Black or Brown Pigment and Cholesterol Gallstones Formation Among Patients that Underwent Gastrectomy for Cancer

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Comparison of analog and digital patient decision aids for the treatment of depression: a scoping review

Introduction: Patient decision aids (PDAs) are important tools to empower patients and integrate their preferences and values in the decision-making process. Even though patients with mental health problems have a strong interest in being more involved in decision making about their treatment, research has mainly focused on PDAs for somatic conditions. In this scoping review, we focus on patients suffering from depression and the role of PDAs for this patient group. The review offers an overview of digital and analog PDAs, their advantages and disadvantages as well as recommendations for further research and development. Methods: A systematic search of the existing literature guided by the Cochrane Handbook for Systematic Reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - extension for scoping reviews (PRISMA-ScR) was conducted. Three electronic literature databases with the appropriate thematic focus were searched (PubMed, PsycInfo, and Web of Science). The search strategy used controlled and natural language to search for the key concepts decision aids and depression. The articles were selected in a two-step process guided by predefined inclusion and exclusion criteria. We narratively synthetized information extracted from 40 research articles. Results: We included 40 articles in our review. Our review revealed that there is more focus on digital PDAs in research than in clinical practice. Digitalization can enhance the benefits of PDAs by developing tools that are more efficient, interactive, and personalized. The main disadvantages of both types of PDAs for the treatment of depression are related to time, dissemination, and capacity building for the health care providers. Digital PDAs need to be regularly updated, effective strategies for their dissemination and acceptance need to be identified, and clinicians need sufficient training on how to use digital PDAs. There is more research needed to study which forms of PDAs are most appropriate for various patient groups (e.g., older adults, or patients with comorbidities), and to identify the most effective ways of PDAs' integration in the clinical workflow. The findings from our review could be well aligned with the International Patient Decision Aids Standards. Discussion: More research is needed regarding effective strategies for the implementation of digital PDAs into the clinical workflow, ethical issues raised by the digital format, and opportunities of tailoring PDAs for diverse patient groups

Global Ethics and Nanotechnology: A Comparison of the Nanoethics Environments of the EU and China

The following article offers a brief overview of current nanotechnology policy, regulation and ethics in Europe and The People’s Republic of China with the intent of noting (dis)similarities in approach, before focusing on the involvement of the public in science and technology policy (i.e. participatory Technology Assessment). The conclusions of this article are, that (a) in terms of nanosafety as expressed through policy and regulation, China PR and the EU have similar approaches towards, and concerns about, nanotoxicity—the official debate on benefits and risks is not markedly different in the two regions; (b) that there is a similar economic drive behind both regions’ approach to nanodevelopment, the difference being the degree of public concern admitted; and (c) participation in decision-making is fundamentally different in the two regions. Thus in China PR, the focus is on the responsibility of the scientist; in the EU, it is about government accountability to the public. The formulation of a Code of Conduct for scientists in both regions (China PR’s predicted for 2012) reveals both similarity and difference in approach to nanotechnology development. This may change, since individual responsibility alone cannot guide S&T development, and as public participation is increasingly seen globally as integral to governmental decision-making

Use of placebo interventions among Swiss primary care providers

Background: Placebo interventions can have meaningful effects for patients. However, little is known about the circumstances of their use in clinical practice. We aimed to investigate to what extent and in which way Swiss primary care providers use placebo interventions. Furthermore we explored their ideas about the ethical and legal issues involved. Methods: 599 questionnaires were sent to general practitioners (GPs) and paediatricians in private practice in the Canton of Zurich in Switzerland. To allow for subgroup analysis GPs in urban, suburban, and rural areas as well as paediatricians were selected in an even ratio. Results: 233 questionnaires were completed (response rate 47%). 28% of participants reported that they never used placebo interventions. More participants used impure placebos therapeutically than pure placebos (57% versus 17%, McNemar's chi2 = 78, p<0.001). There is not one clear main reason for placebo prescription. Placebo use was communicated to patients mostly as being "a drug or a therapy" (64%). The most frequently chosen ethical premise was that they "can be used as long as the physician and the patient work together in partnership" (60% for pure and 75% for impure placebos, McNemar's chi2 = 12, p<0.001). A considerable number of participants (11-38%) were indecisive about statements regarding the ethical and legal legitimacy of using placebos. Conclusions: The data obtained from Swiss primary care providers reflect a broad variety of views about placebo interventions as well as a widespread uncertainty regarding their legitimacy. Primary care providers seem to preferentially use impure as compared to pure placebos in their daily practice. An intense debate is required on appropriate standards regarding the clinical use of placebo interventions among medical professionals

Impact of the DRG-based reimbursement system on patient care and professional practise: perspectives of Swiss hospital physicians

QUESTIONS UNDER STUDY: The reimbursement system SwissDRG sets incentives for hospitals and providers to treat patients in a cost-efficient way. Arising conflicts between the commitment to the patient’s well-being and the economic interests of the hospital can lead to an impairment of quality and equity of health care. We developed and used a monitoring tool to evaluate ethically relevant aspects related to DRGs by surveying physicians. METHODS: We surveyed a random sample of physicians working in Swiss hospitals, exploring potentially positive and negative effects of DRGs on patient care. RESULTS: A total of 382 physicians completed the questionnaire (response rate 47%). More than 90% judged quality of health care “very good” or “rather good”, and 83% were satisfied with their job. The majority of physicians gave more consideration to economic issues in their clinical practise than they would have liked and had experienced various forms of over- and under-provision over the past six months. Overall, physicians considered patient-orientation deteriorating since the introduction of DRGs with no gains in efficiency. Professional principles could not be applied in all instances. CONCLUSIONS: Two years after the introduction of SwissDRG the quality of patient care and the job satisfaction is rated as good by most physicians. However, quality of care could be seriously compromised if more economic pressure is put on physicians in the future. Careful monitoring is needed to ensure that the needed focus on cost-containment and sustainability does not come at the expense of the high performance of the Swiss health care system

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore

Primera cita de <i>Quadrastichus mendeli</i> (Hymenoptera: Eulophidae: Tetrastichinae) de Argentina, asociado a agallas de <i>Leptocybe invasa</i> (Hymenoptera: Eulophidae: Tetrastichinae)

Se cita por primera vez en la Argentina la presencia de Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) asociada a agallas producidas por Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) en eucaliptos de la provincia de Buenos Aires. Quadrastichus mendeli es originaria de Australia y fue introducida en Israel en el año 2007, para ser utilizada como biocontrolador de la «avispa de la agalla», importante plaga de los cultivos de Eucalyptus.First record of Quadrastichus mendeli (Hymenoptera: Eulophidae: Tetrastichinae) in Argentina associated with galls of Leptocybe invasa (Hymenoptera: Eulophidae: Tetrastichinae)». Quadrastichus mendeli Kim & La Salle (Hymenoptera: Eulophidae: Tetrastichinae) is reported for the first time in Argentina, associated to galls produced by Leptocybe invasa Fisher & La Salle (Hymenoptera: Eulophidae: Tetrastichinae). It was found in Eucalyptus crops in Buenos Aires province. Quadrastichus mendeli is native to Australia and it was introduced into Israel in 2007 to be used as anatural enemy of the eucalyptus gall wasp.Centro de Estudios Parasitológicos y de Vectore