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https://www.readbyqxmd.com/read/28076529/relationships-between-oncohematopediatrics-mothers-and-children-in-communicating-bad-news
#1
Selene Beviláqua Chaves Afonso, Maria Cecília de Souza Minayo
We present a study about the relations between pediatric oncological haematologists, mothers, and children in sharing bad news (BN) in a public hospital in Rio de Janeiro. The text emphasizes the intertwining of technique and emotions for the treatment of children with diagnoses in which the fatal outcome is always a probability. We used a qualitative approach, privileging participant observation and open interviews with oncologists (at this service all professionals were female) and mothers. We sought to understand the importance of communication which includes expressions and control of emotions; bioethical issues that require sensitivity, serenity, and truth about approaching the end of life; and how the professionals balance proximity to children and families and objectivity in their activity...
January 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28074581/conflating-capacity-authority-why-we-re-asking-the-wrong-question-in-the-adolescent-decision-making-debate
#2
Erica K Salter
Whether adolescents should be allowed to make their own medical decisions has been a topic of discussion in bioethics for at least two decades now. Are adolescents sufficiently capacitated to make their own medical decisions? Is the mature-minor doctrine, an uncommon legal exception to the rule of parental decision-making authority, something we should expand or eliminate? Bioethicists have dealt with the curious liminality of adolescents-their being neither children nor adults-in a variety of ways. However, recently there has been a trend to rely heavily, and often exclusively, on emerging neuroscientific and psychological data to answer these questions...
January 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28057659/lactobacillus-reuteri-dsm-17938-in-the-prevention-of-antibiotic-associated-diarrhoea-in-children-protocol-of-a-randomised-controlled-trial
#3
Maciej Kołodziej, Hania Szajewska
INTRODUCTION: Administration of some probiotics appears to reduce the risk of antibiotic-associated diarrhoea (AAD). The effects of probiotics are strain-specific, thus, the efficacy and safety of each probiotic strain should be established separately. We aim to assess the effects of Lactobacillus reuteri DSM 17938 administration for the prevention of diarrhoea and AAD in children. METHODS AND ANALYSIS: A total of 250 children younger than 18 years treated with antibiotics will be enrolled in a double-blind, randomised, placebo-controlled trial in which they will additionally receive L...
January 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28039887/the-mitochondrial-replacement-therapy-myth
#4
Tina Rulli
This article argues that two forms of mitochondrial replacement therapy, maternal spindle transfer (MST) and pro-nuclear transfer (PNT), are not therapies at all because they do not treat children who are coming into existence. Rather, these technologies merely create healthy children where none was inevitable. Even if creating healthy lives has some value, it is not to be confused with the medical value of a cure or therapy. The article addresses a recent Bioethics article, 'Mitochondrial Replacement: Ethics and Identity,' by Wrigley, Wilkinson, and Appleby, who argue that PNT is morally favorable to MST due to the Non-Identity Problem...
December 30, 2016: Bioethics
https://www.readbyqxmd.com/read/28025237/responsible-innovation-in-children-s-surgical-care
#5
(no author information available yet)
Advances in medical care may occur when a change in practice incorporates a new treatment or methodology. In surgery, this may involve the translation of a completely novel concept into a new procedure or device or the adaptation of existing treatment approaches or technology to a new clinical application. Regardless of the specifics, innovation should have, as its primary goal, the enhancement of care leading to improved outcomes from the patient's perspective. This policy statement examines innovation as it pertains to surgical care, focusing on some of the definitions that help differentiate applied innovation or innovative therapy from research...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27973721/do-mitochondrial-replacement-techniques-affect-qualitative-or-numerical-identity
#6
S Matthew Liao
Mitochondrial replacement techniques (MRTs), known in the popular media as 'three-parent' or 'three-person' IVFs, have the potential to enable women with mitochondrial diseases to have children who are genetically related to them but without such diseases. In the debate regarding whether MRTs should be made available, an issue that has garnered considerable attention is whether MRTs affect the characteristics of an existing individual or whether they result in the creation of a new individual, given that MRTs involve the genetic manipulation of the germline...
January 2017: Bioethics
https://www.readbyqxmd.com/read/27932193/associations-between-built-environment-and-physical-activity-of-7-8-year-old-children-cross-sectional-results-from-the-lithuanian-cosi-study
#7
Vilma Žaltauskė, Aušra Petrauskienė
BACKGROUND AND AIM: Research shows that regular engagement in physical activity in childhood is associated with multiple physical and psychosocial health benefits. The data on associations between children physical activity level and built environment in Lithuania are limited. The built environment is one of many variables thought to affect children physical activity level. But consequently there is growing interest in how physical environment influences physical activity of school age children...
