scholarly journals Communicating diagnostic uncertainty in the acute and emergency medical setting: A systematic review and ethical analysis of the empirical literature.

2021 ◽  
Vol 20 (3) ◽  
pp. 204-218
Author(s):  
J Hart ◽  
◽  
CL Cox ◽  
Keyword(s):  
Systematic Review ◽  
Ethical Issues ◽  
Ethical Analysis ◽  
Empirical Literature ◽  
Medical Setting ◽  
Negative Effects ◽  
Acute Setting ◽  
Diagnostic Uncertainty ◽  
Inappropriate Use ◽  
Critical Interpretive Synthesis

Background: diagnostic uncertainty is ubiquitous. Its communication to patients requires further investigation. Aims: To determine: 1) What is known about how and why diagnostic uncertainty is communicated in acute care; 2) evidence of the effects of (not) communicating diagnostic uncertainty in the acute setting; 3) associated ethical issues. Methods: systematic review of Medline, Web of Science and SCOPUS for (acute or emergency care) AND (diagnostic uncertainty) AND (ethics OR behaviours). Critical interpretive synthesis and ethical analysis were conducted. Results and conclusion: Nine studies (primarily surveys and interviews) were identified. Doctors are not trained in communicating diagnostic uncertainty and perceive it to have negative effects on patients; however not communicating diagnostic uncertainty can disempower patients, resulting in delayed/missed diagnoses or inappropriate use of resource.

scholarly journals The full spectrum of ethical issues in pediatric genome-wide sequencing: a systematic qualitative review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Johanna Eichinger ◽  
Bernice S. Elger ◽  
Insa Koné ◽  
Isabel Filges ◽  
David Shaw ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ethical Issues ◽  
Qualitative Content Analysis ◽  
Test Procedure ◽  
Economic Incentives ◽  
Empirical Literature ◽  
Ethical Challenges ◽  
Full Spectrum ◽  
Genome Wide ◽  
Google Books

Abstract Background The use of genome-wide sequencing in pediatric medicine and research is growing exponentially. While this has many potential benefits, the normative and empirical literature has highlighted various ethical issues. There have not been, however, any systematic reviews of these issues. The aim of this systematic review is to determine systematically the spectrum of ethical issues that is raised for stakeholders in in pediatric genome-wide sequencing. Methods A systematic review in PubMed and Google Books (publications in English or German between 2004 and 2021) was conducted. Further references were identified via reference screening. Data were analyzed and synthesized using qualitative content analysis. Ethical issues were defined as arising when a relevant normative principle is not adequately considered or when two principles come into conflict. Results Our literature search retrieved 3175 publications of which 143 were included in the analysis. Together these mentioned 106 ethical issues in pediatric genome-wide sequencing, categorized into five themes along the pediatric genome-wide sequencing lifecycle. Most ethical issues identified in relation to genome-wide sequencing typically reflect ethical issues that arise in general genetic testing, but they are often amplified by the increased quantity of data obtained, and associated uncertainties. The most frequently discussed ethical aspects concern the issue of unsolicited findings. Conclusion Concentration of the debate on unsolicited findings risks overlooking other ethical challenges. An overarching difficulty presents the terminological confusion: both with regard to both the test procedure/ the scope of analysis, as well as with the topic of unsolicited findings. It is important that the genetics and ethics communities together with other medical professions involved work jointly on specific case related guidelines to grant the maximum benefit for the care of the children, while preventing patient harm and disproportionate overload of clinicians and the healthcare system by the wealth of available options and economic incentives to increase testing.

