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https://www.readbyqxmd.com/read/29777601/-informed-consent-something-unresolved-in-the-penitentiary-setting
#1
Julio García Guerrero
INTRODUCTION: The exercise of Informed Consent within the penitentiary environment contradicts the ordinary exercise of the same towards the rest of the population. METHODOLOGY: review of legal regulations and constitutional doctrine on IC. Review of the judicial outcomes when a prisoner refuses medical treatment. RESULTS: Normative on IC (Ley 41/2002 y Convenio de Oviedo, Spanish legal framework): with the exception of cases in which IC cannot be taken or under the risk of causong damage to third parties, competent and capable persons can decide over their life and health, and such decisions need to be respected...
May 2018: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/29777425/the-use-of-hiv-post-exposure-prophylaxis-in-forensic-medicine-following-incidents-of-sexual-violence-in-hamburg-germany-a-retrospective-study
#2
Julia Ebert, Jan Peter Sperhake, Olaf Degen, Ann Sophie Schröder
In Hamburg, Germany, the initiation of HIV post-exposure prophylaxis (HIV PEP) in cases of sexual violence is often carried out by forensic medical specialists (FMS) using the city's unique Hamburg Model. FMS-provided three-day HIV PEP starter packs include a combination of raltegravir and emtricitabine/tenofovir. This study aimed to investigate the practice of offering HIV PEP, reasons for discontinuing treatment, patient compliance, and whether or not potential perpetrators were tested for HIV. We conducted a retrospective study of forensic clinical examinations carried out by the Hamburg Department of Legal Medicine following incidents of sexual violence from 2009 to 2016...
May 18, 2018: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/29776701/nonstandard-advance-directives-in-emergency-medicine-what-should-we-do
#3
Kenneth V Iserson
BACKGROUND: Critically ill or injured emergency department or prehospital patients who lack decision-making capacity sometimes present with a non-standard advance directive, such as a "Do Not Resuscitate" tattoo or medallion. Emergency clinicians must immediately address the question of whether to withhold treatment based on what may or may not be a valid patient directive. DISCUSSION: Advance directives have been standardized for a good reason. Emergency department or prehospital healthcare providers must be able to immediately interpret and act on them without needing a legal interpretation...
May 16, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776547/on-the-potential-of-ion-mobility-spectrometry-coupled-to-gc-pre-separation-a-tutorial
#4
REVIEW
Wolfgang Vautz, Joachim Franzke, Stefano Zampolli, Ivan Elmi, Sascha Liedtke
In this tutorial, we want to demonstrate the significant potential of ion mobility spectrometry (IMS), an analytical technique for identification and quantification of gas-phase compounds, in particular combined to other useful analytical tools. Coupled to gas-chromatographic pre-separation (GC-IMS), selectivity can be improved significantly, thus enabling the analysis of complex, humid mixtures. In-line pre-concentration can improve sensitivity down to the ppqV range. Furthermore, the use of non-radioactive ionisation sources in the near future could gain acceptance and will avoid legal restrictions...
September 18, 2018: Analytica Chimica Acta
https://www.readbyqxmd.com/read/29776525/ability-to-monitor-driving-under-the-influence-of-marijuana-among-non-fatal-motor-vehicle-crashes-an-evaluation-of-the-colorado-electronic-accident-reporting-system
#5
Alexis B Peterson, Erin K Sauber-Schatz, Karin A Mack
INTRODUCTION: As more states legalize medical/recreational marijuana use, it is important to determine if state motor-vehicle surveillance systems can effectively monitor and track driving under the influence (DUI) of marijuana. This study assessed Colorado's Department of Revenue motor-vehicle crash data system, Electronic Accident Reporting System (EARS), to monitor non-fatal crashes involving driving under the influence (DUI) of marijuana. METHODS: Centers for Disease Control and Prevention guidelines on surveillance system evaluation were used to assess EARS' usefulness, flexibility, timeliness, simplicity, acceptability, and data quality...
June 2018: Journal of Safety Research
https://www.readbyqxmd.com/read/29775694/advance-care-planning-in-a-multi-cultural-family-centric-community-a-qualitative-study-of-healthcare-professionals-patients-and-caregivers-perspectives
#6
Sumytra Menon, Marijke Kars, Chetna Malhotra, Alastair V Campbell, J J M van Delden
CONTEXT: Advance care planning has been shown to improve end-of-life care but it was developed in the USA and most research has been conducted in western communities. OBJECTIVES: We aimed to study the attitudes and perceptions of patients with life-limiting illnesses, informal caregivers, doctors, nurses and medical social workers regarding advance care planning in a multi-cultural family-centric community. METHODS: We conducted an explorative qualitative study, using focus groups and individual in-depth interviews...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29775692/exploring-canadian-physicians-experiences-providing-medical-assistance-in-dying-a-qualitative-study
#7
Narges Khoshnood, Marie-Clare Hopwood, Bhadra Lokuge, Allison Kurahashi, Anastasia Tobin, Sarina Isenberg, Amna Husain
CONTEXT: MAiD allows a practitioner to administer or prescribe medication for the purpose of ending a patient's life. In 2016, Canada was the latest country, following several European countries and American states, to legalize physician-assisted death. Although some studies report on physician attitudes towards MAiD or describe patient characteristics, there are few that explore the professional challenges faced by physicians who provide MAiD. OBJECTIVES: To explore the professional challenges faced by Canadian physicians who provide MAiD...
