/27573154/second-thoughts-about-who-is-first-the-medical-triage-of-violent-perpetrators-and-their-victims
#10
Azgad Gold, Rael D Strous
Extreme intentional and deliberate violence against innocent people, including acts of terror and school shootings, poses various ethical challenges, some related to the practice of medicine. We discuss a dilemma relating to deliberate violence, in this case the aftermath of a terror attack, in which there are multiple injured individuals, including the terror perpetrator. Normally, the priority of medical treatment is determined based on need. However, in the case of a terror attack, there is reason to question this...
August 29, 2016: Journal of Medical Ethics
https://www.readbyqxmd.com/read/27526003/triage-during-pandemics-difficult-choices-when-business-as-usual-is-not-an-ethically-defensible-option
#11
Mary A King, Niranjan Kissoon
No abstract text is available yet for this article.
September 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27507231/refining-ovarian-cancer-test-accuracy-scores-rockets-protocol-for-a-prospective-longitudinal-test-accuracy-study-to-validate-new-risk-scores-in-women-with-symptoms-of-suspected-ovarian-cancer
#12
Sudha Sundar, Caroline Rick, Francis Dowling, Pui Au, Kym Snell, Nirmala Rai, Rita Champaneria, Hilary Stobart, Richard Neal, Clare Davenport, Susan Mallett, Andrew Sutton, Sean Kehoe, Dirk Timmerman, Tom Bourne, Ben Van Calster, Aleksandra Gentry-Maharaj, Usha Menon, Jon Deeks
INTRODUCTION: Ovarian cancer (OC) is associated with non-specific symptoms such as bloating, making accurate diagnosis challenging: only 1 in 3 women with OC presents through primary care referral. National Institute for Health and Care Excellence guidelines recommends sequential testing with CA125 and routine ultrasound in primary care. However, these diagnostic tests have limited sensitivity or specificity. Improving accurate triage in women with vague symptoms is likely to improve mortality by streamlining referral and care pathways...
2016: BMJ Open
https://www.readbyqxmd.com/read/27442230/the-importance-of-animal-welfare-science-and-ethics-to-veterinary-students-in-australia-and-new-zealand
#13
Rafael Freire, Clive J C Phillips, Joy M Verrinder, Teresa Collins, Chris Degeling, Anne Fawcett, Andrew D Fisher, Susan Hazel, Jennifer Hood, Jane Johnson, Janice K F Lloyd, Kevin Stafford, Vicky Tzioumis, Paul D McGreevy
The study of animal welfare and ethics (AWE) as part of veterinary education is important due to increasing community concerns and expectations about this topic, global pressures regarding food security, and the requirements of veterinary accreditation, especially with respect to Day One Competences. To address several key questions regarding the attitudes to AWE of veterinary students in Australia and New Zealand (NZ), the authors surveyed the 2014 cohort of these students. The survey aimed (1) to reveal what AWE topics veterinary students in Australia and NZ consider important as Day One Competences, and (2) to ascertain how these priorities align with existing research on how concern for AWE relates to gender and stage of study...
July 21, 2016: Journal of Veterinary Medical Education
https://www.readbyqxmd.com/read/27428118/icu-admission-discharge-and-triage-guidelines-a-framework-to-enhance-clinical-operations-development-of-institutional-policies-and-further-research
#14
Joseph L Nates, Mark Nunnally, Ruth Kleinpell, Sandralee Blosser, Jonathan Goldner, Barbara Birriel, Clara S Fowler, Diane Byrum, William Scherer Miles, Heatherlee Bailey, Charles L Sprung
OBJECTIVES: To update the Society of Critical Care Medicine's guidelines for ICU admission, discharge, and triage, providing a framework for clinical practice, the development of institutional policies, and further research. DESIGN: An appointed Task Force followed a standard, systematic, and evidence-based approach in reviewing the literature to develop these guidelines. MEASUREMENTS AND MAIN RESULTS: The assessment of the evidence and recommendations was based on the principles of the Grading of Recommendations Assessment, Development and Evaluation system...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27214562/the-use-of-ethics-decision-making-frameworks-by-canadian-ethics-consultants-a-qualitative-study
#15
Chris Kaposy, Fern Brunger, Victor Maddalena, Richard Singleton
In this study, Canadian healthcare ethics consultants describe their use of ethics decision-making frameworks. Our research finds that ethics consultants in Canada use multi-purpose ethics decision-making frameworks, as well as targeted frameworks that focus on reaching an ethical resolution to a particular healthcare issue, such as adverse event reporting, or difficult triage scenarios. Several interviewees mention the influence that the accreditation process in Canadian healthcare organizations has on the adoption and use of such frameworks...
