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pediatric ethics

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https://www.readbyqxmd.com/read/28640695/gadolinium-brain-deposition-after-macrocyclic-gadolinium-administration-a-pediatric-case-control-study
#1
Daniel Tibussek, Christin Rademacher, Julian Caspers, Bernd Turowski, Jörg Schaper, Gerald Antoch, Dirk Klee
Purpose To determine whether signal intensity (SI) in T1 sequences as a potential indicator of gadolinium deposition increases after repeated administration of the macrocyclic gadolinium-based contrast agents (GBCAs) gadoteridol and gadoterate meglumine in a pediatric cohort. Materials and Methods This retrospective case-control study of children with brain tumors who underwent nine or more contrast material-enhanced brain magnetic resonance (MR) imaging studies from 2008 to 2015 was approved by the local ethics board...
June 21, 2017: Radiology
https://www.readbyqxmd.com/read/28640031/identifying-gaps-in-the-performance-of-pediatric-trainees-who-receive-marginal-unsatisfactory-ratings
#2
Su-Ting T Li, Daniel J Tancredi, Alan Schwartz, Ann Guillot, Ann Burke, R Franklin Trimm, Susan Guralnick, John D Mahan, Kimberly A Gifford
PURPOSE: To perform a derivation study to determine in which subcompetencies marginal/unsatisfactory pediatric residents had the greatest deficits compared with their satisfactorily performing peers and which subcompetencies best discriminated between marginal/unsatisfactory and satisfactorily performing residents. METHOD: Multi-institutional cohort study of all 21 milestones (rated on four or five levels) reported to the Accreditation Council for Graduate Medical Education, and global marginal/unsatisfactory versus satisfactory performance reported to the American Board of Pediatrics...
June 20, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28638969/introduction-childhood-and-disability
#3
EDITORIAL
Erica K Salter
From growth attenuation therapy for severely developmentally disabled children to the post-natal management of infants with trisomy 13 and 18, pediatric treatment decisions regularly involve assessments of the probability and severity of a child's disability. Because these decisions are almost always made by surrogate decision-makers (parents and caregivers) and because these decision-makers must often make decisions based on both prognostic guesses and potentially biased quality of life judgments, they are among the most ethically complex in pediatric care...
June 21, 2017: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/28638256/comparison-of-ultrasonography-and-low-dose-computed-tomography-for-the-diagnosis-of-pediatric-urolithiasis-in-the-emergency-department
#4
Recep Sade, Hayri Ogul, Suat Eren, Akin Levent, Mecit Kantarci
OBJECTIVE: This study aimed to compare ultrasonography (US) and low-dose computed tomography (LDCT) for diagnosing pediatric urolithiasis in the emergency department. MATERIALS AND METHODS: This retrospective study was approved by our institutional ethics committee, and informed consent was waived. From March 2016 to March 2017, 100 consecutive patients met the selection criteria and were enrolled in the study. Patients were randomly selected in a 1:1 ratio and were allocated to one of the following two imaging groups: US or abdominal LDCT...
June 2017: Eurasian Journal of Medicine
https://www.readbyqxmd.com/read/28625022/ethical-moral-and-theological-insights-into-advances-in-male-pediatric-and-adolescent-fertility-preservation
#5
REVIEW
J J Ramstein, J Halpern, A J Gadzinski, R E Brannigan, J F Smith
The successful treatment of boys with cancer has led to increasing attention to preserving their quality of life after completing cancer therapy. One of the top priorities for living a full life is keeping open the opportunity to have children. While sperm banking for males facing sterilizing cancer treatment can be effective, this approach requires subsequent use of reproductive procedures such as in vitro fertilization (IVF) or intrauterine insemination (IUI) to achieve a pregnancy. Advances in fertility preservation techniques may allow pre-pubertal boys to conceive using advanced stem cell technologies and stem cell transplantation in the future...
June 18, 2017: Andrology
https://www.readbyqxmd.com/read/28612650/pediatric-nurses-ethical-difficulties-in-the-bedside-care-of-children
#6
Kwisoon Choe, Yoonjung Kim, Yoonseo Yang
BACKGROUND: Pediatric nurses experience ethically difficult situations in their everyday work. Several studies have been conducted to reveal ethical issues among pediatric nurses; we do not think their ethical difficulties have been explored sufficiently from their own perspective. OBJECTIVES: This study aimed to explore the ethical difficulties faced by pediatric nurses during bedside care for hospitalized children. METHODS: A phenomenological approach was used to collect and analyze interview data from 14 female pediatric nurses in South Korea...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28609432/protective-effects-of-amniotic-fluid-in-the-setting-of-necrotizing-enterocolitis
#7
REVIEW
Soham Dasgupta, Sunil Kumar Jain
Necrotizing Enterocolitis (NEC) is the most common life threatening condition affecting preterm infants. NEC occurs in 1-5% of all neonatal intensive care admissions and 5-10% of very low birth weight infants. The protective role of human breast milk (BM) has been well established. It has also been shown that amniotic fluid (AF) and breast milk have many similarities in terms of presence of growth and other immune-modulatory factors. This finding led to the initial hypothesis that AF may exert similar protective effects against the development of NEC as does BM...
