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Ethics pediatrics

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https://www.readbyqxmd.com/read/28342432/-ethical-dilemmas-in-practice-of-medicine-child
#1
Justo Ruiz López, Javier Navarro Zaragoza, Francisco Carrillo Navarro, Aurelio Luna Maldonado
After reviewing the existing bibliography in the last 20 years, we concluded that there is a lack of information regarding the ethical conflicts that affect to pediatrics in their daily practice. It produces certain degree of uncertainty in these professionals at the time of solving these problems. We made a systematic search in the main data bases, finding more than 150 articles related, of which 80 were considered outstanding. After studying them, we have found 40 ethical dilemmas, related to some principle of solution and that we described in this article...
January 2017: Cuadernos de Bioética: Revista Oficial de la Asociación Española de Bioética y Ética Médica
https://www.readbyqxmd.com/read/28337687/assessing-the-culture-of-residency-using-the-c-change-resident-survey-validity-evidence-in-34-u-s-residency-programs
#2
Linda H Pololi, Arthur T Evans, Janet T Civian, Sandy Shea, Robert T Brennan
BACKGROUND: A practical instrument is needed to reliably measure the clinical learning environment and professionalism for residents. OBJECTIVE: To develop and present evidence of validity of an instrument to assess the culture of residency programs and the clinical learning environment. DESIGN: During 2014-2015, we surveyed residents using the C - Change Resident Survey to assess residents' perceptions of the culture in their programs. PARTICIPANTS: Residents in all years of training in 34 programs in internal medicine, pediatrics, and general surgery in 14 geographically diverse public and private academic health systems...
March 23, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28326208/a-child-as-a-donor-for-hematopoietic-stem-cell-transplantation-bioethical-justification-a-case-study-on-sickle-cell-disease
#3
Andrea Z Pereira, Ricardo Hellman, Nelson Hamerschlak, Andrea Kondo, Polianna Mara Rodrigues de Souza, Wilson Leite Pedreira, Luiz Fernando Alves Lima Mantovani, Eduardo Juan Troster, Henrique Grunspun, Marco Aurélio Scarpinella Bueno
Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28298942/liver-acoustic-radiation-force-impulse-arfi-in-childhood-obesity-comparison-and-correlation-with-biochemical-markers
#4
COMPARATIVE STUDY
Rajeev Kamble, Kushaljit S Sodhi, Babu R Thapa, Akshay K Saxena, Anmol Bhatia, Devi Dayal, Niranjan Khandelwal
PURPOSE: To compare and correlate the diagnostic efficiency of acoustic radiation force impulse (ARFI) elastography with biochemical markers for assessing hepatic changes in overweight and obese children. METHODS: This prospective study was approved by the institutional ethics committee. It included 54 overweight and obese children and 50 normal children (as a control group) in the age range 5-18 years. For all children, we performed grayscale ultrasonography to diagnose fatty liver, ARFI elastography to measure liver stiffness, and biochemical evaluation for aspartate aminotransferase (AST), alanine aminotransferase (ALT), and serum triglyceride (TG) levels...
March 2017: Journal of Ultrasound
https://www.readbyqxmd.com/read/28288355/time-required-to-initiate-outbreak-and-pandemic-observational-research
#5
Asgar H Rishu, Nicole Marinoff, Lisa Julien, Mariana Dumitrascu, Nicole Marten, Shauna Eggertson, Su Willems, Stacy Ruddell, Dane Lane, Bruce Light, Henry T Stelfox, Philippe Jouvet, Richard Hall, Steven Reynolds, Nick Daneman, Robert A Fowler
PURPOSE: Observational research focused upon emerging infectious diseases such as Ebola virus, Middle East respiratory syndrome, and Zika virus has been challenging to quickly initiate. We aimed to determine the duration of start-up procedures and barriers encountered for an observational study focused upon such infectious outbreaks. MATERIALS AND METHODS: At 1 pediatric and 5 adult intensive care units, we measured durations from protocol receipt to a variety of outbreak research milestones, including research ethics board (REB) approval, data sharing agreement (DSA) execution, and patient study screening initiation...
March 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28271812/elite-youth-sports-from-best-pediatric-science-practice-to-sports-practice-2016
#6
Craig A Williams
In my 2015 editorial, I selected two research publications with a focus on an applied sports sciences perspective. This year I have chosen to focus on two publications from a methodological viewpoint, highlighting the importance of laboratory procedures and extraction of data through a systematic review respectively. The first publication by Leites and colleagues (J Appl Physiol) addresses questions in relation to thermoregulation and carbohydrate metabolism in young people. This topic is difficult to conduct due to additional ethical and safety concerns due to exercising in the heat...
