152 research outputs found
LEGAL REGULATION OF TELEMEDICINE SERVICES IN THE LATVIA HEALTHCARE SYSTEM
No full textTiesību zinātneTiesību zinātneLaw ScienceLaw ScienceMaģistra darba temats ir “Telemedicīnas pakalpojumu tiesiskais regulējums Latvijas veselības aprūpes sistēmā” un mērķis ir pētīt telemedicīnas pakalpojumu tiesisko regulējumu būtību, iespējamo anotāciju. Identificējot tiesiskā rakstura izaicinājumus, kādi ar telemedicīnas pakalpojumu sniegšanas problēmas un to risinājumu, ka arī sniegt ieteikumus, priekšlikumus telemedicīnas tiesiskā regulējuma pilnveidošanai Latvijā.
Sākoties globālai pandēmijai Covid-19, Latvijā epidemioloģiskā drošība noteica visu iespējamo cilvēka kontaktu mazināšanu visās iespējamās nozarēs, arī veselības aprūpē. Kam sekoja pakalpojuma ierobežojumi saskaņā ar Covid-19 infekcijas izplatības pārvaldības likumā noteiktajām. Visa šī procesa laikā nevarēja nenodrošināt tādus veselības pakalpojumus, kas varēja radīt pacientu veselības drošības apdraudējumu., kā arī bija jānodrošina uzsāktas ārstniecības terapijas lai nebūtu nepārtrauktības ārstēšanas procesā, ko skaidri definē Latvijas Republikas Satversmes 111. pantā noteiktas tiesības uz veselības garantēto aizsardzību no valsts puses un ikvienam garantēto medicīniskās palīdzības minimumu, Situācija lika rast jaunus medicīniskus tehnoloģiskus risinājumus, veselības aprūpes nepārtrauktības nodrošināšanai, piemēram, telemedicīna Darbs sastāv no četrām pamata nodaļām un tā kopējais apjoms ir 78 lappuses.
Darba gaitā autors konstatējis telemedicīnas tiesiskā regulējuma trūkums, rada iespējamos pacientu fizisku datu aizsardzības apdraudējumu, skaidri nedefinēts telemedicīnas pakalpojums sabiedrībā rada pacientiem neuzticību pakalpojumam. Un šāds tiesiskais regulējums ir ļoti nepieciešams. Autors ir noskaidrojis telemedicīnas attīstības gaitu, Jau esošo tiesību aktu analīzi, kā arī autors ir pētījis starptautisko pieredzi telemedicīnas tiesību aktos.The topic of the Master's thesis is "Legal Regulation of Telemedicine Services in the Latvian Health Care System" and the aim is to study the nature of legal regulation of telemedicine services, possible annotation. Identifying the legal challenges of telemedicine services provision and their solution, as well as to provide recommendations, proposals for improvement of the legal regulation of telemedicine in Latvia.
With the onset of the global pandemic Covid-19, epidemiological safety in Latvia determined the reduction of human contact in all possible sectors, including healthcare. This was followed by service restrictions in accordance with the law on the management of the spread of Covid-19. During all this process, it was impossible not to provide health services that could endanger the health security of patients, and it was necessary to ensure the initiation of medical therapy so that there is no continuity in the treatment process, which is clearly defined in Article 111 of the Constitution of the Republic of Latvia, the right to health protection guaranteed by the state and the guaranteed minimum of medical assistance to everyone, The situation made it necessary to find new medical technological solutions to ensure continuity in health care, such as telemedicine The work consists of four main chapters and has a total of 78 pages.
In the course of the work the author has identified the lack of legal framework for telemedicine, poses potential threats to the protection of patients' physical data, the lack of a clearly defined telemedicine service in society leads patients to distrust the service. And such a legal framework is very much needed. The author has studied the development of telemedicine, the analysis of existing legislation and the international experience in telemedicine legislatio
The patient's right to information
No full textTiesību zinātneTiesību zinātneLaw ScienceLaw ScienceBakalaura darbs “Pacienta tiesības uz informāciju” ir zinātnisks pētījums, kurā ir padziļināti un sistēmiski izpētīti jautājumi, ka izriet no pacienta un ārstniecības personas tiesiskajām attiecībām. Bakalaura darba gaitā tiek analizēts pacienta tiesības uz informāciju, kā arī ārstniecības personu atbildība par pacienta tiesību uz informāciju.
