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Clinical ethics

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https://www.readbyqxmd.com/read/29241024/age-and-gender-associated-liver-physiological-t1rho-dynamics-demonstrated-with-a-clinically-applicable-single-breathhold-acquisition
#1
Yì Xiáng J Wáng, Min Deng, Jiang Lin, Anthony W L Kwok, Eric K W Liu, Weitian Chen
To understand women's and men's physiological ranges of liver T1rho relaxation time measured with a single breathhold black blood sequence, this healthy volunteer study was conducted in 62 women (mean age, 38.9 y; range, 18-75 y) and 34 men (mean age, 44.7 y; range, 24-80 y). Approval from the institutional ethics committee was obtained. Magnetic resonance imaging was performed with a 3.0T scanner with six spin-lock times of 0, 10, 20, 25, 35, and 50 ms and a single breathhold of 12 s per slice acquisition...
December 1, 2017: SLAS Technology
https://www.readbyqxmd.com/read/29240454/a-comparison-of-the-expectations-and-experiences-of-medical-students-from-high-middle-and-low-income-countries-participating-in-global-health-clinical-electives
#2
Michael J Peluso, Adam Rodman, Douglas A Mata, Anne T Kellett, Susan van Schalkwyk, Robert M Rohrbaugh
Phenomenon: Global health education (GHE) is expanding to include socioculturally and resource-different settings, with the goal of developing a workforce with members who can promote health equity locally and globally. GHE is also no longer limited to students from high-income countries (HICs). However, it is unknown whether the motivations and experiences of medical students from HICs and from low- and middle-income countries (LMICs) participating in GHE clinical electives through institutional partnerships are similar or different...
December 14, 2017: Teaching and Learning in Medicine
https://www.readbyqxmd.com/read/29239337/globose-basal-cells-for-spinal-cord-regeneration
#3
Durai Murugan Muniswami, Indirani Kanakasabapathy, George Tharion
Spinal cord injury (SCI) is a devastating condition with loss of motor and sensory functions below the injury level. Cell based therapies are experimented in pre-clinical studies around the world. Neural stem cells are located intra-cranially in subventricular zone and hippocampus which are highly invasive sources. The olfactory epithelium is a neurogenic tissue where neurogenesis takes place throughout the adult life by a population of stem/progenitor cells. Easily accessible olfactory neuroepithelial stem/progenitor cells are an attractive cell source for transplantation in SCI...
November 2017: Neural Regeneration Research
https://www.readbyqxmd.com/read/29237655/evaluation-using-cardiac-insertable-devices-and-telephone-in-hypertrophic-cardiomyopathy-elucidate-hcm-rationale-and-design-a-prospective-observational-study-on-incidence-of-arrhythmias-in-sweden
#4
Peter Magnusson, Stellan Mörner
INTRODUCTION: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease associated with sudden cardiac death (SCD) mainly due to ventricular tachycardia (VT) or fibrillation even though life-threatening bradycardia occurs. Risk stratification takes several variables into consideration including non-sustained VT (NSVT). An implantable cardioverter defibrillator effectively prevents SCD.Atrial fibrillation (AF) is common among patients with HCM and warrants anticoagulation even without conventional risk factors according to European guidelines...
December 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29237578/the-effectiveness-of-exercise-therapy-on-scapular-position-and-motion-in-individuals-with-scapular-dyskinesis-systematic-review-protocol
#5
Afsun Nodehi Moghadam, Kianoush Abdi, Mohsen Shati, Shohreh Noorizadeh Dehkordi, Abbas Ali Keshtkar, Zahra Mosallanezhad
BACKGROUND: Scapular dyskinesis is an alteration in normal scapular position and motion. Some researchers believe that altered kinematics of the scapula subsequent to dysfunction or weakness of scapular stabilizing muscles contributes to impingement syndrome. Scapular muscle exercises are included in the rehabilitation of patients with subacromial impingement syndrome and scapular dyskinesis because the muscular system is one of the major contributors of scapular positioning both at rest and during shoulder movement, but there is considerable uncertainty relating to the relative effectiveness of such approaches on changing scapular position and motion...
December 13, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29236230/gene-patents-in-canada-is-there-a-new-legal-landscape
#6
Katherine L Bonter, Carmela De Luca, Christi J Guerrini
In 2016, the Children's Hospital of Eastern Ontario (CHEO) announced the settlement of its patent lawsuit against US-based Transgenomic, Inc. At issue in the case was CHEO's ability to test for gene mutations associated with long QT syndrome (LQTS) that are described in Transgenomic's patents. CHEO challenged the patents as invalid, and Transgenomic ultimately agreed to license them on a royalty-free basis to CHEO and other healthcare institutions for LQTS testing and research. While widely celebrated in the media, the ethical rhetoric surrounding the settlement has at times obscured the practical and legal context in which it was made and will operate...