Dilemmas of nudging in public health: an ethical analysis of a Danish pamphlet

2020 ◽  
Author(s):  
Jacob Busch ◽  
Emilie Kirstine Madsen ◽  
Antoinette Mary Fage-Butler ◽  
Marianne Kjær ◽  
Loni Ledderer
Keyword(s):  
Public Health ◽  
Ethical Issues ◽  
Screening Programme ◽  
Screening Program ◽  
Ethical Analysis ◽  
Choice Making ◽  
The Face ◽  
Information Materials ◽  
The Individual ◽  
To Receive

Summary Nudging has been discussed in the context of public health, and ethical issues raised by nudging in public health contexts have been highlighted. In this article, we first identify types of nudging approaches and techniques that have been used in screening programmes, and ethical issues that have been associated with nudging: paternalism, limited autonomy and manipulation. We then identify nudging techniques used in a pamphlet developed for the Danish National Screening Program for Colorectal Cancer. These include framing, default nudge, use of hassle bias, authority nudge and priming. The pamphlet and the very offering of a screening programme can in themselves be considered nudges. Whether nudging strategies are ethically problematic depend on whether they are categorized as educative- or non-educative nudges. Educative nudges seek to affect people’s choice making by engaging their reflective capabilities. Non-educative nudges work by circumventing people’s reflective capabilities. Information materials are, on the face of it, meant to engage citizens’ reflective capacities. Recipients are likely to receive information materials with this expectation, and thus not expect to be affected in other ways. Non-educative nudges may therefore be particularly problematic in the context of information on screening, also as participating in screening does not always benefit the individual.

scholarly journals Medication of Hydroxychloroquine, Remdesivir and Convalescent Plasma during the COVID-19 Pandemic in Germany—An Ethical Analysis

2021 ◽  
Vol 18 (11) ◽  
pp. 5685
Author(s):  
Katja Voit ◽  
Cristian Timmermann ◽  
Florian Steger
Keyword(s):  
Early Stage ◽  
Treatment Options ◽  
Drug Distribution ◽  
Experimental Treatment ◽  
Ethical Analysis ◽  
Ethical Principles ◽  
Ethical Challenges ◽  
Ethical Guidelines ◽  
Negative Effects ◽  
Experimental Drug

This paper aims to analyze the ethical challenges in experimental drug use during the early stage of the COVID-19 pandemic, using Germany as a case study. In Germany uniform ethical guidelines were available early on nationwide, which was considered as desirable by other states to reduce uncertainties and convey a message of unity. The purpose of this ethical analysis is to assist the preparation of future guidelines on the use of medicines during public health emergencies. The use of hydroxychloroquine, remdesivir and COVID-19 convalescent plasma in clinical settings was analyzed from the perspective of the ethical principles of beneficence, non-maleficence, justice and autonomy. We observed that drug safety and drug distribution during the pandemic affects all four ethical principles. We therefore recommend to establish ethical guidelines (i) to discuss experimental treatment options with patients from all population groups who are in urgent need, (ii) to facilitate the recording of patient reactions to drugs in off-label use, (iii) to expand inclusion criteria for clinical studies to avoid missing potentially negative effects on excluded groups, and (iv) to maintain sufficient access to repurposed drugs for patients with prior conditions.

Inquiry‐based stress reduction: A systematic review of the empirical literature

2021 ◽  
Author(s):  
Joshua N. Hook ◽  
Jennifer Kim Penberthy ◽  
Don E. Davis ◽  
Daryl R. Van Tongeren
Keyword(s):  
Systematic Review ◽  
Stress Reduction ◽  
Empirical Literature

Focal Concerns and Police Decision Making in Sexual Assault Cases: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 152483802199128
Author(s):  
David S. Lapsey ◽  
Bradley A. Campbell ◽  
Bryant T. Plumlee
Keyword(s):  
Systematic Review ◽  
Decision Making ◽  
Sexual Assault ◽  
Meta Analysis ◽  
The United States ◽  
Empirical Literature ◽  
Campbell Collaboration ◽  
Focal Concerns ◽  
Police Decision Making ◽  
The Impact

