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MedWorm: Medical Ethics



MedWorm.com provides a medical RSS filtering service. Over 7000 RSS medical sources are combined and output via different filters. This feed contains the latest news and research in Medical Ethics



Last Build Date: Mon, 28 Mar 2016 07:22:18 +0100

 



Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria.

Sun, 27 Mar 2016 04:06:02 +0100

This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations. PMID: 27012484 [PubMed - in process] (Source: The Journal of Alzheimers Association)

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The role of the Ethics Committees in the application of the European Regulation No 536/2014.

Sat, 26 Mar 2016 11:11:03 +0100

Authors: Marinelli E, Busardò FP PMID: 27010129 [PubMed - in process] (Source: European Review for Medical and Pharmacological Sciences)



Exploring the views of people with mental health problems’ on coercion: Towards a broader socio-ethical perspective

Fri, 25 Mar 2016 23:00:00 +0100

This study includes semi-structured focus-groups and individual interviews with 24 participants who had various mental health problems and experiences with coercion. Data were collected in 2012- 2013 in three regions of Norway and analysed by a thematic content analysis. Findings show that participants had wide-ranging accounts of coercion, including formal and informal coercion across health- and welfare services. They emphasised that using coercion reflects the mental health system’s tendency to rely on coercion and the lack of voluntary services and treatment methods that are more helpful. Other core characteristics of coercion were deprivation of freedom, power relations, in terms of powerlessness and ‘counter-power,’ and coercion as existential and social life events. Participan...



Risk indicator taxonomy for supervision of clinical trials on medicinal products.

Fri, 25 Mar 2016 18:58:02 +0100

CONCLUSIONS: We identified a wide array of risk indicators for clinical trials on medicinal products and we used a tree-structure to incorporate the indicators identified to clearly distinguish individual indicators and to enable efficient use of the indicators. The overview of indicators may facilitate multiple stakeholders in developing structured risk assessment (identification and analysis) for supervising clinical trials on medicinal products. Stakeholders can interpret and prioritise the indicators from their own perspective. PMID: 27009363 [PubMed - as supplied by publisher] (Source: Current Medical Research and Opinion)



Special Report: The Psychology of Terrorism

Fri, 25 Mar 2016 18:12:16 +0100

Five experts share recent studies, classical research and professional experiences that shed light on defusing the threat of extremism -- Read more on ScientificAmerican.com (Source: Scientific American)



Adolescent Research Participants' Descriptions of Medical Research.

Fri, 25 Mar 2016 16:43:01 +0100

CONCLUSIONS: Adolescents participating in clinical research and their parents generally describe medical research in terms of its goals of advancing science and finding new medicines and treatments, sometimes in combination with helping the enrolled individuals. The majority perceives a difference between research and regular medical care and described these differences in various ways. Further exploration is warranted about how such perceived differences matter to participants and how this understanding could be used to enhance informed consent and the overall research experience. PMID: 27004235 [PubMed - as supplied by publisher] (Source: AJOB Primary Research)

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Involving parents from the start: formative evaluation for a large randomised controlled trial with Botswana Junior Secondary School students.

Fri, 25 Mar 2016 15:52:07 +0100

Authors: Vig J, Miller KS, Chirwa-Motswere C, Winskell K, Stallcup E Abstract While HIV prevention research conducted among adolescent populations may encounter parental resistance, the active engagement of parents from inception to trial completion may alleviate opposition. In preparation for implementing a large randomised controlled trial (RCT) examining the efficacy of a behavioural intervention targeting adolescent sexual risk behaviours, a formative evaluation was undertaken to assess parental reactions to the proposed trial. Six focus groups were conducted with parents of adolescents (aged 13-17) from rural, peri-urban and urban junior secondary schools in Botswana. Focus groups explored comprehension and acceptability among parents of the forthcoming trial including HSV-2 t...



Ethical Problems

Fri, 25 Mar 2016 12:44:18 +0100

No abstract available (Source: Nursing)



Undertake ethically sound medical education research.

Fri, 25 Mar 2016 08:07:04 +0100

Authors: Pugsley L Abstract There are key ethical principles that need to be considered before the start of any research study. The research should be designed, reviewed and conducted in ways that ensure the integrity and the quality of the work. Researchers and research participants need to be fully informed as to the purpose, methods and possible uses of the study. Participation needs to be voluntary with a right to withdraw at any stage clearly stated. Anonymity and confidentiality must be respected and maintained, within the usual caveats of potential for danger or harm. Ethical approval must be obtained from an appropriate professional body or group. This is an essential step which should not be overlooked as it affords objective scrutiny to each piece of research and also pub...



