hospital ethics
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Author(s):  
Samira Raoofi ◽  
Seddighe Arefi ◽  
Rahim Khodayari-Zarnaq ◽  
Bashir Azimi-Nayebi ◽  
Mir Sajjad Seyyed Mousavi

Medical ethics committees play an important role in examining and resolving ethical problems in hospitals by developing ethical guidelines and making ethical decisions. This study aimed at investigating the challenges that these committees typically face. This qualitative phenomenological study was conducted in 2020. Data was collected through semi-structured interviews with purposive sampling and participation of 19 ethics committees’ members in Tehran hospitals. Then, data were analyzed by the content analysis method using MAXQDA-10 software. Challenges of hospital ethics committees were classified into three main themes including external factors, intra-organizational factors, and ethics committee structure, in addition to six sub-themes including inadequate supervision, lack of instructions, organizational culture, human resources, nature of the committee, and ineffectiveness of committees’ decisions. Since many challenges are faced by ethics committees, plans should be developed and implemented to fulfill the following purposes: (i) strengthen the position of these committees in hospitals, (ii) continuous supervision over the formation and holding of the committees, (iii) their operation process, (iv) their decision-making process, and (v) process of sharing committees’ decisions with all hospital stakeholders and staff.


BMJ Open ◽  
2022 ◽  
Vol 12 (1) ◽  
pp. e057618
Author(s):  
Daniel O’Keefe ◽  
J Gunn ◽  
Kathleen Ryan ◽  
Filip Djordjevic ◽  
Phoebe Kerr ◽  
...  

IntroductionThe advent of direct acting antiviral therapy for hepatitis C virus (HCV) means the elimination of HCV is possible but requires sustained effort to achieve. Between 2016 and 2019, 44% of those living with HCV were treated in Australia. However, treatment uptake has declined significantly. In Australia, people who inject drugs (PWID) are the population most at risk of HCV acquisition. Eliminating HCV in Australia will require nuanced understanding of the barriers to HCV treatment experienced by PWID and tailored interventions to address these barriers. The EC-Experience Cohort study aims to explore the barriers and enablers reported by PWID to engagement in HCV care.Methods and analysisThe EC-Experience Cohort study is a prospective cohort of PWID, established in Melbourne, Australia in 2018. Participants are assigned into three study groups: (1) those not currently engaged in HCV testing; (2) those diagnosed with HCV but not currently engaged in treatment and (3) those completed treatment. Participants complete a total of four interviews every 6 months across an 18-month study period. Predictors of experience of key outcome events along the HCV care cascade will be explored over time.Ethics and disseminationEthical approval for the EC-Experience Cohort study was obtained by the Alfred Hospital Ethics Committee in Melbourne, Australia (Project Number: HREC/16/Alfred/164). All eligible participants are assessed for capacity to consent and partake in a thorough informed consent process. Results from the EC-Experience Cohort study will be disseminated via national and international scientific and public health conferences and peer-reviewed journal publications. Data from the EC-Experience Cohort study will improve the current understanding of the barriers to HCV care for PWID and guide the tailoring of service provision for specific subgroups. Understanding the barriers and how to increase engagement in care of PWID is critical to achieve HCV elimination goals.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Justiina Huhtakangas ◽  
Jussi Numminen ◽  
Johanna Pekkola ◽  
Mika Niemelä ◽  
Miikka Korja

AbstractThe prevalence of unruptured intracranial aneurysms (UIAs) is around 2–3% in the general population. We hypothesized that the prevalence of small UIAs is higher among 50 to 60-year-old female smokers, since the incidence of aneurysmal subarachnoid hemorrhage (aSAH) is exceptionally high in 60 to 70-year-old female smokers. Ethics approval for this pilot study of 50 women was obtained from the hospital ethics committee. In order to minimize recruitment bias, preliminary invitation letters were sent to 50 to 60-year-old women who were known to be active smokers. Those interested in participating were further informed about the study rationale and protocol. Following written consent, participants filled a detailed questionnaire and underwent computed tomography angiography (CTA) analysis. All abnormalities were recorded. Of the 158 preliminary invitation letters, 70 potential participants initially replied. Of these, 50 returned questionnaires and written consents, 43 of which underwent CTA analysis. Most (39; 91%) were postmenopausal, and 9 (21%) were hypertensive. Two reported a family history (≥ 1 first-degree members) of intracranial aneurysms. UIAs (maximum sizes of 2, 2, 3, 3 and 7 mm) were found in five (12%) female smokers. One woman was operated on, and the remaining four were treated with non-invasive preventive actions (smoking cessation and follow-ups). Small UIAs, which may be best suited for non-invasive preventive actions, may be relatively common in 50 to 60-year-old female smokers. Whether this kind of targeted screening leads to improved health in female smokers requires further investigation.


BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e055770
Author(s):  
Zhaohui Ni ◽  
Haijiao Jin ◽  
Renhua Lu ◽  
Li Zuo ◽  
Weimin Yu ◽  
...  

IntroductionHyperkalaemia (HK) is a potentially life-threatening electrolyte imbalance associated with several adverse clinical outcomes and is common in patients with kidney failure. However, there is no evidence on the occurrence, recurrence and treatment of HK in patients on haemodialysis (HD) in China.Methods and analysisThe HK Prevalence, Recurrence, and Treatment in Haemodialysis Study is a prospective, multicentre, observational, cohort study being conducted across 15–18 sites in China. Approximately 600 patients with end-stage kidney disease on HD are anticipated to be enrolled and will be followed up for 24 weeks. Patients will be in the long interdialytic interval (LIDI) at enrolment and will receive follow-up care every 4 weeks in LIDI for pre-dialysis and post-dialysis (at enrolment only) serum potassium measurements. To obtain pre-dialysis serum potassium levels in the short interdialytic interval (SIDI), a follow-up visit will be performed in the SIDI during the first week. Information on concomitant medications, blood gas analysis and biochemistry measurements will be obtained at enrolment and at each follow-up visit. The primary endpoint will be the proportion of patients experiencing HK (defined as serum potassium level >5.0 mmol/L) at the study enrolment or during the 24-week follow-up. The key secondary endpoint will be the proportion of patients experiencing HK recurrence (defined as any HK event after the first HK event) within 1–6 months (if applicable) during the 24-week follow-up, including enrolment assessment.Ethics and disseminationThis study has been approved by Shanghai Jiaotong University School of Medicine, Renji Hospital Ethics Committee (2020-040). Other participating subcentres must also obtain ethics committee approval prior to the start of the study. The Good Clinical Practice regulations shall be strictly followed during the test implementation. Amendments to the protocol will be reviewed by the ethics committees. Written informed consent will be obtained from all participants before collection of any patient data and patient information. The findings of this study will be disseminated through peer-reviewed publications and conference presentations.Trial registration numberClinicalTrials.gov Registry (NCT04799067).


Author(s):  
Patrycja Zurzycka ◽  
Grażyna Puto ◽  
Katarzyna Czyżowicz ◽  
Iwona Repka

AbstractThe role of Hospital Ethics Committees (HECs) is to support patients and their relatives as well as medical staff in solving ethical issues that arise in relation to the implementation of medical care. In Poland there are no clearly formulated legal regulations concerning the establishment and functioning of hospital ethics committees. Hospitals applying for accreditation are obliged to present solutions defining the way of solving ethical issues in a given institution, some of them appoint HECs for this purpose. The aim of this study was to analyze information concerning the functioning of hospital ethics committees in Poland on the basis of publicly available data published on the websites of accredited hospitals. Very few accredited hospitals (56) make public information about functioning in their ethics consulting facilities through hospital ethics committees. In most cases, the information provided on the functioning of HECs is general, both in terms of the committees’ functioning, type of cases under consideration and the composition of personnel.


2021 ◽  
Author(s):  
Wei Hu ◽  
Baoyi Ke ◽  
Niansu Xiao ◽  
Sen Li ◽  
Cheng Li ◽  
...  

Abstract Objectives. We retrospectively investigated the clinical materials to seek the factors that lead to relapse after using the Ponseti method.Methods. We retrospectively reviewed all children with congenital club foot treated with the Ponseti method in our hospital from June 2008 to June 2013. The data included the following factors: age, gender, initial Pinari score, number of casts, number of feet (unilateral or bilateral), age at the first casting, age of mother, tenotomy, walking age, and compliance with using bracing. All investigations were conducted in conformity with ethical standards. This study was approved by Guilin Peoples’ Hospital Ethics Committee.Results. In this study, there were 148 cases with 164 feet in total that underwent the Ponseti method. Of them, 64 children presented with left side, 58 with right side, and 26 with bilateral cases. This study included 75 males and 73 females; sex did not affect the outcomes. The mean age of the first casting was 2.50±2.15 months. The average initial Pirani score was 4.98±1.33, 2 and the average number of casts was 5.71±2.28 times. The mean age of mothers at birth was 25.81±2.38 years old. The walking age of children was at a mean of 14.83±1.18 months. Forty-nine cases could not tolerate using braces, namely the rate of noncompliance in this study was 33.1%. Tenotomy was performed on 113 feet (76.4%). The average follow–up period was 7.27±1.29 years (from 5 to 10 years). The rate of relapse was 21.6% (32 cases) at the end of the follow-up. The rate of relapse in the noncompliance with using bracing group was significantly higher compared to the compliance group.Conclusion. The initial Pirani score, compliance with the foot abduction brace and the age at the first casting are three independent factors for relapse in clubfoot.


