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https://www.readbyqxmd.com/read/28930965/bayesian-clinical-trial-designs-another-option-for-trauma-trials
#1
Jan O Jansen, Philip Pallmann, Graeme MacLennan, Marion K Campbell
Conducting clinical trials in trauma care is challenging. As new treatments become available, we are faced with the dilemma of how to confirm their effectiveness and strengthen the evidence base. Randomized controlled trials are the criterion standard, but target groups in trauma care are often small and specialized, making the classic approach to trial design difficult. Bayesian designs represent an innovative means of increasing trial efficiency and conducting trials with more realistic sample sizes. This article examines the design of such trials, using the UK-REBOA Trial as an example...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#2
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28930709/responding-to-moral-distress-and-ethical-concerns-at-the-intersection-of-medical-illness-and-unmet-mental-health-needs
#3
Donna D McKlindon, Pamela Nathanson, Chris Feudtner
Some of the most difficult clinical ethics consultations involve patients who have both medical and mental health needs, as these cases can result in considerable moral distress on the part of the bedside staff. In this article we examine the issues that such consults raise through the illustrative example of a particular case: several years ago our ethics consultation service received a request from a critical care attending physician who was considering a rarely performed psychosurgical intervention to address intractable and life-threatening agitation and aggression in an adolescent patient for whom standard treatments had proven unsuccessful...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28930705/how-we-become-who-we-are-ashley-carla-and-the-rest-of-us
#4
Jamie Lindemann Nelson
Lisa Freitag and Joan Liaschenko's thoughtful and important article goes directly to the under-examined heart of Ashley's case, namely to what sustains her in a habitable and intelligible identity. Though quite sympathetic with their conclusion and line of argument, I try to trouble their proceedings a bit, largely by wondering how having a specific such identity, out of several that may be in-principle available, matters to someone with Ashley's cognitive scope. I do this not simply to be contrary, but because their article also seems to me to raise issues in the ethics of bioethics-in particular, what I call the dilemma of ethical endeavor: How ought one publicly pursue deeply important and complex issues, the very raising of which may offend interlocutors who indeed have grounds for resentment...
2017: Journal of Clinical Ethics
https://www.readbyqxmd.com/read/28929939/the-development-of-the-professional-values-model-in-nursing
#5
Ayla Kaya, İlkay Boz
One of the most important criteria for professionalism is accumulation of knowledge that is usable in professional practice. Nursing models and theories are important elements of accumulating nursing knowledge and have a chance to guarantee the ethical professional practice. In recent years, there has been an increase in the use of models in nursing research and newly created terminology has started to be used in nursing. In this study, a new model, termed as the Professional Values Model, developed by the authors was described...
January 1, 2017: Nursing Ethics
https://www.readbyqxmd.com/read/28928930/sterile-abscess-mimicking-an-abdominal-tumor-8-years-after-laparoscopic-cholecystectomy
#6
Diganta Kakaty, Jlonca Gosztonyi, Chloe Anthamatten, Roland Zengaffinen
Spillage of gallstones (6-40%) are common during laparoscopic cholecystectomy. Development of intraperitoneal and perihepatic abscesses are relatively rare (<0.1%). However, it may pose a diagnostic dilemma mimicking intra-abdominal tumor due to their similar radiologic appearance. CASE REPORT: We present a 57-year-old woman with history of cholecystectomy 8 years prior who presented with a suspected diagnosis of incarcerated port site hernia with associated radiological evidence of an intra-abdominal tumor...
September 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28928027/development-of-a-sexual-needs-rehabilitation-framework-in-women-post-spinal-cord-injury-a-study-from-iran
#7
Raziyeh Maasoumi, Fatemeh Zarei, Effat Merghati-Khoei, Taylor Lawson, Seyyed Hasan Emami-Razavi
OBJECTIVE: To develop a sexual needs rehabilitation framework in women post spinal cord injury (SCI) DESIGN: Mixed-methods study SETTING: Brain and Spinal Cord Injury Research Center (BASIR), Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran PARTICIPANTS: Married women with at least one year passed injury INTERVENTION: Not applicable METHODS: This study was designed in three steps; primary needs assessment with quantitative and qualitative methods, prioritizing identified needs by expert panels, and developing framework...
September 16, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28927391/grand-multiparity-and-the-possible-risk-of-adverse-maternal-and-neonatal-outcomes-a-dilemma-to-be-deciphered
#8
Ghadeer K Al-Shaikh, Gehan H Ibrahim, Amel A Fayed, Hazem Al-Mandeel
BACKGROUND: The relation between grand multiparity (GMP) and the possible adverse pregnancy outcomes is not well identified. GMP (parity ≥5 births) frequently occurs in the Arab nations; therefore, this study aimed to identify the correlation between GMP and the different adverse maternal and neonatal outcomes in the Saudi population. METHOD: This cohort study was conducted on a total of 3327 women from the labour ward in King Khaled University Hospital, Riyadh, Saudi Arabia...
