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Clinical ethics evaluation

Laurence M Binder
OBJECTIVE: To discuss specific issues regarding consent for neuropsychological evaluation and the patient-psychologist relationship within the context of the Ethics Code of the American Psychological Association and relevant literature. METHOD: The author makes recommendations based on the Ethics Code and published sources. This article is advisory and does not prescribe ethical practice. CONCLUSIONS: The presence or absence of a patient-psychologist relationship is an essential consideration...
December 14, 2018: Clinical Neuropsychologist
Kang Wang, Shuo Qi, Hezheng Lai, Xiaoshu Zhu, Guobing Fu
BACKGROUND: Cancer-related fatigue (CRF) is a prevalent and debilitating symptom experienced by cancer survivors, one that severely compromises functional independence and quality of life. Clinical massage therapy (CMT), as an important part of complementary and alternative medicine, is widely employed among massage therapists, physical therapists, nurses, and physicians when managing CRF. Clinical research indicates that CMT produced relief of CRF. In this systematic review, we aim to evaluate the effectiveness and safety of CMT for patients with CRF...
December 2018: Medicine (Baltimore)
Anine P Skibsted, Moshgan Amiri, Patrick M Fisher, Annette Sidaros, Melita Cacic Hribljan, Vibeke Andrée Larsen, Joan Lilja S Højgaard, Miki Nikolic, John Hauerberg, Martin E Fabricius, Gitte Moos Knudsen, Kirsten Møller, Daniel Kondziella
Aims and Objectives: To facilitate individualized assessment of unresponsive patients in the intensive care unit for signs of preserved consciousness after acute brain injury. Background: Physicians and neuroscientists are increasingly recognizing a disturbing dilemma: Brain-injured patients who appear entirely unresponsive at the bedside may show signs of covert consciousness when examined by functional MRI (fMRI) or electroencephalography (EEG). According to a recent meta-analysis, roughly 15% of behaviorally unresponsive brain-injured patients can participate in mental tasks by modifying their brain activity during EEG- or fMRI-based paradigms, suggesting that they are conscious and misdiagnosed...
2018: Frontiers in Neurology
Elisa J Gordon, Catherine Wicklund, Jungwha Lee, Richard R Sharp, John Friedewald
INTRODUCTION: There is debate over whether Apolipoprotein L1 (APOL1) gene risk variants contribute to African American (AA) live donors' (LD) increased risk of kidney failure. Little is known about factors influencing physicians' integration of APOL1 genetic testing of AA LDs into donor evaluation. DESIGN: We conducted a cross-sectional survey, informed by Roger's Diffusion of Innovations theory, among nephrology and surgeon members of the American Society of Nephrology, American Society of Transplantation, and American Society of Transplant Surgeons about their practices of and attitudes about APOL1 genetic testing of AA potential LDs...
December 13, 2018: Progress in Transplantation
Teresa M S A Böhm, Christoph J Klinger, Natalie Gedon, Laura Udraite, Katja Hiltenkamp, Ralf S Mueller
OBJECTIVE: Edible insects (like mealworms, locusts and crickets) contain energy, protein, fatty acids, minerals and trace elements and have been found to be high quality food sources. They could provide a new food source for patients with adverse food reactions, as well as being of ecological and ethical interest. The aim of this study was to evaluate the effect of a new commercially available, insect protein-based diet on the clinical signs in those dogs via Canine Atopic Dermatitis Lesion Index (CADLI), Pruritus Visual Analogue Scale (PVAS) and coat quality score...
October 2018: Tierärztliche Praxis. Ausgabe K, Kleintiere/Heimtiere
Ramona Meister, Mariam Abbas, Jochen Antel, Triinu Peters, Yiqi Pan, Ulrike Bingel, Yvonne Nestoriuc, Johannes Hebebrand
Children and adolescents with major depressive disorder (MDD) appear to be more responsive to placebo than adults in randomized placebo-controlled trials (RCTs) of second and newer generation antidepressants (SNG-AD). Previous meta-analyses obtained conflicting results regarding modifiers. We aimed to conduct a meta-analytical evaluation of placebo response rates based on both clinician-rating and self-rating scales. Based on the most recent and comprehensive study on adult data, we tested whether the placebo response rates in children and adolescents with MDD also increase with study duration and number of study sites...
December 8, 2018: European Child & Adolescent Psychiatry
Jane W Seymour, Laura Fix, Daniel Grossman, Kate Grindlay
Introduction: Despite evidence that the unintended pregnancy rate is higher among U.S. servicewomen than the general population and that servicewomen may face barriers to contraceptive use, there is little research about contraceptive access and use experiences of non-deployed active duty servicewomen. This qualitative study aimed to explore the experiences of accessing contraception while in the U.S. military among active duty servicewomen who had an abortion. Materials and Methods: From January 2015 to July 2016, we conducted qualitative in-depth interviews with 21 servicewomen who had obtained an abortion within the prior two years while active duty...
