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https://www.readbyqxmd.com/read/29341962/withdrawal-of-life-sustaining-therapy
#1
Barbara G Jericho
PURPOSE OF REVIEW: The aim of this review is to examine literature relating to the withdrawal of life-sustaining therapy (WLST). RECENT FINDINGS: Discussions regarding end-of-life issues in adults and children are not occurring comprehensively. Discussions relating to the WLST in the pediatric population varies by institution and may vary by race, age, health insurance, diagnosis, and severity of illness. Completing advance directives prior to placement of life-sustaining treatments is not consistent practice...
January 15, 2018: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/29321068/psychosocial-issues-discovered-through-reflective-group-dialogue-between-medical-students
#2
Shao-Yin Chu, Chi-Wei Lin, Meei-Ju Lin, Chin-Chen Wen
BACKGROUND: The biopsychosocial model is a comprehensive approach emphasizing holistic medical care. However, medical curricula that incorporate narrative reflective writing and group dynamic discussion of psychosocial issues among patients and their family members in reflective dialogue groups are currently underutilized. The aim of this study was to determine psychosocial issues among patients and their family members through medical students' reflective dialogue groups. METHODS: This study was completed as part of a pediatric clerkship...
January 10, 2018: BMC Medical Education
https://www.readbyqxmd.com/read/29317518/should-pediatric-euthanasia-be-legalized
#3
Marije Brouwer, Christopher Kaczor, Margaret P Battin, Els Maeckelberghe, John D Lantos, Eduard Verhagen
Voluntary active euthanasia for adults at their explicit request has been legal in Belgium and the Netherlands since 2002. In those countries, acceptance of the practice for adults has been followed by acceptance of the practice for children. Opponents of euthanasia see this as a dangerous slippery slope. Proponents argue that euthanasia is sometimes ethically appropriate for minors and that, with proper safeguards, it should be legally available in appropriate circumstances for patients at any age. In this Ethics Rounds, we asked philosophers from the United States and the Netherlands, and a Dutch pediatrician, to discuss the ethics of legalizing euthanasia for children...
January 9, 2018: Pediatrics
https://www.readbyqxmd.com/read/29315204/moral-distress-model-reconstructed-using-grounded-theory
#4
Hsun-Kuei Ko, Chi-Chun Chin, Min-Tao Hsu
BACKGROUND: The problems of nurse burnout and manpower shortage relate to moral distress. Thus, having a good understanding of moral distress is critical to developing strategies that effectively improve the clinical ethical climate and improve nursing retention in Taiwan. PURPOSE: The aim of this study was to reconstruct the model of moral distress using the grounded theory. METHODS: Twenty-five staff nurses at work units who attend to the needs of adult, pediatric, acute, and critical disease or end-of-life-care patients were recruited as participants using theoretical sampling from three teaching hospitals in Taiwan...
February 2018: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/29284143/long-term-safety-of-short-term-administration-of-filgrastim-rhg-csf-and-leukophresis-procedure-in-healthy-children-application-of-peripheral-blood-stem-cell-collection-in-pediatric-donors
#5
Maryam Behfar, Sara Faghihi-Kashani, Ashraf Sadat Hosseini, Ardeshir Ghavamzadeh, Amir Ali Hamidieh
INTRODUCTION: Administration of Filgrastim (rhG-CSF) (Neupogen®) in healthy donors to mobilize hematopoietic stem cells (HSC) is a widespread practice in adults. Application of peripheral blood stem cell (PBSC) collection in normal pediatric donors is scarce due to ethical issues. Hence, there are insufficient data on the long-term impact of PBSC procedure in healthy children. This retrospective study aimed to evaluate the early and late adverse effects of PBSC donation in pediatric donors...
December 25, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29282862/use-of-a-historical-control-group-in-a-noninferiority-trial-assessing-a-new-antibacterial-treatment-a-case-study-and-discussion-of-practical-implementation-aspects
#6
David Dejardin, Paul Delmar, Charles Warne, Katie Patel, Joost van Rosmalen, Emmanuel Lesaffre
When recruitment into a clinical trial is limited due to rarity of the disease of interest, or when recruitment to the control arm is limited due to ethical reasons (eg, pediatric studies or important unmet medical need), exploiting historical controls to augment the prospectively collected database can be an attractive option. Statistical methods for combining historical data with randomized data, while accounting for the incompatibility between the two, have been recently proposed and remain an active field of research...
December 28, 2017: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/29280920/liver-transplantation-for-hepatocellular-carcinoma-within-the-milan-criteria-versus-the-university-of-california-san-francisco-criteria-a-comparative-study
#7
Mohamed R Abdelfattah, Hussein El-Siesy, Hadeel Al-Manea, Dieter C Broering
BACKGROUND: Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Currently, liver transplantation (LT) for HCC is the only hope for cure from the tumor and from end-stage liver disease (ESLD). The organ pool shortage in deceased donor LT and the donor-related ethical concerns in living-donor LT necessitate the use of rigorous criteria for LT for HCC. In this respect, two main criteria for LT for HCC were implemented with good outcome, namely, the Milan and the University of California San Francisco criteria...
