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bioethic AND children

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https://www.readbyqxmd.com/read/29806748/review-of-current-care-models-for-transgender-youth-and-application-to-the-development-of-a-multidisciplinary-clinic-the-seattle-children-s-hospital-experience
#1
Parisa Salehi, Sara A Divall, Julia M Crouch, Rebecca A Hopkinson, Leah Kroon, Jennifer Lawrence, Benjamin S Wilfond, David J Inwards-Breland
Care of transgender and gender diverse youth is complex and requires a multidisciplinary approach. Many transgender patients and providers feel the limited availability of affirming, knowledgeable professionals is a barrier to obtaining care. Such care can be provided through a clinic with providers from different disciplines who are trained in the unique care of transgender youth. In this paper, we discuss the care guidelines for transgender youth and the unresolved challenges that need to be addressed during the development of a transgender clinic...
April 2018: Pediatric Endocrinology Reviews: PER
https://www.readbyqxmd.com/read/29799532/-the-horizon-of-medical-attention-in-pediatrics-what-to-do-in-the-case-of-children-who-are-in-abandonment-conflict-harm-or-danger-situations-in-combination-with-a-severe-disease
#2
Jessica H Guadarrama-Orozco, Guillermo R Cantú-Quintanilla, Diana Ávila-Montiel, Myriam Altamirano-Bustamante, Ingris Peláez-Ballestas, Cristina Caballero-Velarde, Luis E Juárez-Villegas, Nahúm de la Vega-Morell, Javier Kelly-García, Adalberto de Hoyos-Bermea, Elisa Dorantes-Acosta, José D Gamboa-Marrufo, Onofre Muñoz-Hernández, Juan Garduño-Espinosa
Background: Laws refer that minors do not have the capability to give informed consent for their own medical attention. However, there are special conditions in which they are allowed to decide about their health. The greater the judgement and experience limitations in minors, the less weight is given to the values and objectives they express. Also, the more adverse consequences might be, the higher the level of authority that is demanded to decide on behalf of the minor, thus granting the State the capability to guarantee the well-being of the minor...
2018: Boletín Médico del Hospital Infantil de México
https://www.readbyqxmd.com/read/29686145/interpretation-of-do-not-attempt-resuscitation-orders-for-children-requiring-anesthesia-and-surgery
#3
Mary E Fallat, Courtney Hardy
This clinical report addresses the topic of pre-existing do not attempt resuscitation or limited resuscitation orders for children and adolescents undergoing anesthesia and surgery. Pertinent considerations for the clinician include the rights of children, decision-making by parents or legally approved representatives, the process of informed consent, and the roles of surgeon and anesthesiologist. A process of re-evaluation of the do not attempt resuscitation orders, called "required reconsideration," should be incorporated into the process of informed consent for surgery and anesthesia, distinguishing between goal-directed and procedure-directed approaches...
May 2018: Pediatrics
https://www.readbyqxmd.com/read/29662022/parental-opinions-and-attitudes-about-children-s-vaccination-safety-in-silesian-voivodeship-poland
#4
Bogumiła Braczkowska, Małgorzata Kowalska, Kamil Barański, Maksymilian Gajda, Tomasz Kurowski, Jan E Zejda
Despite mandatory vaccinations in Poland, the final decision on vaccination in children is taken by their parents or legal guardians. Understanding parents' attitudes and opinions regarding vaccinations is essential for planning and undertaking extensive and properly targeted educational actions aimed at preventing their hesitancy. In 2016, a cross-sectional study was conducted in the Silesian Voivodeship (Poland) in 11 randomly selected educational institutions. The authors' self-administered questionnaire contained 24 mixed-type questions...
