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https://www.readbyqxmd.com/read/28098622/physician-assisted-suicide-and-euthanasia-in-the-icu-a-dialogue-on-core-ethical-issues
#1
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/28098133/-the-need-of-a-new-integral-approach-to-the-care-of-patient-with-severe-mental-disorder-thirty-years-after-the-psychiatric-reform
#2
Agustín Madoz-Gúrpide, Juan Carlos Ballesteros Martín, Mónica Leira Sanmartín, Ernesto García Yagüe
More than thirty years have passed since the beginning of the psychiatric reform, a period of intense and relevant social, scientific and cultural changes which have directly impacted on mental disorders and their management. Improvement in psychopharmacological treatment, a new model of physician-patient relationship, patient´s empowerment as a key issue and the fight against social stigma related to mental health disorders, changes in clinical governance and health policy, the assistential burden derived from the treatment of less severe pathology in mental health community centers, improvements in teamwork and coordination with other resources involved… are some of the relevant changes which determine the scene of community-based mental health assistance...
January 18, 2017: Revista Española de Salud Pública
https://www.readbyqxmd.com/read/28090233/hispanic-patient-perspectives-of-the-physician-s-role-in-obesity-management
#3
Colton Ragsdale, Justin Wright, Gurjeet Shokar, Rebekah Salaiz, Navkiran K Shokar
BACKGROUND: Little is known concerning Hispanic patients' perceptions about the role of the physician in obesity management. This study seeks to describe the perspectives of Hispanic patients toward weight loss, and what they believe their doctor's role should be in the management of obesity. METHODS: A cross-sectional study utilizing semi-structured interviews was conducted in a university-based family medicine clinic. Open-ended questions explored beliefs about the relationship between weight and health, previous weight loss experience, perceptions about the role of the physician in weight loss, past experiences with their physician, and preferences for how a physician could help facilitate weight loss...
February 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28089627/the-relationship-between-tamoxifen-associated-nonalcoholic-fatty-liver-disease-and-the-prognosis-of-patients-with-early-stage-breast-cancer
#4
Meiying Yan, Jingxuan Wang, Qijia Xuan, Tieying Dong, Juan He, Qingyuan Zhang
PURPOSE: To investigate the relationship between tamoxifen-associated nonalcoholic fatty liver disease (NAFLD) and survival outcomes in patients with breast cancer. METHODS: Patients with early-stage invasive breast cancer after curative resection from January 2009 to June 2011 were selected. A total of 646 patients who were treated with tamoxifen were included. Patients diagnosed with NAFLD on ultrasonography were classified into the NAFLD and non-NAFLD groups...
December 24, 2016: Clinical Breast Cancer
https://www.readbyqxmd.com/read/28089308/physicians-views-and-experiences-of-discussing-weight-management-within-routine-clinical-consultations-a-thematic-synthesis
#5
REVIEW
Anne Dewhurst, Sarah Peters, Angela Devereux-Fitzgerald, Jo Hart
OBJECTIVE: To systematically search and synthesise qualitative studies of physicians' views and experiences of discussing weight management within a routine consultation. METHODS: A systematic search of four electronic databases identified 11,169 articles of which 16 studies met inclusion criteria. Quality was appraised using the Critical Appraisal Skills Programme tool and a thematic synthesis conducted of extracted data. RESULTS: Four analytical themes were found: (1) physicians' pessimism about patients' weight loss success (2) physicians' feel hopeless and frustrated (3) the dual nature of the physician-patient relationship (4) who should take responsibility for weight management...
December 21, 2016: Patient Education and Counseling
https://www.readbyqxmd.com/read/28087547/risk-of-pneumonia-in-patients-with-isolated-minor-rib-fractures-a-nationwide-cohort-study
#6
Sai-Wai Ho, Ying-Hock Teng, Shun-Fa Yang, Han-Wei Yeh, Yu-Hsun Wang, Ming-Chih Chou, Chao-Bin Yeh
OBJECTIVES: Isolated minor rib fractures (IMRFs) after blunt chest traumas are commonly observed in emergency departments. However, the relationship between IMRFs and subsequent pneumonia remains controversial. This nationwide cohort study investigated the association between IMRFs and the risk of pneumonia in patients with blunt chest traumas. DESIGN: Nationwide population-based cohort study. SETTING: Patients with IMRFs were identified between 2010 and 2011 from the Taiwan National Health Insurance Research Database...
January 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28078909/apparent-treatment-resistant-hypertension-patient-physician-relationship-and-ethical-issues
#7
Julian E Mariampillai, Per Anders Eskås, Sondre Heimark, Anne Cecilie K Larstorp, Fadl Elmula M Fadl Elmula, Aud Høieggen, Per Nortvedt
BACKGROUND: Poor drug adherence is a major cause of apparent treatment-resistant hypertension. As a consequence, several methods have been developed and attempted implemented in clinical practice to reveal non-adherence and to monitor drug adherence. There are, however, several hitherto unresolved ethical aspects regarding potential methods for drug monitoring in these patients. RESULTS: The most striking challenge is the balance between patient autonomy and the physician's desire for the patient to adhere to the prescribed therapy...