DOW Chemical, EPA to participate in PETA Science Consortium Webinar Series on inhalation toxicity

Fri, 25 Mar 2016 04:00:00 +0100

(People for the Ethical Treatment of Animals) A seminar series starting Tuesday will address current practices for acute inhalation toxicity testing and examine the development and implementation of alternative approaches to reduce and replace acute inhalation testing in mammals for both global regulatory agencies and non-regulatory purposes. (Source: EurekAlert! - Cancer)



Performance of medical students on a virtual reality simulator for knee arthroscopy: an analysis of learning curves and predictors of performance

Fri, 25 Mar 2016 00:00:00 +0100

Ethical concerns for surgical training on patients, limited working hours with fewer cases per trainee and the potential to better select talented persons for arthroscopic surgery raise the interest in simulat... (Source: BMC Surgery)

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[Policy Forum] Ethics review for international data-intensive research

Thu, 24 Mar 2016 23:00:00 +0100

Historically, research ethics committees (RECs) have been guided by ethical principles regarding human experimentation intended to protect participants from physical harms and to provide assurance as to their interests and welfare. But research that analyzes large aggregate data sets, possibly including detailed clinical and genomic information of individuals, may require different assessment. At the same time, growth in international data-sharing collaborations adds stress to a system already under fire for subjecting multisite research to replicate ethics reviews, which can inhibit research without improving the quality of human subjects' protections (1, 2). “Top-down” national regulatory approaches exist for ethics review across multiple sites in domestic research projects [e.g., Un...



Clinical impact of neoadjuvant treatment in resectable pancreatic cancer: a systematic review and meta-analysis protocol

Thu, 24 Mar 2016 23:00:00 +0100

Introduction Although the only curative strategy for pancreatic cancer is surgical resection, up to 85% of patients relapse after surgery. The efficacy of neoadjuvant treatment in resectable pancreatic cancer (RPC) remains unclear and there is no systematic review focusing fully on this issue. Recently, two prospective trials of neoadjuvant treatment in RPC were terminated early because of slow recruiting and existing randomised controlled trials (RCTs) have too small sample sizes. Therefore, to overcome probable biases, it would be more reasonable to include both RCTs and non-randomised studies (NRSs) with selected criteria. This review aims to investigate the effect of neoadjuvant chemotherapy (CTx) and chemoradiation therapy (CRT) in RPC using RCTs and specific NRSs. Method and analysi...



An investigation of general predictors for cognitive-behavioural therapy outcome for anxiety disorders in a routine clinical setting

Thu, 24 Mar 2016 23:00:00 +0100

Introduction Cognitive–behavioural therapy (CBT) is effective for treating anxiety disorders and is offered in most mental health services around the world. However, a relatively large number of patients with anxiety disorders do not benefit from CBT, experience relapses or drop out. Reliable predictors of treatment effects are lacking. The aim of this study is to investigate the predictive value of emotion regulation and attentional control for CBT outcome in a routine setting. Methods and analysis In this prospective and practice-based study, 112 patients with anxiety disorders referred for manual-based group CBT at two psychiatric outpatient clinics will be recruited. Emotion regulation, severity of anxiety and attentional control will be assessed with self-report measures and wi...



Autonomy, Values, and Food Choice

Thu, 24 Mar 2016 23:00:00 +0100

Abstract In most areas of our lives, legal protections are in place to ensure that we have autonomous control over what happens in and to our bodies. However, there are fewer protections in place for autonomous choice when it comes to the food we purchase and consume. In fact, the current trend in US legislation is pushing us away from autonomous food choice. In this paper, I discuss two examples of this trend: corporate resistance to GM labeling laws and farm protection laws (often called “ag-gag” laws). These examples are quite different from a legislative point of view. In one case, laws that would promote autonomous choice are actively resisted, whereas in the other case, laws that undermine autonomy are enacted. The common core of the two examples is the effect: in both c...



Skeletal age estimation in a contemporary Western Australian population using the Tanner-Whitehouse method

Thu, 24 Mar 2016 23:00:00 +0100

Various age estimation techniques have been utilised in Australia to evaluate the age of individuals who do not have documentation to determine legal majority/culpability. These age estimation techniques rely on the assessment of skeletal development as visualized in radiographs, CT scans, MRI or ultrasound modalities, and subsequent comparison to reference standards. These standards are not always population specific and are thus known to be less accurate when applied outside of the original reference sample, leading to potential ethical implications. (Source: Forensic Science International)



Guidelines on What Constitutes Plagiarism and Electronic Tools to Detect it

Thu, 24 Mar 2016 20:34:54 +0100

Plagiarism is a serious ethical problem among scientific publications. There are various definitions of plagiarism, and the major categories include unintentional (unsuitable paraphrasing or improper citations) and intentional. Intentional plagiarism includes mosaic plagiarism, plagiarism of ideas, plagiarism of text, and self-plagiarism. There are many Web sites and software packages that claim to detect plagiarism effectively. A violation of plagiarism laws can lead to serious consequences including author banning, loss of professional reputation, termination of a position, and even legal action. (Source: Journal of Spinal Disorders and Techniques)



Nursing staffs’ attentiveness to older adults falling in residential care – an interview study

Thu, 24 Mar 2016 17:43:46 +0100

ConclusionRisk prevention is not enough. The residents need protection against falls but they also need to be protected from situations that can be detrimental to their well‐being and compromise their dignity. Acknowledging the complexities of safety promotion amongst older persons living in assisted care settings can prevent fall accidents and ensure attentiveness to a more fundamental sense of security that can promote the older person's well‐being and health. Relevance to clinical practiceThis study is relevant to clinical nursing practice as it shows that risk management in fall prevention is not enough. The findings show the need for educated nursing home staff that can incorporate contemplative and scientific knowledge into injury prevention practice. (Source: Journal of Clinical...