June 13, 2017: Pediatric Research
https://www.readbyqxmd.com/read/28562463/an-ethical-justification-for-termination-of-resuscitation-protocols-for-pediatric-patients
#8
Michael G Muñoz, David H Beyda
OBJECTIVE: The aim of this article was to compare specific characteristics and outcomes among adult and pediatric out-of-hospital cardiac arrest (OHCA) patients to show that the existing literature warrants the design and implementation of pediatric studies that would specifically evaluate termination of resuscitation protocols. We also address the emotional and practical concerns associated with ceasing resuscitation efforts on scene when treating pediatric patients. METHODS: Relevant prospective and retrospective studies were used to compare characteristics and outcomes between adult and pediatric OHCA patients...
June 12, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28562269/ethical-conduct-of-research-in-children-pediatricians-and-their-irb-part-2-of-2
#9
REVIEW
Carlos D Rose
In part 1 of this series, we discussed the historical, ethical, and legal background that provides justification for the current system of protection of subjects of human experimentation. We also discussed briefly the implementation of those principles in institutional review board (IRB) operations. In part 2, we focus on legislation dealing with pediatric research, the rules and ethics of assent, and then turn our attention to minimal-risk studies. To that end, we discuss the minimal-risk threshold and the process of balancing benefit and risk in IRB decisions for pediatric studies...
May 11, 2017: Pediatrics
https://www.readbyqxmd.com/read/28557746/ethical-conduct-of-research-in-children-pediatricians-and-their-irb-part-1-of-2
#10
REVIEW
Carlos D Rose
As human experimentation continues to grow into an ever more complex and sophisticated endeavor, the relevant ethical and regulatory structures become more intricate. When pediatricians and general practitioners are invited by pharmaceutical companies to enroll their offices in a clinical trial or a multicenter observational study or when they develop their own research questions, they frequently find themselves at a loss in the human research environment. The legal and regulatory complexity may have an unintended deterring effect at a time when office-based high quality pediatric research is urgently needed to support evidence-based medicine...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28523117/evaluation-of-pediatric-residents-attitudes-toward-ethical-conflict-a-cross-sectional-study-in-tehran-iran
#11
Maliheh Kadivar, Marjan Mardani-Hamooleh, Shiva Shayestefar
Ethical conflicts are recognized as critical aspects in assessing competence in clinical communication. Moreover, pediatrics residents may face more problems, compared to other disciplines; due to the specific characteristics of the age group receiving services as well as the presence of their families. This study has been conducted with the aim of determining the attitude and perspective of pediatric residents toward ethical conflicts in the field of pediatrics. This descriptive, cross-sectional study was carried out on all residents of Tehran University of Medical Sciences (90 residents), selected through census method, in 2014...
2017: Journal of Medical Ethics and History of Medicine
https://www.readbyqxmd.com/read/28513861/regulatory-and-ethical-issues-in-pediatric-clinical-research-recommendations-from-a-panel-discussion
#12
Nilima Kshirsagar, Soumya Swaminathan, Pramod Jog, Samir Dalwai, Roli Mathur, Chandra Shekhar, Bernd Meibohm, Y K Gupta, Nusrat Shafiq, Gangadhar Sunkara, V G Somani, Prasad Kulkarni, Brian Tseng, Dhvani Mehta
No abstract text is available yet for this article.
May 17, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28492186/recent-research-trends-in-dentistry
#13
REVIEW
Shobha Tandon, Annapurny Venkiteswaran, Sudhindra M Baliga, Ullal Anand Nayak
Research being an investigative process is employed to increase or revise the current knowledge. Scientific research involves the conduct of a methodical study to prove a hypothesis or give an answer to a specific question with the main aim of finding definitive answer. This paper aims to advance knowledge of research and develop interest in the postgraduate students. It also throws light on the existing and emerging research strengths within a "high-performance culture." The trends in dental research worldwide are looked at, in particular, a comparison between the publication status in two countries, namely India and Australia...
