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https://www.readbyqxmd.com/read/28231356/using-ethical-frameworks-in-times-of-transition-and-uncertainty
#1
Eileen M Sullivan-Marx
Health care policy is never easy and always fraught with concerns about quality, access, and cost. Currently, uncertainty abounds regarding new federal and state policies on the horizon for older adult care and quality. Empirics undergird most policy-making decisions regarding risk/benefit, cost, and knowing the best action to put in place for the best results. However, in times of great change in policy direction and political viewpoints, empirical knowledge must be combined with ethical knowledge for planning and implementation...
March 1, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28225462/validity-evidence-from-ratings-of-pediatric-interns-and-subinterns-on-a-subset-of-pediatric-milestones
#2
Teri L Turner, Vasudha L Bhavaraju, Ulana A Luciw-Dubas, Patricia J Hicks, Sara Multerer, Amanda Osta, Jennifer McDonnell, Sue Poynter, Daniel J Schumacher, Rebecca Tenney-Soeiro, Linda Waggoner-Fountain, Alan Schwartz
PURPOSE: To investigate evidence for validity of faculty members' pediatric milestone (PM) ratings of interns (first-year residents) and subinterns (fourth-year medical students) on nine subcompetencies related to readiness to serve as a pediatric intern in the inpatient setting. METHOD: The Association of Pediatric Program Directors Longitudinal Educational Assessment Research Network (APPD LEARN) and the National Board of Medical Examiners collaborated to investigate the utility of assessments of the PMs for trainees' performance...
February 21, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28222038/evidence-based-ethically-justified-counseling-for-fetal-bilateral-renal-agenesis
#3
Alana N Thomas, Laurence B McCullough, Frank A Chervenak, Frank X Placencia
BACKGROUND: Not much data are available on the natural history of bilateral renal agenesis, as the medical community does not typically offer aggressive obstetric or neonatal care asbilateral renal agenesis has been accepted as a lethal condition. AIM: To provide an evidence-based, ethically justified approach to counseling pregnant women about the obstetric management of bilateral renal agenesis. STUDY DESIGN: A systematic literature search was performed using multiple databases...
February 21, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28221282/characteristics-and-triage-of-children-presenting-in-mental-health-crisis-to-emergency-departments-at-detroit-regional-hospitals
#4
Kristen Williams, Amanda R Levine, David M Ledgerwood, Alireza Amirsadri, Leslie H Lundahl
OBJECTIVES: The number of children in the United States utilizing emergency department (ED) services for psychiatric crises is increasing, and psychiatric-related ED visits disproportionately burden hospital resources. Yet, there is limited available information on the epidemiology and outcomes of pediatric mental health emergencies. The present study sought to characterize pediatric mental health-related ED presentations in a large urban center and identify factors predictive of inpatient hospitalization...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28216281/clinicians-perspectives-on-advance-care-planning-for-patients-with-ckd-in-australia-an-interview-study
#5
Marcus Sellars, Allison Tong, Tim Luckett, Rachael L Morton, Carol A Pollock, Lucy Spencer, William Silvester, Josephine M Clayton
BACKGROUND: Advance care planning (ACP) empowers patients to consider and communicate their current and future treatment goals. However, ACP is not widely implemented in chronic kidney disease (CKD) care settings. This study aims to describe clinicians' beliefs, challenges, and perspectives of ACP in patients with CKD. STUDY DESIGN: Qualitative study. SETTING & PARTICIPANTS: Nephrologists (n=20), nurses (n=7), and social workers (n=4) with a range of experience in facilitating ACP for patients with CKD across Australia...
February 16, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28212963/clinician-reported-outcome-assessments-of-treatment-benefit-report-of-the-ispor-clinical-outcome-assessment-emerging-good-practices-task-force
#6
John H Powers, Donald L Patrick, Marc K Walton, Patrick Marquis, Stefan Cano, Jeremy Hobart, Maria Isaac, Spiros Vamvakas, Ashley Slagle, Elizabeth Molsen, Laurie B Burke
A clinician-reported outcome (ClinRO) assessment is a type of clinical outcome assessment (COA). ClinRO assessments, like all COAs (patient-reported, observer-reported, or performance outcome assessments), are used to 1) measure patients' health status and 2) define end points that can be interpreted as treatment benefits of medical interventions on how patients feel, function, or survive in clinical trials. Like other COAs, ClinRO assessments can be influenced by human choices, judgment, or motivation. A ClinRO assessment is conducted and reported by a trained health care professional and requires specialized professional training to evaluate the patient's health status...