December 26, 2017: European Journal of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29278434/intended-and-unintended-consequences-ethics-communication-and-prognostic-disclosure-in-pediatric-oncology
#8
Jonathan M Marron, Angel M Cronin, Tammy I Kang, Jennifer W Mack
BACKGROUND: The majority of patients desire all available prognostic information, but some physicians hesitate to discuss prognosis. The objective of the current study was to examine outcomes of prognostic disclosure among the parents of children with cancer. METHODS: The authors surveyed 353 parents of children with newly diagnosed cancer at 2 tertiary cancer centers, and each child's oncologist. Using multivariable logistic regression, the authors assessed associations between parental report of elements of prognosis discussions with the oncologist (quality of information/communication and prognostic disclosure) and potential consequences of these discussions (trust, hope, peace of mind, prognostic understanding, depression, and anxiety)...
December 26, 2017: Cancer
https://www.readbyqxmd.com/read/29277588/sport-related-traumatic-brain-injury-with-and-without-helmets-in-children
#9
Angela Bandte, Friederike-Sophie Fritzsche, Pedram Emami, Getrud Kammler, Klaus Püschel, Kara Krajewski
BACKGROUND: Soccer, bicycling and horseback riding are sports most commonly associated with traumatic brain injury (TBI) in Germany. The latter are commonly practiced with helmets and data on helmet use and usefulness vary widely. METHODS: After ethics approval, retrospective analysis was performed for patients ages 5-17 from 01/2009- 08/2014 based on the diagnosis TBI using the electronic patient file for both university hospital locations. Descriptive data analysis, multi- and univariate logistic regression were employed to calculate the odds ratio...
December 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29273009/overweight-in-children-and-its-perception-by-parents-cross-sectional-observation-in-a-general-pediatric-outpatient-clinic
#10
Daniela Nemecek, Christian Sebelefsky, Astrid Woditschka, Peter Voitl
BACKGROUND: Childhood overweight is a growing problem in industrialized countries. Parents play a major role in the development and the treatment of overweight in their children. A key factor here is the perception of their child's weight status. As we know of other studies, parental perception of children's weight status is very poor. This study aimed to determine factors associated with childhood overweight and parental misperception of weight status. The height and weight of children, as reported by parents were compared with measured data...
December 22, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/29260640/ultrasound-self-referral-does-not-increase-utilization-in-pediatric-urology
#11
Lesli Nicolay, Adam S Howe, Lane S Palmer
INTRODUCTION: Costs of radiologic imaging are rising. The goal of this study is to examine the utilization practices of pediatric urologists who have access to in-office ultrasound imaging when managing children with primary hydronephrosis. MATERIALS AND METHODS: A retrospective cross sectional study was performed of children ≤ 5 years old with an isolated diagnosis of hydronephrosis. Ultrasound utilization was evaluated by tallying the number of ultrasounds obtained during the time each child was followed...
December 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/29244801/hope-vs-caution-ethical-and-regulatory-considerations-for-neonatal-stem-cell-therapies
#12
Naomi Laventhal, Scott Rivkees, Valerie Opipari
Pediatric Research accepted article preview online, 15 December 2017. doi:10.1038/pr.2017.320.
December 15, 2017: Pediatric Research
https://www.readbyqxmd.com/read/29223665/guidelines-and-checklists-for-short-term-missions-in-global-pediatric-surgery-recommendations-from-the-american-academy-of-pediatrics-delivery-of-surgical-care-global-health-subcommittee-american-pediatric-surgical-association-global-pediatric-surgery-committee
#13
REVIEW
Marilyn Butler, Elizabeth Drum, Faye M Evans, Tamara Fitzgerald, Jason Fraser, Ai-Xuan Holterman, Howard Jen, J Matthew Kynes, Jenny Kreiss, Craig D McClain, Mark Newton, Benedict Nwomeh, James O'Neill, Doruk Ozgediz, George Politis, Henry Rice, David Rothstein, Julie Sanchez, Mark Singleton, Francine S Yudkowitz
INTRODUCTION: Pediatric surgeons, anesthesia providers, and nurses from North America and other high-income countries (HICs) are increasingly engaged in resource-limited areas, with short-term missions (STMs) as the most common form of involvement. However, consensus recommendations currently do not exist for STMs in pediatric general surgery and associated perioperative care. METHODS: The American Academy of Pediatrics (AAP) Delivery of Surgical Care Subcommittee and American Pediatric Surgical Association (APSA) Global Pediatric Surgery Committee, with the American Pediatric Surgical Nurses Association, Inc...