September 19, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28927351/public-health-terminology-hindrance-to-a-health-in-all-policies-approach
#9
Ellen S Synnevåg, Roar Amdam, Elisabeth Fosse
AIM: National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach...
September 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/28926831/multiparameter-investigation-of-a-46-xx-46-xy-tetragametic-chimeric-phenotypical-male-patient-with-bilateral-scrotal-ovotestes-and-ovulatory-activity
#10
Yolande van Bever, Katja P Wolffenbuttel, Hennie T Brüggenwirth, Eric Blom, Annelies de Klein, Bert H J Eussen, Florijn van der Windt, Sabine E Hannema, Arianne B Dessens, Lambert C J Dorssers, Katharina Biermann, Remko Hersmus, Yolanda B de Rijke, Leendert H J Looijenga
We report on an adult male initially presenting with gynecomastia and a painless scrotal mass without additional genital anomalies. Hyperpigmentation of the skin following the Blaschko's lines was identified. He underwent gonadectomy because of suspected cancer. Histological analyses revealed an ovotestis with ovulatory activity confirmed by immunohistochemistry with multiple markers. Karyotyping of cultured peripheral blood lymphocytes and a buccal smear revealed a 46,XX/46,XY chimeric constitution with different percentages...
September 20, 2017: Sexual Development: Genetics, Molecular Biology, Evolution, Endocrinology, Embryology, and Pathology of Sex Determination and Differentiation
https://www.readbyqxmd.com/read/28926501/moral-distress-and-associated-factors-among-baccalaureate-nursing-students-a-multisite-descriptive-study
#11
Lorretta Krautscheid, Deborah A DeMeester, Valorie Orton, Austin Smith, Conor Livingston, Susan M McLennon
AIM: The three study aims were to assess moral distress among senior baccalaureate nursing students, describe ethical dilemmas contributing to their moral distress in practice settings, and identify reasons for inaction when encountering dilemmas. BACKGROUND: Previous studies have linked postlicensure nurses' moral distress to compassion fatigue, frustration, and turnover. Little is known about this phenomenon in students. METHOD: This study employed a descriptive cross-sectional survey design to measure moral distress and reasons for not taking action across three academic sites (N = 267)...
September 19, 2017: Nursing Education Perspectives
https://www.readbyqxmd.com/read/28924481/euglycemic-diabetic-ketoacidosis-a-diagnostic-and-therapeutic-dilemma
#12
Prashanth Rawla, Anantha R Vellipuram, Sathyajit S Bandaru, Jeffrey Pradeep Raj
Euglycemic diabetic ketoacidosis (EDKA) is a clinical triad comprising increased anion gap metabolic acidosis, ketonemia or ketonuria and normal blood glucose levels <200 mg/dL. This condition is a diagnostic challenge as euglycemia masquerades the underlying diabetic ketoacidosis. Thus, a high clinical suspicion is warranted, and other diagnosis ruled out. Here, we present two patients on regular insulin treatment who were admitted with a diagnosis of EDKA. The first patient had insulin pump failure and the second patient had urinary tract infection and nausea, thereby resulting in starvation...
2017: Endocrinology, Diabetes & Metabolism Case Reports
https://www.readbyqxmd.com/read/28924312/outcome-of-early-surgery-in-infantile-esotropia-our-experience-in-tertiary-care-hospital
#13
Anirudh Singh, J K S Parihar, S K Mishra, R Maggon, Anurag Badhani
BACKGROUND: Infantile esotropia is a convergent strabismus presenting before 6 months of age and is the most common strabismus disorder presenting in the ophthalmology OPD. The dilemma of whether to go for early surgery and how early has been a matter of research for the last 50 years. We describe our results of surgery in infantile esotropia at variable age groups, as well as with different reoperation rates and compare with the results in western literature. METHODS: A prospective study was carried out through a review of 113 cases operated for infantile esotropia between February 2013 and August 2014...
April 2017: Medical Journal, Armed Forces India
https://www.readbyqxmd.com/read/28924060/the-dilemma-of-predicting-violent-radicalization
#14
Cécile Rousseau, B Heidi Ellis, John D Lantos
Parents, educators, law enforcement officials, and health professionals are all concerned about the violent radicalization of adolescents. Health professionals may be called on to assess teenagers regarding the risk that they will become dangerous. We present a case in which a psychiatrist is asked to do a forensic evaluation of a young adolescent who said troubling things and had some concerning posts on his Facebook page. The evaluation reveals things about both the young boy and his community.