February 2017: Pediatric Exercise Science
https://www.readbyqxmd.com/read/28261576/personalized-medicine-in-allergic-asthma-at-the-crossroads-of-allergen-immunotherapy-and-biologicals
#7
REVIEW
Benedikt Fritzsching
Major allergic disease can be viewed as clinical syndromes rather than discrete disease entities. Emerging evidence indicates that allergic asthma includes several disease phenotypes. Immunological deviation toward high T helper cell type 2 cytokine levels has been demonstrated for a subgroup of pediatric asthma patients, and now, several novel monoclonal antibodies have been approved for treatment of this subgroup as a stratified approach of "personalized" medicine in allergy. Introduction of component-based IgE testing before allergen immunotherapy (AIT), i...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28250033/cross-sectional-analysis-of-national-dental-residency-match-data
#8
Sivaraman Prakasam, Patrick Brady, Veeratrishul Allareddy, Sankeerth Rampa, Kyungsup Shin, Romesh Nalliah, Veerasathpurush Allareddy
The Dental Residency Match (DRM) program provides an ethical and unbiased selection process for applicants to postdoctoral dental programs, based on mutual interests of applicants and programs. The aims of this study were to conduct a descriptive analysis of DRM metrics for the years 2008 to 2015 and to test the hypothesis that there was a difference in number of ranks submitted between programs that filled all their offered positions and those that did not. DRM metrics data from years 2008 to 2015 were obtained from the National Matching Service...
March 2017: Journal of Dental Education
https://www.readbyqxmd.com/read/28242148/-next-generation-dna-sequencing-in-clinical-diagnostics
#9
C Lacoste, A Fabre, C Pécheux, N Lévy, M Krahn, P Malzac, N Bonello-Palot, C Badens, P Bourgeois
The advent of next generation sequencing (NGS) technologies is so scale-changing that it modifies molecular diagnostics indications and induces laboratories to rethink their diagnostic strategies, until now based on the Sanger sequencing routine. Several high-throughput approaches are available from the sequencing of a gene panel, to an exome, or even a genome. In all cases, a tremendous amount of data is generated, which has to be filtered, interpreted and analyzed using powerful bioinformatics tools. In parallel, ethical considerations are raised to avoid the potential drifts of these powerful approaches...
February 24, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28238498/legal-social-ethical-and-medical-perspectives-on-the-care-of-the-statutory-rape-adolescent-in-the-emergency-department
#10
Shiu-Lin Tsai, Elvira Acosta, Toni Cardenas, Jeremy K Sigall, Kevin Van Geem
Rapes involving adolescents who present to the emergency department (ED) are fraught with ethical and legal complexities and are often emotionally turbulent for patients, their families, and medical providers. Management requires a thoughtful approach from multiple standpoints, including legal, psychosocial, ethical, and medical ones. However, there is no standardized sexual assault education for emergency medicine residents, and management practices vary widely.(1,2) We present a hypothetical statutory rape case based on real cases that occurred in New York City and bring together the perspectives of an attorney on the legal parameters, two social workers on the psychosocial issues, an ethicist on the moral considerations, and a pediatric emergency physician-who is also a sexual assault forensic examiner-on the medical treatments...
February 24, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28216079/2016-caps-ethics-session-ein-debate-1-regionalization-of-pediatric-surgical-care-2-ethical-introduction-of-surgical-innovation-3-addressing-stress-in-a-surgical-practice-resiliency-well-being-and-burnout
#11
REVIEW
Charles E Bagwell, Priscilla Chiu, Annie Fecteau, Kenneth W Gow, Claudia M Mueller, David Price, Andrew F Zigman
The following is the conference proceeding of the Second Ein Debate from the 48th Annual Meeting of the Canadian Association of Paediatric Surgeons held in Vancouver, BC, from September 22 to 24, 2016. The three main topics for debate, as prepared by the members of the CAPS Ethics Committee, are: 1. Regionalization of care: pros and cons, 2. Innovation in clinical care: ethical considerations, and 3. Surgeon well-being: caring for the caregiver. The authors of this paper, as participants in the debate, were assigned their positions at random...
January 29, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28207982/understanding-ethical-issues-of-research-participation-from-the-perspective-of-participating-children-and-adolescents-a-systematic-review
#12
Stacey Crane, Marion E Broome
BACKGROUND: The past 20 years have seen distinct shifts in the way the participation of children and adolescents in research is viewed. This has been emphasized by the growing pediatric research enterprise. Additional information on children's and adolescents' experiences during research participation is needed to better inform researchers on the ethical conduct of research with this vulnerable population. AIMS: The objective of this analysis was to examine ethical issues in research with children and adolescents from their perspective as participants, including: assent, parental consent, risk perception, impact of research participation, and incentives...
February 16, 2017: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/28186557/defining-the-boundaries-of-a-right-to-adequate-protection-a-new-lens-on-pediatric-research-ethics
#13
David DeGrazia, Michelle Groman, Lisa M Lee
No abstract text is available yet for this article.
February 10, 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28159363/do-the-european-medicines-agency-decisions-hurt-pediatric-melanoma-patients
#14
REVIEW
Klaus Rose, Philip D Walson
PURPOSE: US pediatric legislation was introduced in 1997 and was followed by European Union pediatric legislation that, since 2007, requires a European Medicines Agency (EMA)-approved pediatric investigation plan (PIP) for registration of new medicines unless they are PIP exempted. In 2008, the EMA decided that enough adolescent patients with melanoma existed and removed melanoma from the list of PIP-exempted diseases (class waiver list). We examined the logic and the results of this decision...