May 15, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29773480/must-i-respond-if-my-health-is-at-risk
#8
Kenneth V Iserson
BACKGROUND: Widespread epidemics, pandemics, and other risk-prone disasters occur with disturbing regularity. When such events occur, how should, and will, clinicians respond? The moral backbone of medical professionals-a duty to put the needs of patients first-may be sorely tested. DISCUSSION: It is incumbent on health care professionals to ask what we must do and what we should do if a dangerous health care situation threatens both ourselves and our community...
May 14, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29771763/recognizing-diagnosing-and-preventing-child-maltreatment-an-update-for-pediatric-clinicians
#9
Fiona Danaher, Andrea Vandeven, Aine Blanchard, Alice W Newton
PURPOSE OF REVIEW: Despite an increasing understanding of the impact of emotional trauma and physical abuse on children, clinicians and hospitals still sometimes miss the diagnosis of abuse. The literature in 2017 focused on creating standardized approaches to recognition and diagnosis of physical abuse and occult injury, including using the electronic medical record to provide triggers for consultation of the hospital Child Protection Program. The American College of Radiology updated their standardized approach to the evaluation of physical abuse in the child, and other authors gave us screening tools for commercial exploitation, as well as guidance about how to recognize risks for emotional abuse in families...
May 15, 2018: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/29767834/nutrition-care-of-cancer-patients-a-survey-among-physicians-and-nurses
#10
N Erickson, K Paradies, D Buchholz, J Huebner
In order to quantify gaps in the provision of medical nutrition care in Germany and pinpoint specific areas of need, we collected data from patients, nurses and physicians. The results from the patient survey were published separately. A total of 506 participants from 69 certified centers answered the questions developed in cooperation with representatives from different professional groups (physicians, nurses and dietitians). Only about a third of participants reported that their institution provides structured pathways to nutritional counseling...
May 16, 2018: European Journal of Cancer Care
https://www.readbyqxmd.com/read/29767828/a-digitally-facilitated-citizen-science-driven-approach-accelerates-participant-recruitment-and-increases-study-population-diversity
#11
Milo A Puhan, Nina Steinemann, Christian P Kamm, Stephanie Müller, Jens Kuhle, Roland Kurmann, Pasquale Calabrese, Jürg Kesselring, Viktor von Wyl, Swiss Multiple Sclerosis Registry Smsr
QUESTION UNDER STUDY: Our aim was to assess whether a novel approach of digitally facilitated, citizen-science research, as followed by the Swiss Multiple Sclerosis Registry (Swiss MS Registry), leads to accelerated participant recruitment and more diverse study populations compared with traditional research studies where participants are mostly recruited in study centres without the use of digital technology. METHODS: The Swiss MS Registry is a prospective, longitudinal, observational study covering all Switzerland...
May 16, 2018: Swiss Medical Weekly
https://www.readbyqxmd.com/read/29767338/-beginners-operations-and-medical-specialist-standards-avoidance-of-criminal-liability-and-civil-liability
#12
REVIEW
H Schneider
BACKGROUND: In all phases, patients are entitled to receive medical treatment according to medical specialist standards. This does not mean that patients necessarily have to be treated by a medical specialist. Operations performed by "beginners", e. g. assistant physicians, are permitted. However, there are increased liability risks, both for the specialist and the assistant physician. Furthermore, there are risks of criminal responsibility for causing bodily harm by negligence or negligent manslaughter...
May 16, 2018: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/29766728/-euthanasia-legal-comparison-in-selected-european-countries
#13
Adam Doležal
This article deals with the subject of euthanasia (all its forms) and other end-of-life decisions, such as assisted suicide, withdrawing and whithholding life-sustaining treatments. Among other things, the article will also deal with the issue of the offense of Homicide by the Victims Request. Based on an empirical historical method, the article compares the various selected legal orders. From this analysis, it draws some conclusions that have an impact on ethical discourse. First of all, the terminology is defined in the article, which is very important in this area...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29766481/-is-psychiatry-ready-to-let-patients-review-their-own-files-inventory-of-initial-experiences
#14
S M P van Veen, M Mostert, L de Witte, M Somers
BACKGROUND: Dutch patients will be granted the right to digitally access their own medical records, an option already available to the patients at the University Medical Center Utrecht since 2015. AIM: To start a conversation about the development of readily accessible online patient records. METHODS Describe the experiences of a University department of psychiatry with an online patient portal, obtained through discussions and questionnaires. RESULTS: During the next few years three legal developments will enable patients to acquire direct, remote, digital access to their medical files...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29763271/adults-with-developmental-disabilities-a-comprehensive-approach-to-medical-care
#15
Clarissa Kripke
Developmental disabilities are attributable to a cognitive impairment, physical impairment, or both. They manifest during the developmental period from birth to early adulthood, and are likely to continue indefinitely. The life expectancy of most persons with developmental disabilities now approaches that of the general population. According to the neurodiversity model of care, developmental disability is accepted as a valued part of human neurologic diversity. The social model focuses on improving participation in society with accommodations such as adaptive equipment or improvements to the social and physical environment...