January 12, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28077940/physician-tobacco-screening-and-advice-to-quit-among-u-s-adolescents-national-survey-on-drug-use-and-health-2013
#8
Lauren Collins, Sabrina L Smiley, Rakiya A Moore, Amanda L Graham, Andrea C Villanti
BACKGROUND: Initiating tobacco use in adolescence increases the risk of nicotine dependence and continued smoking. Physician screening for tobacco use increases the odds of physicians intervening with patients who smoke; However, without appropriate follow-through by the physician, screening for tobacco use is not enough to significantly increase cessation rates. Given the critical phase of development adolescence poses in tobacco use and evidence that physician intervention improves adult cessation efforts, we sought to examine physician tobacco use screening and advice to quit among adolescents (12-17 years)...
2017: Tobacco Induced Diseases
https://www.readbyqxmd.com/read/28076992/the-issue-of-delivery-room-infections-in-the-italian-law-a-brief-comparative-study-with-english-and-french-jurisprudence
#9
Simona Zaami, Gianluca Montanari Vergallo, Simona Napoletano, Fabrizio Signore, Enrico Marinelli
Delivery room infections are frequent, and many of them could be avoided through higher standards of care. The authors examine this issue by comparing it to English and French reality. Unlike England, in Italy and France the relationship established between health facility, physician and patient is outlined in a contract. In England, the judges' decisions converge towards a better and higher protection of the patient - the actor - and facilitate the probative task. In case of infections, including those occurring in the delivery room, three issues are evaluated: the hospital's negligent conduct, damages if any and causal nexus...
January 11, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28076645/is-there-a-correlation-between-physicians-clinical-impressions-and-patients-perceptions-of-change-use-of-the-perceived-change-scale-with-inpatients-with-mental-disorders
#10
Gabriela Pavan, Julia Almeida Godoy, Ricardo Tavares Monteiro, Hugo Karling Moreschi, Eduardo Lopes Nogueira, Lucas Spanemberg
Introduction: Assessment of the results of treatment for mental disorders becomes more complete when the patient's perspective is incorporated. Here, we aimed to evaluate the psychometric properties and application of the Perceived Change Scale - Patient version (PCS-P) in a sample of inpatients with mental disorders. Methods: One hundred and ninety-one psychiatric inpatients answered the PCS-P and the Patients' Satisfaction with Mental Health Services Scale (SATIS) and were evaluated in terms of clinical and sociodemographic data...
October 2016: Trends in Psychiatry and Psychotherapy
https://www.readbyqxmd.com/read/28076251/comparison-of-medical-diagnoses-among-same-sex-and-opposite-sex-partnered-patients
#11
Katie M Heiden-Rootes, Joanne Salas, Jeffrey F Scherrer, F David Schneider, Craig W Smith
BACKGROUND: Health disparities for gay and lesbian individuals are well documented in survey research. However, a limitation throughout the existing literature is the reliance on self-reported health conditions. This study used medical record diagnoses for gay and lesbian patients seen in primary care clinics. METHODS: This study used medical records of primary care patients (n = 31,569) seen at Midwestern, university-affiliated primary care clinics. First, all records with information about the sexual partnering of the patient were identified (n = 13,509)...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28076248/prediabetes-screening-and-treatment-in-diabetes-prevention-the-impact-of-physician-attitudes
#12
Arch G Mainous, Rebecca J Tanner, Christopher B Scuderi, Maribeth Porter, Peter J Carek
PURPOSE: Detection and treatment of prediabetes is an effective strategy in diabetes prevention. However, most patients with prediabetes are not identified. Our objective was to evaluate the relationship between attitudes toward prediabetes as a clinical construct and screening/treatment behaviors for diabetes prevention among US family physicians. METHODS: An electronic survey of a national sample of academic family physicians (n 1248) was conducted in 2016. Attitude toward prediabetes was calculated using a summated scale assessing agreement with statements regarding prediabetes as a clinical construct...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28073800/relationship-between-exposure-to-tumour-necrosis-factor-inhibitor-therapy-and-incidence-and-severity-of-myocardial-infarction-in-patients-with-rheumatoid-arthritis
#13
Audrey S L Low, Deborah P M Symmons, Mark Lunt, Louise K Mercer, Chris P Gale, Kath D Watson, William G Dixon, Kimme L Hyrich
OBJECTIVES: Patients with rheumatoid arthritis (RA) are at increased risk of myocardial infarction (MI) compared with subjects without RA, with the increased risk driven potentially by inflammation. Tumour necrosis factor inhibitors (TNFi) may modulate the risk and severity of MI. We compared the risk and severity of MI in patients treated with TNFi with that in those receiving synthetic disease-modifying antirheumatic drugs (sDMARDs). METHODS: This analysis included patients with RA recruited from 2001 to 2009 to the British Society for Rheumatology Biologics Register for Rheumatoid Arthritis starting TNFi (etanercept/infliximab/adalimumab) and a biologic-naïve comparator cohort receiving sDMARD...