January 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28190695/ethical-dimensions-of-the-fetus-as-a-patient
#7
REVIEW
Frank A Chervenak, Laurence B McCullough
In this chapter, we present an account of the ethical concept of the fetus as a patient to guide clinical judgment and decision-making in the obstetrician-patient relationship. We explicate this concept and explore its clinical implications on the basis of the professional responsibility model of obstetric ethics. We will emphasize a preventive ethics approach, which is based on the recognition of the potential for ethical conflict in patient care and adopts ethically justified strategies to prevent those conflicts from occurring...
January 23, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/28169135/case-study-and-case-based-research-in-emergency-nursing-and-care-theoretical-foundations-and-practical-application-in-paramedic-pre-hospital-clinical-judgment-and-decision-making-of-patients-with-mental-illness
#8
Ramon Z Shaban, Julie Considine, Margaret Fry, Kate Curtis
Generating knowledge through quality research is fundamental to the advancement of professional practice in emergency nursing and care. There are multiple paradigms, designs and methods available to researchers to respond to challenges in clinical practice. Systematic reviews, randomised control trials and other forms of experimental research are deemed the gold standard of evidence, but there are comparatively few such trials in emergency care. In some instances it is not possible or appropriate to undertake experimental research...
February 3, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28161750/quality-assessment-of-structure-and-language-elements-of-written-responses-given-by-seven-scandinavian-drug-information-centres
#9
Linda Amundstuen Reppe, Olav Spigset, Jens Peter Kampmann, Per Damkier, Hanne Rolighed Christensen, Ylva Böttiger, Jan Schjøtt
PURPOSE: The aim of this study was to identify structure and language elements affecting the quality of responses from Scandinavian drug information centres (DICs). METHODS: Six different fictitious drug-related queries were sent to each of seven Scandinavian DICs. The centres were blinded for which queries were part of the study. The responses were assessed qualitatively by six clinical pharmacologists (internal experts) and six general practitioners (GPs, external experts)...
February 5, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28153163/perceptions-of-orthodontic-case-complexity-among-orthodontists-general-practitioners-orthodontic-residents-and-dental-students
#10
Elizabeth M Heath, Jeryl D English, Cleverick D Johnson, Elizabeth B Swearingen, Sercan Akyalcin
INTRODUCTION: Our aims were to assess the perceptions of orthodontic case complexity among orthodontists, general dentists, orthodontic residents, and dental students and to compare their perceptions with the American Board of Orthodontics Discrepancy Index (DI). METHODS: Orthodontists, general dentists, orthodontic residents, and dental students (n = 343) participated in a Web-based survey. Pretreatment orthodontic records of 29 cases with varying DI scores were obtained...
February 2017: American Journal of Orthodontics and Dentofacial Orthopedics
https://www.readbyqxmd.com/read/28144992/facilitating-and-inhibiting-factors-in-transition-to-parenthood-ways-in-which-health-professionals-can-support-parents
#11
Mia Barimani, Anna Vikström, Michael Rosander, Karin Forslund Frykedal, Anita Berlin
BACKGROUND: The transition to parenthood is an overwhelming life event. From a theoretical perspective, transition to parenthood is a developmental transition that contains certain phases and patterns. AIM: This study aim was twofold (i) discover, describe and comprehend transitional conditions that parents perceive as facilitating and inhibiting during transition to parenthood and to (ii) use that knowledge to develop recommendations for professional interventions that support and facilitate transition to parenthood...
January 31, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28135690/wasting-the-doctor-s-time-a-video-elicitation-interview-study-with-patients-in-primary-care
#12
Nadia Llanwarne, Jennifer Newbould, Jenni Burt, John L Campbell, Martin Roland
Reaching a decision about whether and when to visit the doctor can be a difficult process for the patient. An early visit may cause the doctor to wonder why the patient chose to consult when the disease was self-limiting and symptoms would have settled without medical input. A late visit may cause the doctor to express dismay that the patient waited so long before consulting. In the UK primary care context of constrained resources and government calls for cautious healthcare spending, there is all the more pressure on both doctor and patient to meet only when necessary...
January 18, 2017: Social Science & Medicine
https://www.readbyqxmd.com/read/28130665/parent-s-use-of-the-internet-in-the-search-for-healthcare-information-and-subsequent-impact-on-the-doctor-patient-relationship
#13
S Harvey, A Memon, R Khan, F Yasin
BACKGROUND: The Internet is an unavoidable source of healthcare information. This information, both reliable and unreliable, has previously been shown to influence carer's decisions. AIMS: Our aim was to evaluate this information seeking behavior among parents and its subsequent potential impact on the doctor-patient relationship. METHOD: We undertook a cross-sectional questionnaire-based survey of paediatric outpatients. Enrollment took place over 4 weeks in March 2015...