2021 ◽  
Author(s):  
Justiina Huhtakangas ◽  
Jussi Numminen ◽  
Johanna Pekkola ◽  
Mika Niemelä ◽  
Miikka Korja

Abstract Background: The prevalence of unruptured intracranial aneurysms (UIAs) is around 2 to 3% in the general population. We hypothesized that the prevalence of small UIAs is higher among 50 to 60-year-old female smokers, since the incidence of aneurysmal subarachnoid hemorrhage (aSAH) is exceptionally high in 60 to 70-year-old female smokers. Methods: Ethics approval for this pilot study of 50 women was obtained from the hospital ethics committee. In order to minimize recruitment bias, preliminary invitation letters were sent to 50 to 60-year-old women who were known to be active smokers. Those interested in participating were further informed about the study rationale and protocol. Following written consent, participants filled a detailed questionnaire and underwent computed tomography angiography (CTA) analysis. All abnormalities were recorded. Results: Of the 158 preliminary invitation letters, 70 potential participants initially replied. Of these, 50 returned questionnaires and written consents, 43 of which underwent CTA analysis. Most (39; 91%) were postmenopausal, and 9 (21%) were hypertensive. Two reported a family history (≥ 1 first-degree members) of intracranial aneurysms. UIAs (maximum sizes of 2, 2, 3, 3 and 7 mm) were found in five (12%) female smokers. One woman was operated on, and the remaining four were treated with non-invasive preventive actions (smoking cessation and follow-ups). Conclusion: Small UIAs, which may be best suited for non-invasive preventive actions, may be relatively common in 50 to 60-year-old female smokers. Whether this kind of targeted screening leads to improved health in female smokers requires further investigation.


HEC Forum ◽  
2021 ◽  
Author(s):  
Michall Ferencz-Kaddari ◽  
Abira Reizer ◽  
Meni Koslowsky ◽  
Ora Nakash ◽  
Shai Konas

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12595-e12595
Author(s):  
Iandra Freire Oliveira ◽  
Jhonata Lima Rocha ◽  
Anamaria Falcão Pereira ◽  
Marina Helena Silva Lopes ◽  
Aurilene Gomes Cajado ◽  
...  

e12595 Background: Breast cancer is one of the most frequent neoplasms worldwide, contributing to women's morbimortality. Triple-negative breast cancer (TNBC) is a highly aggressive subtype of cancer marked by negative estrogen receptors, progesterone receptors, and lack of the human epidermal growth factor 2 (C-erbB2, HER2/neu) gene overexpression. The high mobility group box-1 (HMGB1) is a factor that regulates malignant tumorigenesis, proliferation, and metastasis. Aim: Here, the HMGB1 expression was investigated as a prognostic factor for TNBC. Methods: Clinico-pathological data and surgical paraffin histopathology blocks were assessed from 85 patients treated at Haroldo Juaçaba Hospital (Ethics committee approval number 407.395). Samples were analyzed by immunofluorescence using the Tissue Microarray technique to determine the percentage of fluorescent cells with cytoplasmic HMGB1 (cHMGB1) expression. Results: The clinico-pathological data analysis indicated that patients were older than 50 years (68.2%) and diagnosed with grade 2–3 ductal carcinomas (91.8%). Tumor metastasis was observed in 9.9% of cases. TNBC patients that tumor cells presented high cHMGB1 fluorescence demonstrated increased local tumor recurrence compared with low expressing tumors (P=0.019). Five-year overall survival was simmilar between the patients with low (63%) versus high (66%) cHMGB1 expression (P=0.7441). Additionally, the risk of death was 0.8 (95% CI = 0.21–2.96). Conclusions: The cHMGB1 expression is associated with an increased tumor relapse in TNBC, not affecting patients' survival.


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