scholarly journals Psychological and Medico-Legal Perspectives on Electroconvulsive Therapy and Patient-Centered Care: A Short Review of Cross-Cutting Issues

2020 ◽  
Vol 13 (1) ◽  
pp. 253-263
Author(s):  
Valeria Tullio ◽  
Stefania Zerbo ◽  
Antonietta Lanzarone ◽  
Salvatore Procaccianti ◽  
Antonina Argo
Keyword(s):  
Electroconvulsive Therapy ◽  
Short Review ◽  
Point Of View ◽  
Clinical Settings ◽  
Patient Centered ◽  
Medical Settings ◽  
Scientific World ◽  
Centered Care ◽  
The Impact

Electroconvulsive therapy is a treatment that, since its first administration, has been a major topic for debate within the scientific world. In recent years, the debate has become increasingly focused on the short- and/or long-term efficacy of electroconvulsive therapy, its appropriateness in clinical settings, its mechanism of action, the impact evaluation of transient and/or persistent adverse effects, and the drafting of international guidelines, etc. From the authors’ point of view, these themes are inevitably crossed by three other fundamental issues of significant psychological, relational, ethical, and medico-legal impact. Still, they are less studied than purely biomedical issues in recent times. Therefore, the aim of this article is to focus on the following cross-cutting issues: the therapist-patient relationship, the patient’s perspective, the attitude on electroconvulsive therapy, and informed consent. This short review refers to the international literature on ECT published since 2000. Analyses of the three previously listed topics are, in part, made within the context of Italian medical settings.

scholarly journals Building Better Clinical Relationships With Patients: An Argument for Digital Health Solutions With Black Men

2019 ◽  
Vol 12 ◽  
pp. 117863291983431
Author(s):  
Ledric D Sherman ◽  
Stuart W Grande
Keyword(s):  
Black Men ◽  
Information Exchange ◽  
Care Delivery ◽  
Digital Health ◽  
Rapid Evolution ◽  
Patient Centered ◽  
Health Technologies ◽  
Centered Care ◽  
The Impact

There is a rapid evolution of care delivery taking place across the globe in response to an explosion of novel health technologies. Growing in parallel to this expansion is the anticipation of mHealth technologies to drive patient-centered care into the future. Despite this hope, continuing reports of health inequities and lived experiences of substandard care fill national, state, and community health reports. The impact of these inequities is particularly pernicious on Black men and their long-term health status. As decades of robust evidence substantiates needed interventions, current progress is not seeing expected gains. In this commentary, we argue that at the heart of these inequities are issues of access, health literacy, institutional racism, and growing social distance between clinicians and Black men. To address these inequities, we suggest that digital interventions, designed to support decision-making, information exchange, and shared accountability have the best hope to overcome current inequities by promoting authentic relationships that ultimately drive better communication between Black men and their clinicians.

scholarly journals Healing at the End of Life: The Voice of the Patient

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Cory Ingram
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Lived Experience ◽  
End Of Life ◽  
Life Story ◽  
Patient Centered ◽  
Whole Person ◽  
Centered Care ◽  
The Impact

In palliative care we have the privilege to care for seriously ill people and their families. Some people value capturing their life story or illness journey on film. I have been fortunate to have been invited into the lives of many people close the end of life for a heartfelt conversation.On an interactive iPad incorporated in the poster, the recorded narrative of patients and one bereft spouse the poster audience will experience the lived experience of people close to the end of life as they reflect on their lives. The narratives will demonstrate how each lived with a new found improved quality of life in the face of increasing symptoms, declining functioning and the approaching end of life; otherwise known as healing. Topics of healing and quality of life, patient-centered care, dignity, human development, spirituality and love will be the focus of their stories. The stories lay bare the very practical, emotional, existential, and personal experience central to our provision of whole person care through palliative care. The poster audience will experience a renewed sense of the impact of a dedicated approach to whole person care as experienced through those on the receiving end.

Assessment and Counseling of Older Drivers

2017 ◽  
Author(s):  
Thomas M. Meuser ◽  
David B. Carr
Keyword(s):  
Motor Vehicle ◽  
Warning Signs ◽  
Older Drivers ◽  
Patient Centered ◽  
Fitness Evaluation ◽  
Centered Care ◽  
Individualized Approach ◽  
Health Related ◽  
Safety Considerations ◽  
The Impact

Driving a motor vehicle is an important instrumental activity of daily living and thus a target for health-related assessment and assistance. Most older drivers self-regulate in response to changes in medical and functional status. A minority may not recognize the impact of such changes on driving (e.g., in dementia) and so may continue driving when no longer safe to do so, despite warning signs. When evaluating driver fitness, clinicians must weigh individual rights of autonomy and choice against objective findings of deficits and broader safety considerations. Driver evaluation requires a sensitive, individualized approach that also takes daily-life mobility into account. This chapter discusses driver fitness evaluation in the context of patient-centered care and resources to support patients in the transition in mobility from driving to not driving.