October 2016: Bioethics
https://www.readbyqxmd.com/read/27182461/two-decades-of-teledermatology-current-status-and-integration-in-national-healthcare-systems
#16
E Tensen, J P van der Heijden, M W M Jaspers, L Witkamp
Teledermatology, originating in 1995, has been one of the first telemedicine services to see the light of day. Two decades of teledermatology research is summarized in this review. A literature search was conducted in PubMed. Search terms included "teledermatology," "teledermoscopy," "tele wound care," "telederm*," "(dermatology OR dermoscopy OR wound care OR skin) AND (telemedicine OR ehealth or mhealth OR telecare OR teledermatology OR teledermoscopy)." Inclusion criteria were (i) Dutch or English written papers and (ii) publication year from 2011 to present or (iii) (systematic) reviews with publication year before 2011...
2016: Current Dermatology Reports
https://www.readbyqxmd.com/read/27148976/triage-ethics-not-individual-choice
#17
Tracy K Koogler
No abstract text is available yet for this article.
August 2016: Acta Paediatrica
https://www.readbyqxmd.com/read/27135864/-patients-with-acute-non-traumatic-abdominal-pain-in-german-emergency-departments-a-prospective-monocentric-observation-study
#18
M Kulla, S Kraus, F Walcher, R Somasundaram, C E Wrede, L Lampl, M Helm
Background: Up to 11 % of patients in an Emergency Department (ED) present with non-traumatic acute abdominal pain. Based on this presenting symptom, this study aimed to analyse how residents (surgery, internal medicine, anaesthesiology and other fields) working in an ED during their second and third year of education treat these patients. Material and Methods: We performed a prospective, monocentric observation study in an ED in accordance with the STROBE recommendations, following the recommendations from the Ethics Committee of the University of Ulm (application no...
December 2016: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/27076499/first-line-fertility-treatment-strategies-regarding-iui-and-ivf-require-clinical-evidence
#19
G Bahadur, R Homburg, A Muneer, P Racich, T Alangaden, A Al-Habib, S Okolo
The advent of intracytoplasmic sperm injection (ICSI) has contributed to a significant growth in the delivery of assisted conception technique, such that IVF/ICSI procedures are now recommended over other interventions. Even the UK National Institute for Health Care Excellence (NICE) guidelines controversially recommends against intrauterine insemination (IUI) procedures in favour of IVF. We reflect on some of the clinical, economic, financial and ethical realities that have been used to selectively promote IVF over IUI, which is less intrusive and more patient friendly, obviates the need for embryo storage and has a global application...
June 2016: Human Reproduction
https://www.readbyqxmd.com/read/26927524/formal-academic-training-on-ethics-may-address-junior-physicians-needs
#20
Michael Darmon, Guillaume Ducos, Isaline Coquet, Matthieu Resche-Rigon, Frederic Pochard, Marie Paries, Nancy Kentish-Barnes, Marine Chaize, Benoit Schlemmer, Elie Azoulay
BACKGROUND: Surveys have highlighted perceived deficiencies among ICU residents in end-of-life care, symptom control, and confidence in dealing with dying patients. Lack of formal training may contribute to the failure to meet the needs of dying patients and their families. The objective of this study was to evaluate junior intensivists' perceptions of triage and of the quality of the dying process before and after formal academic training. METHODS: Formal training on ethics was implemented as a part of resident training between 2007 and 2012...
July 2016: Chest
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