Medicine and Health Sciences Commons^™

Controversy In Consciousness: Is The Brainstem Sufficient For Sentience?, Shadia Kawkabani, Kevin P. Kaut

Journal of Neuropsychology and Behavioral Processes

Our understanding of consciousness is quite possibly in need of further discussion, elaboration, and updating. What was once principally the domain of philosophical inquiry has entered the era of advanced research methods and biomedical ethics – both of which have influenced the need to reconsider this most challenging of topics. The challenge for those interested in consciousness is at least twofold: 1) to further operationally define what is meant by consciousness, with a greater understanding of how consciousness can be manifest, and 2) to better identify the neural mechanisms subserving the diverse presentations/manifestations of consciousness, and reconcile the developing literatures …

Warning Crowdsourced Study Participants About Possible Consequences For Inattentive Participation Relates To Informed Consent, Regardless Of Effects On Data Quality, Jon Agley, Casey Mumaw

Health Behavior Research

Brühlmann and colleagues recently examined the effects of “warning statements” on insufficient effort responding (IER) in crowdsourced research, specifically Amazon’s Mechanical Turk (MTurk). Among other findings, it showed that passively reading a warning statement did not significantly reduce careless responding relative to a control condition. This brief essay discusses the context around IER on crowdsourced data collection platforms, finding Brühlmann’s contribution valuable. It then points out how crowdsourced studies by U.S. researchers using mechanisms like attention checks to control for IER plausibly should include warning statements regardless of their effect on IER due to federal research regulations around payment transparency.

Using Gerontechnology For Care Transition Conversations In Senior Living, Roschelle L. Fritz, Catherine Van Son, Chris Veloicaza, Stephanie Soriano, Gabrielle Barling

ICHRIE Research Reports

Every day across the United States, thousands of senior living organizations assist with housing transition decisions for older adults experiencing health-related changes. These decisions impact resources for older adults and senior housing corporations, yet these decisions are based primarily on subjective observational data regarding older adults’ changes in function or cognition. Smart homes offering continuous, unobtrusive health monitoring with artificial intelligence capabilities are emerging as solutions offering health maintenance support and objective functional and health information. Such systems are well-positioned to support hospitality staff conversing with residents about transitioning from independent to assisted living. Our interdisciplinary nursing research and hospitality …

The New Professional: Navigating The Journey: Finding Your Practice Philosophy As A New Dentist, Amrita Patel Dds

The Journal of the Michigan Dental Association

Dr. Amrita Patel highlights the importance of defining a practice philosophy as a new dentist. Self-reflection, mentorship, patient-centered care, continuous learning, and adaptability are crucial elements in this journey. Embracing personal values and ethics ensures authenticity and guides decision-making. The evolving nature of this philosophy underscores the need for flexibility and openness to change. Dentists can shape their professional identity and approach to patient care through introspection and experiential learning.

Nonfinancial Conflict Of Interest In Medical Research: Is Regulation The Right Answer, Nehad Mikhael

Journal of Law and Health

Medical research plays a vital role in advancing human knowledge, developing new therapies and procedures, and reducing human suffering. Following the atrocities committed in the name of medical research by German physicians during the Nazi era, the Nuremberg trials were held, and an ethical code was created to establish the limits within which medical research can operate. Consequently, legal regimes built upon this ethical foundation to develop laws that ensure the integrity of medical research and the safety of human subjects. These laws sought to protect human subjects by minimizing conflicts of interest that may arise during the process. Furthermore, …

Patient Perspectives On The Use Of Artificial Intelligence In Health Care: A Scoping Review, Sally Moy, Mona Irannejad, Stephanie Jeanneret Manning, Mehrdad Farahani, Yomna Ahmed, Ellis Gao, Radhika Prabhune, Suzan Lorenz, Raza Mirza, Christopher Klinger

Journal of Patient-Centered Research and Reviews

Purpose

Artificial intelligence (AI) technology is being rapidly adopted into many different branches of medicine. Although research has started to highlight the impact of AI on health care, the focus on patient perspectives of AI is scarce. This scoping review aimed to explore the literature on adult patients’ perspectives on the use of an array of AI technologies in the health care setting for design and deployment.