Beyond the Albanian–Slav Divide: Political Cooperation and National Identities in the Balkans at the Turn of the Twentieth Century

2019 ◽  
Vol 34 (1) ◽  
pp. 25-47
Author(s):  
Fabio Bego
Keyword(s):  
Twentieth Century ◽  
Political Activism ◽  
Point Of View ◽  
National Identities ◽  
The Balkans ◽  
Surrounding Environment ◽  
Recent Scholarship ◽  
Political Cooperation ◽  
The Impact

This article investigates how some prominent and less known Albanian activists perceived their Southern Slav neighbors at the turn of the twentieth century. The research explores the way in which the spread of nationalism conditioned the positioning of Albanians and Slavs in the process of identity construction and how such identities mirrored their reciprocal political claims. Recent scholarship has often emphasized that the affirmation of national ideas led to the fragmentation of Balkan communities by turning Albanian-speaking populations and their Slavic-speaking neighbors into “others.” My analysis expands this assertion by elaborating a theoretical approach that allows us to explore the impact of nationalism on the post-1878 Balkan context from a more dynamic point of view. National discourses did not only lay the foundation for a differentiation between the Balkan communities, but were also tools for promoting joint political activism. National activists often felt it necessary to cooperate in order to deal with the challenges posed by the surrounding environment, which was common to both Albanians and Slavs. Various contingent circumstances led Albanian activists to project long-term forms of coexistence with their neighbors, and to imagine forms of political, cultural, and social synthesis with the Slavs.

scholarly journals Endoscopic and Histologic Predictors of Outcomes in Pediatric Ulcerative Colitis—Caveat Emptor

2021 ◽  
Vol 9 ◽  
Author(s):  
Lorraine Stallard ◽  
Séamus Hussey
Keyword(s):  
Ulcerative Colitis ◽  
Mucosal Healing ◽  
Term Treatment ◽  
Clinical Settings ◽  
Adult Disease ◽  
Long Term Treatment ◽  
Acute Severe Colitis ◽  
The Impact ◽  
Severe Colitis

The impact of endoscopic and histological mucosal healing on outcomes in adult settings is impressive. Despite many clinical parallels, pediatric ulcerative colitis (UC) is set apart from adult disease in several respects. Many frequently used indices are not fully validated, especially in pediatric settings, and consensus on precise definitions in clinical settings are lacking. Endoscopic mucosal healing is an acceptable long-term treatment goal in pediatrics, but not histologic normalization. Early prediction of disease course in UC may allow treatment stratification of patients according to risks of relapse, acute severe colitis, and colectomy. Putative endoscopic and histologic predictors of poor clinical outcomes in adults have not held true in pediatric settings, including baseline endoscopic extent, endoscopic severity, and specific histologic characteristics which are less prevalent in pediatrics at diagnosis. In this mini-review we appraise predictive endoscopic and histologic factors in pediatric UC with reference to relapse, severe colitis, and colectomy risks. We recommend that clinicians routinely use endoscopic and histologic sores to improve the quality of clinical and research practice. The review summarizes differences between adult and pediatric prediction data, advises special consideration of those with primary sclerosing cholangitis, and suggests areas for future study in this field.

scholarly journals A Multilevel Study of Patient-Centered Care Perceptions In Mental Health Teams

2020 ◽  
Author(s):  
Francois Durand ◽  
Marie-Josée Fleury
Keyword(s):  
Mental Health ◽  
Interprofessional Collaboration ◽  
Patient Centered Care ◽  
Multidisciplinary Teams ◽  
Patient Centered ◽  
Cross Sectional ◽  
Team Processes ◽  
Interprofessional Care ◽  
Centered Care ◽  
The Impact

Abstract Background: The combination of interprofessional collaboration in teams and patient-centered care is a necessary amalgamation when it comes to delivering complex mental healthy care and services. Yet collaboration is challenging and patient-centered care is intricate to manage. This study examines the impact of predictors of patient-centered care such as team adaptivity and proactivity, collaboration, belief in interprofessional collaboration, informal role self-efficacy in multidisciplinary mental health teams.Method: Cross-sectional multilevel design using self-administered bilingual validated questionnaires.Results: This study showed that belief in interprofessional collaboration’s impact on patient-centered perceptions is increased in teams with high collaboration. We also showed that collaboration is a mediator; that is, a process by which team adaptive and proactive behaviors are transformed into positive patient-centered perceptions.Conclusions: In terms of research our results are in line with recent theorising on team processes and specifically established collaboration as key in a multilevel examination of predictors of patient-centered care perceptions. In terms of practice, we showed that multidisciplinary teams should know that working hard on collaboration as an answer to the complexity of patient-centered care impacts the teams’ ability to respond to its challenges but also impacts individuals’ beliefs central to the delivery of interprofessional care.