Across our country those who the vulnerable rely upon are being let down

Thu, 24 Mar 2016 16:54:35 +0100

It’s nearly twenty years since the National Minimum Wage Act was passed. It was a tough fight, but even those who fought hard against this most basic of protections now accept that a minimum wage is a good and necessary thing. And despite the persistent scourge of low pay, a legal national minimum wage is part of what makes our society civilised. Today, the minimum wage is accepted and praised across the political spectrum. In fact, last year the Chancellor even announced a minimum wage increase as a key part of his Budget. Admittedly he’s tried to claim that it’s a “living wage” (it isn’t), but it’ll see wages rise for some of the lowest paid workers next week – albeit only for over 25s. So would it shock you to hear that there are hundreds of thousands of people – mostl...



BMA releases deprivation of liberty guidance

Thu, 24 Mar 2016 14:19:35 +0100

New guidance designed to assist doctors is assessing the deprivation of liberty of vulnerable patients has been published by the BMA. DoLS (Deprivation of Liberty Safeguards) were introduced in 2009 as an amendment to the Mental Capacity Act 2005. This guidance has been developed following the supreme court judgements in Cheshire West, which considerably widened the number of adults deemed to be deprived of their liberty.  In addition to protecting the rights of patients, DoLS set out the procedure authorising deprivation of liberty in clinical settings, such as hospitals and care homes.   Help for doctors BMA deputy head of ethics Julian Sheather said that he hoped the guidelines would enable doctors to consider the implications when assessing whether a restriction of liberty w...

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Leveraging Social Computing for Personalized Crisis Communication using Social Media

Thu, 24 Mar 2016 14:12:25 +0100

Conclusions In very fast pace, social media have acquired a prominent role in media and our daily life71. During crisis and emergency, people tend to approach social media not only because of the need for quick information, but also due to the human tendency for storytelling, which allows people to experience their lives as coherent, orderly and meaningful. It is what makes people’s life more than a blooming, buzzing confusion117. Communication with public during emergency is critical for successful emergency management118 life saving, rescue and recovery. On the other hand , one should take into account that 2.08 billion people world-wide are social media users11 and significant number of people are expected to participate in the online convergence, posting massive amount of user-genera...



U.N. Aims to Protect More of the High Seas

Thu, 24 Mar 2016 13:30:00 +0100

A new United Nations plan could help conserve more ocean habitat -- Read more on ScientificAmerican.com (Source: Scientific American)



Stop Wasting Time--Create a Long-Term Solution for Nuclear Waste

Thu, 24 Mar 2016 12:15:00 +0100

Three decades after Chernobyl, the U.S. needs to tackle its own ominous nuclear safety problem -- Read more on ScientificAmerican.com (Source: Scientific American)



Review of the Revised 2014 American Academy of Child and Adolescent Psychiatry Code of Ethics

Thu, 24 Mar 2016 12:08:11 +0100

Child and adolescent psychiatrists (CAPs) have vital societal roles as advocates for the optimal development and overall wellness of youth and their families. The profession has distinct ethical, legal, and clinical responsibilities. In 1847, the world’s first national professional medical organization (the American Medical Association) was founded, and the American Medical Association created the world’s first national code of medical ethics. Previously, in 1844, 13 medical administrator superintendents organized the Association of Medical Superintendents of American Institutions for the Insane, which later became the foundation for the creation of the American Psychiatric Association in 1921. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)



Combination chemotherapy of solid tumors: an American-Italian collaboration: a celebration of the work of Gianni Bonadonna.

Thu, 24 Mar 2016 12:07:02 +0100

This article highlights the important collaboration between the U.S. NCI in Bethesda, Maryland and the Istituto Tumori in Milan, Italy that had a major impact on the development of curative regimens for breast cancer, Hodgkin's disease and diffuse large B cell lymphoma.In addition to his contribution to developing new therapies, Gianni Bonadonna played an important role in bringing highly focused, disciplined, ethical clinical trials to the European continent. PMID: 27002947 [PubMed - as supplied by publisher] (Source: Tumori)

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Call to defend labour rights in medical gloves industry

Thu, 24 Mar 2016 10:14:46 +0100

  The medical profession must take action to counter the abuse of labour rights in the medical gloves industry, a new BMA report has warned. The report, In Good Hands, highlights the extent of workplace abuses within the medical glove-making industry, particularly in factories based in south-east Asia. It concludes that it is incumbent on health providers in the developed world to monitor working conditions and address unethical practices taking place within the supply chains of the medical goods they are purchasing. It says: ‘A number of reports in recent years have documented labour rights abuse in several of the largest medical glove-manufacturing units, particularly in Malaysia and Thailand. ‘Workers are often asked to pay extortionate fees to join the factory — ...