Methods

This scoping review followed Arksey and O'Malley’s framework and Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews (PRISMA-ScR). To evaluate patient perspectives, we conducted a comprehensive literature search using …

Balancing The Medical, Psychiatric, And Ethical Considerations In The Inpatient Treatment Of Extreme Anorexia Nervosa: A Case Report, Carter A. Schulz, Carolyn A. Kennedy

Aesculapius Journal (Health Sciences & Medicine)

Introduction: Anorexia nervosa (AN) is a psychiatric illness characterized by restricted energy intake, intense fear of gaining weight, and a disturbance in body image. A 2011 meta-analysis estimated the mortality rate for anorexia nervosa to be over 5 times that of the general population, with one-fifth of deaths in AN patients being due to suicide. Treating this disease is notoriously difficult, and treatment is complicated by these patients’ characteristically poor insight.

Case summary: Here we present the case of a 37 year old woman who visited the ED with complaints of nausea and weakness; she was admitted due to hypoglycemia, …

Social Functioning And Associated Social Skills In Patients With Depressive Disorder In Psychiatric Outpatients, King Chulalongkorn Memorial Hospital, Peeraphon Lueboonthavatchai

Chulalongkorn Medical Journal

Background: Previous study have shown that 68.0% of patients with depressive disorder had social functioning impairment. The impaired social skills of these patients also affected the patients’ daily lives. However, there were limited studies concerning on social functioning, social skills and associated factors of patients with depressive disorder.

Objectives: This study aimed to investigate social functioning, social skills, and associated factors of patients with depressive disorder.

Methods: We recruited 150 patients from June to December 2019, aged above 18 years old, assessed: 1) Demographic data form; 2) Beck Depression Inventory-II (BDI-II) - Thai Version; 3) Social Skills Inventory; 4) Interpersonal …

Predictive Factors Of Success In The First Radioactive Iodine Treatment For Graves’ Disease, Pinyaporn On-Ekkasit

Chulalongkorn Medical Journal

Background: Initial treatment options for Graves’ disease are radioactive iodine (RAI) treatment, antithyroid drugs (ATDs), and surgery. RAI is effective and the definitive treatment for Graves’ disease.

Objective: To evaluate factors associated with success in the first RAI treatment for Graves’ disease.

Methods: A total of 89 patients who received the first RAI treatment for Graves’ disease between September 2016 and January 2021 were retrospectively reviewed. Thyroid function outcome was evaluated within one year after RAI treatment. Logistic regression analysis was performed to identify factors associated with success after RAI treatment.

Results: The success rate of the first RAI treatment …

The Effectiveness Of A Multimodal Preoperative Anxiety Intervention On Postanesthetic Emergence Delirium In Preschoolers, Thitima Veeraburus

Chulalongkorn Medical Journal

Background: Preoperative anxiety has been reported as one of the major contributors to emergence delirium (ED) in preschoolers.

Objective: This study investigated the effectiveness of multimodal preoperative anxiety intervention (MPreop-AI) in reducing the incidence and severity of ED in preschoolers.

Methods: A prospective study, posttest only nonequivalent groups design, was conducted in 44 children aged 2 - 6 years scheduled for tonsillectomy and/or adenoidectomy under sevoflurane anesthesia. They were equally allocated into two groups. The usual preoperative preparation group (control group) received narrative preoperative education, parental presence, and self-selected toy. The MPreop-AI group received 2-Dimensional (2D) animation modeling-based information, an …

Panorama Of Human Embryo-Derived Cells In Biomedicine And Progress In Their Research And Regulation, Jianchao Gao, Yaojin Peng, Wei Wei, Shuang Lu, Chenyan Gao

Bulletin of Chinese Academy of Sciences (Chinese Version)