May 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29757778/a-contemporary-analysis-of-medicolegal-issues-in-obstetric-anesthesia-between-2005-and-2015
#16
Vesela P Kovacheva, Ethan Y Brovman, Penny Greenberg, Ellen Song, Arvind Palanisamy, Richard D Urman
BACKGROUND: Detailed reviews of closed malpractice claims have provided insights into the most common events resulting in litigation and helped improve anesthesia care. In the past 10 years, there have been multiple safety advancements in the practice of obstetric anesthesia. We investigated the relationship among contributing factors, patient injuries, and legal outcome by analyzing a contemporary cohort of closed malpractice claims where obstetric anesthesiology was the principal defendant...
May 10, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29754566/current-ethical-and-legal-issues-in-health-related-direct-to-consumer-genetic-testing
#17
Emilia Niemiec, Louiza Kalokairinou, Heidi Carmen Howard
A variety of health-related genetic testing is currently advertized directly to consumers. This article provides a timely overview of direct-to-consumer genetic testing (DTC GT) and salient ethical issues, as well as an analysis of the impact of the recently adopted regulation on in vitro diagnostic medical devices on DTC GT. DTC GT companies currently employ new testing approaches, report on a wide spectrum of conditions and target new groups of consumers. Such activities raise ethical issues including the questionable analytic and clinical validity of tests, the adequacy of informed consent, potentially misleading advertizing, testing in children, research uses and commercialization of genomic data...
September 2017: Personalized Medicine
https://www.readbyqxmd.com/read/29753518/application-of-the-canadian-computed-tomography-head-rule-to-patients-with-minimal-head-injury
#18
Kevin Davey, Turandot Saul, Geoffrey Russel, Jonathan Wassermann, Joshua Quaas
STUDY OBJECTIVE: Two clinical decision rules, the Canadian CT Head Rule and the New Orleans Criteria, set the standard to guide clinicians in determining which patients with minor head trauma need computed tomography (CT) imaging. Both rules were derived with patients with minor head injury who had had a loss of consciousness or witnessed disorientation. No evidence exists for evaluating patients and need for CT imaging with minimal head injury; that is, patients who had a head injury but no loss of consciousness or disorientation and therefore would have been excluded from the Canadian CT Head Rule and New Orleans Criteria trials...
May 9, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29751277/study-of-chemiluminescence-measured-by-luminometry-and-its-application-in-the-estimation-of-postmortem-interval-of-bone-remains
#19
Jesús Sarabia, Cristina Pérez-Martínez, Juan Pedro Hernández Del Rincón, Aurelio Luna
A substantial challenge faced by forensic medicine is determining the postmortem interval (PMI) of skeletonized remains. Currently, the luminol method is of limited forensic usefulness, since it uses qualitative and subjective methods to estimate PMI by the naked eye assessing the degree of chemiluminescence (CL) emitted by bone remains, a technique which is not sensitive enough to distinguish between historical or forensically significant time intervals. The aim of the present study was to use a direct and accurate measurement of the CL by luminol technique in relative light units (RLU) using a luminometer to establish this method as a possible complementary and low cost tool for the determination of the PMI for distinguishing between remains of medical-legal (<20 years) and historical (≥20 years) interest in 102 femur remains with a range of PMI between 15 and 64 years...
May 5, 2018: Legal Medicine
https://www.readbyqxmd.com/read/29746453/access-to-syringe-services-programs-kentucky-north-carolina-and-west-virginia-2013-2017
#20
Danae Bixler, Greg Corby-Lee, Scott Proescholdbell, Tina Ramirez, Michael E Kilkenny, Matt LaRocco, Robert Childs, Michael R Brumage, Angela D Settle, Eyasu H Teshale, Alice Asher
The Appalachian region of the United States is experiencing a large increase in hepatitis C virus (HCV) infections related to injection drug use (IDU) (1). Syringe services programs (SSPs) providing sufficient access to safe injection equipment can reduce hepatitis C transmission by 56%; combined SSPs and medication-assisted treatment can reduce transmission by 74% (2). However, access to SSPs has been limited in the United States, especially in rural areas and southern and midwestern states (3). This report describes the expansion of SSPs in Kentucky, North Carolina, and West Virginia during 2013-August 1, 2017...
May 11, 2018: MMWR. Morbidity and Mortality Weekly Report
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