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The Journal of Adolescent Health :... Apr 2021The purpose of the study was to increase the proportion of youth living with HIV (YLWH) aged ≥11 years who undergo developmentally appropriate disclosure about their...
PURPOSE
The purpose of the study was to increase the proportion of youth living with HIV (YLWH) aged ≥11 years who undergo developmentally appropriate disclosure about their HIV status.
METHODS
A quality improvement project was initiated at an urban pediatric HIV clinic between July 2018 and March 2020. The primary outcome measure was the proportion of YLWH aged ≥11 years who were disclosed to about their HIV status. The proportion of undisclosed YLWH who had documented nondisclosure status was also assessed as a process measure. Plan-Do-Study-Act (PDSA) cycles for change included monthly clinic staff check-ins to discuss new disclosures, quarterly team meetings to discuss strategies to improve disclosure, and modifying a clinic note template to prompt providers to document disclosure status. Annotated run charts were used to analyze the data.
RESULTS
Before the first PDSA cycle, 26/46 (57%) of the target population of YLWH aged ≥11 years had their HIV status disclosed to them, and none of the undisclosed youth had disclosure status documented in their medical record. After 20 months and six PDSA cycles, the proportion of YLWH aged ≥11 years disclosed to about their HIV status increased to 80% and the proportion of undisclosed YLWH with documentation of their disclosure status increased to 100%.
CONCLUSIONS
Several interventions integrated throughout the pediatric HIV care process were associated with an increase in the proportion of YLWH with developmentally appropriate HIV disclosure and documentation of disclosure status, an important psychosocial aspect of care in these individuals.
Topics: Adolescent; Child; Disclosure; HIV Infections; Humans; Truth Disclosure
PubMed: 33187819
DOI: 10.1016/j.jadohealth.2020.10.010 -
The Journal of Law, Medicine & Ethics :... 2015This article is an initial attempt to compare the pre-abortion disclosure mandates that have proliferated in the two decades since the Court decided Planned Parenthood...
This article is an initial attempt to compare the pre-abortion disclosure mandates that have proliferated in the two decades since the Court decided Planned Parenthood v. Casey with laws that, in the context of assisted reproduction and reproductive health, require specific disclosures beyond a state's baseline informed consent requirements. While some scholars have characterized pre-abortion disclosure laws as sui generis, they share some important common features with disclosure mandates in the context of oocyte donation and other reproductive health procedures. This article suggests that in critiquing pre-abortion disclosure mandates, scholars and advocates should be careful to differentiate the use of disclosure laws in general from uses where the government interest conveys a moral preference against a particular procedure.
Topics: Abortion, Induced; Disclosure; Female; Government Regulation; Humans; Informed Consent; Pregnancy; United States
PubMed: 26242945
DOI: 10.1111/jlme.12239 -
Brain and Behavior Mar 2016Although incidental findings (IF) are commonly encountered in neuroimaging research, there is no consensus regarding what to do with them. Whether researchers are... (Review)
Review
BACKGROUND
Although incidental findings (IF) are commonly encountered in neuroimaging research, there is no consensus regarding what to do with them. Whether researchers are obligated to review scans for IF, or if such findings should be disclosed to research participants at all, is controversial. Objective data are required to inform reasonable research policy; unfortunately, such data are lacking in the published literature. This manuscript summarizes the development of a radiology review and disclosure system in place at a neuroimaging research institute and its impact on key stakeholders.
METHODS
The evolution of a universal radiology review system is described, from inception to its current status. Financial information is reviewed, and stakeholder impact is characterized through surveys and interviews.
RESULTS
Consistent with prior reports, 34% of research participants had an incidental finding identified, of which 2.5% required urgent medical attention. A total of 87% of research participants wanted their magnetic resonance imaging (MRI) results regardless of clinical significance and 91% considered getting an MRI report a benefit of study participation. A total of 63% of participants who were encouraged to see a doctor about their incidental finding actually followed up with a physician. Reasons provided for not following-up included already knowing the finding existed (14%), not being able to afford seeing a physician (29%), or being reassured after speaking with the institute's Medical Director (43%). Of those participants who followed the recommendation to see a physician, nine (38%) required further diagnostic testing. No participants, including those who pursued further testing, regretted receiving their MRI report, although two participants expressed concern about the excessive personal cost. The current cost of the radiology review system is about $23 per scan.
CONCLUSIONS
It is possible to provide universal radiology review of research scans through a system that is cost-effective, minimizes investigator burden, and does not overwhelm local healthcare resources.
Topics: Disclosure; Humans; Incidental Findings; Magnetic Resonance Imaging; Neuroimaging; Physicians; Research; Surveys and Questionnaires
PubMed: 26893955
DOI: 10.1002/brb3.428 -
PloS One 2021This paper empirically examines whether there is an association between financial reporting disclosure quality and sustainability disclosure quality of the top 100...
This paper empirically examines whether there is an association between financial reporting disclosure quality and sustainability disclosure quality of the top 100 socially reputed Chinese listed firms. The paper computed financial disclosure quality by empirically combining earning qualities of accrual, persistence, predictability, and smoothness. Using content analysis and survey questionnaire research methods, it calculated sustainability quality by combining disclosure quantity (through quantitative weightings), disclosure type (through qualitative weightings), and disclosure item importance (through qualitative weightings) of economic, social, and environmental disclosures made in annual and sustainability reports, ascertained using the Global Reporting Initiative sustainability framework. The study finds that sustainability disclosure in the current period is sufficiently associated with financial disclosure quality of the current period and future period. Consistent with stakeholder theory, firms with a social reputation are perceived as trustworthy by stakeholders and shareholders. The findings lead to a cultural stakeholder theory where underlying values of societal culture create a condition supporting mutual stakeholder relationships between firm and various stakeholders. Demonstrating trustworthiness through disclosures can help boost consumer confidence and foreign trade relations for Chinese firms. The Chinese government can design innovative schemes to reward and promote trustworthiness in firms, such as regulating base-point reductions in interest rates on borrowing or raising funds.