Since the establishment of the first human diploid cell line derived from aborted fetal tissue in the 1960s, human embryoderived cells have been widely used in biomedical field and significantly contributes to improving human health. In recent years, human pluripotent stem cells, including human embryonic stem cells (hESCs), have shown great therapeutic potential in regenerative medicine, and thus received great attention from governments and the public. However, due to various factors such as history, culture, religious beliefs, ethics and morality, research and application involving human embryo-derived cells have been controversial worldwide. This study explores the history and progress of human …

How To Respond To Racist Patients: Recommendations From A Literature Review, Benjamin Caplan Ba (4th Year Medical Student), Jocelyn Mitchell-Williams Md, Phd

Cooper Rowan Medical Journal

Introduction: Dealing with racist patients is not uncommon, and these interactions can sever the therapeutic alliance, as well as leave providers feeling isolated, dehumanized, and ashamed. Investigation of published recommendations for handling these situations can give victims, peers, and institutions the tools necessary to prepare, protect, and support providers through these challenging encounters.

Methods: This paper is a literature review. For inclusion in this review, studies must have met the criteria of providing recommendations for healthcare providers or institutions on how to deal with racist patients. Excluded articles did not include recommendations on how to handle such situations or did …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Intentional Parenthood, Contingent Fetal Personhood, And The Right To Reproductive Self-Determination, Laura Hermer

University of Michigan Journal of Law Reform

This Article argues that intent should govern legal parenthood, regardless of the method of conception, the person’s biological or genetic relationship to the resulting embryo/fetus, or the person’s gender. This proposition is not new. This Article adds to scholarly discourse by extending the concept: Intent should not just determine parenthood, but also fetal rights. When a pregnant person establishes their procreational intent (or lack thereof) prior to birth, then both the existence (or lack thereof) of legal protections for the embryo/fetus and the gestator’s rights and duties (or lack thereof) should flow from this intent. Non-gestating gamete contributors would do …

To Till And To Keep: Following The Ethical Imperative To Care For Creation Through Gender Exploration And Expression, Phoebe Carstens

Obsculta

In light of the recent USCCB document regarding 'the Moral Limits to Technological Manipulation of the Human Body,' this essay explores an alternative, transgender-affirming ethical framework drawn from Pope Francis's Laudato si’. Within this framework, gender-affirming care is presented as fulfilling the call to care for creation through exploration and cultivation of the self.

Bioethics And A Theology Of Vulnerability, Carrie Oneil-Smith

Obsculta

This essay looks at how a theology of vulnerability can contribute to ethical decision-making in an increasingly secular society. Relationality, power dynamics and scriptural justifications are considered, as well as early contributions made to this nascent field of Christian thought. This essay was written for a class on Health Care Ethics taught by Dr. Mary Ann Kish.

On The Discontinuation Of Enteral Feeding In Head And Neck Cancer: A Case Report, Kyle Fisk, Ana Sanchez

HCA Healthcare Journal of Medicine

Introduction

The goal of palliative care is to preserve the quality of life or patient “comfort” in patients with serious diseases. Palliative care providers serve a wide range of patients: from those who seek curative treatment to those who are actively dying. Given this range, palliative care must mirror the dynamic goals of the patient at different stages of life and treatment. Throughout these stages, a goal of the palliative care provider would be to avoid hastening death; however, this often leads to clinical decisions that directly pit the patient’s comfort against the patient’s life span. This is most salient …

End Of Life In The Ed – Brain Death And Organ Transplantation, Madison Cohen, Donald Penney

The Journal of Integrated Primary Care

Every year thousands of Americans die awaiting an organ transplant. While our knowledge and experience with organ transplantation has only improved, organ availability continues to be a major issue due to a lack of suitable donor organs. A large population of organ donors are those who have been clinically diagnosed as brain dead. Brain death is defined as the irreversible loss of all brain and brainstem functions. Despite brainstem functions being lost, mechanical ventilation and perfusion techniques allow for proper organ maintenance. This gives brain-dead individuals a unique opportunity to serve as multiple organ donors. However, due to mistrust of …