January 27, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28125080/genome-editing-in-clinical-genetics-points-to-consider-a-statement-of-the-american-college-of-medical-genetics-and-genomics
#14
Acmg Board Of Directors
Disclaimer: These recommendations are designed primarily as an educational resource for medical geneticists and other health-care providers, to help them provide quality medical genetic services. Adherence to these recommendations does not necessarily assure a successful medical outcome. These recommendations should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen...
January 26, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28122727/inter-rater-agreement-in-evaluation-of-disability-systematic-review-of-reproducibility-studies
#15
Jürgen Barth, Wout E L de Boer, Jason W Busse, Jan L Hoving, Sarah Kedzia, Rachel Couban, Katrin Fischer, David Y von Allmen, Jerry Spanjer, Regina Kunz
OBJECTIVES:  To explore agreement among healthcare professionals assessing eligibility for work disability benefits. DESIGN:  Systematic review and narrative synthesis of reproducibility studies. DATA SOURCES:  Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies. ELIGIBILITY CRITERIA:  Observational studies investigating reproducibility among healthcare professionals performing disability evaluations using a global rating of working capacity and reporting inter-rater reliability by a statistical measure or descriptively...
January 25, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28120116/urine-drug-screen-findings-among-ambulatory-oncology-patients-in-a-supportive-care-clinic
#16
Sherri Rauenzahn, Adam Sima, Brian Cassel, Danielle Noreika, Teny Henry Gomez, Lynn Ryan, Carl E Wolf, Luke Legakis, Egidio Del Fabbro
PURPOSE: Professional organizations provide no guidelines regarding assessment and management of opioid abuse risk in cancer. Universal precautions (UP) developed for non-cancer pain, include assessments for aberrant behavior, screening questionnaires, and urine drug screens (UDS). The role of UDS for identifying opioid abuse risk in cancer is uncertain. Our aim is to characterize inappropriate UDS, and identify a potential role for UDS in therapeutic decision-making. METHODS: An observational retrospective chart review of 232 consecutive supportive care clinic patients were seen during the study...
January 25, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28096705/situational-judgment-tests-reliably-measure-professional-attributes-important-for-clinical-practice
#17
EDITORIAL
Katie Petty-Saphon, Kim A Walker, Fiona Patterson, Vicki Ashworth, Helena Edwards
Over the course of more than 40 years, international research has consistently shown situational judgment tests (SJTs) to be a reliable and valid selection method for assessing a range of professional attributes. However, SJTs still represent a relatively new selection method within the medical profession, and as such it is to be expected that applicant reactions will vary. In this Expert Opinion piece, we respond to Najim et al's article "The situational judgement test: a student's worst nightmare" by highlighting three key clarifications...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28072923/language-the-diabetes-restricted-code-dialect-and-what-it-means-for-people-with-diabetes-and-clinicians
#18
Trisha Dunning, Jane Speight, Craig Bennett
Purpose The purpose of the paper is to explore the notion of a diabetes language restricted code or "dialect" and its effect on people with diabetes. Language is a complex phenomenon comprising verbal and nonverbal components used to communicate in human interactions. Methods Information was collected from a literature review, during clinical consultations, and from an email survey. Results Language and the way clinicians use language affect motivation, behaviors, and outcomes of people with diabetes. Language is influenced by culture, experience, and familiarity with words and their use and is idiosyncratic...
February 2017: Diabetes Educator
https://www.readbyqxmd.com/read/28055022/laboratory-diagnosis-of-creatine-deficiency-syndromes-a-technical-standard-and-guideline-of-the-american-college-of-medical-genetics-and-genomics
#19
J Daniel Sharer, Olaf Bodamer, Nicola Longo, Silvia Tortorelli, Mirjam M C Wamelink, Sarah Young
Disclaimer: These ACMG Standards and Guidelines are intended as an educational resource for clinical laboratory geneticists to help them provide quality clinical laboratory genetic services. Adherence to these standards and guidelines is voluntary and does not necessarily assure a successful medical outcome. These Standards and Guidelines should not be considered inclusive of all proper procedures and tests or exclusive of others that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, clinical laboratory geneticists should apply their professional judgment to the specific circumstances presented by the patient or specimen...
January 5, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/28055021/laboratory-and-clinical-genomic-data-sharing-is-crucial-to-improving-genetic-health-care-a-position-statement-of-the-american-college-of-medical-genetics-and-genomics
#20
Acmg Board Of Directors
Disclaimer: These recommendations are designed primarily as an educational resource for medical geneticists and other health-care providers, to help them provide quality medical genetic services. Adherence to these recommendations does not necessarily assure a successful medical outcome. These recommendations should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed to obtaining the same results. In determining the propriety of any specific procedure or test, the geneticist should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen...
January 5, 2017: Genetics in Medicine: Official Journal of the American College of Medical Genetics
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