Garbage Pickings Get Storks to Stop Migrating

Thu, 24 Mar 2016 04:20:08 +0100

Some white storks have stopped migrating from Europe to sub-Saharan Africa in the winter, because of the availability of food in landfills.     -- Read more on ScientificAmerican.com (Source: Scientific American)



Language Scientific and Ethical GmbH Announce Partnership for...

Thu, 24 Mar 2016 00:07:02 +0100

Language Scientific is proud to announce a new partnership with Switzerland based Ethical GmbH for translation services, enabling sponsors and clinical research organizations to manage endpoint...(PRWeb March 23, 2016)Read the full story at http://www.prweb.com/releases/2016/03/prweb13286102.htm (Source: PRWeb: Medical Pharmaceuticals)



Criminal Background Checks for Employment

Wed, 23 Mar 2016 23:07:32 +0100

This article will provide an overview of the various federal laws pertaining to the use of criminal background checks in the context of employment. (Source: Journal of the American Dietetic Association)



Flourishing Dogs: The Case for an Individualized Conception of Welfare and Its Implications

Wed, 23 Mar 2016 23:00:00 +0100

Abstract Martha Nussbaum argues that animals (including ourselves) are entitled to a flourishing life according to the norm for their species. Nussbaum furthermore suggests that in the case of dogs, breed norms as well as species norms are relevant. Her theses capture both common intuitions among laypeople according to which there is something wrong with the breeding of “unnatural” animals, or animals that are too different from their wild ancestors, and the dog enthusiast’s belief that dogs departing from the norms for their breed are tragic. I argue that the high diversity of the dog species and the ultimate arbitrariness of breed norms support the thesis that a conception of welfare must be tied to what the individual requires in order to flourish. In the second part of t...

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What does it mean to be a vet?

Wed, 23 Mar 2016 23:00:00 +0100

PROFESSIONAL identity – how we see ourselves as professionals – our values, beliefs and norms of behaviour are central to the trust placed in our profession by society. It has implications for our ethics, the way we make sense of our professional lives and how we survive or thrive in our environment (Allister 2015). Individual professional identity and cultural and identity issues in the wider profession are a relatively new area of exploration in veterinary medicine, although in other professions they have been discussed for some time. Developing a professional identity is dynamic; it is a process of becoming (Scanlon 2011) and is seen as a crucial part of medical education and professionalism (Wong and Trollope-Kumar 2014). Understanding professionalism offers an opportunity ...



Arrhythmia management in the elderly – Implanted Cardioverter Defibrillators and Prevention of Sudden Death

Wed, 23 Mar 2016 23:00:00 +0100

We present an overview of arrhythmia management in the elderly, as it pertains to implantable cardioverter defibrillator therapy and prevention of sudden death. Treatment of arrhythmia in the elderly is fraught with challenges pertaining to goals of care and patient frailty. With an ever increasing amount of technology available, realistic expectations of therapy need to balance quality and quantity of life. The implantable cardioverter defibrillator (ICD) is an important treatment option for selected patients at risk of ventricular arrhythmia and sudden cardiac death. However, the incidence of sudden death as a percentage of all-cause mortality decreases with age. Studies have demonstrated that 20% of elderly patients may die within one year of an episode of life-threatening ventricular a...



Defining polypharmacy in the elderly: a systematic review protocol

Wed, 23 Mar 2016 23:00:00 +0100

Introduction Ageing—along with its associated physiological and pathological changes—places individuals at a higher risk of multimorbidity and treatment-related complications. Today, polypharmacy, a common and important problem related to drug use, occurs subsequent to this multimorbidity in the elderly in all populations. In recent decades, several scientific investigations have studied polypharmacy and its correlates, using different approaches and definitions, and their results have been inconclusive. Differences in definitions and approaches in these studies form a barrier against reaching a conclusion regarding the risk factors and consequences of polypharmacy. It is therefore imperative to establish an appropriate definition of polypharmacy. Methods and analysis A system...



Effective strategies to motivate nursing home residents in oral healthcare and to prevent or reduce responsive behaviours to oral healthcare: a systematic review protocol

Wed, 23 Mar 2016 23:00:00 +0100

Introduction Oral healthcare in nursing homes is less than optimal, with severe consequences for residents' health and quality of life. To provide the best possible oral healthcare to nursing home residents, care providers need strategies that have been proven to be effective. Strategies can either encourage and motivate residents to perform oral healthcare themselves or can prevent or overcome responsive behaviours from residents when care providers assist with oral healthcare. This systematic review aims to identify studies that evaluate the effectiveness of such strategies and to synthesise their evidence. Methods and analysis We will conduct a comprehensive search in the databases MEDLINE, EMBASE, Evidence Based Reviews—Cochrane Central Register of Controlled Trials, CINAHL and ...