scholarly journals Institutional environment tools for small and medium-sized enterprises development

2021 ◽  
Vol 39 (3) ◽  
Author(s):  
Inna Deineha ◽  
Anatoly Maslov ◽  
Natalia Potryvaieva ◽  
Uliana Berezhnytska ◽  
Liudmyla Verbivska ◽  
...  
Keyword(s):  
Institutional Environment ◽  
Point Of View ◽  
Complex Nature ◽  
Real Sector ◽  
Existing Problems ◽  
Social Sphere ◽  
The Social ◽  
Key Factor ◽  
The Impact

This work's relevance is due to the need to improve the use of tools to stimulate the development of enterprises and the development of effective measures of government influence on the market economy. The article discusses the institutional environment's main characteristics in which enterprises of the real sector of the economy operate.Arguments showing the need for state support and development of small business, from the point of view of a key factor in the development of both the national economy and the factor of stabilization of the social sphere, are presented. The characteristic is given, and the main nuances of the impact and transformation of the institutional environment with the help of available tools are considered to achieve the effect of stable and long-term development of small and medium-sized enterprises.The article attempts to highlight the existing problems and the complex nature of the impact of instruments on enterprises' institutional environment.

Cycling Without Age Program: The Impact for Residents in Long-Term Care

2019 ◽  
Vol 42 (9) ◽  
pp. 728-735 ◽  
Author(s):  
Paula McNiel ◽  
Judith Westphal
Keyword(s):  
Lived Experience ◽  
Long Term Care ◽  
Care Facility ◽  
The United States ◽  
Structured Interviews ◽  
Term Care ◽  
Long Term Care Facility ◽  
Centered Care ◽  
The Impact

Long-term care facilities seek ways to enhance the quality of life for residents. Cycling Without Age (CWA), a new international cycling program, is gaining momentum for older adults. This study explored resident riders’ and trishaw pilots’ lived experience of their participation in the CWA program using a qualitative approach at a long-term care facility in the United States. Researchers conducted 27 face-to-face, semi-structured interviews with riders and pilots. For resident riders, the three themes identified included (a) breath of fresh air; (b) wave, chat, and remember; and (c) sit back and relax. Two themes were identified for the pilots: (a) change in frame of mind, and (b) mental and physical rewards. CWA can be as a new strategy for person-centered care. The CWA program provides nursing an opportunity to advocate, recommend, and obtain an order for residents to participate in the program.

scholarly journals Care Pathways in Persistent Orofacial Pain

2016 ◽  
Vol 2 (1) ◽  
pp. 48-57 ◽  
Author(s):  
M. Breckons ◽  
S.M. Bissett ◽  
C. Exley ◽  
V. Araujo-Soares ◽  
J. Durham
Keyword(s):  
Health Care Providers ◽  
Orofacial Pain ◽  
Care Pathway ◽  
Comparative Method ◽  
Qualitative Interviews ◽  
Care Pathways ◽  
Care Providers ◽  
Patient Centered ◽  
Centered Care ◽  
The Impact

Persistent orofacial pain is relatively common and known to have an adverse effect on quality of life. Previous studies suggest that the current care pathway may be problematic, but it is not well understood which health services patients access and what their experience is. The aim of this study was to explore care pathways and their impact from the perspective of patients. Qualitative interviews were conducted with a maximum variation sample of patients recruited from primary (community based) and secondary (specialist hospital based) care in the United Kingdom. Questions focused on the stages in their pathway and the impact of the care that they had received. Interviews were digitally recorded and transcribed verbatim, and analysis followed principles of the constant comparative method. NVivo 10 was used to help organize and analyze data. Twenty-two patients were interviewed at baseline, and 18 took part in a second interview at 12 mo. Three main themes emerged from the data: the “fluidity of the care pathway,” in which patients described moving among health care providers in attempts to have their pain diagnosed and managed, occurring alongside a “failure to progress,” where despite multiple appointments, patients described frustration at delays in obtaining a diagnosis and effective treatment for their pain. Throughout their care pathways, patients described the “effects of unmanaged pain,” where the longer the pain went unmanaged, the greater its potential to negatively affect their lives. Findings of this study suggest that the current care pathway is inefficient and fails to meet patient needs. Future work needs to focus on working with stakeholder groups to redesign patient-centered care pathways. Knowledge Transfer Statement: Data from qualitative interviews conducted with patients with persistent orofacial pain suggest significant problems with the existing care pathway, consisting of delays to diagnosis, treatment, and referral. Patients describing their struggle to progress through the current care pathway highlighted the difficulties occurring while living with orofacial pain. This study suggests a need for a revised care pathway, which better meets the needs of people with persistent orofacial pain.

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