Lu Yao, Jia Yin, Ruiting Huo, Ding Yang, Liyan Shen, Shuqin Wen, Qiang Sun
Background: Irrational antibiotics use in clinical prescription, especially in primary health care (PHC) is accelerating the spread of antibiotics resistance (ABR) around the world. It may be greatly useful to improve the rational use of antibiotics by effectively intervening providers' prescription behaviors in PHC. This study aimed to systematically review the interventions targeted to providers' prescription behaviors in PHC and its' effects on improving the rational use of antibiotics...
2020: Global Health Research and Policy
Anuja Damani, Arunangshu Ghoshal, Naveen Salins, Sushma Bhatnagar, Priti R Sanghavi, Vidya Viswanath, Shrenik Ostwal, Gauraiya Chinchalkar, Nandini Vallath
Novel corona virus disease 2019 (COVID-19) is an ongoing pandemic that has impacted the entire world. The Indian government has responded strongly and very stringently to the crisis, through a nationwide lockdown. The health-care (HC) systems in the country are striving hard to maintain equitable care across illness spectra, while responding the emergencies imposed by the COVID-19 crisis. Under these circumstances, guidelines for managing several diseases including that for cancer care have been modified. As modified guidelines for cancer care have their focus on disease management, cancer pain management and maintaining continuity of care for patients with advanced progressive disease have taken a backseat in the available cancer care guidelines...
June 2020: Indian Journal of Palliative Care
Anuja Damani, Arunangshu Ghoshal, Krithika Rao, Pankaj Singhai, Spandana Rayala, Seema Rao, K V Ganpathy, Nisha Krishnadasan, Lt Alice Stella Verginiaz, Nandini Vallath, Gayatri Palat, Chitra Venkateshwaran, Jeba S Jenifer, Lulu Matthews, Stanley Macaden, Mary Ann Muckaden, Srinagesh Simha, Naveen Salins, Jeremy Johnson, Savita Butola, Sushma Bhatnagar
The global pandemic involving severe acute respiratory syndrome-coronavirus-2 has brought new challenges to clinical practice and care in the provision of palliative care. This position statement of the Indian Association of Palliative Care (IAPC) represents the collective opinion of the experts chosen by the society and reports on the current situation based on recent scientific evidence. It purports to guide all health-care professionals caring for coronavirus disease 2019 (COVID-19) patients and recommends palliative care principles into government decisions and policies...
June 2020: Indian Journal of Palliative Care
Alvisa Palese, Elena Navone, Matteo Danielis, Stavros Vryonides, Walter Sermeus, Evridiki Papastavrou
BACKGROUND: Different tools have been developed and validated to measure unfinished nursing care. However, no systematic review of the psychometric properties has been performed describing the quality of the methods used to estimate their validity. AIMS: (a) To identify tools measuring unfinished nursing care that have undergone validation processes; (b) to evaluate critically the quality of the methods used in ascertaining their psychometric properties; and (c) to compare the estimated psychometric properties of these tools...
October 19, 2020: Journal of Advanced Nursing
Mauricio Rodríguez-Álvarez, Yolanda López-Vidal, José Luis Soto-Hernández, María Guadalupe Miranda-Novales, Karen Flores-Moreno, Samuel Ponce de León-Rosales
In recent years, the increase in antimicrobial resistance (AMR) has been recognized as a real threat to human and animal health. It is a problem that has been given the highest priority, uniting nations in the fight against its causes and effects. Among the actions that have been implemented are: clinical and microbiological surveillance, promotion of rational and controlled use of antibiotics, AMR stewardship programs in hospitals, development of tools for rapid diagnosis of infectious diseases to establish prompt and adequate treatment, and radically improving vaccination strategies...
October 10, 2020: Archives of Medical Research
Avinash Jain, Amita Aggarwal, Jo Adams, Rachel E Jordan, Steven Sadhra, Shirish Dubey, Kerry Allen, Kanta Kumar
BACKGROUND: Rheumatoid arthritis (RA) is an autoimmune disease with varied articular and extra-articular manifestations. In developing countries such as India patients with RA often delay seeking medical advice which may impact prognosis and disease burden. AIM: To explore perceptions and experiences of patients living in India in seeking medical help for their RA symptoms. METHODS: Clinician-diagnosed RA participants from different socioeconomic backgrounds were interviewed using a semi-structured topic guide...
