Managing ethical issues in patient care and the need for clinical ethics support

Objective: To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. Methods: Cross-sectional survey of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Results: Sixty-two (59%) respondents reported occasionally to often having ethical concerns. Forty-six (44%) reported often to occasionally having legal concerns. The three most common response to concerns was: talking to colleagues (96, 91.4%); raising the issue in a group forum (68, 65%) and consulting a relevant guideline. Most respondents were highly (62%) or moderately (31%) satisfied with the ethical environment of the hospital. Twenty-two (22%) were highly satisfied with the ethical environment of their department and 74 (75%) were moderately satisfied. A majority 72 (69%) of respondents indicated that additional support in dealing with ethical issues would be helpful. Conclusion: Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. While this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, the majority of respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. Key Question Summary 1. What is known about the topic? Clinicians working in hospitals in the USA, Canada and the United Kingdom have access to ethics expertise to help them manage ethical issues that arise in patient care. How Australian clinicians currently manage the ethical issues they face has not been investigated 2. What does this paper add? This paper describes the types of ethical issues faced by Australian clinicians, how they manage these issues and whether they think ethics support would be helpful. 3. What are the implications for practitioners? Clinicians frequently encounter ethically and legally difficult decisions and want additional ethics support. Helping clinicians to provide ethically sound patient care should be a priority of public hospitals in NSW and elsewhere in Australia.NSW Ministry of Healt

Managing ethical issues in patient care and the need for clinical ethics support

Objective: To investigate the range, frequency and management of ethical issues encountered by clinicians working in hospitals in New South Wales (NSW), Australia. Methods: Cross-sectional survey of a convenience sample of 104 medical, nursing and allied health professionals in two NSW hospitals. Results: Sixty-two (59%) respondents reported occasionally to often having ethical concerns. Forty-six (44%) reported often to occasionally having legal concerns. The three most common response to concerns was: talking to colleagues (96, 91.4%); raising the issue in a group forum (68, 65%) and consulting a relevant guideline. Most respondents were highly (62%) or moderately (31%) satisfied with the ethical environment of the hospital. Twenty-two (22%) were highly satisfied with the ethical environment of their department and 74 (75%) were moderately satisfied. A majority 72 (69%) of respondents indicated that additional support in dealing with ethical issues would be helpful. Conclusion: Clinicians reported frequently experiencing ethical and legal uncertainty and concern. They usually managed this by talking with colleagues. While this approach was considered adequate, and the ethics of their hospital was reported to be satisfactory, the majority of respondents indicated that additional assistance with ethical and legal concerns would be helpful. Clinical ethics support should be a priority of public hospitals in NSW and elsewhere in Australia. Key Question Summary 1. What is known about the topic? Clinicians working in hospitals in the USA, Canada and the United Kingdom have access to ethics expertise to help them manage ethical issues that arise in patient care. How Australian clinicians currently manage the ethical issues they face has not been investigated 2. What does this paper add? This paper describes the types of ethical issues faced by Australian clinicians, how they manage these issues and whether they think ethics support would be helpful. 3. What are the implications for practitioners? Clinicians frequently encounter ethically and legally difficult decisions and want additional ethics support. Helping clinicians to provide ethically sound patient care should be a priority of public hospitals in NSW and elsewhere in Australia.NSW Ministry of Healt

Religious perspectives on umbilical cord blood banking

Umbilical cord blood is a valuable source of haematopoietic stem cells. There is little information about whether religious affiliations have any bearing on attitudes to and decisions about its collection, donation and storage. The authors provided information about umbilical cord blood banking to expert commentators from six major world religions (Catholicism, Anglicanism, Islam, Judaism, Hinduism and Buddhism) and asked them to address a specific set of questions in a commentary. The commentaries suggest there is considerable support for umbilical cord blood banking in these religions. Four commentaries provide moral grounds for favouring public donation over private storage. None attach any particular religious significance to the umbilical cord or to the blood within it, nor place restrictions on the ethnicity or religion of donors and recipients. Views on ownership of umbilical cord blood vary. The authors offer a series of general points for those who seek a better understanding of religious perspectives on umbilical cord blood banking

Religious perspectives on umbilical cord blood banking

Umbilical cord blood is a valuable source of haematopoietic stem cells. There is little information about whether religious affiliations have any bearing on attitudes to and decisions about its collection, donation and storage. The authors provided information about umbilical cord blood banking to expert commentators from six major world religions (Catholicism, Anglicanism, Islam, Judaism, Hinduism and Buddhism) and asked them to address a specific set of questions in a commentary. The commentaries suggest there is considerable support for umbilical cord blood banking in these religions. Four commentaries provide moral grounds for favouring public donation over private storage. None attach any particular religious significance to the umbilical cord or to the blood within it, nor place restrictions on the ethnicity or religion of donors and recipients. Views on ownership of umbilical cord blood vary. The authors offer a series of general points for those who seek a better understanding of religious perspectives on umbilical cord blood banking

Translanguaging in mainstream education:a sociocultural approach

Due to the monolingual self-understanding of European nation-states, migration-induced multilingualism and the language mixing practices it triggers are not usually acknowledged as resources for learning within mainstream classrooms. The term translanguaging has recently been put forward as both a way of describing the flexible ways in which bilinguals draw upon their multiple languages to enhance their communicative potential and a pedagogical approach in which teachers and pupils use these practices for learning. However, little research has been conducted in how the translanguaging approach can be used in mainstream education to enhance knowledge. This study draws on videographic data recorded in 59 10th grade (15-year-olds) subject-matter classes in 4 secondary schools. Applying sociocultural discourse analysis to peer–peer interaction and therefore considering how learners scaffold one another as they participate in collaborative talk and in the co-construction of knowledge, results describe several functions of translanguaging for ‘exploratory talk’ leading to content-matter learning. Multilingual adolescents in naturalistic settings thus use their multilingualism to cognitively engage with content-based tasks and produce high-order speech acts embedded in complex talk

Excretion of Vancomycin-Resistant Enterococci by Wild Mammals

A survey of fecal samples found enterococcal excretion in 82% of 388 bank voles (Clethrionomys glareolus), 92% of 131 woodmice (Apodemus sylvaticus), and 75% of 165 badgers (Meles meles). Vancomycin-resistant enterococci, all Enterococcus faecium of vanA genotype, were excreted by 4.6% of the woodmice and 1.2% of the badgers, but by none of the bank voles