2016: Medicina
https://www.readbyqxmd.com/read/27612155/prenatal-effects-of-zika-virus-and-management-of-the-pregnant-woman
#8
Solange N Eloundou, Jeanne S Sheffield
The identification of Zika virus as a significant teratogen has raised international concern, causing the World Health Organization to declare a Public Health Emergency of International Concern. This has allowed a global mobilization of experts in tropical infectious diseases, obstetrics, pediatrics, virology, public health policy, reproductive health, bioethics, and germ cell research to name just a few. This worldwide crisis has also raised awareness of health care disparities and concerns regarding the ability of families and societies to shoulder the long-term financial burden that the follow-up of affected children will require...
September 2016: Seminars in Reproductive Medicine
https://www.readbyqxmd.com/read/27587443/vulnerable-subjects-why-does-informed-consent-matter
#9
Michele Goodwin
This special issue of the Journal Law, Medicine & Ethics takes up the concern of informed consent, particularly in times of controversy. The dominant moral dilemmas that frame traditional bioethical concerns address medical experimentation on vulnerable subjects; physicians assisting their patients in suicide or euthanasia; scarce resource allocation and medical futility; human trials to develop drugs; organ and tissue donation; cloning; xenotransplantation; abortion; human enhancement; mandatory vaccination; and much more...
September 2016: Journal of Law, Medicine & Ethics: a Journal of the American Society of Law, Medicine & Ethics
https://www.readbyqxmd.com/read/27584610/reproductive-planning-in-times-of-zika-getting-pregnant-or-delaying-plans-the-opinion-of-the-brazilian-society-of-assisted-reproduction-committee-a-basis-for-a-bioethical-discussion
#10
Bruno R de Carvalho, Paulo F Taitson, Karina S A G Brandão, Rui Alberto Ferriani, Hitomi M Nakagawa, Adelino A Silva, Joaquim R C Lopes
Although the causality between Zika virus, microcephaly, and other central nervous system disorders has been taken for granted by the scientific community, many uncertainties remain. The gap of knowledge at the moment is large enough to remove part of the confidence physicians have on the advice given to patients - and infertile women in particular - on their reproductive plans. Pretreatment serologic screening is a possible strategy to offer more confidence for individuals choosing to bear children regardless of the Zika virus, but the tests currently available do not seem to be sufficiently adequate...
August 1, 2016: JBRA Assisted Reproduction
https://www.readbyqxmd.com/read/27558392/mars-ain-t-the-kind-of-place-to-raise-your-kid-ethical-implications-of-pregnancy-on-missions-to-colonize-other-planets
#11
Haley Schuster, Steven L Peck
The colonization of a new planet will inevitably bring about new bioethical issues. One is the possibility of pregnancy during the mission. During the journey to the target planet or moon, and for the first couple of years before a colony has been established and the colony has been accommodated for children, a pregnancy would jeopardize the safety of the crew and the wellbeing of the child. The principal concern with a pregnancy during an interplanetary mission is that it could put the entire crew in danger...
December 2016: Life Sciences, Society and Policy
https://www.readbyqxmd.com/read/27462957/exhaust-all-measures-ethical-issues-in-pediatric-end-of-life-care
#12
Kara J Thieleman, Cara Wallace, Andrea N Cimino, Heidi A Rueda
The death of a child may have a profound impact on parents, family members, and health care providers who provided care for the child. Unique challenges are faced by parents of seriously ill children as they must serve as the legal authority for health care decisions of children under age 18, although the child's wishes must also be considered. Social workers must balance core social work values, bioethical values, and psychosocial issues presented by such situations. While studies have been conducted with physicians and nurses regarding ethical issues in pediatric end-of-life care settings, little is known about how social workers experience these conflicts...
July 2016: Journal of Social Work in End-of-life & Palliative Care
https://www.readbyqxmd.com/read/27461194/developing-a-bioethics-curriculum-for-medical-students-from-divergent-geo-political-regions
#13
Rebecca A Greenberg, Celine Kim, Helen Stolte, Jonathan Hellmann, Randi Zlotnik Shaul, Rahim Valani, Dennis Scolnik
BACKGROUND: The World Health Organization calls for stronger cross-cultural emphasis in medical training. Bioethics education can build such competencies as it involves the conscious exploration and application of values and principles. The International Pediatric Emergency Medicine Elective (IPEME), a novel global health elective, brings together 12 medical students from Canada and the Middle East for a 4-week, living and studying experience. It is based at a Canadian children's hospital and, since its creation in 2004, ethics has informally been part of its curriculum...
July 27, 2016: BMC Medical Education
https://www.readbyqxmd.com/read/27460832/the-dispositions-of-things-the-non-human-dimension-of-power-and-ethics-in-patient-centred-medicine
#14
John Gardner, Alan Cribb
This article explores power relations between clinicians, patients and families as clinicians engage in patient-centred ethical work. Specifically, we draw on actor-network theory to interrogate the role of non-human elements in distributing power relations in clinical settings, as clinicians attempt to manage the expectations of patients and families. Using the activities of a multidisciplinary team providing deep brain stimulation to children with severe movement disorders as an example, we illustrate how a patient-centred tool is implicated in establishing relations that constitute four modes of power: 'power over', 'power to', "power storage" and "power/discretion"...