Introduction: Conversations On Abortion Rights And Bodily Autonomy In The Eighteenth Century And Today, Vicki Barnett Woods, Manushag N. Powell

ABO: Interactive Journal for Women in the Arts, 1640-1830

This piece serves as an introduction to the discussions of bodily autonomy and reproductive rights, revised from roundtable presentations held at ASECS 2023. This collection of essays contributes to the resounding responses of frustration and anger toward the overturning of Roe v. Wade. The collection was written and presented by eighteenth-century scholars who have a comprehensive knowledge of the eighteenth-century legal, social, and medical histories that center around reproductive rights and bodily autonomy.

New Dentists’ Most-Asked Legal Questions, Dan Schulte Jd

The Journal of the Michigan Dental Association

This feature addresses new dentists' most frequently asked legal questions, offering concise answers to guide them. Topics include licensing requirements, dental record maintenance, accommodations for hearing-impaired and non-English proficient patients, the enforceability of covenants not to compete, the necessity of written employment agreements, responding to bad dental work, reporting suspected abuse, prescribing drugs to friends and family, contract terms with dental plans, and handling suspected employee theft. The article emphasizes the importance of understanding legal aspects to navigate a dental career successfully.

Promoting Mammography Screenings In African American Women: Media, Church, And Health Providers, Lasonya Little, Debra C. Wallace, K.Jay Poole

Journal of Health Disparities Research and Practice

Due to the underutilization of screening mammography, African American women (AAW) are more likely to experience negative health outcomes after receiving a late-stage breast cancer diagnosis than White Women (WW). The purpose of this article is to examine the roles of the media, health community and the African American church and pastor and their potential impact in AAW screening decisions. Fifteen AAW, ages 45 and older, were invited to participate in a semi-structured interview. Most women agreed the African American pastor and church as well as the health community, and media are an integral part of their lives. Therefore, specific …

The 14-Day Rule For In Vitro Human Embryo Research Requires Adjustment: From A Comprehensive Perspective Of Science, Ethics And Policy Research, Xiao Lu, Ming Zhao, Huihui Liu, Tianqing Li, Tao Tan, Weizhi Ji

Bulletin of Chinese Academy of Sciences (Chinese Version)

Since it was proposed, in vitro human embryo research had been following the 14-day rule, which limited in vitro research on human embryos within 14 days after fertilization. With the advancement in embryo culturing technology, this ethical rule has been greatly challenged. In 2021, the International Society for Stem Cell Research (ISSCR) recommended a conditional extension of the existing time limit in ISSCR Guidelines for Stem Cell Research and Clinical Translation, hence the international scientific community has restarted the debate on the 14-day rule. This study systematically analyzed the historical background and controversies of the 14-day rule ethical regulation of …

Athletics

DePaul Magazine

DePaul University women’s tennis player Yuliya Kizelbasheva participates in Be The Match, an organization that finds stem cell and marrow donors for people with life-threatening blood cancers. DePaul senior Noelle Malkamaki wins gold in the Paralympic shot put competition. DePaul Athletics reframes its mission.

Discordant Cardiopulmonary Resuscitation At An Academic Midwest Medical Center- Prevalence And Solutions, Jeremy Payne, Anne Skinner, David Gannon, Jenenne A. Geske

Graduate Medical Education Research Journal

Background: Code status orders are important features of patient-centered clinical decisions, patient autonomy, and end-of-life care. Despite proper documentation of “do not resuscitate” (DNR) code status, hospitalized patients may be subjected to cardiopulmonary resuscitation (CPR) efforts that go against their wishes.

Purpose: The objective of this study was to identify and describe the population of hospitalized patients receiving discordant resuscitation efforts at a Midwest academic medical center utilizing electronic health records (EHR).