Pacientu tiesību likumā vieni no galvenajiem nosacījumiem ir pacienta tiesības saņemt informāciju, kvalitatīvu ārstēšanu un aprūpi, taču šis nosacījums ne vienmēr tiek realizēts. Kā Latvijā, tā arī citur pasaulē veselības aprūpē radītais kaitējums ir bieži sastopams. Pētnieciskā darba ietvaros tiks analizētas visbiežāk sastopamās problēmas pacientu tiesību uz informāciju nodrošināšanā.
Bakalaura darba mērķis ir, izpētot pacientu tiesību uz informāciju institūtu un izzinot tiesiskā regulējuma problēmas, izstrādāt ieteikumus pacientu tiesību tiesiskā regulējuma pilnveidei un esošo normu vienveidīgai izpratnei.
Bakalaura darba ietvaros ir analizēts pacienta tiesības uz informāciju jēdziens un tā tiesiskā izpausme, informētās piekrišanas jēdziens, piekrišana vai atteikšanās no tās un to tiesiskā izpausme, ārstniecības personu atbildība pārkāpjot pacienta tiesības uz informāciju un nobeigumā ir apkopoti secinājumi un priekšlikumi.
Darba autore secina, ka pacientu tiesību uz informāciju tiesiskajā regulējumā ir vairākas būtiskas problēmas, kas liedz šim institūtam strādāt pilnvērtīgi. Pārsvarā esošais normatīvais regulējums neizpildās praksē. Ārstniecības personas pārkāpj pacientu tiesības uz informāciju, kā arī, nesaņemot informēto piekrišanu, veic pacientam medicīnisku procedūru vai manipulāciju.
Bakalaura apjoms ir 67 lpp.
Atslēgvārdi: ārstniecības persona, pacients, veselības aprūpe, veselības aprūpes pakalpojums, tiesības uz informāciju.The bachelor's thesis "The patient's right to information" is a scientific study in which the issues arising from the legal relationship between the patient and the medical practitioner are in-depth and systematically studied. During the bachelor's thesis, the patient's right to information is analysed, as well as the responsibility of medical personnel for the patient's right to information.
One of the main conditions in the Patient Rights Act is the patient's right to receive information, quality treatment, and care, but this condition is not always implemented. As in Latvia, so also in other parts of the world, harm caused in health care is common. Within the framework of the research work, the most common problems in ensuring patients' rights to information will be analysed.
The bachelor's thesis aims to develop recommendations for the improvement of the legal regulation of patients' rights and a uniform understanding of the existing norms, by studying the institute of patients' rights to information and learning the problems of the legal framework.
The concept of the patient's right to information and its legal expression, the concept of informed consent, consent or refusal from it and their legal expression, and the responsibility of medical personnel in violation of the patient's right to information have been analysed as part of the bachelor's thesis, and conclusions and proposals are summarized in the end.
The author of the paper concludes that there are several significant problems in the legal regulation of patients' rights to information, which prevent this institute from working to its full potential. The prevailing regulatory framework is not implemented in practice. Medical personnel violates the patients' right to information, as well as perform a medical procedure or manipulation on the patient without obtaining informed consent.
The volume of the bachelor's thesis is 67 pages.
Keywords: medical practitioner, patient, health care, health care service, right to information
Intervention Research, Establishing Fidelity of the Independent Variable in Nursing Clinical Trials
No full textBackground: Internal validity of a randomized clinical trial
of a nursing intervention is dependent on intervention
fidelity. Although several methods have been developed,
evaluating audio or audiovisual tapes for prescribed
and proscribed interventionist behaviors is considered the
gold standard test of treatment fidelity. This approach
requires development of a psychometrically sound instrument
to meaningfully categorize and quantify interventionist
behaviors.
b Objective: To outline critical steps necessary to develop a
treatment fidelity instrument.
b Methods: A comprehensive literature review was conducted
to determine procedures used by other researchers. The
literature review produced five quantitative studies of
treatment fidelity, all in the field of psychotherapy, and
two replication studies. A synthesis of methodologies
across studies combined with researchers’ experiences
resulted in identification of the steps necessary to develop
a treatment fidelity measure.
b Results: Seven sequential steps were identified as essential
to the development of a valid and reliable measure of
treatment fidelity. These steps include (a) identification of
the essential elements of the experimental and control
treatment modalities; (b) construction of scale items; (c)
development of item scaling; (d) identification of the units
for coding; (e) item testing and revision; (f) specification of
rater qualifications and development of rater training
program; and (g) development and completion of pilot
testing to test psychometric properties. Development of the
Possibilities Project Psychotherapy Coding Questionnaire
is described as an illustration of the seven-step process.