October 17, 2020: International Journal of Rheumatic Diseases
Lasse Nielsen
Age rationing is a central issue in the health care priority-setting literature, but it has become ever more salient in the light of the Covid-19 outbreak, where health authorities in several countries have given higher priority to younger over older patients. But how is age rationing different under outbreak circumstances than under normal circumstances, and what does this difference imply for ethical theories? This is the topic of this paper. The paper argues that outbreaks such as that of Covid-19 involve special circumstances that change how age should influence our prioritization decisions, and that while this shift in circumstances poses a problem for consequentialist views such as utilitarianism and age-weighted consequentialism, contractualism is better equipped to cope with it...
October 17, 2020: Bioethics
Benjamin Tolchin, Sarah C Hull, Katherine Kraschel
Shortages of life-saving medical resources caused by COVID-19 have prompted hospitals, healthcare systems, and governmentsto develop crisis standards of care, including 'triage protocols' to potentially ration medical supplies during the public health emergency. At the same time, the pandemic has highlighted and exacerbated racial, ethnic, and socioeconomic health disparities that together constitute a form of structural racism. These disparities pose a critical ethical challenge in developing fair triage systems that will maximize lives saved without perpetuating systemic inequities...
October 16, 2020: Journal of Medical Ethics
Martine Elbejjani, Mary Abed Al Ahad, Michael Simon, Dietmar Ausserhofer, Nuhad Dumit, Huda Abu-Saad Huijer, Suzanne R Dhaini
Background: Worldwide, studies show a relationship between nurses' health and some work environment factors; however, data on nurses' health and self-perceived workload and nursing task allocation are lacking, particularly for Lebanese nurses. We assessed the relationship of several work environment factors: overall workload and specific temporal, physical, mental, effort, frustration, and performance demands (NASA Task Load Index), staffing resources and adequacy and leadership (Practice Environment Scale of Nursing Work Index), teamwork climate (Safety Attitudes Questionnaire), and nursing task allocation (Basel Extent of Rationing of Nursing Care)) with self-reported musculoskeletal, cardiovascular, skin, and mental health diseases (Work Ability Index) and emotional exhaustion (Maslach Burnout Inventory) among Lebanese nurses...
2020: BMC Nursing
Faouzia Tanveer, Ali Talha Khalil, Muhammad Ali, Zabta Khan Shinwari
COVID-19 which started in Wuhan, China and swiftly expanded geographically worldwide, including to Low to Middle Income Countries (LMICs). This in turn raised numerous ethical concerns in preparedness, knowledge sharing, intellectual property rights, environmental health together with the serious constraints regarding readiness of health care systems in LMICs to respond to this enormous public health crisis. From the restrictions on public freedom and burgeoning socio-economic impacts to the rationing of scarce medical resources, the spread of COVID-19 is an extraordinary ethical dilemma for resource constrained nations with less developed health and research systems...
October 15, 2020: International Journal for Equity in Health
Grygoriy P Griban, Zoia M Dikhtiarenko, Eduard A Yeromenko, Andrii M Lytvynenko, Alla A Koval, Irina V Ramsey, Vadym O Muzhychok
OBJECTIVE: The aim is to analyze the factors that affect the students' health both positively and negatively and to evaluate the real health status of Ukrainian student youth. PATIENTS AND METHODS: Materials and methods: The research was conducted at Zhytomyr Ivan Franko State University and University of State Fiscal Service of Ukraine, 647 students of the 1st - 4th years of study were examined. To study both negative and positive factors, we conducted a survey of the students of different genders of several education departments, using original questionnaires...
2020: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
A S C E Bezerra, S P B Franco, K C Mousinho, S A Fonseca, T J Matos-Rocha, J M S J Pavão, A F Santos
The incorporation of the use of phytotherapy in the primary health care is an important gain for the Unified Health System, besides reducing the cost in the treatment of the patient, rescues the popular knowledge and promotes the rational use of the medicinal plants. To determine the situational diagnostic profile of professionals of family health units on phytotherapy. A quantitative observational study was carried out, in which forms were applied to the team of the family health units of the municipality of Marechal Deodoro da Fonseca/Alagoas...
October 12, 2020: Brazilian Journal of Biology
Sara Raquel Almeida Andrade, Priscila Abigail Nascimento de Moraes Santos, Paulo Henrique Santos Andrade, Wellington Barros da Silva
OBJECTIVE: To evaluate unlicensed and off-label prescription and use of drugs to children in primary health care. METHODS: This is a systematic review that was written based on Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). The studies were extracted from the databases: LILACS, PubMed/MEDLINE, and Scopus. Studies in English, Spanish or Portuguese with abstract available regarding the use and prescription of off-label and unlicensed drugs to children aged 0-18 years in primary health care were included...