September 2016: Sociology of Health & Illness
https://www.readbyqxmd.com/read/27456514/informed-consent-in-decision-making-in-pediatric-practice
#15
(no author information available yet)
Informed consent should be seen as an essential part of health care practice; parental permission and childhood assent is an active process that engages patients, both adults and children, in health care. Pediatric practice is unique in that developmental maturation allows, over time, for increasing inclusion of the child's and adolescent's opinion in medical decision-making in clinical practice and research.
August 2016: Pediatrics
https://www.readbyqxmd.com/read/27456510/informed-consent-in-decision-making-in-pediatric-practice
#16
Aviva L Katz, Sally A Webb
Informed consent should be seen as an essential part of health care practice; parental permission and childhood assent is an active process that engages patients, both adults and children, in their health care. Pediatric practice is unique in that developmental maturation allows, over time, for increasing inclusion of the child's and adolescent's opinion in medical decision-making in clinical practice and research. This technical report, which accompanies the policy statement "Informed Consent in Decision-Making in Pediatric Practice" was written to provide a broader background on the nature of informed consent, surrogate decision-making in pediatric practice, information on child and adolescent decision-making, and special issues in adolescent informed consent, assent, and refusal...
August 2016: Pediatrics
https://www.readbyqxmd.com/read/27349042/-results-of-autonomic-testing-in-children-with-migraine-with-aura-including-visual-and-sensory
#17
Aleksandra Gergont, Beata Gajda, Ewa Wesołowska
BACKGROUND: Despite the signs of involvement of autonomic nervous system (ANS) in the pathomechanism of migraine, the significance of its dysfunction was not fully explained. One of parameters serving to establish a balance of both ANS parts is relation of low frequency (LF) to high frequency (HF) heart rate variability (HRV), LF/ HF ratio. HF reflects parasympathetic activity, whereas LF both sympathetic and parasympathetic as well as respiratory rhythm. AIMS: The aims of the study was to establish LF and HF ratio in children with migraine with aura, during rest, passive tilting and also during active standing...
2016: Przegla̧d Lekarski
https://www.readbyqxmd.com/read/27310353/ethical-and-psychosocial-considerations-in-informing-hiv-exposed-uninfected-children-that-they-were-exposed-to-hiv-and-antiretroviral-medications-in-utero
#18
Robert Klitzman, Claude A Mellins, Morgan M Philbin, Elaine J Abrams, Robert H Remien
We build on what is known about the potential long-term health effects of perinatal antiretroviral medication exposure to examine ethical and psychosocial issues associated with disclosure by applying lessons from other health conditions, theories of child and adolescent development and rights, and the relevant literature and legal contexts. We present 2 cases to highlight potential issues; apply a bioethical framework that includes principles of autonomy, beneficence, nonmaleficence, and justice; and explore other factors, including the current uncertainty about these exposures' possible long-term health risks...
August 2016: American Journal of Public Health
https://www.readbyqxmd.com/read/27307100/effect-of-public-deliberation-on-attitudes-toward-return-of-secondary-results-in-genomic-sequencing
#19
Michele C Gornick, Aaron M Scherer, Erica J Sutton, Kerry A Ryan, Nicole L Exe, Ming Li, Wendy R Uhlmann, Scott Y H Kim, J Scott Roberts, Raymond G De Vries
The increased use of genomic sequencing in clinical diagnostics and therapeutics makes imperative the development of guidelines and policies about how to handle secondary findings. For reasons both practical and ethical, the creation of these guidelines must take into consideration the informed opinions of the lay public. As part of a larger Clinical Sequencing Exploratory Research (CSER) consortium project, we organized a deliberative democracy (DD) session that engaged 66 participants in dialogue about the benefits and risks associated with the return of secondary findings from clinical genomic sequencing...
June 16, 2016: Journal of Genetic Counseling
https://www.readbyqxmd.com/read/27251403/genomic-testing-in-the-paediatric-population-ethical-considerations-in-light-of-recent-policy-statements
#20
Ainsley J Newson, Lisa Schonstein
Genomic testing is rapidly becoming established in clinical practice and research. In this paper we consider the ethical issues arising in genomic testing in children, focusing on the clinical context. After describing how genomics can be said to depart from genetics in ethically relevant ways, we introduce two case studies involving ethical issues in paediatric genomic testing. We then summarise and critically engage with recent professional statements regarding genomic testing in children; notably the 2015 position statement from the American Society for Human Genetics...
October 2016: Molecular Diagnosis & Therapy
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