Ethics - A matter of principle?

Discussion of bioethical issues using the four principles approach proposed by Beauchamp and Childress is now standard practice in the UK. This paper first documents the history of principlism before considering its impact and reviewing some criticisms of the approach. A future paper will examine some of the philosophical difficulties arising from principlism in greater depth.

Ethics - A matter of principle?Part 2: Rationality, ends, and the levels of moral discourse.

Discussion of bioethical issues using four principles approach proposed by Beauchamp and Childress is now standard practice in the UK. An earlier paper documented the history of principlism before considering its impact and reviewing some criticisms of the approach. This paper will examine some of the philosophical difficulties in greater depth.

Guest Editorial - Moral injury in acute medicine.

Recently I had to have a few minutes in my office to regroup after I'd seen a patient. I didn't quite know how to process my feelings. I was feeling ashamed and upset.

Personalised music as a treatment for epilepsy.

In this paper we look at non-pharmaceutical treatments for intractable epilepsy based on neurophysiological methods especially with EEG analysis. In summary, there are a number of limbic and thalamo-cortical related structures involved in the processing of musical emotion (exposure), including the amygdala (arousal, expression of mood, fear), hippocampus (memory, regulation of HPA axis, stress), parahippocampal gyrus (recognition, memory retrieval), insula (valence), temporal poles (connectivity), ventral striatum (expectation and experience of reward), orbitofrontal cortex (valence) and cingulate cortex (autonomic regulation). One method is to audify (a form of sonification) EEG activity to find music by feedback to entrain abnormal EEG activity.

Sugar-Sweetened Beverages, Foods of Low Nutritional Value, and Child Undernutrition in Cambodia.

Child undernutrition persists in Cambodia despite recent progress. As Cambodia undergoes a shift in dietary consumption that coincides with economic, demographic, and epidemiologic changes, there is risk of ultra-processed foods and sugar-sweetened beverages displacing nutrient-dense foods during the critical period of infant growth in the first 24 months. The aim of this study was to assess the introduction and intake of foods of low nutritional value and sugar-sweetened beverages and their association with undernutrition among children 24 months of age in rural and semi-urban Cambodia.

Assessment of undergraduate medical students' understanding and application of ethics: must do better.

Current methods used to assess newly qualified doctors have limited ability to assess reasoning about complex issues. This editorial looks at the points this raises in relation to the new medical licensing assessment.

The medical licensing assessment will fall short of determining whether a UK medical graduate behaves ethically.

UK medical graduates will soon need to pass the medical licensing assessment, which assesses skills and knowledge in ethics using multiple choice questions (eg single best answer questions) and objective structured clinical examination. However, educational leaders have recognised that these methods lack the sophistication needed to accurately assess medical ethics. The reasons are two-fold.

Society for Acute Medicine undergraduate syllabus for Acute Internal Medicine.

This syllabus is intended to act as a guide for students and their instructors in medical schools. It describes the range of clinical presentations that they should be able to recognize and the underlying conditions that they should know how to treat. It also includes knowledge of the practice of Acute Internal Medicine and systems of care.

A Rare Case of Splenic Infarct Secondary to Mobile Cardiac Echodensity.

Lambl's excrescences (LE) are mobile filiform lesions, mostly found on the left-sided heart valves. Histologically, they have a mesenchymal origin with a single endothelial layer. They have the potential to detach, resulting in catastrophic thromboembolic events.

Clinical decision making in acute medicine.

Clinical decision-making is a core skill for the practice of medicine and yet during training there is often little formal analysis of the process of clinical reasoning or instruction about how to do it better. This paper reviews the process of clinical decision-making with a particular focus on diagnostic reasoning. Aspects of psychology and philosophy are applied to the process along with consideration of potential sources of error and the steps that can be taken to minimize this.

The Potential Effects of Implementing an Antibiotic Stewardship Program by Integrating It with Medication Therapy Service in a Low-Income Serving Clinic - A Single-Center Experience.

Bacterial antimicrobial resistance (AMR) is a leading cause of mortality worldwide. Although AMR is common in low-income communities, there is limited evidence of the effect of antibiotic stewardship programs in low-income communities in the United States. Our goal is to assess the effects of implementing pharmacist-led ASP by integrating it with medication therapy management service (MTM) in a low-income serving clinic.

Cross-Sectional Analysis of Oral Healthcare vs. General Healthcare Utilization in Five Low- and Middle-Income Countries.

Oral health is integral to overall health and is often neglected, especially in low- and middle-income countries (LMICs). Oral disease, including untreated dental caries, affects nearly 3.5 billion people globally, contributing to poor health and quality of life.

Adolescents' and Young Adults' Recommendations for Implementing Healthcare Transition in Rheumatology: A Mixed Methods Study.

Objective: The goal was to elicit adolescents' and young adults' (AYAs) perspectives about how to implement the Six Core Elements of Healthcare Transition within rheumatology care.

Methods: AYAs (ages 16-28 years old) with self-reported rheumatic conditions were recruited through patient organizations and social media. In Phase One (qualitative [QUAL]), 90-minute focus groups were facilitated to elicit AYAs' reactions to Six Core Elements content.

Antibiofilm and immunomodulatory resorbable nanofibrous filing for dental pulp regenerative procedures.

Multifunctional scaffolds with host defense peptides designed for regenerative endodontics are desirable nanobiotechnological tools for dentistry. Here, different scaffolds were tested for use during the pulp revascularization process, including poly(vinyl alcohol)-PVA hydrogels or resins, collagen hydrogels and poly(vinyl alcohol) PVA/Chitosan (PVA/CS) nanofibers. Based on time to degradation (21 days), nanofibers were chosen to be incorporated with ciprofloxacin and IDR-1002 (each at 50 mg/g).

Catalytic and structural factors behind advancements of co-management in protected areas: Contributions for its evaluation.

Over the past few decades, the literature has pointed out pathways to success in co-management processes based on key conditions. Rather than offering prescriptive conclusions for successful co-management in protected areas, in this article, we highlight the importance of the "process" and certain elements that contribute to advancements of formal and informal co-management. We analyzed the trajectory of two protected areas for sustainable use in coastal Brazil - Extractive Reserves of Prainha do Canto Verde and São João da Ponta.