Medical Practitioners Who Deny Young Women Sterilisation Surgery "Because They Will Regret It Later": Patient-centred Practice or Discrimination?

Women in Australia routinely access medical services which, by design or consequence, sterilise them. There is evidence which suggests that some medical practitioners are not offering procedures to young women where the surgery will make them infertile. These decisions are often defended on the basis that women who lose their fertility will go on to regret the medical procedure in the future. This article will consider the legal and ethical implications of this practice. It will first critically analyse the ethics of this decision according to the Beauchamp and Childress principles of justice, applying them through the lens of a patient-centred practice framework. It will then examine whether such practice may constitute discrimination under the Federal and Victorian discrimination frameworks, focusing on whether such decisions constitute age discrimination, gender discrimination, or discrimination on the basis of parental status. This article will draw the conclusion that such decisions are generally unethical and may constitute discrimination under Australian laws.

Factors Associated with COVID-19 Vaccination Promptness after Eligibility in a North Carolina Longitudinal Cohort Study.

Many studies identified factors associated with vaccination intention and hesitancy, but factors associated with vaccination promptness and the effect of vaccination intention on vaccination promptness are unknown. This study identified factors associated with COVID-19 vaccination promptness and evaluated the role of vaccination intention on vaccination promptness in 1223 participants in a community-based longitudinal cohort study (June 2020 to December 2021). Participants answered questions regarding COVID-19 vaccination intention, vaccination status, and reasons for not receiving a vaccine. The association of baseline vaccine hesitancy with vaccination was assessed by the Kaplan-Meier survival analysis. Follow-up analyses tested the importance of other variables predicting vaccination using the Cox proportional hazards model. Older age was associated with shorter time to vaccination (HR = 1.76 [1.37-2.25] 85-year-old versus 65-year-old). Lower education levels (HR = 0.80 [0.69-0.92]), household incomes (HR = 0.84 [0.72-0.98]), and baseline vaccination intention of 'No' (HR = 0.16 [0.11-0.23]) were associated with longer times to vaccination. The most common reasons for not being vaccinated (N = 58) were vaccine safety concerns (n = 33), side effects (n = 28), and vaccine effectiveness (n = 25). Vaccination campaigns that target populations prone to hesitancy and address vaccine safety and effectiveness could be helpful in future vaccination rollouts.

Evaluating the Distribution, Quality, and Educational Value of Videos Related to Shoulder Instability Exercises on the Social Media Platform TikTok.

BACKGROUND: Because of the lack of scientific oversight, the quality, applicability, and consistency of healthcare-related TikTok videos have become a focus of research exploration. The orthopaedic surgery literature lags behind other medical fields in analyzing the widespread utilization of TikTok videos for medical information delivery. METHODS: TikTok was queried using the hashtag #shoulderstabilityexercises, and 109 videos were included. The videos were collected by two authors and independently evaluated using DISCERN (a well-validated informational analysis tool) and shoulder stability exercise education score (a self-designed tool for the evaluation of shoulder instability-related exercises). RESULTS: DISCERN scores of videos uploaded by general users had significantly lower scores in all four categories than those uploaded by healthcare professionals (P < 0.001, P = 0.005, P = 0.002, and P < 0.001). For the shoulder stability exercise education score, general users had a significantly lower score than the healthcare professionals at 3.36 and 4.91 on a 25-point scale, respectively (P = 0.034). General users had more videos graded as very poor (84.2%) in comparison to the number of videos uploaded by healthcare professionals deemed very poor (51.5%). However, the remainder of healthcare professionals had their videos graded as poor (48.5%). CONCLUSION: Despite slightly improved video quality from healthcare professionals, the overall educational of the videos related to shoulder instability exercises was poor.

An Improved Comprehensive Medication Review Process to Assess Healthcare Outcomes in a Rural Independent Community Pharmacy.

For years many pharmacists have been performing 'brown bag' medication reviews for patients. While most pharmacists and student pharmacists are familiar with this process, it is important to determine the value patients receive from this service. Over the course of this study the authors attempted to modernize the medication reconciliation process and collect data on patient prescription drug and over-the-counter drug use, along with quantifying the types of interventions the pharmacy's clinical staff performed for patients during this process. The pharmacy partnered with a Quality Improvement Organization to trial their Blue Bag Intervention (BBI) program. The BBI program offered several additional services to the traditional brown bag review. The BBI was instituted as a follow-up tool in the pharmacy's diabetes self-management education/training clinic to aid in patient follow-up and help the clinical staff identify medication-related events such as medication adherence issues and drug-drug interactions. The clinical staff identified approximately 2.2 events per patient with over 50% being issues that affected patient safety.