33 hours ago · Case report: 8 years after liver transplantation: ... Tada T. Changes in patient backgrounds may increase the incidence of HCC after SVR in the era of IFN-free therapy for HCV. Hepatology. 2016; 64:1818–1819. doi: 10.1002/hep.28632. [Google Scholar] 35. Ravi S, Axley P, Jones D, Kodali S, Simpson H, McGuire BM, et al. Unusually high rates of ... >> Go To The Portal
The ANA Code of Ethics provides a standard by which nurse managers can assess ethical issues in nursing. However, the way it addresses ethical dilemmas can vary in different situations. One ethical dilemma that can occur in healthcare facilities is when nurses themselves are not properly equipped to complete their duties.
Even though nursing is a fast-paced job with new challenges daily, many nurse managers report facing similar ethical dilemmas. A recent study found that the most frequently occurring and stressful ethical situations are protecting patients’ rights, staffing, advanced care planning and decision-making.
The Duquesne University School of Nursing’s MSN program integrates ethical problem-solving and decision-making to help MSN graduates explore and address ethical issues.
Introduction In 2016, an international working group proposed a revised definition and new diagnostic criteria for the acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF). Based on these criteria, AE-IPF was diagnosed regardless of the presence or absence of a known trigger and categorised as triggered (T-AE) or idiopathic (I-AE) AE-IPF.
Clinical characteristics of acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) based on the new American Thoracic Society 2016 criteria, and clinical differences between triggered AE (T-AE) and idiopathic AE (I-AE) are unresolved.
Idiopathic pulmonary fibrosis (IPF) is the most common form of idiopathic interstitial lung disease. IPF usually progresses gradually, with a median survival of 2–4 years; 1 2 however, some patients with IPF experience a rapid progression of respiratory failure that has been termed an acute exacerbation of IPF (AE-IPF).
We retrospectively analysed consecutive patients with AE-IPF admitted to our hospital from January 2008 to December 2017.
All statistical analyses were performed using JMP software package V.13 (SAS, Cary, North Carolina, USA). Continuous variables were compared using unpaired t-test and Mann–Whitney U test. Categorical variables were compared using χ² and Fisher’s exact tests.
We identified 321 cases with IPF admitted to our hospital during the study period. Of these 321 IPF admissions, 64 cases (57 unique patients) represented AE-IPF.
Some patients with IPF experience AE-IPF, which has a poor prognosis, a median survival of 3–4 months 4 5 and is a main cause of death. 6–8 Definite and suspected AE both show similar outcomes 4 so that revised AE-IPF diagnostic criteria have been proposed regardless of the presence or absence of a trigger.
Improving the quality of healthcare involves collaboration between many different stakeholders. Collaborative learning theory suggests that teaching different professional groups alongside each other may enable them to develop skills in how to collaborate effectively, but there is little literature on how this works in practice.
Healthcare professionals have an obligation not to work in uniprofessional groups in order to provide the best patient care (Brandt, Lutfiyya, King, & Chioreso, 2014 Brandt, B., Lutfiyya, M. N., King, J. A., & Chioreso, C. ( 2014 ). A scoping review of interprofessional collaborative practice and education using the lens of the Triple Aim.
We conducted an exploratory study with the first six cohorts of the Fellowship programme.
Three inter-related themes helped inform our understanding of how a collaborative learning approach may support interprofessional education for quality improvement.
The findings from this study illustrates the benefits and challenges of collaborative learning in an interprofessional education programme (Anderson et al., 2017 Anderson, E., Gray, R., & Price, K. ( 2017 ). Patient safety and interprofessional education: A report of key issues from two interprofessional workshops.
The authors would like to acknowledge all the individuals who have completed the CLAHRC NWL Improvement Leader Fellowship programme for their enthusiastic participation and help in improving the programme and contributing to this research.
The authors report no conflicts of interest. The authors alone are responsible for the writing and content of this article. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the NIHR, or the Department of Health.
A 55-year-old man being treated with fluorouracil, leucovorin, irinotecan, and oxaliplatin (FOLFIRINOX) for metastatic pancreatic cancer presents to your clinic with a plethora of symptoms, including nausea and vomiting, pain, insomnia from steroids, and constipation from opioids.
Cannabis (marijuana) use is becoming more prevalent in patients with cancer [ 1 ••]. However, only 30% of oncologists feel that they have sufficient training to make informed recommendations about cannabis [ 2 ••] and 85% want more education about it [ 3 ].
At the federal level, cannabis (including all derivatives of the plant that come from the flowering tops, resin, and leaves) remains classified as a Schedule I substance under the Controlled Substances Act.
While cannabis has been used by humans for centuries, research into its palliative effects specifically for cancer patients started in the 1970s [ 4, 46 ]. Early researchers investigated its analgesic potential, finding that it could manage pain without significant side effects when administered at low doses [ 47, 48 ].
As with most medications, cannabis is not risk-free. However, adverse events recorded in the cancer population in studies were relatively mild and dose-dependent. In the nabiximols studies, the most common adverse events were dizziness, dry mouth, nausea/vomiting, somnolence, and confusion [ 55 ].
The patient was certified by his treating oncologist in his state’s medical cannabis program. He began a regimen using 10 mg of THC-dominant oral capsules each night, which helped his insomnia. He found benefits for pain and nausea using a 5mg THC/5mg CBD balanced solution four times a day as needed.
The authors thank Justin Eklund, Aminah Jatoi, and Mary Van Beusekom for their critical review of this manuscript.