December 13, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/29234536/role-of-urethral-plate-and-fossa-navicularis-biopsies-in-the-detection-of-balanitis-xerotica-obliterans-in-boys-undergoing-redo-hypospadias-repair
#7
Mohamed Sultan, Mohamed El-Shazly, Eid Elsherif, Sheren Younes, Mohamed Selim
Objectives: To evaluate the presence of balanitis xerotica obliterans (BXO), clinically and pathologically, in the urethra of boys with failed previous hypospadias repair and where surgical management was planned. Patients and methods: Between February 2010 and March 2015, boys with failed distal penile hypospadias repair who were planned for surgical management were evaluated for the presence of clinical and pathological evidence of BXO. Samples were obtained from the urethral plate and fossa navicularis, after obtaining informed consent and ethical approval...
December 2017: Arab Journal of Urology
https://www.readbyqxmd.com/read/29234480/which-benefits-are-mentioned-most-often-in-drug-development-publications
#8
Vanessa Strüver
Objectives: The aim was to identify theoretically expected as well as actually reported benefits from drug development and the importance of individual patient benefits compared to the collective benefits to society in general. Background: Ethical guidelines require that clinical research involving humans offer the potential for benefit. A number of characteristics can be applied to define research benefit. Often benefit is categorized as being either direct or indirect...
2017: Current Therapeutic Research, Clinical and Experimental
https://www.readbyqxmd.com/read/29233397/assessment-of-student-pharmacists-ethical-decision-making
#9
Jaclyn R Myers, Mary E Kiersma, Kimberly S Plake
INTRODUCTION: In previous research, investigators have expressed concern about the ethical ambivalence of pharmacists in decision-making. The objectives of this study were to examine student pharmacists': 1) attitudes and responses regarding specific common ethical situations and 2) perceived level of difficulty in making ethical decisions. METHODS: A self-administered 38-item survey was given to second and third year student pharmacists at Purdue University. The survey comprised five sections, including: 1) attitudes towards common ethical situations, 2) responses to specific ethical scenarios, 3) emergency lending, 4) perceived level of difficulty in resolving ethical dilemmas, and 5) demographics...
November 2017: Currents in Pharmacy Teaching & Learning
https://www.readbyqxmd.com/read/29230696/an-exploration-of-the-protective-effects-of-investigators-ethical-awareness-upon-subjects-of-drug-clinical-trials-in-china
#10
L Zhang, X X Huang, H F Chen
Up till now, China has not enacted any legal mechanisms governing certification or supervision for ethics committees. This article analyses deficiencies in the protection of subjects in clinical drug trials under China's current laws and regulations; it emphasizes that investigators, as practitioners who have direct contact with subjects, play significant roles in protecting and safeguarding subjects' rights and interests. The paper compares the status quo in China in this area to that of other countries and discusses ways China might enhance the protection of rights and interests of trial subjects, such as enhancing the ethical awareness of investigators through training, improving laws and regulations, and strengthening the communication between investigators and ethics committees...
December 11, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/29229658/effectiveness-of-acupuncture-for-cancer-pain-protocol-for-an-umbrella-review-and-meta-analyses-of-controlled-trials
#11
Yihan He, Yihong Liu, Brian H May, Anthony Lin Zhang, Haibo Zhang, ChuanJian Lu, Lihong Yang, Xinfeng Guo, Charlie Changli Xue
INTRODUCTION: The National Comprehensive Cancer Network guidelines for adult cancer pain indicate that acupuncture and related therapies may be valuable additions to pharmacological interventions for pain management. Of the systematic reviews related to this topic, some concluded that acupuncture was promising for alleviating cancer pain, while others argued that the evidence was insufficient to support its effectiveness. METHODS AND ANALYSIS: This review will consist of three components: (1) synthesis of findings from existing systematic reviews; (2) updated meta-analyses of randomised clinical trials and (3) analyses of results of other types of clinical studies...
December 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/29229589/the-effect-of-group-support-psychotherapy-delivered-by-trained-lay-health-workers-for-depression-treatment-among-people-with-hiv-in-uganda-protocol-of-a-pragmatic-cluster-randomized-trial
#12
Etheldreda Nakimuli-Mpungu, Seggane Musisi, Kizito Wamala, James Okello, Sheila Ndyanabangi, Ramin Mojtabai, Jean Nachega, Ofir Harari, Edward Mills
BACKGROUND: There is limited information on the effectiveness of task shifting of mental health services in populations with HIV. OBJECTIVE: This trial aims to evaluate the effectiveness of group support psychotherapy delivered by trained lay health workers to persons living with HIV (PLWH) with depression in primary care. METHODS: Thirty eligible primary care health centers across three districts were randomly allocated to have their lay health workers trained to deliver group support psychotherapy (intervention arm) or group HIV education and treatment as usual (control arm) to PLWH with depression...