September 18, 2017: Pediatrics
https://www.readbyqxmd.com/read/28923445/-professional-ethics-an-essential-element-of-nursing-practice
#15
Christophe Debout
The context of contemporary practice exposes nurses to a wide variety of ethical dilemmas. In 1978, nurses were granted autonomy within the scope of their therapeutic role but there was also a need for the profession to embark on a new stage by introducing a code of ethics. It was not until 2016 that the first code of ethics for nurses was published in France, 63 years after the publication of a code by the International Council of Nurses.
September 2017: Soins; la Revue de Référence Infirmière
https://www.readbyqxmd.com/read/28922189/acr-acnm-practice-parameter-for-the-performance-of-dopamine-transporter-dat-single-photon-emission-computed-tomography-spect-imaging-for-movement-disorders
#16
Rathan M Subramaniam, Kirk A Frey, Christopher H Hunt, Gustavo A Mercier, Lilja B Solnes, Patrick M Colletti, Yang Lu, Bital Savir-Baruch, Hadyn T Williams
This American College of Radiology and American College of Nuclear Medicine joint clinical practice parameter is for performance of dopamine transporter single photon emission computed tomography (SPECT) imaging, for patients with movement disorders. Parkinsonian syndrome (PS) consists of a group of neurodegenerative diseases including Parkinson disease (PD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), corticobasal degeneration (CBD), and dementia with Lewy bodies (DLB). Accurate diagnosis of PS is critical for clinical management...
September 15, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/28922001/reasons-probably-won-t-change-your-mind-the-role-of-reasons-in-revising-moral-decisions
#17
Matthew L Stanley, Ashley M Dougherty, Brenda W Yang, Paul Henne, Felipe De Brigard
Although many philosophers argue that making and revising moral decisions ought to be a matter of deliberating over reasons, the extent to which the consideration of reasons informs people's moral decisions and prompts them to change their decisions remains unclear. Here, after making an initial decision in 2-option moral dilemmas, participants examined reasons for only the option initially chosen (affirming reasons), reasons for only the option not initially chosen (opposing reasons), or reasons for both options...
September 18, 2017: Journal of Experimental Psychology. General
https://www.readbyqxmd.com/read/28921599/the-stories-we-tell-introduction-to-the-special-issue-on-ethical-challenges-in-community-psychology-research-and-practice
#18
Rebecca Campbell, Michael Morris
This Special Issue examines ethical challenges in community psychology research and practice. The literature on ethics in community psychology has remained largely abstract and aspirational, with few concrete examples and case studies, so the goal of this Special Issue was to expand our written discourse about ethical dilemmas in our field. In these articles, researchers and practitioners share stories of specific ethical challenges they faced and how they sought to resolve them. These first-person narratives examine how ethical challenges come about, how community psychology values inform ethical decision making, and how lessons learned from these experiences can inform an ethical framework for community psychology...
September 18, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28921556/dating-and-sexual-violence-research-in-the-schools-balancing-protection-of-confidentiality-with-supporting-the-welfare-of-survivors
#19
Jill D Sharkey, Lauren A Reed, Erika D Felix
Rigorous research and program evaluation are needed to understand the experience of dating and sexual violence among youth and the impact of prevention and intervention efforts. Our dilemma in doing this work occurred when youth disclosed dating and sexual violence on a research survey. What responsibility do researchers have to protect survivors' confidentiality as a research participant versus taking steps to ensure the student has the opportunity to access help? In our evaluation of a pilot dating violence prevention program, our protocols employed widely used procedures for providing resources to participants upon their completion of the survey and de-identifying survey data...
September 18, 2017: American Journal of Community Psychology
https://www.readbyqxmd.com/read/28921059/very-early-systemic-sclerosis-and-pre-systemic-sclerosis-definition-recognition-clinical-relevance-and-future-directions
#20
REVIEW
Silvia Bellando-Randone, Marco Matucci-Cerinic
PURPOSE OF REVIEW: The approach to systemic sclerosis (SSc) has changed over the years with an increasing focus on the very early diagnosis of the disease. The terminology identifying patients in the early phase of SSc has been significantly confusing in the last three decades. The purpose of this article is to analyze how the concept of "very early SSc" has evolved over the years, which is the role of an early diagnosis and how early treat patients. RECENT FINDINGS: Several attempts have been made over time, to create more sensitive and specific classification criteria to include the largest number of SSc patients, also in the earliest phase...
September 18, 2017: Current Rheumatology Reports
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