Narrow Results

Carpal tunnel decompression (CTD) is a common procedure amenable to procedure specific consent forms (PSCFs). These may help better inform patients and so increase patient satisfaction with the consent process. We assessed the use of a PSCF for CTD. The PSCF mentions eight complications of carpal tunnel surgery and alternative non-operative treatments.

Two groups of 40 patients each were compared prospectively. Patients in one group were issued with a PSCF prior to admission whereas those in the other group were not. After standard pre-operative consent, patients were interviewed prior to surgery and assessed for their awareness of complications and alternative treatment options. The patients who received a PSCF showed greater awareness of different complications and alternative treatments and reported greater satisfaction with the consent process. We conclude that using PSCFs is a very useful and inexpensive adjunct to improve patient awareness and satisfaction with the consent process.

Background: To assess how much information communicated to patients is understood and retained after preoperative discussion of upper extremity procedures.

Methods: A prospective study was designed by recruiting patients prior to undergoing upper extremity surgical procedures after a detailed discussion of their operative technique, postoperative care and treatment outcomes. Patients were given the same 20-item questionnaire to fill out twice, at two pre operative visits. An independent evaluator filled out a third questionnaire as a control. Various discussion points of the survey were compared among the 3 questionnaires and retained information and perceived comprehension were evaluated.

Results: The average patients’ age was 50.3 (27–75) years The average time between the two surveys preoperative 1 and preoperative 2 was 40.7 (7–75) days,. The average patient had approximately 2 years of college or an associate’s degree. Patients initially retained 73% (52–90%) of discussion points presented during preoperative 1 and 61% (36–85%) of the information at preoperative 2 p = .002. 50% of patients felt they understood 100% of the discussion, this dropped to only 10% at their preoperative 2 visit. 15% of our patients did not know what type of anesthesia they were having at preoperative 2.

Conclusions: A communication barrier between patients and physicians exists when patients are informed about their preoperative surgical discussion. The retention of information presented is worsened with elapsing time from the initial preoperative discussion to the second preoperative visit immediately prior to surgery. Methods to enhance patients’ retention of information prior to surgery must be sought and implemented which will improve patients’ treatment outcome.

Although human embryonic stem cells may have enormous potential for the treatment of degenerative diseases, their origins and derivation have raised unprecedented controversy in many societies. Many organisations, on both international and national levels, have responded with regulatory systems that seek to manage and supervise such work. These systems vary from voluntary professional guidelines and international treaties to government agencies and binding national legislation. This chapter briefly summarises the main controversies surrounding human embryonic stem cell research and the existing international mechanisms that address its conduct. We then offer a more detailed overview of the relevant regulatory structures of five nations — the US, the UK, China, India and South Korea — where research with human embryonic stem cells is commonly practiced. A review of the responsible state and professional bodies in each country is included, along with a brief discussion of any relevant legislation. Regulations relevant to the conduct of international collaboration with national research groups are included where possible.

The United States’ All of Us Research Program is a longitudinal research initiative with ambitious national recruitment goals, including of populations traditionally underrepresented in biomedical research, many of whom have high geographic mobility. The program has a distributed infrastructure, with key programmatic resources spread across the US. Given its planned duration and geographic reach both in terms of recruitment and programmatic resources, a diversity of state and territory laws might apply to the program over time as well as to the determination of participants’ rights. Here we present a listing and discussion of state and territory guidance and regulation of specific relevance to the program, and our approach to their incorporation within the program’s informed consent processes.