April 15, 2018: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/29579026/targeted-muscle-reinnervation-considerations-for-future-implementation-in-adolescents-and-younger-children
#5
Kevin J Zuo, Michael P Willand, Emily S Ho, Sandra Ramdial, Gregory H Borschel
Prosthetic options for patients with proximal upper limb absence are limited. Current above-elbow prostheses may restore basic motor functions for crucial activities, but they are cumbersome to operate, lack sensory feedback, and are often abandoned. Targeted muscle reinnervation is a novel surgical procedure that enhances the ability of patients with above-elbow amputations to intuitively control a myoelectric prosthesis. By transferring multiple severed peripheral nerves to a robust target muscle, targeted muscle reinnervation restores physiologic continuity and enables more intuitive prosthetic control...
June 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29575874/influence-of-growth-hormone-therapy-on-selected-dental-and-skeletal-system-parameters
#6
Małgorzata Partyka, Renata Chałas, Izabella Dunin-Wilczyńska, Myroslava Drohomyretska, Maria Klatka
INTRODUCTION: Growth hormone deficiency (GHD) is one of the main indications for growth hormone therapy. One characteristic of this disease is bone age delay in relation to the chronological age. Pituitary dysfunction negatively affects the growth and development of the jaws and teeth of the child. The secretion of endocrine glands regulates growth, development, and gender differentiation. It also controls the growth of bones and teeth, regulates metabolism of calcium and phosphate, proteins, lipids and carbohydrates...
March 14, 2018: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/29500209/7-day-compared-with-10-day-antibiotic-treatment-for-febrile-urinary-tract-infections-in-children-protocol-of-a-randomised-controlled-trial
#7
Maria Daniel, Hania Szajewska, Małgorzata Pańczyk-Tomaszewska
INTRODUCTION: The optimal duration of antibiotic therapy in children with febrile urinary tract infections (UTIs) is still a matter of debate. Current guidelines recommend treating children with febrile UTIs with antimicrobials for 7 to 14 days. We aim to compare the efficacy and safety of 7-day versus 10-day course of oral or sequence therapy (intravenous with a switch to oral) with cefuroxime/cefuroxime axetil for febrile UTIs in children. METHODS AND ANALYSIS: A non-inferiority, double-blind, randomised, controlled trial will be conducted...
March 2, 2018: BMJ Open
https://www.readbyqxmd.com/read/29495934/the-moral-experiences-of-pediatric-nurses-in-brazil-engagement-and-relationships
#8
Raissa Passos Dos Santos, Eliane Tatsch Neves, Franco Carnevale
BACKGROUND: Pediatric nursing care involves many significant ethical challenges. Although nurses are broadly recognized as professionals with relevant knowledge about children and families, little is known about how nurses experience ethical concerns in their everyday practice. OBJECTIVE: The objective of this study was to better understand the moral experiences and related moral distress experiences of nurses working in pediatric settings in Brazil. DESIGN: Interpretative phenomenological study conducted through narrative interviews...
January 1, 2018: Nursing Ethics
https://www.readbyqxmd.com/read/29490907/parents-refusing-dialysis-for-a-3-month-old-with-renal-failure
#9
Laurel Willig, Erin Paquette, D Micah Hester, Bradley A Warady, John D Lantos
A 3-month-old boy with failure to thrive was referred to a nephrology clinic after a diagnostic workup for failure to thrive revealed a serum urea nitrogen level of 95 mg/dL and creatinine level of 3.6 mg/dL. A renal ultrasound revealed marked bilateral hydronephrosis with little remaining renal cortex in either kidney. A voiding cystourethrogram revealed evidence of posterior urethral valves. The child had no evident comorbidities. Fulguration of the valves was successfully performed but did not lead to improvement in kidney function...
February 28, 2018: Pediatrics
https://www.readbyqxmd.com/read/29363412/depathologising-gender-diversity-in-childhood-in-the-process-of-icd-revision-and-reform
#10
Amets Suess Schwend, Sam Winter, Zhan Chiam, Adam Smiley, Mauro Cabral Grinspan
From 2007 on, the World Health Organisation (WHO) has been revising its diagnostic manual, the International Statistical Classification of Diseases and Related Health Problems (ICD), with approval of ICD-11 due in 2018. The ICD revision has prompted debates on diagnostic classifications related to gender diversity and gender development processes, and specifically on the 'Gender incongruence of childhood' (GIC) code. These debates have taken place at a time an emergent trans depathologisation movement is becoming increasingly international, and regional and international human rights bodies are recognising gender identity as a source of discrimination...