Sexual assault and case attrition at the arrest stage are serious problems in the United States. Focal concerns have increasingly been used to explain police decision making in sexual assault cases. Because of the popularity of the focal concerns perspective and potential to inform evidence-based training, a systematic review and meta-analysis are needed to condense the literature. In this study, we assess the overall strength of the relationship between focal concerns variables and police decisions to arrest in cases of sexual assault. Our assessment of the effects of focal concerns variables on arrest decision making in sexual assault cases followed the systematic review protocols provided by the Campbell Collaboration of Systematic Reviews. Specifically, we used the Campbell Collaboration recommendations to search empirical literature and used meta-analysis to evaluate the size, direction, and strength of the impact of focal concerns variables on arrest decisions. Our search strategy detected 14 eligible studies and 79 effect sizes. The meta-analysis found several robust and statistically significant correlates of arrest. In fact, each focal concerns concept produced at least one robust arrest correlate. Overall, focal concerns offers a strong approach for explaining police decisions in sexual assault cases. Although practical concerns and resource constraints produced the strongest arrest correlates, results show the importance of additional case characteristics in officers’ decision to arrest.

scholarly journals A Comparison of Psychological and Work Outcomes in Open-Plan and Cellular Office Designs: A Systematic Review

SAGE Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. 215824402098886
Author(s):  
Olivia James ◽  
Paul Delfabbro ◽  
Daniel L. King
Keyword(s):  
Systematic Review ◽  
Social Relationships ◽  
Social Relationship ◽  
Work Outcomes ◽  
Negative Effects ◽  
Health Satisfaction ◽  
Financial Benefits ◽  
Open Plan ◽  
Employee Characteristics ◽  
Design Factors

A high percentage of information-based work is now conducted in open-plan offices as opposed to traditional cellular offices. In this systematic review, we compare health, work, and social outcomes as well as employee outcomes for workers in the two environments. From a total of 10,242 papers reviewed, we identified 31 papers which met strict inclusion/exclusion criteria of allowing a direct comparison between the office types. The results showed that working in open-plan workplace designs is associated with more negative outcomes on many measures relating to health, satisfaction, productivity, and social relationship. Notable health outcomes included decreased overall health and increased stress. Environmental characteristics of particular concern included noise and distractions, poor privacy, lighting and glare, and poorer temperature control. Most studies indicated negative effects on social relationships and interactions. Overall, the findings showed that while open-plan workplace designs may offer financial benefits for management, these appear to be offset by the intangible costs associated with the negative effects on workers. The study encourages further focused investigations into design factors as well as employee characteristics that might contribute to better outcomes in open-plan designs.

scholarly journals Perception of Gamblers: A Systematic Review

2021 ◽  
Author(s):  
Andrea Wöhr ◽  
Marius Wuketich
Keyword(s):  
Systematic Review ◽  
Empirical Studies ◽  
Grey Literature ◽  
Future Research ◽  
Gambling Problems ◽  
Negative Effects ◽  
Strong Focus ◽  
The Media ◽  
Social Scientific ◽  
Psychological Knowledge

AbstractIt is generally assumed that gamblers, and particularly people with gambling problems (PG), are affected by negative perception and stigmatisation. However, a systematic review of empirical studies investigating the perception of gamblers has not yet been carried out. This article therefore summarises empirical evidence on the perception of gamblers and provides directions for future research. A systematic literature review based on the relevant guidelines was carried out searching three databases. The databases Scopus, PubMed and BASE were used to cover social scientific knowledge, medical-psychological knowledge and grey literature. A total of 48 studies from 37 literature references was found. The perspective in these studies varies: Several studies focus on the perception of gamblers by the general population, by subpopulations (e. g. students or social workers), or by gamblers on themselves. The perspective on recreational gamblers is hardly an issue. A strong focus on persons with gambling problems is symptomatic of the gambling discourse. The analysis of the studies shows that gambling problems are thought to be rather concealable, whereas the negative effects on the concerned persons‘ lives are rated to be quite substantial. PG are described as “irresponsible” and “greedy” while they perceive themselves as “stupid” or “weak”. Only few examples of open discrimination are mentioned. Several studies however put emphasis on the stereotypical way in which PG are portrayed in the media, thus contributing to stigmatisation. Knowledge gaps include insights from longitudinal studies, the influence of respondents‘ age, culture and sex on their views, the relevance of the type of gambling a person is addicted to, and others. Further studies in these fields are needed.

