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Kacey Y Eichelberger, Julianna G Alson, Kemi M Doll
Racial variations in preterm birth (PTB) outcomes are well described, but causal mechanisms linking race and PTB are not. In clinical research, race is typically treated as representing fixed biological traits. In reality, race is a social construct that approximates lived experiences of historical and ongoing systematic discrimination and, in the case of PTB, particular stressors of black womanhood and reproduction. These experiences are embodied as adverse multigenerational health outcomes. Race thus presents a dilemma for researchers...
March 1, 2018: AMA Journal of Ethics
Yee Pei Song, Rovel J Colaco
Stereotactic radiosurgery (SRS) provides excellent control in the treatment of brain metastases (BM). The use of newer, targeted and immunotherapy treatments have resulted in improved overall survival in patients even with an extensive metastatic disease. Hence, it is increasingly important to consider the potential for late toxicities like radiation-induced necrosis (RN) of the brain. We present a case of a patient with stage IV anaplastic lymphoma kinase (ALK) positive adenocarcinoma of the lung who underwent stereotactic radiosurgery to her brain metastases and received targeted treatment...
January 8, 2018: Curēus
Nicholas Agyepong, Usha Govinden, Alex Owusu-Ofori, Sabiha Yusuf Essack
Background: Multidrug-resistant Gram-negative bacteria have emerged as major clinical and therapeutic dilemma in hospitals in Ghana.To describe the prevalence and profile of infections attributable to multidrug-resistant Gram-negative bacteria among patients at the Komfo Anokye Teaching Hospital in the Ashanti region of Ghana. Methods: Bacterial cultures were randomly selected from the microbiology laboratory from February to August, 2015. Bacterial identification and minimum inhibitory concentrations were conducted using standard microbiological techniques and the Vitek-2 automated system...
2018: Antimicrobial Resistance and Infection Control
Lasse T Bergmann, Larissa Schlicht, Carmen Meixner, Peter König, Gordon Pipa, Susanne Boshammer, Achim Stephan
Autonomous vehicles, though having enormous potential, face a number of challenges. As a computer system interacting with society on a large scale and human beings in particular, they will encounter situations, which require moral assessment. What will count as right behavior in such situations depends on which factors are considered to be both morally justified and socially acceptable. In an empirical study we investigated what factors people recognize as relevant in driving situations. The study put subjects in several "dilemma" situations, which were designed to isolate different and potentially relevant factors...
2018: Frontiers in Behavioral Neuroscience
H M M T B Herath, S P Pahalagamage, Sunethra Senanayake
BACKGROUND: The pathogenesis of osmotic demyelination syndrome is not completely understood and usually occurs with severe and prolonged hyponatremia, particularly with rapid correction. It can occur even in normonatremic patients, especially who have risk factors like alcoholism, malnutrition and liver disease. Bilateral tongue fasciculations with denervation pattern in electromyogram is a manifestation of damage to the hypoglossal nucleus or hypoglossal nerves. Tongue fasciculations were reported rarely in some cases of osmotic demyelination syndrome, but the exact mechanism is not explained...
March 14, 2018: BMC Research Notes
Fanny Alexandra Jakobsen, Kjersti Vik
AIM: To describe health professionals' perspectives of next of kin in the context of reablement. METHODS: A total of 49 health professionals from different organizational levels participated. Their ages, genders, experiences, and professions varied. A total of 10 focus group discussions were held in two municipalities. The data analysis was conducted using a constructivist grounded theory approach. RESULTS: The core category was identified as negotiating between themselves...
March 15, 2018: Disability and Rehabilitation
Bradley J Schaffer, Kelly Fulmer
The study examines and evaluates the effectiveness of a federal and county collaboration in Pennsylvania designed to help military veterans with child support arrearages in the criminal justice system. The study focused on the veteran participants (n=232) identified psychosocial problems, their range of justice involvement, strategies to mitigate, address barriers and legal dilemmas through the collaborative. The average age 40, majority male, Caucasian, divorced, enrolled in Veterans Administration (VA) healthcare, serving on supervised parole or probation, homeless episodes, and income <$500...
March 14, 2018: Journal of Evidence-informed Social Work
Anne-Marie Reid, Jeremy M Brown, Julie M Smith, Alexandra C Cope, Susan Jamieson
CONTEXT: For medical education researchers, a key concern may be the practicalities of gaining ethical approval where this is a national or local requirement. However, in qualitative studies, where the dynamics of human interaction pervade, ethical considerations are an ongoing process which continues long after approval has been granted. Responding to ethical dilemmas arising 'in the moment' requires a reflexive approach whereby the researcher questions his/her own motivations, assumptions and interests...
March 13, 2018: Perspectives on Medical Education
Aditya Simha, Camille Maria Webb, Ramakrishna Prasad, N Randall Kolb, Peter J Veldkamp
BACKGROUND AND OBJECTIVE: To determine whether family medicine program directors (PDs) experienced moral distress due to obstacles to Hepatitis C virus (HCV) treatment, and to explore whether they found those obstacles to be unethical. DESIGN: An omnibus survey by the Council of Academic Family Medicine's Educational Research Alliance was administered to 452 and completed by 273 US-based PDs. The survey gauged attitudes and opinions regarding ethical dilemmas in patient access to HCV treatment...
March 2018: Journal of the American Board of Family Medicine: JABFM
David B Resnik, Duncan C Randall
In this article, we explore the ethical issues related to the reporting of suspected abuse or neglect in research involving children. Ethical dilemmas related to reporting child maltreatment are often complex because the rights of children and their adult caregivers may conflict and determinations of abuse or neglect are socially constructed judgments that depend on particular circumstances. We argue that when reporting is legally mandated, investigators must follow the law and report their suspicions to Child Protective Services...