December 7, 2018: Military Medicine
Ashleigh C N Gibb, Megan A Crosby, Caraline McDiarmid, Denisa Urban, Jennifer Y K Lam, Paul W Wales, Megan Brockel, Mehul Raval, Martin Offringa, Erik D Skarsgard, Tomas Wester, Kenneth Wong, David de Beer, Gregg Nelson, Mary E Brindle
INTRODUCTION: Enhanced Recovery After Surgery (ERAS) guidelines integrate evidence-based practices into multimodal care pathways designed to optimise patient recovery following surgery. The objective of this project is to create an ERAS protocol for neonatal abdominal surgery. The protocol will identify and attempt to bridge the gaps between current practices and best evidence. Our study is the first paediatric ERAS protocol endorsed by the International ERAS Society. METHODS: A research team consisting of international clinical and family stakeholders as well as methodological experts have iteratively defined the scope of the protocol in addition to individual topic areas...
December 9, 2018: BMJ Open
Yan Luo, Anna Chaimani, Yuki Kataoka, Edoardo Giuseppe Ostinelli, Yusuke Ogawa, Andrea Cipriani, Georgia Salanti, Toshi A Furukawa
INTRODUCTION: Depressive disorders are the most common, burdensome and costly mental disorders. Their treatments have developed through the past decades and we now have more than a dozen new generation antidepressants, while a series of guidelines have been published to provide recommendations over the years. However, there still may exist important gaps in this evidence synthesis and implementation process. Systematic reviews may not have been conducted in the most unbiased, informative and timely manners; guidelines may not have reflected the most up-to-date evidence; clinicians may not have changed their clinical decision-makings in accordance with the relevant evidence...
December 9, 2018: BMJ Open
Christopher Herndon, Joseph Lider
INTRODUCTION: This study compared the end-of-life care (EOLC) content in pharmacy-related textbooks to textbooks evaluated in a comparable 2003 study. METHODS: Six common pharmacy-related textbooks were reviewed for content relating to EOLC. Five of the textbooks were the newest editions of the same texts reviewed in a similar 2003 study, and one focused primarily on clinical ethics, a topic that was underrepresented in the previous study. The six texts were searched for a list of 33 keywords or phrases pertaining to EOLC...
January 2019: Currents in Pharmacy Teaching & Learning
Alan E Kazdin
Single-case designs refer to a methodological approach that can be used to investigate the effectiveness of treatment with the individual client. The designs permit scientifically valid inferences to be drawn about the effects of treatment and hence offer advantages over alternative strategies such as the uncontrolled case study or open study that are used with the individual case. The present article discusses the key features of the methodology, illustrates specific designs and how inferences are drawn, and discusses critical issues (feasibility, generality of results, ethical issues) in the use of the designs...
December 2, 2018: Behaviour Research and Therapy
Chris Wayman, Rachel Russell, Kim Tang, Laura Weibly, Samantha Gaboardi, Lucy Fisher, Kelly Allers, Margaret Jackson, Tony Hawcock, Nicola Robinson, Lesley Wilson, Julie Gupta, James Casey, Karl R Gibson
INTRODUCTION: Few treatments are available for men with premature ejaculation (PE); oxytocin (OT) receptor antagonism in the central nervous system (CNS) is a potential new approach. AIM: To determine if cligosiban selectively inhibits human OT receptors, penetrates the CNS, shows pharmacology in the CNS, and effects ejaculatory physiology in pre-clinical systems. METHODS: Experiments complied with United Kingdom legislation and were subject to local ethical review...
December 2018: Journal of Sexual Medicine
Sanne M Snelder, Lotte E de Groot-de Laat, L Ulas Biter, Manuel Castro Cabezas, Gert-Jan van de Geijn, Erwin Birnie, Bianca Boxma-de Klerk, René A Klaassen, Felix Zijlstra, Bas M van Dalen
INTRODUCTION: In view of the increasing occurrence of both obesity and heart failure, a growing overlap of these two clinical entities in the near future is expected. Significant advances in our understanding of the pathophysiological consequences of obesity for the cardiovascular system have been made over the past two decades. However, to optimise management and treatment of obesity patients, further research is required to improve early identification of cardiac dysfunction in obesity and to gain insight in the underlying pathophysiology...
