Journal of evaluation in clinical practice
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The Joint Commission emphasizes the importance of cultural competence and effective communication in quality medical care, particularly during end-of-life (EOL), when decisions are influenced by diverse cultural and religious backgrounds. For Orthodox Jewish patients, the philosophical framework used for EOL decision-making may conflict with that used in traditional Western medical ethics. In this paper, we explore the complexities of EOL decision-making for devout Jewish patients and highlight how approaches may differ from a Western ethical framework. ⋯ This case illustrates the ethical tensions that may arise when Western medical practices intersect with Orthodox Jewish beliefs, particularly regarding brain death, resuscitation, and artificial nutrition. We underscore the need for cultural sensitivity when approaching EOL decision-making, allowing for compassionate and comprehensive care that respects religious perspectives. This paper helps provide a structure for clinicians to navigate the complex EOL care needs for the devout Jewish patient in a manner consistent with their cultural and religious identity.
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To investigate the relationship between medical narrative ability and humanistic care ability among Chinese clinical nurses, examining the potential mediating role of empathy. ⋯ This study involves clinical nurses as participants and does not involve patients. This study collected data from clinical nurses using an online questionnaire platform in China. The questionnaire consisted of four sections, including demographic information and scales such as Narrative Competence Scale, Caring Ability Inventory and the Jefferson Scale of Empathy-Health Professional. Clear instructions were given to participants on how to complete each scale, and measures were taken to prevent missing or duplicate responses.
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This research aims to develop an effective algorithm for diagnosing COVID-19 in chest X-rays using the transfer learning method and support vector machines. ⋯ This study confirms the importance of applying machine learning methods in medical applications and opens new perspectives for early diagnosis of infectious diseases. The practical application of the obtained results can enhance the efficiency of diagnosis and control the spread of COVID-19, as well as contribute to the development of innovative methods in medical practice.
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Observational Study
Effect of a Contamination Prevention Activity Against Contamination of Blood Culture.
Blood culture is important in the diagnosis of blood infections and the identification of treatment strategies. Increased contamination in blood culture is a reduction in quality of care. This retrospective observational study, set in an emergency department in Japan, aims to elucidate the contamination rate before and after the introduction of contamination prevention activities. ⋯ Prevention activities including specific use of a blood culture cart and careful adherence to a checklist were not associated with a significant decrease in contamination rate in our hospital. Further studies based in hospitals with greater rates of contamination may see higher rates of reduction.
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Individuals experiencing homelessness (IEH) tend to have increased length of stay (LOS) in acute care settings, which negatively impacts health care costs and resource utilisation. It is unclear however, what specific factors account for this increased LOS. This study attempts to define which diagnoses most impact LOS for IEH and if there are differences based on their demographics. ⋯ Homelessness significantly increases the LOS of individuals within both ED and inpatient settings. We have identified several diagnoses that are associated with increased LOS in IE; these should inform the prioritisation and development of targeted interventions to improve the health of IEH.