March 13, 2018: Journal of Medical Ethics
Klaus Bsl Batista, Badri Thiruvenkatachari, Jayne E Harrison, Kevin D O'Brien
BACKGROUND: Prominent upper front teeth are a common problem affecting about a quarter of 12-year-old children in the UK. The condition develops when permanent teeth erupt. These teeth are more likely to be injured and their appearance can cause significant distress. Children are often referred to an orthodontist for treatment with dental braces to reduce the prominence of their teeth. If a child is referred at a young age, the orthodontist is faced with the dilemma of whether to treat the patient early or to wait and provide treatment in adolescence...
March 13, 2018: Cochrane Database of Systematic Reviews
Morenike Oluwatoyin Folayan, Bridget Gabriella Haire, Abiola A Adeniyi, Wasiu Lanre Adeyemo
Dental caries is the main oral health challenge for children in Nigeria. Concern about its negative impact makes screening for caries in children an attractive public health strategy. The ability to detect the preclinical phase of caries, the availability of screening tools with high accuracy, and the possibility of treatment before onset of clinical symptoms with significant cost and health benefits, makes it appropriate for screening. However in Nigeria, the poor availability of highly specific and sensitive screening tools, poor access to oral health care and concerns with pre-screening consent, raise the question of the appropriateness of conducting screening programmes for children...
March 13, 2018: New Bioethics: a Multidisciplinary Journal of Biotechnology and the Body
Jennifer L Glick, Katherine Theall, Katherine Andrinopoulos, Carl Kendall
Gender-minority health disparity research is limited by binary gender measurement practices. This study seeks to broaden current discourse on gender identity measurement in the USA, including measurement adoption challenges and mitigation strategies, thereby allowing for better data collection to understand and address health disparities for people of all genders. Three data sources were used to triangulate findings: expert interviews with gender and sexuality research leaders; key-informant interviews with gender minorities in New Orleans, LA; and document analysis of relevant surveys, guides and commentaries...
March 13, 2018: Culture, Health & Sexuality
Dominik Gross, Karin Gross, Mathias Schmidt
Dental implantology is one of the most attractive and dynamic fields of work within clinical dentistry. It provides many patients with new and improved opportunities for stable (implant-supported) rehabilitation and also offers dentists a field that is interesting in both technical and economic terms. Adverse clinical outcomes are, however, often the subject of discussion. These relate both to prosthetic failure and to biologic complications and side effects, namely persistent infections surrounding implants...
March 12, 2018: Quintessence International
Antoinette J Wozniak, Ann G Schwartz
No abstract text is available yet for this article.
February 2018: Translational Lung Cancer Research
N Ab Latip, P Y Ng, S Jaili, N Mohd Noordin
Procidentia is uncommon condition altering quality of life of young and nulliparous women. Its management poses significant dilemma and challenges as its associated body image, fertility and sexuality issues. Uterine preservation surgery described by Archibald Donald in 1888 known as Manchester -Fothergill procedure seems best option as alternative to vaginal hysterectomy. Despite its increasing popularity among surgeons and patients, robust clinical evidence is needed. We report a case of recurrent procidentia in a young nulliparous woman who had Manchester repair following vaginal sacrospinous hysteropexy...
February 2018: Medical Journal of Malaysia
Roan Louw, Izelle Smuts, Kimmey-Li Wilsenach, Lindi-Maryn Jonck, Maryke Schoonen, Francois H van der Westhuizen
BACKGROUND: Coenzyme Q10 (CoQ10 ) is an important component of the mitochondrial respiratory chain (RC) and is critical for energy production. Although the prevalence of CoQ10 deficiency is still unknown, the general consensus is that the condition is under-diagnosed. The aim of this study was to retrospectively investigate CoQ10 deficiency in frozen muscle specimens in a cohort of ethnically diverse patients who received muscle biopsies for the investigation of a possible RC deficiency (RCD)...
February 23, 2018: Molecular Genetics and Metabolism
Azmeta Chowdhary, Victoria Zlotnikova, Cherie Lucas, John M Lonie
In any given year approximately 34% of the 130 million adults in the United States suffer from a mental health condition or disorder. Anxiety and depressive disorders are the most common followed by substance use disorder. Many people who suffer from a mental illness do not seek help. Studies have shown that the stigma of being perceived as having a mental illness prevents many adults from seeking help. Mental Health First Aid ™ (MHFA) is an educational program geared towards educating MHFA responders to assist those who may be experiencing a mental health condition or disorder...
February 27, 2018: Research in Social & Administrative Pharmacy: RSAP
Deanne Wong, Sebastian Morgan-Lynch
Patient portals enable people to access their health information electronically, but concerns about confidentiality and privacy breaches, particularly for young people, may be impeding portal adoption in New Zealand. This paper considers the legal and ethical framework relating to health information privacy and informed consent in New Zealand, and proposes an approach to implementing patient portals for young people. Shared portal access (where both a young person and their parent or guardian have access to the young person's portal) may be appropriate for young children whose parents or guardians are responsible for their health care...
December 2017: Journal of Primary Health Care
Jessica G Rushton, Reinhard Ertl, Dieter Klein, Alexander Tichy, Barbara Nell
Objectives Feline diffuse iris melanoma (FDIM) is the most common malignant primary intraocular tumour in cats, with reported metastases rates between 19% and 63%. Currently, the only available diagnostic tool for a tentative diagnosis is histopathological examination of the enucleated eye. Therefore, the veterinary ophthalmologist is often faced with the dilemma of whether to enucleate an oftentimes visual eye or to continue monitoring, with the risk of metastases developing. In the past, cell-free DNA (cfDNA) gained more attention in human medicine, especially in the field of oncology...
March 1, 2018: Journal of Feline Medicine and Surgery
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