April 2017: Journal of the Indian Society of Pedodontics and Preventive Dentistry
https://www.readbyqxmd.com/read/28473474/unpasteurized-shared-human-milk-use-in-pediatric-inpatients-health-and-ethical-implications
#14
Kimberly H Barbas, Karen Sussman-Karten, Daniel Kamin, Susanna Y Huh
Growing evidence supporting the health benefits of human milk, particularly in the preterm population, has led to rising demand for donor human milk in NICUs and pediatric hospitals. There are no previous reports describing the use of unpasteurized shared human milk (USHM) in the hospital setting, but the use of USHM solicited from community donors through social networks appears to be common. Many pediatric hospitals permit inpatients to receive breast milk that has been screened and pasteurized by a human milk banking organization and will provide pasteurized donor human milk (PDHM) only to infants who are preterm or have specific medical conditions...
June 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28460701/effective-management-of-pain-and-anxiety-for-the-pediatric-patient-in-the-emergency-department
#15
REVIEW
Virginia B Young
Inadequate treatment of pain for children in the emergency department is a persistent problem. Health care professionals are bound by ethical principles to provide adequate pain management; in children, this may be challenging owing to cognitive and developmental differences, lack of knowledge regarding best practices, and other barriers. Studies have concluded that immediate assessment, treatment, and reassessment of pain after an intervention are essential. Self-report and behavioral scales are available...
June 2017: Critical Care Nursing Clinics of North America
https://www.readbyqxmd.com/read/28456730/usefulness-of-pbpk-modeling-in-incorporation-of-clinical-conditions-in-personalized-medicine
#16
REVIEW
Niloufar Marsousi, Jules A Desmeules, Serge Rudaz, Youssef Daali
Personalized medicine aims to determine the most adequate treatment and dose regimen to obtain the maximum efficacy and minimum side effect by taking into account patients' characteristics. For numerous reasons one being ethical and methodological hurdles in including specific populations in clinical trials, innovative methods for optimization of drugs safety and efficacy in such patients have received increasing interest recently. Physiologically-Based PharmacoKinetic (PBPK) modeling has emerged as a promising approach in designing adequate clinical trials and quantifying anticipated changes in unknown clinical situations...
April 26, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28456425/the-position-of-a-written-document-in-preoperative-information-for-pediatric-surgery-a-randomized-controlled-trial-on-parental-anxiety-knowledge-and-satisfaction
#17
M Landier, T Villemagne, A Le Touze, K Braïk, P Meignan, A R Cook, B Morel, H Lardy, A Binet
INTRODUCTION: Preoperative information is a legal and ethical obligation. Very little studies have evaluated the preoperative information method in pediatrics. Having a child operated on is stressful for the parents. Improving information is a way to lower their anxiety. Our study aims to measure the impact of a leaflet, which supports spoken information on parental anxiety, the comprehension-memorization of the information and their satisfaction. MATERIALS & METHODS: Prospective study including 178 patients of outpatient surgery, randomized in two groups: spoken information versus spoken information supported by a leaflet, which is then handed out to the parents...
April 21, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28448684/statistical-modeling-for-bayesian-extrapolation-of-adult-clinical-trial-information-in-pediatric-drug-evaluation
#18
Margaret Gamalo-Siebers, Jasmina Savic, Cynthia Basu, Xin Zhao, Mathangi Gopalakrishnan, Aijun Gao, Guochen Song, Simin Baygani, Laura Thompson, H Amy Xia, Karen Price, Ram Tiwari, Bradley P Carlin
Children represent a large underserved population of "therapeutic orphans," as an estimated 80% of children are treated off-label. However, pediatric drug development often faces substantial challenges, including economic, logistical, technical, and ethical barriers, among others. Among many efforts trying to remove these barriers, increased recent attention has been paid to extrapolation; that is, the leveraging of available data from adults or older age groups to draw conclusions for the pediatric population...
April 27, 2017: Pharmaceutical Statistics
https://www.readbyqxmd.com/read/28419461/assent-in-pediatric-patients
#19
Jean C Self, Jennifer A Coddington, Karen J Foli, Melanie L Braswell
AIM: To report an analysis of the concept of pediatric assent. BACKGROUND: The concept of assent is poorly defined in current literature which may lead to potentially flawed practices in obtaining pediatric assent. DESIGN: The Walker and Avant (2011) method is used to provide clarity to the concept of pediatric assent. DATA SOURCES: Data were collected from PubMed, Academic Search Premier, PhilPapers, Wikipedia, and Google...
April 17, 2017: Nursing Forum
https://www.readbyqxmd.com/read/28419019/complexities-of-consent-ethics-in-the-pediatric-emergency-department
#20
Naomi Dreisinger, Nathan Zapolsky
Informed consent is a communicative process of sharing information with patients, which helps assure their understanding of the information provided and asks for their permission to proceed. Informed consent allows a patient or a patient's family to use his or her own value system to determine the need for a particular procedure or test. Asking a patient for permission to treat requires the provider to respect the patient's autonomy through allowing him or her to be an active part of the decision-making process...
April 18, 2017: Pediatric Emergency Care
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