January 24, 2018: Global Public Health
https://www.readbyqxmd.com/read/29343272/biotechnologies-that-empower-transgender-persons-to-self-actualize-as-individuals-partners-spouses-and-parents-are-defining-new-ways-to-conceive-a-child-psychological-considerations-and-ethical-issues
#11
REVIEW
Agnès Condat, Nicolas Mendes, Véronique Drouineaud, Nouria Gründler, Chrystelle Lagrange, Colette Chiland, Jean-Philippe Wolf, François Ansermet, David Cohen
Today, thanks to biomedical technologies advances, some persons with fertility issues can conceive. Transgender persons benefit also from these advances and can not only actualize their self-identified sexual identities but also experience parenthood. Based on clinical multidisciplinary seminars that gathered child psychiatrists and psychoanalysts interested in the fields of assisted reproduction technology (ART) and gender dysphoria, philosophers interested in bioethics, biologists interested in ART, and endocrinologists interested in pubertal suppression, we explore how new biotechnical advances, whether in gender transition or procreation, could create new ways to conceive a child possible...
January 17, 2018: Philosophy, Ethics, and Humanities in Medicine: PEHM
https://www.readbyqxmd.com/read/29258537/gender-differences-and-typical-nutrition-concerns-of-the-diets-of-preschool-children-the-results-of-the-first-stage-of-an-intervention-study
#12
Sylwia Merkiel-Pawłowska, Wojciech Chalcarz
BACKGROUND: Nutrition in children has an important influence on health both in childhood and adulthood. Actions aimed at improving children's nutrition are essential, not only to the children and their families, but also to the whole society. The aim of the study was to present the results of nutrient intake before starting a nutrition and physical activity intervention programme, to investigate gender differences in nutrient intake and to discuss whether the preschoolers' nutrient intake is similar to the intake of their peers from other countries...
December 19, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29209695/cosmetic-surgery-for-children-and-adolescents-deontological-and-bioethical-remarks
#13
REVIEW
A Del Rio, R Rinaldi, S Napoletano, N M di Luca
The only interventions deemed ethically acceptable are those that serve the "objective interest" of the minors involved from the standpoint of and conducive to sound mental health and balance in a patient's teenage years; by the same token, disproportionate interventions (e.g. overly invasive or pointlessly risky), or all those deemed unsuitable with regards to a poor cost-benefit ratio are viewed as unacceptable. In the process of considering the best interest of the minors involved, a wide array of factors come into play, such as: age, maturity, psychological and emotional conditions, motivations put forth by the underage patient, the opportunity to procrastinate the operation: parents, who are naturally entitled to give consent to the surgical procedures, and physicians are primarily liable to safeguard and act in the minor's best interest...
November 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/29190346/broad-support-for-regulating-the-clinical-implementation-of-future-reproductive-techniques
#14
S Hendriks, R Vliegenthart, S Repping, E A F Dancet
STUDY QUESTION: Do gynaecologists, infertile patients and the general public, consider that regulation of the clinical implementation of stem cell-based fertility treatments is required? SUMMARY ANSWER: There is broad support from gynaecologists, patients and the general public for regulating the clinical implementation of future stem cell-based fertility treatments. WHAT IS KNOWN ALREADY: There is debate on the need to regulate the clinical implementation of novel techniques...
January 1, 2018: Human Reproduction
https://www.readbyqxmd.com/read/29111941/reasons-to-amplify-the-role-of-parental-permission-in-pediatric-treatment
#15
Mark Christopher Navin, Jason Adam Wasserman
Two new documents from the Committee on Bioethics of the American Academy of Pediatrics (AAP) expand the terrain for parental decision making, suggesting that pediatricians may override only those parental requests that cross a harm threshold. These new documents introduce a broader set of considerations in favor of parental authority in pediatric care than previous AAP documents have embraced. While we find this to be a positive move, we argue that the 2016 AAP positions actually understate the importance of informed and voluntary parental involvement in pediatric decision making...