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Brief strategic therapy for obsessive-compulsive disorder: a clinical and research protocol of a one-group observational study

Wed, 23 Mar 2016 23:00:00 +0100

Introduction Obsessive–compulsive disorder (OCD) is a disabling psychopathology. The mainstay of treatment includes cognitive–behavioural therapy (CBT) and medication management. However, individual suffering, functional impairments as well as the direct and indirect costs associated with the disease remain substantial. New treatment programmes are necessary and the brief strategic therapy (BST) has recently shown encouraging results in clinical practice but no quantitative study has as yet been conducted. Methods and analysis The clinical effectiveness of the OCD-specific BST protocol will be evaluated in a one-group observational study. Participants will be sequentially recruited from a state community psychotherapy clinic in Dublin, Ireland. Outcome measures will be the Yal...



Rehabilitation interventions in children and adults with infectious encephalitis: a systematic review protocol

Wed, 23 Mar 2016 23:00:00 +0100

Introduction Many encephalitis survivors can benefit from rehabilitation. However, there is currently no comprehensive review describing rehabilitation intervention outcomes among children and adults with infectious encephalitis. This is a protocol for a systematic review that will summarise the current literature on outcomes following rehabilitative interventions among children and adults with infectious encephalitis. With a sufficient sample size, a sex-stratified analysis of the findings will also be presented, as variability between male and female patients with neurological disorders, including encephalitis, regarding outcomes after rehabilitative interventions has been noted in the literature. Methods and analysis This review will systematically search MEDLINE, MEDLINE In-Process, E...



Role of institutional entrepreneurship in building adaptive capacity in community-based healthcare organisations: realist review protocol

Wed, 23 Mar 2016 23:00:00 +0100

This study focuses on the strategies used by institutional entrepreneurs to build adaptive capacity in the community-based healthcare sector. Methods and analysis The research will use an adapted rapid realist review. The review will find underlying theories that explain the circumstances surrounding the implementation of capacity-building strategies that shape organisational response and generate outcomes by activating causal mechanisms. An early scoping of the literature, and consultations with key stakeholders, will be undertaken to identify an initial programme theory. We will search for relevant journal articles and grey literature. Data will be extracted based on contextual factors, mechanisms and outcomes, and their configurations. The analysis will seek patterns and regularities i...



Ethical challenges of reconsidered informed consent in trauma

Wed, 23 Mar 2016 23:00:00 +0100

A 27-year-old, right hand–dominant man with partial amputation of 4 digits of his dominant hand from a machinery accident was transferred by helicopter for possible replantation. He had a sharp, guillotine-style, near-amputation of his right index through ring fingers at the level of the middle phalanges and a near-complete amputation of the tip of his small finger. Five hours of warm ischemia time had passed. Three of the 4 fingers were deemed suitable for replantation, and urgent operative intervention was recommended. (Source: Surgery)



Paying for Kidneys Might Boost Donor Rate

Wed, 23 Mar 2016 18:20:46 +0100

But transplant experts say it's an ethically loaded idea that needs much review (Source: WebMD Health)

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Paying for Kidneys Might Boost Donor Rate, Study Says

Wed, 23 Mar 2016 16:00:00 +0100

But transplant experts say it's an ethically loaded idea that needs much review (Source: U.S. News - Health)



Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea.

Wed, 23 Mar 2016 12:41:08 +0100

Conclusions: : Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program. PMID: 26996220 [PubMed - as supplied by publisher] (Source: Clinical Endoscopy)



The ethics of insurance limiting institutional medical care: It's all about the money

Wed, 23 Mar 2016 06:35:50 +0100

Dr F. Inest practices surgery at a renowned medical center but is concerned because increasing numbers of medical insurers are excluding his institution from coverage. Many of his former referring physicians are beginning to send their patients elsewhere for this reason. The marketing people have been busy increasing their advertising buys and exploring new business models. There is even talk about reducing expensive clinical trials. However, regardless of his affiliation, he has little control over these and other organizational decisions that directly impact his practice clinically and fiscally. (Source: Journal of Vascular Surgery)



[Assisted reproductive techniques in single women: Which proposals for which demands?]