January 10, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28072897/building-on-success
#14
Amy Lynn Sorrel
Undaunted by what could be a challenging 2017 Texas legislative session, TMA is poised to build on significant successes medicine achieved over the past two legislative sessions, including reforming the state's Medicaid program and expanding graduate medical education opportunities. TMA will defend the patient-physician relationship against a backdrop of some potentially big shifts for Texas, such as a major review of the state's health professions licensing boards.
January 1, 2017: Texas Medicine
https://www.readbyqxmd.com/read/28070750/examining-trends-in-prediabetes-and-its-relationship-with-the-metabolic-syndrome-in-us-adolescents-1999-2014
#15
Arthur M Lee, Cyrelle R Fermin, Stephanie L Filipp, Matthew J Gurka, Mark D DeBoer
AIMS: We sought to investigate temporal trends in prediabetes prevalence among US adolescents using two definitions and evaluate relationships with obesity and a MetS-severity score. METHODS: We evaluated data from 5418 non-Hispanic white, non-Hispanic black, and Hispanic adolescents aged 12-19 participating in the National Health and Nutrition Examination Survey 1999-2014 with complete data regarding MetS and hemoglobin A1c (HbA1c). Prediabetes status was defined by American Diabetes Association (ADA) criteria: fasting glucose 100-125 mg/dL or HbA1c 5...
January 9, 2017: Acta Diabetologica
https://www.readbyqxmd.com/read/28070258/a-scientific-correlation-between-dystemprament-in-unani-medicine-and-diseases-a-systematic-review
#16
REVIEW
Sepideh Miraj, Sara Kiani
BACKGROUND: Temperament or mezaj refers to four different humors differentiating in individuals and, as a result, proposes specific therapy for their diseases. OBJECTIVE: The aim of this study was to overview the scientific correlation between temperaments in Unani medicine and diseases. METHODS: This study was carried out from March 2015 to February 2016. A computerized search of published articles was performed using PubMed, Google Scholar, Scopus and Web of Science, and Medline databases as well as local and regional resources between 1983 and 2014...
November 2016: Electronic Physician
https://www.readbyqxmd.com/read/28069782/delivering-patient-centred-care-in-rural-family-practice-using-the-patient-s-concept-of-health-to-guide-treatment
#17
Jennifer M Charlesworth, Evelyn McManus
Through an examination of the life of an 83-year-old patient diagnosed clinically with secondary progressive multiple sclerosis (MS), general practice specialists, consultants and junior doctors will see the importance of assessing their patient's concept of health and how to use this understanding to target healthcare options within their healthcare system. This article highlights, in a resource limited context of rural family practice, the utility of a strong physician-patient relationship, recalls the definition of patient-centred care, and the role of judicious inaction in certain contexts...
January 9, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28066820/hiv-care-providers-attitudes-regarding-mobile-phone-applications-and-web-based-dashboards-to-support-patient-self-management-and-care-coordination-results-from-a-qualitative-feasibility-study
#18
Dallas Swendeman, Shu Farmer, Deborah Mindry, Sung-Jae Lee, Melissa Medich
In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination...
October 2016: Journal of HIV and AIDS
https://www.readbyqxmd.com/read/28064257/epistemic-cognition-in-medical-education-a-literature-review
#19
REVIEW
Jennifer L Eastwood, Elysa Koppelman-White, Misa Mi, Jason Adam Wasserman, Ernest F Krug Iii, Barbara Joyce
Objective: To review the research literature on epistemic cognition in medical education. Methods: We conducted database searches using keywords related to epistemic cognition and medical education or practice. In duplicate, authors selected and reviewed empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. Independent thematic analysis and consensus procedures were used to identify major findings about epistemic cognition and implications for research and medical education...
January 7, 2017: International Journal of Medical Education
https://www.readbyqxmd.com/read/28063375/identifying-the-barriers-to-antiepileptic-drug-adherence-among-adults-with-epilepsy
#20
REVIEW
Geraldine O' Rourke, Julie Jordan O' Brien
PURPOSE: To identify the barriers to antiepileptic drug (AED) adherence among adults with epilepsy (AWE). The impact of AED non-adherence on quality of life (QoL) was also examined. METHOD: Systematic design (SR) study. A search strategy was undertaken with no time limits, for articles published in English, in MEDLINE, CINANL, PsycINFO, EMBASE, Cochrane databases and grey literature sources. Eligibility criteria included participants with epilepsy over 18 years, who were prescribed AEDs...
December 23, 2016: Seizure: the Journal of the British Epilepsy Association
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