November 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29025837/effects-of-lactobacillus-rhamnosus-gg-and-bifidobacterium-lactis-bb12-on-beta-cell-function-in-children-with-newly-diagnosed-type-1-diabetes-protocol-of-a-randomised-controlled-trial
#16
Lidia Groele, Hania Szajewska, Agnieszka Szypowska
INTRODUCTION: Recent evidence has demonstrated that, among other factors, dysbiosis (imbalances in the composition and function of the gut microbiota) may be relevant in the development of type 1 diabetes (T1D). Thus, gut microbiota may be a target for improving outcomes in subjects with T1D. The aim of the study is to examine the effects of Lactobacillus rhamnosus GG and Bifidobacterium lactis Bb12 on beta-cell function in children with newly diagnosed T1D. METHODS AND ANALYSIS: A total of 96 children aged 8 to 17 years with newly diagnosed T1D, confirmed by clinical history and the presence of at least one positive autoantibody, will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will receive L...
October 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28947504/medical-and-bioethical-considerations-in-elective-cochlear-implant-array-removal
#17
Maryanna S Owoc, Elliott D Kozin, Aaron Remenschneider, Maria J Duarte, Ariel Edward Hight, Marjorie Clay, Susanna E Meyer, Daniel J Lee, Selena Briggs
OBJECTIVE: Cochlear explantation for purely elective (e.g. psychological and emotional) reasons is not well studied. Herein, we aim to provide data and expert commentary about elective cochlear implant (CI) removal that may help to guide clinical decision-making and formulate guidelines related to CI explantation. DATA SOURCES: We address these objectives via three approaches: case report of a patient who desired elective CI removal; review of literature and expert discussion by surgeon, audiologist, bioethicist, CI user and member of Deaf community...
March 2018: Journal of Medical Ethics
https://www.readbyqxmd.com/read/28945637/serum-hepcidin-in-children-with-inflammatory-bowel-disease
#18
Paulina Krawiec, Agnieszka Mroczkowska-Juchkiewicz, Elżbieta Pac-Kożuchowska
BACKGROUND: Hepcidin is a major regulator of iron homeostasis and a mediator of innate immunity. To date, the role of hepcidin in inflammatory bowel disease (IBD) children is not clearly established. We aimed to assess serum hepcidin concentration in IBD children and correlate hepcidin with iron status parameters and inflammatory markers. METHODS: The study group included 46 pediatric patients with ulcerative colitis and 29 with Crohn's disease. In control group, there were 21 children with functional gastrointestinal disorders...
December 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28943969/the-right-to-know-and-the-right-not-to-know-revisited-part-one
#19
Roger Brownsword, Jeff Wale
Prompted by developments in human genetics, a recurrent bioethical question concerns a person's 'right to know' and 'right not to know' about genetic information held that is intrinsically related to or linked to them. In this paper, we will revisit the claimed rights in relation to two particular test cases. One concerns the rights of the 500,000 participants in UK Biobank (UKB) whose biosamples, already having been genotyped, will now be exome sequenced, and the other concerns the rights of pregnant women (and their children) who undergo non-invasive prenatal testing (NIPT)-a simple blood test that can reveal genetic information about both a foetus and its mother...
2017: Asian Bioethics Review
https://www.readbyqxmd.com/read/28873213/bioethics-children-and-the-environment
#20
Timothy F Murphy
Queer perspectives have typically emerged from sexual minorities as a way of repudiating flawed views of sexuality, mischaracterized relationships, and objectionable social treatment of people with atypical sexuality or gender expression. In this vein, one commentator offers a queer critique of the conceptualization of children in regard to their value for people's identities and relationships. According to this account, children are morally problematic given the values that make them desirable, their displacement of other beings and things entitled to moral protection, not to mention the damaging environmental effects that follow in the wake of population growth...
January 2018: Bioethics
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