February 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28141771/ethics-in-the-pediatric-emergency-department-when-mistakes-happen-an-approach-to-the-process-evaluation-and-response-to-medical-errors
#15
Naomi Dreisinger, Nathan Zapolsky
The emergency department (ED) is an environment that is conducive to medical errors. The ED is a time-pressured environment where physicians aim to rapidly evaluate and treat patients. Quick thinking and problem-based solutions are often used to assist in evaluation and diagnosis. Error analysis leads to an understanding of the cause of a medical error and is important to prevent future errors. Research suggests mechanisms to prevent medical errors in the pediatric ED, but prevention is not always possible...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28140662/pediatric-issues-in-return-of-results-and-incidental-findings-weighing-autonomy-and-best-interests
#16
Ingrid A Holm
Nowhere are the ethical issues in genomic research more complex than in pediatrics. Balancing the sometime conflicting autonomy of the parent and the child, and the best interest of the family and the child, brings up many challenging issues. Addressing this balance, especially in the context of the child's developing maturity and comprehension, requires deep analysis and discussion. Issues discussed include the impact of genetic information on the family, parental versus the child's autonomy, the best interests of the child versus the family, potential limitations on the parents' right to know or not know information about their child, and changing role of the developing child in return of research results...
March 2017: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/28132577/unsolved-challenges-in-pediatric-whole-exome-sequencing-a-literature-analysis
#17
Gabrielle Bertier, Karine Sénécal, Pascal Borry, Danya F Vears
Whole-exome sequencing (WES) has been instrumental in the discovery of novel genes and mechanisms causing Mendelian diseases. While this technology is now being successfully applied in a number of clinics, particularly to diagnose patients with rare diseases, it also raises a number of ethical, legal and social issues. In order to identify what challenges were directly foreseen by technology users, we performed a systematic review of the literature. In this paper, we focus on recent publications related to the use of WES in the pediatric context and analyze the most prominent challenges raised by technology users...
January 28, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28106679/a-daisy-nurse-moral-distress-and-end-of-life-decisions-in-the-pediatric-setting
#18
Cynthia Divens Sweeney
What does it mean to be a "DAISY nurse"? Moral distress and end-of-life issues are difficult in any situation but, within the context of a pediatric setting, can be even more difficult. In this column, a DAISY nurse shares her thoughts on her role, her professional journey to explore moral distress and ethical decision making, and the lessons learned that led to her recognition with The DAISY Award and the joyful celebration.
February 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/28096516/newborn-sequencing-in-genomic-medicine-and-public-health
#19
Jonathan S Berg, Pankaj B Agrawal, Donald B Bailey, Alan H Beggs, Steven E Brenner, Amy M Brower, Julie A Cakici, Ozge Ceyhan-Birsoy, Kee Chan, Flavia Chen, Robert J Currier, Dmitry Dukhovny, Robert C Green, Julie Harris-Wai, Ingrid A Holm, Brenda Iglesias, Galen Joseph, Stephen F Kingsmore, Barbara A Koenig, Pui-Yan Kwok, John Lantos, Steven J Leeder, Megan A Lewis, Amy L McGuire, Laura V Milko, Sean D Mooney, Richard B Parad, Stacey Pereira, Joshua Petrikin, Bradford C Powell, Cynthia M Powell, Jennifer M Puck, Heidi L Rehm, Neil Risch, Myra Roche, Joseph T Shieh, Narayanan Veeraraghavan, Michael S Watson, Laurel Willig, Timothy W Yu, Tiina Urv, Anastasia L Wise
The rapid development of genomic sequencing technologies has decreased the cost of genetic analysis to the extent that it seems plausible that genome-scale sequencing could have widespread availability in pediatric care. Genomic sequencing provides a powerful diagnostic modality for patients who manifest symptoms of monogenic disease and an opportunity to detect health conditions before their development. However, many technical, clinical, ethical, and societal challenges should be addressed before such technology is widely deployed in pediatric practice...
February 2017: Pediatrics
https://www.readbyqxmd.com/read/28077127/navigating-social-and-ethical-challenges-of-biobanking-for-human-microbiome-research
#20
Kim H Chuong, David M Hwang, D Elizabeth Tullis, Valerie J Waters, Yvonne C W Yau, David S Guttman, Kieran C O'Doherty
BACKGROUND: Biobanks are considered to be key infrastructures for research development and have generated a lot of debate about their ethical, legal and social implications (ELSI). While the focus has been on human genomic research, rapid advances in human microbiome research further complicate the debate. DISCUSSION: We draw on two cystic fibrosis biobanks in Toronto, Canada, to illustrate our points. The biobanks have been established to facilitate sample and data sharing for research into the link between disease progression and microbial dynamics in the lungs of pediatric and adult patients...
January 11, 2017: BMC Medical Ethics
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