Wed, 23 Mar 2016 00:46:02 +0100

Authors: Decanter C Abstract The French bio-ethic law concerning ART is more restricted than in other countries. Techniques can only be applied in heterosexual couples presenting a documented infertility. Nevertheless, concerns about fertility planning are numerous in young women, leading to a growing demand of reproductive medicine consultations. Two situations can be distinguished: firstly, single patients wishing sperm donation and, secondly, single patients who wish to preserve their fertility for future parenting project. This latter situation can be discussed in the French legislative context while the other will require soliciting the neighboring European teams. PMID: 26997464 [PubMed - as supplied by publisher] (Source: Gynecologie Obstetrique Fertilite)

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The Ethical Dilemma of Compensating Living Kidney Donation

Wed, 23 Mar 2016 00:00:00 +0100

Since 1954, when the first kidney transplantation was performed, more than half a million living donor kidney transplants have been completed. A study on 3698 living kidney donors showed that the postoperative mortality rate of donation is 0.03% and that the risk of long-term end-stage renal disease is comparable with the risk of the matched general US population. The authors concluded that the life expectancy and quality of life of living donors is comparable with the general population. (Source: JAMA Surgery)



Malignancies in a renal transplant population: The St. Michael's Hospital experience

Tue, 22 Mar 2016 23:00:00 +0100

The objective of this study was to analyze the rate and types of malignancies occurring in the St. Michael's Hospital renal transplant population and to determine whether our results were comparable to those previously published. Methods: After approval by the hospital's research ethic board, review of the records and pathology of the 1584 patients in the renal transplant clinic database patients was performed. The reports dated back to the year 1970. Results: Amongst the 1584 renal transplant patients, 106 patients with 132 dysplastic and malignant posttransplant lesions were identified. The highest incidence amid the malignancies was in nonmelanoma skin malignancies squamous cell carcinoma (SCC), basal cell carcinoma, and Kaposi sarcoma, with a total of 32 patient...



Erratum to: Neonatal Junctional Epidermolysis Bullosa: Treatment Conundrums and Ethical Decision Making

Tue, 22 Mar 2016 23:00:00 +0100

(Source: American Journal of Clinical Dermatology)



Changes in Plasma Steroids and Cytokines levels in Betel Chewing Patients in Taiwan

Tue, 22 Mar 2016 23:00:00 +0100

Publication date: Available online 23 March 2016 Source:Steroids Author(s): Sindy Hu, Wen-Chyuan Chen, Guey-Shyang Hwang, Szu-Tah Chen, Song-Bor Kuo, Yifen Chen, Galina Idova, Shyi-Wu Wang Betel nut is the second largest economic food product in Taiwan. In southeast Asia, the habit of chewing betel nut seems to be highly correlated with oral submucous fibrosis and oral squamous cell carcinoma. Oral submucous fibrosis is characterized by abnormal accumulation of oral submucous collagen fibers and limitation of mouth opening. Although the mechanism responsible for tissue damage is still unknown, prolonged irritation caused by betel nut and tobacco is considered to be a major factor contributing to the pathogenesis of oral submucous fibrosis. The effect of betel nut chewing on immun...



Improving the management of behaviour that challenges associated with dementia in care homes: protocol for pharmacy-health psychology intervention feasibility study

Tue, 22 Mar 2016 23:00:00 +0100

Introduction The inappropriate use of antipsychotics in people with dementia for behaviour that challenges is associated with an estimated 1800 deaths annually. However, solely focusing on antipsychotics may transfer prescribing to other equally dangerous psychotropics. Little is known about the role of pharmacists in the management of psychotropics used to treat behaviours that challenge. This research aims to determine whether it is feasible to implement and measure the effectiveness of a combined pharmacy–health psychology intervention incorporating a medication review and staff training package to limit the prescription of psychotropics to manage behaviour that challenges in care home residents with dementia. Methods/analysis 6 care homes within the West Midlands will be recruit...

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Curved versus Straight Stem Uncemented Total Hip Arthroplasty Osteoarthritis Multicenter trial (CUSTOM): design of a prospective blinded randomised controlled multicentre trial

Tue, 22 Mar 2016 23:00:00 +0100

Introduction Answering the demands of an increasingly young and active patient population, recent developments in total hip arthroplasty (THA) have shifted towards minimising tissue damage. The Collum Femoris Preserving (CFP) stem was developed to preserve the trochanteric region of the femur, which potentially preserves the insertion of the gluteus musculature. This might accelerate early postoperative rehabilitation and improve functional outcome. Currently the functional results of the CFP stem have not been compared with conventional straight stems in a randomised controlled trial (RCT). The primary purpose of this trial is to compare the functional result of CFP stem THA with conventional uncemented straight stem THA, measured by the Dutch Hip disability and Osteoarthritis Outcome Sco...



Protocol for a feasibility study to inform the development of a multicentre randomised controlled trial of asthma-tailored pulmonary rehabilitation versus usual care for individuals with severe asthma

Tue, 22 Mar 2016 23:00:00 +0100

Introduction Pulmonary rehabilitation with core components of exercise training and multiprofessional education is an integral part of the management of patients with chronic lung disease. International guidelines for individuals with asthma recommend exercise as exercise improves symptoms, indices of cardiopulmonary efficiency, health status and psychosocial outcome. However, there is little published evidence evaluating safety and acceptability of exercise training for individuals with severe asthma and there are concerns regarding exercise-induced asthma. We propose a feasibility study for a multicentre randomised controlled trial (RCT) of asthma-tailored pulmonary rehabilitation (asthma-tailored PR) versus usual care in individuals with severe asthma. Methods and analysis The study wi...