October 13, 2020: Journal of Evidence-based Medicine
Elise Riquin, Thomas Le Nerzé, Yénofa Rousselot, Katia Nardin Godet, Sylvie Nordström Schüler, Julie Lebrun, Florence Biquard, Philippe Gillard, Guillaume Legendre, Philippe Duverger
The requesting of medical termination of pregnancy (MTP) for psychosocial reasons invites several questions concerning progress in medicine as well raising necessary and legitimate ethical questions. The law currently permits MTP for maternal reasons at any stage of pregnancy if the woman's health is at a significant risk. However, conceptions of mental health risks remain a grey area and present difficulties in terms of psychiatric assessment. When dealing with a patient suffering from a psychiatric disorder, questions must be asked on the reasons behind the request as well as questions concerning free and clear consent...
October 5, 2020: Journal of Gynecology Obstetrics and Human Reproduction
Chi Wang, Su-Fen Cheng, Jui-Lan Hung, Pei-Ling Tang
Objective: We aimed to identify associated factors of highly frequent use of outpatient services and explore how they were impacted to provide policy references for government and medical institutes in their efforts to seek provision of reasonable medical services, continuous care and integrated outpatient services. Methods: The Taiwanese national health insurance database was used and 661,125 patients were identified in 2009. The patients with ≥100 internal medicine outpatient (IMO) visits were defined as the highly frequent group and they were matched at a ratio of 1:4 with patients of 1-99 IMO visits based on demographic characteristics...
October 5, 2020: Current Medical Research and Opinion
Si Yuan Chew, Yee Shay Lee, Deepak Ghimiray, Chee Keat Tan, Gerald Sw Chua
INTRODUCTION: Singapore was one of the first countries affected by the coronavirus disease 2019 (COVID-19) pandemic but has been able to prevent its healthcare system and intensive care units (ICU) from being overwhelmed. We describe the clinical features, management and outcomes of COVID-19 patients with respiratory failure admitted to our ICU. MATERIALS AND METHODS: A case series of COVID-19 patients admitted to our ICU for respiratory failure from 7 February, with data censoring at 30 June 2020, was performed from a review of medical records...
July 2020: Annals of the Academy of Medicine, Singapore
Adam E Berman, Douglas Miller, Robert A Sorrentino, Elias A Mossialos
The COVID-19 pandemic has led to significant morbidity and mortality globally. As health systems grapple with caring for patients affected with COVID-19, cardiovascular procedures that are deemed 'elective' have been postponed. Guidelines concerning which cardiac procedures should be performed during the pandemic vary by specialty and geography in the USA. We propose a clinical heuristic to guide individual physicians and governing bodies in their decision making regarding which cardiac procedures should be performed during the COVID-19 pandemic using the behavioural economics concept of heuristics and ecological rationality...
September 2020: BMJ Open Quality
Erika Bassi, Daniela Tartaglini, Giorgia Valpiani, Luca Grassetti, Alvisa Palese
AIMS: To develop and validate a comprehensive tool based on those established in the field capable of reflecting the broader concept of Unfinished Nursing Care. BACKGROUND: Different tools have been established in the field of Missed Care, Rationing Care, and Tasks Left Undone. However, despite them sharing similar items and all referring to the common concept of Unfinished Nursing Care, no attempts to collapse them in a single tool capable of reflecting current nursing practice, and its increased complexity, have been attempted to date...
September 27, 2020: Journal of Nursing Management
Matilda Aberese-Ako, Pascal Magnussen, Margaret Gyapong, Gifty D Ampofo, Harry Tagbor
BACKGROUND: Malaria in pregnancy (MiP) is an important public health problem across sub-Saharan Africa. The package of measures for its control in Ghana in the last 20 years include regular use of long-lasting insecticide-treated bed nets (LLINs), directly-observed administration (DOT) of intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP) and prompt and effective case management of MiP. Unfortunately, Ghana like other sub-Saharan African countries did not achieve the reset Abuja targets of 100% of pregnant women having access to IPTp and 100% using LLINs by 2015...
September 25, 2020: Malaria Journal
Esther Peiying Ho, Han-Yee Neo
At the start of the COVID-19 pandemic, mounting demand overwhelmed critical care surge capacities, triggering implementation of triage protocols to determine ventilator allocation. Relying on triage scores to ration care, while relieving clinicians from making morally distressing decisions under high situational pressure, distracts clinicians from what is essentially deeply humanistic issues entrenched in this protracted public health crisis. Such an approach will become increasingly untenable as countries flatten their epidemic curves...
September 25, 2020: Age and Ageing
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