scholarly journals The job demands-resources model and the international work context – a systematic review

2014 ◽  
Vol 2 (3) ◽  
pp. 260-279 ◽  
Author(s):  
Lucy T.B. Rattrie ◽  
Markus G. Kittler
Keyword(s):  
Systematic Review ◽  
Empirical Studies ◽  
Domestic Work ◽  
Job Demands ◽  
Empirical Literature ◽  
Future Research ◽  
Content Type ◽  
International Work ◽  
Work Related ◽  
Work Contexts

Purpose – The purpose of this paper is to provide a synthesis and evaluation of literature surrounding the job demands-resources (JD-R) model (Demerouti et al., 2001) in the first decade since its inception, with particular emphasis on establishing an evidence-based universal application towards different national and international work contexts. Design/methodology/approach – The study uses a systematic review approach following the stages suggested by Tranfield et al. (2003). Based on empirical data from 62 studies, the authors systematically analyse the application of the JD-R model and queries whether it is applicable outside merely domestic work contexts. Findings – The authors find convincing support for the JD-R model in different national contexts. However, the authors also found an absence of studies employing the JD-R model in cross-national settings. None of the empirical studies in the sample had explicitly considered the international context of today’s work environment or had clearly associated JD-R research with the IHRM literature. Research limitations/implications – Based on the wide acceptance of the JD-R model in domestic work contexts and the increased interest in work-related outcomes such as burnout and engagement in the IHRM literature, the study identifies a gap and suggests future research applying the JD-R model to international work and global mobility contexts. Originality/value – This study is the first to systematically assess the application of the JD-R model in domestic and international work contexts based on a systematic review of empirical literature in the first decade since the inception of the model. The study identifies a lack of internationally focussed JD-R studies and invites further empirical research and theoretical extensions.

scholarly journals The Chronic Effects of Narghile Use on Males’ Cardiovascular Response During Exercise: A Systematic Review

2021 ◽  
Vol 15 (2) ◽  
pp. 155798832199770
Author(s):  
Faten Chaieb ◽  
Helmi Ben Saad
Keyword(s):  
Systematic Review ◽  
Heart Rate ◽  
Cardiovascular Response ◽  
Recovery Period ◽  
Cardiopulmonary Exercise Test ◽  
Negative Effects ◽  
Chronic Effects ◽  
Blood Pressures ◽  
Response To Exercise ◽  
Harmful Effects

Narghile use has regained popularity throughout the world. Public opinion misjudges its chronic harmful effects on health, especially on the cardiovascular system. This systematic review aimed to evaluate the chronic effects of narghile use on cardiovascular response during exercise. It followed the preferred reporting items for systematic reviews guidelines. Original articles from PubMed and Scopus published until January 31, 2020, written in English, and tackling the chronic effects of narghile use on human cardiovascular response during exercise were considered. Five studies met the inclusion criteria. Only males were included in these studies. They were published between 2014 and 2017 by teams from Tunisia ( n = 4) and Jordan ( n = 1). One study applied the 6-min walk test, and four studies opted for the cardiopulmonary exercise test. Narghile use was associated with reduced submaximal (e.g., lower 6-min walk distance) and maximal aerobic capacities (e.g., lower maximal oxygen uptake) with abnormal cardiovascular status at rest (e.g., increase in heart rate and blood pressures), at the end of the exercise (e.g., lower heart rate, tendency to chronotropic insufficiency) and during the recovery period (e.g., lower recovery index). To conclude, chronic narghile use has negative effects on cardiovascular response to exercise with reduced submaximal and maximal exercise capacities.

Minimalism, voluntary simplicity, and well-being: A systematic review of the empirical literature

2021 ◽  
pp. 1-12
Author(s):  
Joshua N. Hook ◽  
Adam S. Hodge ◽  
Hansong Zhang ◽  
Daryl R. Van Tongeren ◽  
Don E. Davis
Keyword(s):  
Systematic Review ◽  
Well Being ◽  
Empirical Literature ◽  
Voluntary Simplicity
Sign in / Sign up

Export Citation Format

Share Document