CNU Library Blog

Title: Sharing Health Data: The Why, the Will, and the Way Forward

Authors: National Academy of Medicine, The Learning Health System Series, Claudia Grossmann, Peak Sen Chua, Mahnoor Ahmed, Sarah M. Greene

Publication Information: Washington, DC: National Academies Press. 2022.

Start reading: Academic eBook Collection.

Description: Sharing health data and information across stakeholder groups is the bedrock of a learning health system. As data and information are increasingly combined across various sources, their generative value to transform health, health care, and health equity increases significantly. Health data have proven their centrality in guiding action to change the course of individual and population health, if properly stewarded and used. In the context of the COVID-19 pandemic, both data and a lack of data illuminated profound shortcomings that affected health care and health equity. Yet, a silver lining of the pandemic was a surge in collaboration among data holders in public health, health care, and technology firms, suggesting that an evolution in health data sharing is visible and tangible. This Special Publication features some of these novel data-sharing collaborations, and has been developed to provide practical context and implementation guidance that is critical to advancing the lessons learned identified in its parent NAM Special Publication, Health Data Sharing: Building a Foundation of Stakeholder Trust. The focus of this publication is to identify and describe exemplar groups to dispel the myth that sharing health data more broadly is impossible and illuminate the innovative approaches that are being taken to make progress in the current environment. It also serves as a resource for those waiting in the wings, showing how barriers were addressed and harvesting lessons and insights from those on the front lines. In the meantime, knowledge is already available to foster better health care and health outcomes. The examples described in this volume suggest how intentional attention to health data sharing can enable unparalleled advances, securing a healthier and more equitable future for all.

Title: Ethical Case Studies for Advanced Practice Nurses: Solving Dilemmas in Everyday Practice

Authors: Amber L. Vermeesch, Patricia H. Cox, Inga M. Giske, Katherine M. Roberts.

Publication Information: Indianapolis, IN : Sigma. 2023.

Location: Academic eBook Collection.

Description: Healthcare delivery can present ethical conflicts and dilemmas for advanced practice registered nurses (APRNs)—nurses who already have a myriad of responsibilities in caring for patients. Ethical Case Studies for Advanced Practice Nurses improves APRNs'agility to resolve ethical quandaries encountered in primary care, hospital-based, higher education, and administration beyond community settings. Through case studies examining various types of ethical conflicts, the authors empower APRNs and students with the critical knowledge and skills they need to handle even the most complex dilemmas in their practice. By applying a set of criteria and framework, this book guides APRNs to use critical thinking to make ethically sound decisions.

TABLE OF CONTENTS

• Case Study #1: Defensive Medicine
• Case Study #2: STI Confidentiality
• Case Study #3: Substance Use in Pregnancy
• Case Study #4: HPV Vaccine Refusal
• Case Study #5: Abortion
• Case Study #6: Prostate Cancer Screening with Prostate-Specific Antigen
• Case Study #7: Administration of Long-Acting Injectable Antipsychotics
• Case Study #8: Depression Screening in Adolescents
• Case Study #9: Treatment of Resistant Anxiety
• Case Study #10: COVID-19 Vaccine in Adolescence
• Case Study #11: Medical Emancipation Versus Confidentiality in Transgender and Gender-Nonconforming People
• Case Study #12: Childhood Obesity
• Case Study #13: Dementia and Stopping Driving
• Case Study #14: When to Transition to Palliative Care
• Case Study #15: Prescription Refill Dilemma for Patient and Spouse in Financial Straits
• Case Study #16: CRNA Labor and Delivery Epidural Pain Management With a Language Barrier
• Case Study #17: Violence, Suicide, and Family Dynamics With Medical Complexity
• Case Study #18: Psychiatric Acute Concerns and Fall Risks
• Case Study #19: Telehealth
• Case Study #20: Guiding a School of Nursing Through COVID-19 Focusing on Clinical Placements
• Case Study #21: Emergency Department Closure Decision-Making: Health System and Community Impact
• Case Study #22: Ethical Dilemmas in School of Nursing Leadership Pre-COVID-19

Title: Graphic Medicine Manifesto.

Published: 2015. 

Available: as an eBook in Academic eBook Collection.