A grounded theory of humanistic nursing in acute care work environments.

Tue, 22 Mar 2016 23:00:00 +0100

CONCLUSION: This theory shows that professional values, elements of care promotion, and sensitivity of the situation have a key role in activation of humanistic approach in nursing. Violation of the nurses' professional rights often leads to a decrease in care, but these factors make the nurses practice in an unsparing response approach. It is necessary to focus on development of professional values and provide essential elements of care promotion as changeable factors for realization of humanistic nursing although there is a context in which the nurses' rights are violated. PMID: 27009740 [PubMed - as supplied by publisher] (Source: Nursing Ethics)



Should parents be allowed to choose the gender of their baby?

Tue, 22 Mar 2016 20:43:55 +0100

Chrissy Teigen and John Legend wanted a girl, but was it safe and ethical for them to decide? (Source: CNN.com - Health)



Who Are You, Deep Down?

Tue, 22 Mar 2016 16:17:19 +0100

Who are you, deep down? The Practice: Know you're a good person. Why? For many of us, perhaps the hardest thing of all is to believe that "I am a good person." We can climb mountains, work hard, acquire many skills, act ethically -- but truly feel that one is good deep down? Nah! We end up not feeling like a good person in a number of ways. For example, I once knew a little girl who'd been displaced by her baby brother and fended off and scolded by her mother who was worn down and busy caring for an infant. This girl was angry at her brother and parents, plus lost and disheartened and feeling cast out and unloved. She'd been watching cartoons in which the soldiers of an evil queen attacked innocent villagers, and one day she said sadly, "Mommy, I feel like a bad soldier." Later in life -- ...

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LGBT Physicists Face Discrimination, Exclusion, Intimidation

Tue, 22 Mar 2016 14:35:00 +0100

Transgender people are the most affected, according to survey by the American Physical Society -- Read more on ScientificAmerican.com (Source: Scientific American)



Feature: Should Parents of Children With Severe Disabilities Be Allowed to Stop Their Growth?

Tue, 22 Mar 2016 11:00:03 +0100

Caring for people with severe mental and physical limitations becomes vastly harder as they get older. Some parents believe medically stunting them is the answer — but is it ethical? (Source: NYT Health)



Dying with dignity: a concept analysis

Tue, 22 Mar 2016 09:13:44 +0100

ConclusionThe concept of patient dignity has been referred to in many contexts. However, considering the dignity of dying patients commensurate with their culture is the most important component of care provided by nurses to facilitate a peaceful death. Relevance to clinical practiceRespecting the dignity of the patient results in the reduction of her/his suffering and prepares her/him for a comfortable death. (Source: Journal of Clinical Nursing)



Data Sharing

Tue, 22 Mar 2016 00:00:00 +0100

Sharing data produced from clinical trials has 2 principal purposes: verification of the original analysis and hypothesis generation. It has the potential to advance scientific discovery, improve clinical care, and increase knowledge gained from data collected in these trials. As such, data sharing has become an ethical and scientific imperative. The data sharing process has generated controversy, for example, about which data should be shared, with whom, and how quickly. However, there is limited information to help guide the discussion. (Source: JAMA)



Ethical analysis in HTA of complex health interventions

Tue, 22 Mar 2016 00:00:00 +0100

In the field of health technology assessment (HTA), there are several approaches that can be used for ethical analysis. However, there is a scarcity of literature that critically evaluates and compares the str... (Source: BMC Medical Ethics)

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'Cognitive biases plus: covert subverters of healthcare evidence

Mon, 21 Mar 2016 23:00:00 +0100

The evidence-based medicine (EBM) paradigm has been associated with many benefits, but there have also been ‘some negative consequences’. In part, the consequences may be attributable to: (1) limitations in some of the tenets of EBM, and (2) flawed or unethical decisions in healthcare related organisations. We hypothesise that at the core of both is a cascade of predominantly unconscious cognitive processes we have syndromically termed ‘cognitive biases plus’, with conflicts of interest (CoIs) as crucial elements. CoIs (financial, and non-financial including intellectual) catalyse self-serving bias and a cascade of other ‘cognitive biases plus’ with several reinforcing loops. Authority bias, herd effect, scientific inbreeding, replication publication bia...