December 5, 2018: BMJ Open
Elif Akyüz, Hülya Bulut, Mevlüde Karadağ
BACKGROUND: Informed consent involves patients being informed, in detail, of information relating to diagnosis, treatment, care and prognosis that relates to him or her. It also involves the patient explicitly demonstrating an understanding of the information and a decision to accept or decline the intervention. Nurses in particular experience problems regarding informed consent. RESEARCH QUESTION AND DESIGN: This descriptive study was designed to determine nurse knowledge and practices regarding their roles and responsibilities for informed consent in Turkey...
December 6, 2018: Nursing Ethics
Talia Donenberg, Sophia George, Jameel Ali, Gabriela Bravo, Karen Hernandez, Navin Sookar, Kimlin Tam Ashing, Steven A Narod, Mohammad R Akbari, Judith Hurley
INTRODUCTION: Breast cancer (BC) is the leading cause of cancer death in Caribbean women. Across the Caribbean islands, the prevalence of hereditary breast cancer among unselected breast cancer patients ranges from 5 to 25%. Moreover, the prevalence of BC among younger women and the high mortality in the Caribbean region are notable. This BC burden presents an opportunity for cancer prevention and control that begins with genetic testing among high-risk women. Measured response to positive genetic test results includes the number of preventive procedures and cascade testing in family members...
December 4, 2018: Breast Cancer Research and Treatment
Jacques Balayla, Togas Tulandi
OBJECTIVE: This study sought to evaluate perceptions and insights regarding uterine transplantation among members of a women's health care national specialty organization in Canada. METHODS: The investigators obtained permission and used an electronic survey developed by Bortoletto et al. to conduct a cross-sectional study of members of the SOGC between April and May 2018. Participants were requested to answer a total of 29 questions grouped into four different categories: personal opinions and attitudes, medical opinions, ethical opinions, and demographics...
December 1, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
Karsten Bernerth, Ingolf Schiefke, Karin Liebscher, Susanne Raczynski, Tanja Kottmann, Niels Teich
OBJECTIVE: Coagulation factor XIII plays a key role in fibrin clot stabilization and epithelial healing. Under chronic inflammatory conditions involving bleeding and an activation of the coagulation cascade, the FXIIIa inversely correlate with disease activity. We assumed that FXIIIa could be a predictor of severity in patients with ulcerative colitis (UC). Here, we evaluated the course of plasma activity of FXIIIa in 49 patients with mild to moderate UC and active rectal bleeding. Patients with a partial Mayo bleeding subscore > 2 were eligible to participate in our prospective observational study in an outpatient setting...
December 4, 2018: BMC Research Notes
Joyson J Karakunnel, Nam Bui, Latha Palaniappan, Keith T Schmidt, Kenneth W Mahaffey, Briggs Morrison, William D Figg, Shivaani Kummar
BACKGROUND: With the exception of genotoxic oncology drugs, first-in-human, Phase 1 clinical studies of investigational drugs have traditionally been conducted in healthy volunteers (HVs). The primary goal of these studies is to investigate the pharmacokinetics and pharmacodynamics of a novel drug candidate, determine appropriate dosing, and document safety and tolerability. MAIN BODY: When tailored to specific study objectives, HV studies are beneficial to manufacturers and patients alike and can be applied to both non-oncology and oncology drug development...
December 4, 2018: Journal of Translational Medicine
Marthe Smedinga, Krista Tromp, Maartje H N Schermer, Edo Richard
BACKGROUND: The shift to defining Alzheimer's disease (AD) as a biological continuum, which is characterized by the presence of biomarkers instead of clinical symptoms, has sparked a widespread debate. Insight into the given arguments and their underlying moral values is crucial to ensure well-considered and appropriate AD biomarker testing in the future. OBJECTIVE: To critically review the arguments in favor of or against AD biomarker testing in people with no or mild cognitive impairment and to explicate their underlying moral values...
November 26, 2018: Journal of Alzheimer's Disease: JAD
Yuhong Xie, Xiaojie Wang, Zhifen Chen, Pan Chi, Guoxian Guan, Huiming Lin, Xingrong Lu, Ying Huang, Zhengqiong Wang, Mingxing Wang, Jie Chen, Xiuying Li, Min Wang, Xuezhen Zheng, Ximei Zheng, Ran Li, Qianqian Lin
OBJECTIVE: To investigate the efficacy and safety of the bladder training in male patients before urinary catheter removal after mid-low rectal cancer surgery. METHODS: This was a prospective, open, randomized controlled study. INCLUSION CRITERIA: male patients; pathologically diagnosed as mid-low rectal adenocarcinoma; distance from tumor lower edge to anal margin ≤10 cm; standard radical surgery for rectal cancer, including intestinal resection and regional lymph node dissection...
November 25, 2018: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
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