 

Description: "This inaugural volume in the graphic medicine series establishes the principles of graphic medicine and begins to map the field. The volume combines scholarly essays by members of the editorial team with previously unpublished visual narratives by Ian Williams and MK Czerwiec, and it includes arresting visual work from a wide range of graphic medicine practitioners. The book's first section, featuring essays by Scott Smith and Susan Squier, argues that as a new area of scholarship, research on graphic medicine has the potential to challenge the conventional boundaries of academic disciplines, raise questions about their foundations, and reinvigorate literary scholarship—and the notion of the literary text—for a broader audience. The second section, incorporating essays by Michael Green and Kimberly Myers, demonstrates that graphic medicine narratives can engage members of the health professions with literary and visual representations and symbolic practices that offer patients, family members, physicians, and other caregivers new ways to experience and work with the complex challenges of the medical experience. The final section, by Ian Williams and MK Czerwiec, focuses on the practice of creating graphic narratives, iconography, drawing as a social practice, and the nature of comics as visual rhetoric. A conclusion (in comics form) testifies to the diverse and growing graphic medicine community. Two valuable bibliographies guide readers to comics and scholarly works relevant to the field."

Article-linking websites online can help you find relevant articles from one article's DOI. Scroll through these slides to learn more about LitMaps, Citation Gecko, and Connected Papers.

Academic research is an ongoing conversation between authors. by Sadie Davenport

Title: What Patients Teach: The Everyday Ethics of Health Care.

By: Larry R. Churchill; Joseph B. Fanning; David Schenck. Oxford University Press. 2013.

Available in our Academic eBook Collection. 

Description: "Being a patient is a unique interpersonal experience but it is also a universal human experience. The relationships formed when we are patients can also teach some of life's most important lessons, and these relationships provide a special window into ethics, especially the ethics of healthcare professionals. This book answers two basic questions: As patients see it, what things allow relationships with healthcare providers to become therapeutic? What can this teach us about healthcare ethics? This volume presents detailed descriptions and analyses of 50 interviews with 58 patients, representing a wide spectrum of illnesses and clinician specialties. The authors argue that the structure, rhythm, and horizon of routine patient care are ultimately grounded in patient vulnerability and clinician responsiveness. From the short interview segments, the longer vignettes and the full patient stories presented here emerge the neglected dimensions of healthcare and healthcare ethics. What becomes visible is an ethics of everyday interdependence, with mutual responsibilities that follow from this moral symbiosis. Both professional expressions of healthcare ethics and the field of bioethics need to be informed and reformed by this distinctive, more patient-centered, turn in how we understand both patient care as a whole and the ethics of care more specifically. The final chapters present revised codes of ethics for health professionals, as well as the implications for medical and health professions education." 

On this day in 1960, for the first time, Dr. Belding Scribner (Scrib) inserted a shunt into a man's arm to connect an artery to a dialysis machine. The operation was successful and enabled the man, Clyde Shields, to survive on dialysis for over a decade. This shunt (shown in the images below) was the last piece of technology needed to provide long-term dialysis for patients with failing kidneys. The impact of this successful procedure was immediate -- kidney failure was no longer a death sentence. 

Left: A diagram naming parts of the original 1960 shunt. Middle: The shunt inserted into Clyde Shields's arm in 1960. Right: Dr. Belding Scribner. 

How it works: The shunt consists of two extension tubes, a stabilizer, and a "U tube" (which takes on a U-shape closer to the patient's elbow). When dialysis is needed, the "U tube" is removed and the dialysis machine connected in its place. (The original 1966 article below explains how this shunt works in more detail.)

Today: Now there are more options for dialysis. Patients may undergo surgery to have a fistula or graft in their arm, or a catheter in their neck, all of which improve access to the bloodstream for dialysis. At-home dialysis is also possible. The patient education webpages listed below offer general overviews of dialysis, including its types, steps, effects, risks, and outlooks. 

Read more: 

• Cleveland Clinic: Dialysis (patient education)
• Fresenius Medical Care: The History of Dialysis (patient education)
• Kansas Health System: Dialysis Shunt Graft Catheter (patient education)
• New York Times: Dr. Belding H. Scribner, Medical Pioneer, Is Dead at 82 (brief biography) 
• Pubmed: The 50th anniversary of long-term hemodialysis: University of Washington Hospital, March 9th, 1960 (free article)
• Oxford Academic: History of vascular access for haemodialysis (free article)
• Routine Use of the Scribner Shunt for Haemodialysis (ORIGINAL ARTICLE 1966)

Visit graphicmedicine.org to read graphic medicine comics and listen to some podcast episodes! 

Author Ian Williams describes graphic medicine as "the intersection between the medium of comics and the discourse of healthcare." Graphic medicine is used to highlight vulnerability, the complexity of different medical issues, patients' perspectives, and healthcare hardships. 

More information on graphic medicine: 

• Library of Congress exhibit: "Graphic Medicine: Ill-conceived and Well Drawn!"
• Annals of Internal Medicine: Graphic Medicine
• Public Health Insider: Comics Archive
• Matt the Owl: A comic about cancer
• The Empathy Project (aligns with the mission of graphic medicine)
• Penn State medical students' comics