November 15, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29221705/female-fertility-preservation-in-the-pediatric-and-adolescent-cancer-patient-population
#14
REVIEW
Gabriela N Algarroba, Joseph S Sanfilippo, Hanna Valli-Pulaski
The 5-year survival rate for childhood cancer is over 80%, thereby increasing the number of young women facing infertility in the future because of the gonadotoxic effects of chemotherapy and radiation. The gonadotoxic effects of childhood cancer treatment vary by the radiation regimen and the chemotherapeutic drugs utilized. Although the American Society of Clinical Oncology guidelines recommend fertility preservation for all patients, there are several barriers and ethical considerations to fertility preservation in the pediatric and adolescent female population...
October 26, 2017: Best Practice & Research. Clinical Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/29191351/how-issues-of-autonomy-and-consent-differ-between-children-and-adults-kids-are-not-just-little-people
#15
Sean Reynolds, Jane M Grant-Kels, Lionel Bercovitch
Decision making in dermatology practice with adult patients is in most cases a relatively straightforward process, involving a back-and-forth exchange of information, ideas and opinions between the physician and patient. This process is more complex in the field of pediatric dermatology. It involves the triad of the patient, parent or guardian, and physician. It utilizes a model, common to many fields in pediatrics, whereby the physician seeks to obtain informed permission from the parent with the assent of the child, all the while endeavoring to act in the best interests of the child...
November 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/29187107/the-burdens-of-offering-ethical-and-practical-considerations
#16
Roxanne E Kirsch, Jillian Coronado, Peter P Roeleveld, James Tweddell, Antonio M Mott, Stephen J Roth
We reflect upon highlights of a facilitated panel discussion from the 2016 Pediatric Cardiac Intensive Care Society Meeting. The session was designed to explore challenges, share practical clinical experiences, and review ethical underpinnings surrounding decisions to offer intensive, invasive therapies to patients who have a poor prognosis for survival or are likely to be burdened with multiple residual comorbidities if survival is achieved. The discussion panel was representative of a variety of disciplines including pediatric cardiology, cardiac intensive care, nursing, and cardiovascular surgery as well as different health-care delivery systems...
November 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29184834/knowledge-attitude-and-practice-of-upper-middle-class-toward-the-importance-of-a-pediatric-dentist
#17
Gunmeen Sadana, Satinder Walia, Hashmit Kaur Rai, Neha Aggarwal, Ankita Bhargava
Aims and Objectives: This study was carried out to assess the knowledge, attitude, and practice of upper middle class toward the importance of a pediatric dentist in the city of Amritsar, Punjab. Materials and Methods: A cross-sectional study was carried out among the parents of children belonging to upper middle class in the city of Amritsar. This proposed study was assessed by the Institutional Ethical Committee (531/IDSR/2016) and their clearance was attained...
October 2017: Journal of International Society of Preventive & Community Dentistry
https://www.readbyqxmd.com/read/29184812/fertility-counseling-and-preservation-considerations-for-the-pediatric-endocrinologist
#18
REVIEW
Amanda J Saraf, Leena Nahata
Infertility is a distressing consequence of numerous pediatric medical conditions and treatments. The field of pediatric fertility preservation has expanded rapidly over the past decade, and clinical guidelines emphasize the importance of discussing infertility risk and fertility preservation options with patients and families in a timely manner. Understanding the various mechanisms and presentations of fertility issues across diagnoses is imperative to provide counseling to patients and families, and identify individuals who may benefit from fertility preservation...
October 2017: Translational Pediatrics
https://www.readbyqxmd.com/read/29184591/iranian-pediatric-nurse-s-experience-the-facilitators-of-the-learning-of-ethical-practices
#19
Kobra Karami, Sadat SeyedBagher Maddah, Abbas Abbaszadeh, Farahnaz Mohammadi Shahboulaghi, Mohammadali Hosseini, Nazila MousaviArfa, Mohammad Almasian
Background: Ethical care is a core value in nursing. Pediatric nurses are in direct and continuous contact with children and their parents. They manage their lives and health. As part of the pediatric nurses' daily work, ethical issues play an important role in making decisions, are important to make decisions, and this capability is only achieved by ethical practice. This study aimed to explore the factors facilitating the learning of ethical practice among Iranian pediatric nurses. Materials and Methods: This study is a conventional qualitative content analysis based on the Graneheim and Lundman method...
November 2017: Iranian Journal of Nursing and Midwifery Research
https://www.readbyqxmd.com/read/29179625/the-ethics-of-health-care-delivery-in-a-pediatric-malaria-vaccine-trial-the-perspectives-of-stakeholders-from-ghana-and-tanzania
#20
Claire Leonie Ward, David Shaw, Evelyn Anane-Sarpong, Osman Sankoh, Marcel Tanner, Bernice Elger
This study explores ethical issues raised in providing medical care to participants and communities of low-resource settings involved in a Phase II/III pediatric malaria vaccine trial (PMVT). We conducted 52 key informant interviews with major stakeholders of an international multi-center PMVT (GSK/PATH-MVI RTS,S) (NCT00866619) in Ghana and Tanzania. Based on their stakeholder experiences, the responses fell into three main themes: (a) undue inducement, (b) community disparities, and (c) broad therapeutic misconceptions...
November 1, 2017: Journal of Empirical Research on Human Research Ethics: JERHRE
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