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The study reviewed 20 currently-available structured ethical decision-making models and developed an integrated model consisting of six steps with useful questions and tools that help better performance each step: (1) the identification of an ethical problem; (2) the collection of additional information to identify the problem and develop solutions; (3) the development of alternatives for analysis and comparison; (4) the selection of the best alternatives and justification; (5) the development of diverse, practical ways to implement ethical decisions and actions; and (6) the evaluation of effects and development of strategies to prevent a similar occurrence. From a pilot-test of the model, nursing students reported positive experiences, including being satisfied with having access to a comprehensive review process of the ethical aspects of decision making and becoming more confident in their decisions. There is a need for the model to be further tested and refined in both the educational and practical environments.

To develop and deploy CCMs better matched to societal healthcare needs, characteristics of CCMs should be precisely understood. Managing the CM workforce is expected to be critical because of a shortage of RN workers and aging-of-the-workforce issues in the US.

Decreased swallowing function is a common and main cause of malnutrition and aspiration pneumonia in patients with Parkinson's disease. The aims of this systematic review were to summarize and qualitatively analyze the studies that have been published on behavioral therapies for improving swallowing functions in patients with Parkinson's disease. Studies published from January 2000 to December 2015 were identified via electronic database searches using Ovid-MEDLINE, Ovid-EMBASE, the Cochrane Library, and 8 Korean databases. Two reviewers independently evaluated the studies using inclusion criteria. Nine studies were included, of which 6 evaluated rehabilitation technique studies and 3 evaluated compensatory strategies. The 9 studies were evaluated qualitatively using a methodology checklist of the Scottish Intercollegiate Guideline Network, according to which all of the studies had acceptable quality. The available data on the effects of rehabilitation techniques and compensatory strategies remain insufficient. Further randomized controlled studies should be done to investigate the effect of behavioral therapy on improving swallowing functions in patients with Parkinson's disease.