b Discussion: The results show the essential steps that are
unique to the development of treatment fidelity measures
and show the feasibility of using these steps to construct a
psychometrically sound treatment-specific fidelity measure.
b Key Words: internal validity & intervention fidelity & randomized
clinical trialshttp://deepblue.lib.umich.edu/bitstream/2027.42/65122/2/Stein Fidelity.pd
The role of ST2 and ST2 genetic variants in schistosomiasis
No full textOliveira, Ricardo Riccio. Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil. aHepatic Surgery Center, bthe Clinical Study Center of Liver Surgery in Hubei
Province, and cthe Division of Gastroenterology and Hepatology, Tongji Hospital,
Tongji Medical College, Huazhong University of Science and Technology, Wuhan;
dthe Johns Hopkins Asthma and Allergy Center, Johns Hopkins University School
of Medicine, and ethe Bloomberg School of Public Health, The Johns Hopkins University,
Baltimore; fthe Biomedical Informatics and Personalized Medicine, University of
Colorado School of Medicine, Aurora; gthe Arizona Respiratory Center, University of
Arizona, Tucson; hthe Department ofMedicine, University of Rochester Medical Center,
Rochester; ithe Servico de Imunologia, Hospital Universitario Professor Edgard
Santos, and jthe Instituto Goncalo Moniz, Fundacao Oswaldo Cruz - Bahia, Salvador - Xin Long, MD, PhD,a,b,d Michelle Daya, PhD,f Jianping Zhao, MD,a,b Nicholas Rafaels, MS,d Huifang Liang, MD, PhD,a,b
Joseph Potee, MS,d Monica Campbell, MS,d Bixiang Zhang, MD,a,b Maria Ilma Araujo, PhD,i Ricardo R. Oliveira, MS, PhD,j
Rasika A. Mathias, ScD,d Li Gao, MD, PhD,d Ingo Ruczinski, PhD,e Steve N. Georas, MD,h Donata Vercelli, MD,g
Terri H. Beaty, PhD,e Kathleen C. Barnes, PhD,d Xiaoping Chen, MD,a,b and Qian Chen, MD, PhDNational Institutes of Health (grant R01HL112088), the Mary Beryl Patch Turnbull Scholar Program, the Major and Special Program of National Science and Technology in Twelfth Five-year Plan of China (grant 2012ZX10002016-004), the National Natural Science Foundation of China (grant 81471612), State Key Project on Infection Disease of China (grants 2012ZX10002016-004 and 2012ZX10002010-001-
004), the Natural Science Foundation of Hubei Province, China (grant 2011BCB035), and the Hepatic Surgery Clinical Study Center of Hubei Province, China (grants 2014BKB089 and 2013BCB026).Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, BrasilMúltipla – ver em NotasChronic schistosomiasis and its severe complication, periportal fibrosis, are characterized by a predominant Th2 response. To date, specific single nucleotide polymorphisms in ST2 have been some of the most consistently associated genetic variants for asthma. Objective: We investigated the role of ST2 (a receptor for the
TH2 cytokine IL-33) in chronic and late-stage schistosomiasis
caused by Schistosoma japonicum and the potential effect of ST2
genetic variants on stage of disease and ST2 expression.
Methods: We recruited 947 adult participants (339 with endstage
schistosomiasis and liver cirrhosis, 307 with chronic
infections without liver fibrosis, and 301 health controls) from a
S japonicum–endemic area (Hubei, China). Six ST2 single
nucleotide polymorphisms were genotyped. Serum soluble ST2
(sST2) was measured by ELISA, and ST2 expression in normal
liver tissues, Hepatitis B virus–induced fibrotic liver tissues, and
S japonicum–induced fibrotic liver tissues was measured by
immunohistochemistry.
Results:We found sST2 levels were significantly higher in the endstage
group (36.04 [95% CI, 33.85-38.37]) compared with chronic
cases and controls (22.7 [95% CI, 22.0-23.4], P < 1E-10). In
addition, S japonicum–induced fibrotic liver tissues showed
increased ST2 staining compared with normal liver tissues
(P5.0001). Markers rs12712135, rs1420101, and rs6543119 were
strongly associated with sST2 levels (P52E-10, 5E-05, and 6E-05,
respectively), and these results were replicated in an independent
cohort from Brazil living in a S mansoni endemic region.