Topics: China; Disclosure; Environmental Policy; Government; Humans; Income; Industry; Sustainable Development
PubMed: 34048431
DOI: 10.1371/journal.pone.0250884 -
Internal Medicine Journal Apr 2011
Topics: Disclosure; Humans; Publishing; Records
PubMed: 21507162
DOI: 10.1111/j.1445-5994.2011.02469.x -
CMAJ : Canadian Medical Association... Oct 2010
Topics: Conflict of Interest; Congresses as Topic; Disclosure; Drug Industry; Editorial Policies; Education, Medical, Undergraduate; Faculty, Medical; Humans; Periodicals as Topic; Research Support as Topic
PubMed: 20921261
DOI: 10.1503/cmaj.110-2109 -
Lancet (London, England) Mar 2022
Topics: Authorship; Conflict of Interest; Disclosure; Editorial Policies; Periodicals as Topic; Research Support as Topic
PubMed: 31999953
DOI: 10.1016/S0140-6736(20)30187-2 -
JAMA Ophthalmology May 2019Beside the goal of increasing transparency to the public, disclosure policies and laws have been established with a goal to also reduce ethically questionable financial...
IMPORTANCE
Beside the goal of increasing transparency to the public, disclosure policies and laws have been established with a goal to also reduce ethically questionable financial relationships between physicians and the medical industry. Data on these relationships should be reviewed to understand the association between these policies and laws and the attainment of reduced relationships.
OBJECTIVE
To assess whether disclosure policies and laws have been associated with a decrease in financial disclosure reporting by physicians.
DESIGN, SETTING, AND PARTICIPANTS
This cross-sectional study uses yearly data from 2008 through 2015 from the participants in the American Academy of Ophthalmology's Annual Meeting. Trends in financial disclosures over time were investigated for the association of disclosure policies and laws with potentially beneficial, as well as ethically questionable physician-industry ties. Linear regression models were used to estimate the annual change in financial disclosures and are reported with 95% CIs.
EXPOSURES
Disclosure policies and laws.
MAIN OUTCOMES AND MEASURES
The annual aggregate financial disclosures by type (ie, consultant, lecturer, employee, grant support, equity owner, patent holder).
RESULTS
Financial disclosures increased from 3966 in 2008 to 5266 in 2015 (P < .001). The number of disclosures reported in the categories consultant, equity owner, patents, and grant support all increased from 2008 to 2015 (consultant disclosures, 121 [95% CI, 88-155] per year; P < .001; equity owner disclosures, 32 [95% CI, 22-42] per year; P < .001; patent disclosures, 19 [95% CI, 13-26] per year; P < .001; grant support disclosures, 78 [95% CI, 48-107] per year; P < .001), while the employee and lecturer categories did not change significantly. The percentage of financial disclosures in the lecturer category decreased relative to the total (estimate, -1.1% [95% CI, -1.3% to -0.8%] per year; P < .001), owing to the number of financial disclosures for this category remaining stable while most other types increased.
CONCLUSIONS AND RELEVANCE
Disclosure was not associated with a chilling effect (decrease in financial disclosures associated with potentially beneficial physician-industry ties). Disclosure was associated with a possible disinfecting effect, whereby the percentage of ethically questionable disclosures (ie, lecturers) decreased, although the frequency remained stable. A permissive effect (physicians becoming more inclined to having industry relationships) was also observed. Thus, disclosure rules should be enhanced or alternative approaches to disclosure reconsidered to promote a decrease in ethically questionable relationships.
Topics: Conflict of Interest; Cross-Sectional Studies; Disclosure; Humans; Industry; Physicians; United States
PubMed: 30816947
DOI: 10.1001/jamaophthalmol.2019.0085 -
Health Informatics Journal 2021Within the anamnesis, medical information is frequently withheld, incomplete, or incorrect, potentially causing negative consequences for the patient. The use of...
Within the anamnesis, medical information is frequently withheld, incomplete, or incorrect, potentially causing negative consequences for the patient. The use of conversational agents (CAs), computer-based systems using natural language to interact with humans, may mitigate this problem. The present research examines whether CAs differ from physicians in their ability to elicit truthful disclosure and discourage concealment of medical information. We conducted an online questionnaire with German participants ( = 148) to assess their willingness to reveal medical information. The results indicate that patients would rather disclose medical information to a physician than to a CA; there was no difference in the tendency to conceal information. This research offers a frame of reference for future research on applying CAs during the anamnesis to support physicians. From a practical view, physicians might gain better understanding of how the use of CAs can facilitate the anamnesis.
Topics: Communication; Disclosure; Humans; Physicians; Surveys and Questionnaires; Truth Disclosure
PubMed: 33779384
DOI: 10.1177/1460458221994861 -
Archives of Disease in Childhood Jan 2010
Review
Topics: Adoption; Child, Preschool; Confidentiality; Conflict of Interest; Disclosure; Family Health; Female; Humans; Infant; Male; Medical History Taking; Practice Guidelines as Topic; Third-Party Consent; United Kingdom
PubMed: 20040680
DOI: 10.1136/adc.2009.164970