Method: The study included EHR records between 01/01/2011 and 01/01/2021 for hospitalized patients 19 years and older who experienced cardiac arrest (ICD-10 I46) and were documented as DNR. …

A Pre-Medical Student’S Reconciliation Of Feminist Narratives Regarding Women’S Health: A Consideration Of Perspectives On Childbirth In The U.S., Laura Clayton

sprinkle: an undergraduate journal of feminist and queer studies

Many feminists argue that one major negative aspect of reproductive healthcare in the U.S. is the common over-medicalization of women during childbirth, including potentially unnecessary procedures such as cesarean-section and episiotomy. As a solution, they advocate for increased involvement of midwives in childbirth practices, as midwives allow women to give birth at home with minimal medical intervention. This paper analyzes the benefits of midwifery as well as the current increased risk associated with homebirth in the U.S. Additionally, it questions the damaging stigma associated with assumptions of cesarean-section as a suboptimal outcome. A false dichotomy has developed in our culture …

Poverty And Commercial Surrogacy In India: An Intersectional Analytical Approach, Sheela Suryanarayanan

Dignity: A Journal of Analysis of Exploitation and Violence

The destination and source countries for commercial surrogacy match world patterns of inequality. India, Nepal, Thailand, Mexico, and Cambodia banned commercial surrogacy, moving the market to other less-developed countries in South Africa and South America. India had a commercial surrogacy boom until exploitative factors led to the passage of the Surrogacy (Regulation) Bill in 2019, which banned the practice. This paper examines surrogacy's monetary, health, and emotional effects on 45 surrogate mothers in Gujarat State, India. The study revealed that a majority (63%) of the very poor women remained very poor post-surgery. Surrogate mothers in poor households had to do …

The Dilemma Of Socrates’ Position: Interview Methods And Feminist Empirical Bioethics, Michiel De Proost

The Qualitative Report

There is a growing body of bioethics research that addresses the importance of adapting empirical, predominantly qualitative, methods to generate debate on ethical arguments. However, there is an absence of illustrative work examining how this could be realised from a feminist perspective. This article, seeking to address the research gap, examines interview methods through a reflexive lens. Drawing on the doctoral research I conducted through interviews with women who were interested in social egg freezing (i.e., healthy women freezing their eggs in anticipation of future infertility), I describe how I encountered a dilemma because of my gendered positionality and the …

Does Using Sofa Score For Ventilator Triage Among Covid 19 Patients Result In Suboptimal Allocation Of Medical Ventilators For The Bipoc Population?, Alexandrea Mp Masocco, Elisabeth Michel, Ebbin Dotson

Journal of Health Disparities Research and Practice

Introduction: Since the COVID-19 pandemic in the United States, Black, and Latinx populations have been disproportionately affected by the COVID-19 pandemic. It can be inferred with high confidence that those most vulnerable are the least likely to receive essential care. Kidney transplant allocation and COVID-19 triage protocols share commonalities in that both protocols involve using multivariate scored criteria with objective and subjective inputs. As such, the similar conclusion in outcomes is concerning. It is worth questioning whether the racial inequalities demonstrated in the COVID-19 pandemic related to access to life-saving ventilators were associated with triage protocols.

Methodology: Using an exploratory …

State Oversight Of Polypharmacy And Psychotropic Medication Use Among Individuals With Intellectual And Developmental Disabilities: A Three State Case Study, James Houseworth, Kami L. Gallus, Tiffany Greene, Steven R. Erickson, Jennifer Lynn Jones, Laura Vegas

Developmental Disabilities Network Journal

Adults with intellectual and developmental disabilities (IDD) are prescribed more medications than the general population, placing them at significantly higher risk for issues due to taking multiple medications (polypharmacy). There are currently no clear national standards for the administration of medications given this risk. The following policy analysis explores state policies related to prescription medication oversight. This analysis pays particular attention to the use of medications that alter one’s mental state (psychotropics) among people with IDD who receive home and community-based services (HCBS) in the United States. The article outlines current efforts implemented to reduce medication-related risks for people with …