Conclusions: We demonstrate for the first time that end-stage
schistosomiasis is associated with elevated sST2 levels and show
that ST2 genetic variants are associated with sST2 levels in
patients with schistosomiasis
Sensitization To Dust Mite And Dog Independently Predict Asthma Severity In African Caribbean Asthmatics From Barbados
No full text[[alternative]]Author Correction: Inherited causes of clonal haematopoiesis in 97,691 whole genomes (Nature, (2020), 586, 7831, (763-768), 10.1038/s41586-020-2819-2)
No full text[[abstract]]In this Article, Abhishek Niroula should have been listed as an author, with the affiliations: Broad Institute of MIT and Harvard, Cambridge, MA, USA; and Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA. They performed additional bioinformatic analyses (see ‘Author contributions’). The original Article has been corrected online. *A list of authors and their affiliations appears online
Filaggrin-stratified transcriptomic analysis of pediatric skin identifies mechanistic pathways in patients with atopic dermatitis
No full textBackground: Atopic dermatitis (AD; eczema) is characterized by a widespread abnormality in cutaneous barrier function and propensity to inflammation. Filaggrin is a multifunctional protein and plays a key role in skin barrier formation. Loss-of-function mutations in the gene encoding filaggrin (FLG) are a highly significant risk factor for atopic disease, but the molecular mechanisms leading to dermatitis remain unclear. Objective: We sought to interrogate tissue-specific variations in the expressed genome in the skin of children with AD and to investigate underlying pathomechanisms in atopic skin. Methods: We applied single-molecule direct RNA sequencing to analyze the whole transcriptome using minimal tissue samples. Uninvolved skin biopsy specimens from 26 pediatric patients with AD were compared with site-matched samples from 10 nonatopic teenage control subjects. Cases and control subjects were screened for FLG genotype to stratify the data set. Results: Two thousand four hundred thirty differentially expressed genes (false discovery rate, P <.05) were identified, of which 211 were significantly upregulated and 490 downregulated by greater than 2-fold. Gene ontology terms for "extracellular space" and "defense response" were enriched, whereas "lipid metabolic processes" were downregulated. The subset of FLG wild-type cases showed dysregulation of genes involved with lipid metabolism, whereas filaggrin haploinsufficiency affected global gene expression and was characterized by a type 1 interferon-mediated stress response. Conclusion: These analyses demonstrate the importance of extracellular space and lipid metabolism in atopic skin pathology independent of FLG genotype, whereas an aberrant defense response is seen in subjects with FLG mutations. Genotype stratification of the large data set has facilitated functional interpretation and might guide future therapy development.</p
A Comprehensive Evaluation of Potential Lung Function Associated Genes in the SpiroMeta General Population Sample
No full textRationale: Lung function measures are heritable traits that predict population morbidity and mortality and are essential for the diagnosis of chronic obstructive pulmonary disease (COPD). Variations in many genes have been reported to affect these traits, but attempts at replication have provided conflicting results. Recently, we undertook a meta-analysis of Genome Wide Association Study GWAS) results for lung function measures in 20,288 individuals from the general population (the SpiroMeta consortium).
Objectives: To comprehensively analyse previously reported genetic associations with lung function measures, and to
investigate whether single nucleotide polymorphisms (SNPs) in these genomic regions are associated with lung function in a large population sample.
Methods: We analysed association for SNPs tagging 130 genes and 48 intergenic regions (+/210 kb), after conducting a
systematic review of the literature in the PubMed database for genetic association studies reporting lung function
associations.
Results: The analysis included 16,936 genotyped and imputed SNPs. No loci showed overall significant association for FEV1 or FEV1/FVC traits using a carefully defined significance threshold of 1.361025. The most significant loci associated with FEV1 include SNPs tagging MACROD2 (P = 6.8161025), CNTN5 (P = 4.3761024), and TRPV4 (P = 1.5861023). Among eversmokers, SERPINA1 showed the most significant association with FEV1 (P = 8.4161025), followed by PDE4D (P = 1.2261024). The strongest association with FEV1/FVC ratio was observed with ABCC1 (P = 4.3861024), and ESR1 (P = 5.4261024) among ever-smokers.
Conclusions: Polymorphisms spanning previously associated lung function genes did not show strong evidence for
association with lung function measures in the SpiroMeta consortium population. Common SERPINA1 polymorphisms may
affect FEV1 among smokers in the general population
African and non-African admixture components in African Americans and an African Caribbean population
No full text- …
