A Review of Surgical Informed Consent: Past, Present, and Future. A Quest to Help Patients Make Better Decisions

Contains fulltext : 87422.pdf (publisher's version ) (Closed access)BACKGROUND: Informed consent (IC) is a process requiring a competent doctor, adequate transfer of information, and consent of the patient. It is not just a signature on a piece of paper. Current consent processes in surgery are probably outdated and may require major changes to adjust them to modern day legislation. A literature search may provide an opportunity for enhancing the quality of the surgical IC (SIC) process. METHODS: Relevant English literature obtained from PubMed, Picarta, PsycINFO, and Google between 1993 and 2009 was reviewed. RESULTS: The body of literature with respect to SIC is slim and of moderate quality. The SIC process is an underestimated part of surgery and neither surgeons nor patients sufficiently realize its importance. Surgeons are not specifically trained and lack the competence to guide patients through a legally correct SIC process. Computerized programs can support the SIC process significantly but are rarely used for this purpose. CONCLUSIONS: IC should be integrated into our surgical practice. Unfortunately, a big gap exists between the theoretical/legal best practice and the daily practice of IC. An optimally informed patient will have more realistic expectations regarding a surgical procedure and its associated risks. Well-informed patients will be more satisfied and file fewer legal claims. The use of interactive computer-based programs provides opportunities to improve the SIC process.1 juli 201

Deutsch-Ostafrika : wirtschaftliche Studien

von Hermann Paasch

Kultur- und reiseskizzen aus Nord- und Mittel-Amerika; entworfen auf einer zum studium der zuckerindustrie unternommenen

t. 1. Aus Nord-Amerika.--t. 2. Aus Mexico.--t. 3. Von den Antillen und Venezuela.Mode of access: Internet

Inkjet printing for localized coating and functionalization of medical devices

Inkjet printing has become essential for pharmaceutical research as well as biomedical applications. It is a promising tool to meet future challenges in patientindividual designed pharmaceuticals and implants. In this context, the main areas of use are high-throughput screening (HTS), drug-loaded microparticles, drug formulation and oral dose development, 3D-printing/bioprinting as well as coating of implants. This study deals with the latter. In view of promising applications for localized coating and functionalization of implant surfaces this work shows preliminary results on inkjet printing of the polymer poly(2- ethyl-2-oxazoline) (PetOx), a protein repellent polymer (PRP). To deposit single droplets with small volumes (~500 pl) of aqueous PetOx solution (50 g/l), printing parameters were determined for the piezo-driven drop-ondemand inkjet printhead NanoTip J, operating in a Nanoplotter 2.1 (both from GeSiM mbH, Germany). Different printing strategies are demonstrated by varying droplet spacing and drying time while printing on hydrophilic glass substrate. Printing and stacking of almost uniform polymer lines (width ~ 200 μm) is demonstrated

Ideas and perspectives: Land-ocean connectivity through groundwater

For millennia humans have gravitated towards coastlines for their resource potential and as geopolitical centres for global trade. A basic requirement ensuring water security for coastal communities relies on a delicate balance between the supply and demand of potable water. The interaction between freshwater and saltwater in coastal settings is, therefore, complicated by both natural and human-driven environmental changes at the land-sea interface. In particular, ongoing sea level rise, warming and deoxygenation might exacerbate such perturbations. In this context, an improved understanding of the nature and variability of groundwater fluxes across the land-sea continuum is timely, yet remains out of reach. The flow of terrestrial groundwater across the coastal transition zone as well as the extent of freshened groundwater below the present-day seafloor are receiving increased attention in marine and coastal sciences because they likely represent a significant, yet highly uncertain component of (bio)geochemical budgets, and because of the emerging interest in the potential use of offshore freshened groundwater as a resource. At the same time, “reverse” groundwater flux from offshore to onshore is of prevalent socio-economic interest as terrestrial groundwater resources are continuously pressured by overpumping and seawater intrusion in many coastal regions worldwide. An accurate assessment of the land-ocean connectivity through groundwater and its potential responses to future anthropogenic activities and climate change will require a multidisciplinary approach combining the expertise of geophysicists, hydrogeologists, (bio)geochemists and modellers. Such joint activities will lay the scientific basis for better understanding the role of groundwater in societal-relevant issues such as climate change, pollution and the environmental status of the coastal oceans within the framework of the United Nations Sustainable Development Goals. Here, we present our perspectives on future research directions to better understand land-ocean connectivity through groundwater, including the spatial distributions of the essential hydrogeological parameters, highlighting technical and scientific developments, and briefly discussing its societal relevance in rapidly changing coastal oceans