Attitudes on Medical Ethics of Criminal Neurointerventional Treatment

As contemporary scientific advancements offer the opportunity to manipulate processes of the human body at a higher degree of invasiveness than ever before, a number of bioethical concerns are raised. One significant concern is how to discern the acceptable integration of advancements in neurologically-based interventions into the criminal justice system. Past literature supports the idea that there are several variables that interact to form a global conversation on the ethics of compromising a criminal’s freedom of mind for the purposes of sentencing or rehabilitation. Attitudes toward the current criminal justice system and the current uses of neurointerventions are significantly influential, and the public attitudes of such topics have been well-recorded through the literature. An experienced physician was interviewed in order to gain the perspective of a professional who regularly implements neurologically-based treatments. The results of the interview suggested that professionals have a moderate level of confidence that the current relationship between the criminal justice system and neurointerventional methods has generally remained within ethical boundaries. The results also suggested that medical practitioners are tasked with balancing the dignity and the safety patients, which can cause frequent ethical dilemmas. The varying responsibilities of medical professionals keep them equipped to implement expert-level care while simultaneously considering the ethical ramifications of their decisions

The Jefferson Scale of Empathy: a nationwide study of measurement properties, underlying components, latent variable structure, and national norms in medical students.

The Jefferson Scale of Empathy (JSE) is a broadly used instrument developed to measure empathy in the context of health professions education and patient care. Evidence in support of psychometrics of the JSE has been reported in health professions students and practitioners with the exception of osteopathic medical students. This study was designed to examine measurement properties, underlying components, and latent variable structure of the JSE in a nationwide sample of first-year matriculants at U.S. colleges of osteopathic medicine, and to develop a national norm table for the assessment of JSE scores. A web-based survey was administered at the beginning of the 2017-2018 academic year which included the JSE, a scale to detect good impression responses, and demographic/background information. Usable surveys were received from 6009 students enrolled in 41 college campuses (median response rate = 92%). The JSE mean score and standard deviation for the sample were 116.54 and 10.85, respectively. Item-total score correlations were positive and statistically significant (p \u3c 0.01), and Cronbach α = 0.82. Significant gender differences were observed on the JSE scores in favor of women. Also, significant differences were found on item scores between top and bottom third scorers on the JSE. Three factors of Perspective Taking, Compassionate Care, and Walking in Patient\u27s Shoes emerged in an exploratory factor analysis by using half of the sample. Results of confirmatory factor analysis with another half of the sample confirmed the 3-factor model. We also developed a national norm table which is the first to assess students\u27 JSE scores against national data

Designing Cost-Effective Telemedicine Camps for Underprivileged Individuals in Less Developed Countries: A Decomposed Affordance-Effectivity Framework

Free telemedicine camps (telecamps) are emergent joint initiatives of healthcare organizations, national and local governments, and not-for-profit nongovernmental organizations (NGOs) with the goal of alleviating the health divide for underprivileged individuals in rural areas of less developed countries. Our study seeks to understand the effectiveness of physician-patient communication at telecamps with several salient characteristics: rural underprivileged patients, physicians in remote cities, and frugal telemedicine technology—specifically, videoconferencing—deployed in Hospitals on Wheels and appropriated by operators. We adopt a multiple-actor perspective, propose a decomposed affordance-effectivity framework, and combine variance and process perspectives to examine the phenomenon of interest. We collaborated with Apollo Hospitals, a leading hospital system in India, and collected multisource data from two major telecamps in rural South India. Based on an analysis of survey data from 216 telecamp participants through a variance perspective, we found support for the fit of patient-perceived media richness with two contingency factors—(1) disease diagnostic complexity and (2) patient healthcare needs fulfillment—in influencing patient satisfaction with teleconsultation. Based on an analysis of 46 sessions of teleconsultation video archives through a process perspective, we found that technology appropriation is realized through verbal and nonverbal communication events between patients and physicians, with on-site operators playing multiple roles that serve as “compensatory user effectivity.” Our findings yield theoretical and practical implications for how effective telemedicine encounters using frugal technologies can be designed in combination with other cost-effective support personnel resources to broaden healthcare access for underprivileged individuals in less developed countries and, more broadly, to actualize technology affordances in use situations involving multiple actors

An integrated framework to classify healthcare virtual communities

Healthcare (HC) strives to improve service quality through its cost-effective social computing strategy. However, sudden rise in the count of virtual community of practices (VCoPs) introduced many choices for physicians; As a result, it is not surprising to observe current literature reporting lack of study to investigate ideas integration within and between VCoPs. VCoPs need to be categorized for HC physicians so they will be able to pin-point effective a VC to attain assistance from. This paper is one of the first investigative studies, in HC sector, that proposed a framework to classify and pin-point appropriate VCoPs, for physicians, after it reviewed and analyzed traditional and up-to-date theoretical, empirical and case study literature in the area of social computing, knowledge management (KM) and VCoPs. The implementation of this framework pinpointed professional VCoPs as most appropriate for physicians based on strict requirements, i.e. closed physician communities holding many participants, which are older than 5 years with high boundary crossing. This framework is also a “one-size-fit-all” formula to build an organizational VCoP, utilizable by other business sectors

Intraspinal Drug Delivery Reservoir Refill Procedure by Non-Physician Clinicians: A Nation-Wide Survey of Training, Pocket Fill Experience, and Life-Long Learning Behaviors

Intraspinal drug delivery (IDD) is a safe and efficacious method used to deliver medications for the treatment of chronic neurologic disease that requires periodic reservoir refills that can place patients at risk for a rare, accidental but potentially life-threatening, pocket fill. In the United States (US), non-physician clinicians perform this procedure. This study reports the results of a nationwide survey completed by 65 non-physician clinicians, obtained through social media, who performed the reservoir refill procedure. The results of the survey showed no standardized training was used, lack of attention to existing clinical practice guidelines in the training given, lack of supervision and mentoring for inexperienced clinicians, an unexpected number of pocket fills, and limited participation in professional meetings where intraspinal therapy is discussed. Suggestions for improvement are given

Achieving change in primary care—causes of the evidence to practice gap : systematic reviews of reviews

Acknowledgements The Evidence to Practice Project (SPCR FR4 project number: 122) is funded by the National Institute of Health Research (NIHR) School for Primary Care Research (SPCR). KD is part-funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Research and Care West Midlands and by a Knowledge Mobilisation Research Fellowship (KMRF-2014-03-002) from the NIHR. This paper presents independent research funded by the National Institute of Health Research (NIHR). The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Funding This study is funded by the National Institute for Health Research (NIHR) School for Primary Care Research (SPCR).Peer reviewedPublisher PD

We are bitter, but we are better off: Case study of the implementation of an electronic health record system into a mental health hospital in England

In contrast to the acute hospital sector, there have been relatively few implementations of integrated electronic health record (EHR) systems into specialist mental health settings. The National Programme for Information Technology (NPfIT) in England was the most expensive IT-based transformation of public services ever undertaken, which aimed amongst other things, to implement integrated EHR systems into mental health hospitals. This paper describes the arrival, the process of implementation, stakeholders' experiences and the local consequences of the implementation of an EHR system into a mental health hospital