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Sökning: WFRF:(Munthe Christian 1962)

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1.
  • Bergström, Martin, et al. (författare)
  • Interventions in Foster Family Care: A Systematic Review
  • 2020
  • Ingår i: Research on social work practice. - : Sage Publications. - 1049-7315 .- 1552-7581. ; 30:1, s. 3-18
  • Tidskriftsartikel (refereegranskat)abstract
    • Objective: Foster family care is associated with adverse short- and long-term consequences for the child. A systematic review was conducted on interventions for foster children and foster careers. Method: A comprehensive search process was used to find eligible interventions evaluated in randomized controlled trials or quasi-experimental studies. The quality of studies was assessed with GRADE, and effects were synthesized using meta-analytic methods. Results: In all, 28 publications of 18 interventions, including 5,357 children, were identified. Only three specific interventions had sufficient confidence of evidence. No study had examined tools for foster parent selection nor had evaluated preservice programs related to outcomes. Discussion: These analyses provide new insights and hope into the field of systematic interventions in foster care. The overall results indicate that it is possible to improve eight outcomes but cannot point out which programs are superior. Ethically, social care organizations should systematically collect knowledge about effects and side effects.
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2.
  • Heintz, Emelie, et al. (författare)
  • FRAMEWORK FOR SYSTEMATIC IDENTIFICATION OF ETHICAL ASPECTS OF HEALTHCARE TECHNOLOGIES: THE SBU APPROACH
  • 2015
  • Ingår i: International Journal of Technology Assessment in Health Care. - : Cambridge University Press (CUP): HSS Journals. - 0266-4623 .- 1471-6348. ; 31:3, s. 124-130
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives: Assessment of ethical aspects of a technology is an important component of health technology assessment (HTA). Nevertheless, how the implementation of ethical assessment in HTA is to be organized and adapted to specific regulatory and organizational settings remains unclear. The objective of this study is to present a framework for systematic identification of ethical aspects of health technologies. Furthermore, the process of developing and adapting the framework to a specific setting is described. Methods: The framework was developed based on an inventory of existing approaches to identification and assessment of ethical aspects in HTA. In addition, the framework was adapted to the Swedish legal and organizational healthcare context, to the role of the HTA agency and to the use of non-ethicists. The framework was reviewed by a group of ethicists working in the field as well as by a wider set of interested parties including industry, interest groups, and other potential users. Results: The framework consists of twelve items with sub-questions, short explanations, and a concluding overall summary. The items are organized into four different themes: the effects of the intervention on health, its compatibility with ethical norms, structural factors with ethical implications, and long term ethical consequences of using the intervention. Conclusions: In this study, a framework for identifying ethical aspects of health technologies is proposed. The general considerations and methodological approach to this venture will hopefully inspire and present important insights to organizations in other national contexts interested in making similar adaptations.
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3.
  • Munthe, Christian, 1962, et al. (författare)
  • Health‐related Research Ethics and Social Value: Antibiotic Resistance Intervention Research and Pragmatic Risks
  • 2019
  • Ingår i: Bioethics. - : Wiley. - 0269-9702 .- 1467-8519. ; 33:3, s. 335-342
  • Tidskriftsartikel (refereegranskat)abstract
    • We consider the implications for the ethical evaluation of research programs of two fundamental changes in the revised research ethical guideline of the Council for International Organizations of Medical Sciences. The first is the extension of scope that follows from exchanging “biomedical” for “health-related” research, and the second is the new evaluative basis of “social value,” which implies new ethical requirements of research. We use the example of antibiotic resistance interventions to explore the need to consider what we term the pragmatic risks of such interventions to evaluate the so- cial value of certain kinds of health-related research. These (pragmatic) risks severely threaten the social value of interventions in every area where human and social re- sponses significantly impact on their effectiveness. Thus, the social value of health-re- lated research needed to demonstrate its effectiveness depends on the successful management of such risks. Research designed to take into account pragmatic risks also gives rise to similar types of risks, and the potential for social value in light of those risks needs to be considered in ethical reviews based on the new guidelines. We argue that, to handle this new expanded task, the international system of research ethical review addressed by the guidelines needs institutional development. In particular, we consider lifting research ethical review to a level closer to actual health policy making.