December 11, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29228962/decision-making-on-therapeutic-futility-in-mexican-adolescents-with-cancer-a-qualitative-study
#13
Carlo Egysto Cicero-Oneto, Edith Valdez-Martinez, Miguel Bedolla
BACKGROUND: The world literature shows that empirical research regarding the process of decision-making when cancer in adolescents is no longer curable has been conducted in High-income, English speaking countries. The objective of the current study was to explore in-depth and to explain the decision-making process from the perspective of Mexican oncologists, parents, and affected adolescents and to identify the ethical principles that guide such decision-making. METHODS: Purposive, qualitative design based on individual, fact-to-face, semi-structured, in-depth interviews...
December 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29228939/the-ethics-of-caring-for-hospital-dependent-patients
#14
Calvin Sung, Jennifer L Herbst
BACKGROUND: Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis...
December 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29228447/ethical-and-medico-legal-remarks-on-uterus-transplantation-may-it-solve-uterine-factor-infertility
#15
S Zaami, E Marinelli, N M di Luca, G Montanari Vergallo
Uterus transplantation was firstly tested with animal trials sixty-five years ago. Despite several successful attempts in human subjects, the different procedures still lay at the experimental stage, in need of further studies and investigations before they can be considered as standard clinical practices. Uterus transplant cannot be regarded as a life-saving procedure, but rather a method to restore woman ability to procreate, when lost, thus improving her quality of life. Uterus transplant is a complex surgical procedure and presents significant health threats...
November 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29226266/the-influence-of-race-and-ethnicity-on-becoming-a-human-subject-factors-associated-with-participation-in-research
#16
Mary A Garza, Sandra Crouse Quinn, Yan Li, Luciana Assini-Meytin, Erica T Casper, Craig S Fryer, James Butler, Natasha A Brown, Kevin H Kim, Stephen B Thomas
INRODUCTION: The purpose of this study was to explore factors associated with willingness of African Americans and Latinos to participate in biomedical and public health research and to delineate factors that influences the decision to become a human subject. METHODS: We present results from a 2010 random digit-dial telephone survey of 2,455 African American (N= 1,191) and Latino (N= 1,264) adults. We used standard measures to assess knowledge of research, terminology, informed consent procedures, previous participation in research, health care experiences, social support, risk perception, religiousness, and trust...
September 2017: Contemporary Clinical Trials Communications
https://www.readbyqxmd.com/read/29225935/gendered-negotiations-for-research-participation-in-community-based-studies-implications-for-health-research-policy-and-practice
#17
Dorcas M Kamuya, Catherine S Molyneux, Sally Theobald
There is a growing literature documenting the complex realities of consent processes in the field, and the negotiations and ethical dilemmas involved. Much has also been written about how gender and power shape household decision-making processes. However, these bodies of literature have rarely been brought together to inform research theory and practice in low-income settings. In this paper, qualitative research (observation, focus group discussions and interviews) were used alongside large clinical community-based studies conducted on the Kenyan Coast to explore how gender and power relations within households and communities and between fieldworkers and communities shape consent processes and interactions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29225934/health-policy-and-systems-research-towards-a-better-understanding-and-review-of-ethical-issues
#18
REVIEW
Valerie Ann Luyckx, Nikola Biller-Andorno, Abha Saxena, Nhan T Tran
Given the focus on health systems in the post-millennium development goal era and moving towards the sustainable development goals, there is a compelling need for a common framework for health policy and systems research ethics to guide researchers and facilitate review by research ethics committees. A consultation of global health policy and systems research and ethics experts was convened to identify ethical considerations relevant to health policy and systems research based on existing knowledge and to identify knowledge gaps through a scoping review and further expert deliberation...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29224380/ethics-and-practice-of-trials-within-cohorts-an-emerging-pragmatic-trial-design
#19
Scott Yh Kim, James Flory, Clare Relton
BACKGROUND: With increasing emphasis on pragmatic trials, new randomized clinical trial designs are being proposed to enhance the "real world" nature of the data generated. We describe one such design, appropriate for unmasked pragmatic clinical trials in which the control arm receives usual care, called "Trials within Cohorts" that is increasingly used in various countries because of its efficiency in recruitment, advantages in reducing subject burden, and ability to better mimic real-world consent processes...
December 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29224379/just-in-time-consent-the-ethical-case-for-an-alternative-to-traditional-informed-consent-in-randomized-trials-comparing-an-experimental-intervention-with-usual-care
#20
Andrew J Vickers, Danny A Young-Afat, Behfar Ehdaie, Scott Yh Kim
Informed consent for randomized trials often causes significant and persistent anxiety, distress and confusion to patients. Where an experimental treatment is compared to a standard care control, much of this burden is potentially avoidable in the control group. We propose a "just-in-time" consent in which consent discussions take place in two stages: an initial consent to research from all participants and a later specific consent to randomized treatment only from those assigned to the experimental intervention...
December 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
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