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4.
  • Munthe, Christian, 1962, et al. (författare)
  • Person centred care and shared decision making: Implications for ethics, public health and research
  • 2012
  • Ingår i: Health Care Analysis. - : Springer New York LLC. - 1065-3058 .- 1573-3394. ; 20:3, s. 231-249
  • Tidskriftsartikel (refereegranskat)abstract
    • This paper presents a systematic account of ethical issues actualised in different areas, as well as at different levels and stages of health care, by introducing organisational and other procedures that embody a shift towards person centred care and shared decision-making (PCC/SDM). The analysis builds on general ethical theory and earlier work on aspects of PCC/SDM relevant from an ethics perspective. This account leads up to a number of theoretical as well as empirical and practice oriented issues that, in view of broad advancements towards PCC/SDM, need to be considered by health care ethics researchers. Given a PCC/SDM-based reorientation of health care practice, such ethics research is essential from a quality assurance perspective.
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5.
  • Sandin, Per, et al. (författare)
  • Technology Neutrality in European Regulation of GMOs
  • 2021
  • Ingår i: Ethics, Policy & Environment. - : Informa UK Limited. - 2155-0085 .- 2155-0093.
  • Tidskriftsartikel (refereegranskat)abstract
    • Objections to the current EU regulatory system on genetically modified organisms (GMOs) in terms of high cost and lack of consistency, speed and scientific underpinning have prompted proposals for a more technology-neutral system. We sketch the conceptual background of the notion of ‘technology neutrality’ and propose a refined definition of the term. The proposed definition implies that technology neutrality of a regulatory system is a gradual and multidimensional feature. We use the definition to analyze two regulatory reform proposals: One proposal from the Netherlands for improving the exemption mechanism for GMOs under Directive 2001/18/EC, and one from the Norwegian Biotechnology Advisory Board, outlining a new stratified risk assessment procedure. While both proposals offer some degree of improved technology neutrality in some dimensions compared to current EU regulation, in some extents and dimensions, they do not. We conclude that proposals for more technology-neutral regulation of GMOs need, first, to make explicit to what extent and in what dimensions the proposal improves neutrality and, second, to present arguments supporting that these specific improvements constitute desirable policy change against the background of objections to current policy.
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6.
  • Sandman, Lars, et al. (författare)
  • Shared Decision Making, Paternalism and Patient Choice
  • 2010
  • Ingår i: Health Care Analysis. - : Springer. - 1065-3058 .- 1573-3394. ; 18:1, s. 60-84
  • Tidskriftsartikel (refereegranskat)abstract
    • In patient centred care, shared decision making is a central feature and widely referred to as a norm for patient centred medical consultation. However, it is far from clear how to distinguish SDM from standard models and ideals for medical decision making, such as paternalism and patient choice, and e.g., whether paternalism and patient choice can involve a greater degree of the sort of sharing involved in SDM and still retain their essential features. In the article, different versions of SDM are explored, versions compatible with paternalism and patient choice as well as versions that go beyond these traditional decision making models. Whenever SDM is discussed or introduced it is of importance to be clear over which of these different versions are being pursued, since they connect to basic values and ideals of health care in different ways. It is further argued that we have reason to pursue versions of SDM involving, what is called, a high level dynamics in medical decision-making. This leaves four alternative models to choose between depending on how we balance between the values of patient best interest, patient autonomy, and an effective decision in terms of patient compliance or adherence: Shared Rational Deliberative Patient Choice, Shared Rational Deliberative Paternalism, Shared Rational Deliberative Joint Decision, and Professionally Driven Best Interest Compromise. In relation to these models it is argued that we ideally should use the Shared Rational Deliberative Joint Decision model. However, when the patient and professional fail to reach consensus we will have reason to pursue the Professionally Driven Best Interest Compromise model since this will best harmonise between the different values at stake: patient best interest, patient autonomy, patient adherence and a continued care relationship.
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7.
  • Åström, Therese, et al. (författare)
  • Treatment Foster Care Oregon for Delinquent Adolescents: A Systematic Review and Meta-Analysis
  • 2020
  • Ingår i: Research on social work practice. - : SAGE Publications. - 1049-7315. ; 30:4, s. 355-367
  • Tidskriftsartikel (refereegranskat)abstract
    • Purpose To examine the effects of Treatment Foster Care on youth with serious behavior problems. Method Included studies are controlled trials with high or medium quality, published between 1990 and September 2017. The control group consists of youth with serious behavior problems in group care, and the follow-up time was at least 12 months. The review also examines ethical and economic aspects. Results A total of eight controlled studies were included, consisting of 633 young people and 55 effect sizes. All studies examined the same model, Treatment Foster Care Oregon (TFCO). There is moderate certainty of evidence that TFCO reduces the risk of future criminal behavior and the number of days in locked settings. Furthermore, there is low certainty of evidence that TFCO reduces the risk of delinquent peer associations, drug use, and depression. Discussion TFCO is to be preferred to group care for youth with serious behavior problems. Ethical and economic implications are discussed.
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8.
  • Abraha, Aynalem, et al. (författare)
  • Breaking bad news in cancer care: preferences of patients, family caregivers and general public in Ethiopia
  • 2021
  • Ingår i: International Conference on Communication in Healthcare (ICCH) 2020 Part 2, 15-16 April, 2021.
  • Konferensbidrag (övrigt vetenskapligt)abstract
    • This study explores the preferences of cancer patients, family caregivers, and the general public regarding breaking bad news in an Ethiopian oncology setting. The research was conducted at Tikur Anbessa (Black Lion) Specialized Hospital. The sample consists of patients with a confirmed cancer diagnosis, their family caregivers, and representatives from the general public with 150 subjects per cohort. A comparative cross-sectional study design and a multivariable analysis were used. The patients would like to be informed, which contradicts the perceptions of family caregivers. This creates an ethical dilemma for staff in terms of how much they involve their patients in clinical decision-making. The patients also indicate that information not to be withheld from them. In contrast, the general public prefers information about poor life expectancy to be communicated to family only, which may reflect widespread public perception of cancer as a deadly disease. The findings indicate the complexity of communication concerning breaking bad news in oncology care in Ethiopia. It requires oncologists to probe patient attitudes before information disclosure in order to find a balance between involving patients in communication at the same time as keeping a constructive alliance with family caregivers.
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9.
  • Abraha Woldemariam, Aynalem, et al. (författare)
  • Breaking Bad News in Cancer Care: Ethiopian Patients Want More Information Than What Family and the Public Want Them to Have.
  • 2021
  • Ingår i: JCO global oncology. - 2687-8941. ; 7, s. 1341-1348
  • Tidskriftsartikel (refereegranskat)abstract
    • This study explores the preferences of patients with cancer, family caregivers, and the general public regarding breaking bad news in an Ethiopian oncology setting.The study was conducted at Tikur Anbessa (Black Lion) Specialized Hospital. The sample consists of patients with a confirmed cancer diagnosis, their family caregivers, and representatives from the general public with 150 subjects per cohort. The study used a comparative cross-sectional design and multivariable data analysis.The patients would like to be informed, which contradicts the preferences of family caregivers. This creates an ethical dilemma for staff in terms of how much they involve their patients in clinical decision making. The patients also indicate that information should not be withheld from them. By contrast, the general public prefers information about poor life expectancy to be communicated to family only, which may reflect a widespread public perception of cancer as a deadly disease.The findings indicate the complexity of communication-related preferences concerning breaking bad news in oncology care in Ethiopia. It requires oncologists to probe patient attitudes before information disclosure to find a balance between involving patients in communication at the same time as keeping a constructive alliance with family caregivers.
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10.
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