More data needed on hysteroscopic compared with laparoscopic sterilisation

Mon, 21 Mar 2016 23:00:00 +0100

Commentary on: Mao J, Pfeifer S, Schlegel P, et al.. Safety and efficacy of hysteroscopic sterilization compared with laparoscopic sterilization: an observational cohort study. BMJ 2015;351:h5162. Context Safety and effectiveness of hysteroscopic sterilisation (Essure System) is an important and timely topic. Recent concerns, including 5093 adverse event reports related to Essure made to the US Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database prompted the FDA to reconvene its Obstetrics and Gynecology Devices Panel in September 2015 to evaluate the safety, effectiveness, and need for further postmarketing studies on Essure.1 Benefits of hysteroscopic sterilisation include no skin incision, probable avoidance of abdominal entry and general...



Health Outcomes and Patient Empowerment: The Case of Health Budgets in Italy

Mon, 21 Mar 2016 23:00:00 +0100

Scholars claim that the outcomes of health interventions are the products of three factors: the size, the penetration and the sustainability of their effects. Nonetheless, the prevailing biomedical ethic of care engenders a mere ‘fix-it’ approach, which focuses on the clinical treatment of the disease and neglects the role of patients in the process of care. This approach undermines both the size and the penetration of health interventions. From this standpoint, the authors examine different health interventions aimed at improving the size and the penetration of their effects through the empowerment of the patients and their involvement in the provision of care. They are confronted in terms of two different criteria: the ‘intensity’ of the health care co-production ...



Duties to rescue: individual, professionaland institutional

Mon, 21 Mar 2016 23:00:00 +0100

Clinicians and researchers can often rescue patients or research participants from serious harms. Indeed, they often have a duty to do so—a duty to rescue. Duties to rescue are frequently discussed in the medical ethics literature, but according to Tina Rulli and Joseph Millum they are under-theorised and more problematic than is normally acknowledged.1 Rulli and Millum outline two widely discussed conceptions of rescue duties: a so-called duty of easy rescue, applying to all moral agents (including healthcare professionals), and the rule of rescue, applying specifically to institutions. They raise concerns about both. The duty of easy rescue The duty of easy rescue is, as its name suggests, a duty to rescue that obtains only where the rescue can be effected at minimal cost to the re...

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The Ebola outbreak in Western Africa: ethical obligations for care

Mon, 21 Mar 2016 23:00:00 +0100

The recent wave of the Ebola Virus Disease (EVD) in Western Africa and efforts to control the disease where the health system requires strengthening raises a number of ethical challenges for healthcare workers practicing in these countries. We discuss the implications of weak health systems for controlling EVD and limitations of the ethical obligation to provide care for patients with EVD using Nigeria as a case study. We highlight the right of healthcare workers to protection that should be obligatorily provided by the government. Where the national government cannot meet this obligation, healthcare workers only have a moral and not a professional obligation to provide care to patients with EVD. The national government also has an obligation to adequately compensate healthcare workers tha...



The practices of do-it-yourself brain stimulation: implications for ethical considerations and regulatory proposals

Mon, 21 Mar 2016 23:00:00 +0100

This study presents the results of a preliminary inquiry into the DIY tDCS community, with a focus on knowledge that is formed, shared and appropriated within it. I show that when making or acquiring a device, DIYers (as some members call themselves) produce a body of knowledge that is completely separate from that of the scientific community, and share it via online forums, blogs, videos and personal communications. However, when applying tDCS, DIYers draw heavily on existing scientific knowledge, posting links to academic journal articles and scientific resources and adopting the standardised electrode placement system used by scientists. Some DIYers co-opt scientific knowledge and modify it by creating their own manuals and guides based on published papers. Finally, I explore how DIYers...



Research led by participants: a new social contract for a new kind of research

Mon, 21 Mar 2016 23:00:00 +0100

In recent years, there have been prominent calls for a new social contract that accords a more central role to citizens in health research. Typically, this has been understood as citizens and patients having a greater voice and role within the standard research enterprise. Beyond this, however, it is important that the renegotiated contract specifically addresses the oversight of a new, path-breaking approach to health research: participant-led research. In light of the momentum behind participant-led research and its potential to advance health knowledge by challenging and complementing traditional research, it is vital for all stakeholders to work together in securing the conditions that will enable it to flourish. (Source: Journal of Medical Ethics)



Beyond antidoping and harm minimisation: a stakeholder-corporate social responsibility approach to drug control for sport

Mon, 21 Mar 2016 23:00:00 +0100

Debate about the ethics of drug control in sport has largely focused on arguing the relative merits of the existing antidoping policy or the adoption of a health-based harm minimisation approach. A number of ethical challenges arising from antidoping have been identified, and a number of, as yet, unanswered questions remain for the maturing ethics of applying harm minimisation principles to drug control for sport. This paper introduces a ‘third approach’ to the debate, examining some implications of applying a stakeholder theory of corporate social responsibility (CSR) to the issue of doping in sport. The introduction of the stakeholder-CSR model creates an opportunity to challenge the two dominant schools by enabling a different perspective to contribute to the development of ...



Fidelity to the healing relationship: a medical student's challenge to contemporary bioethics and prescription for medical practice

Mon, 21 Mar 2016 23:00:00 +0100

As a medical  student, I observed that different physicians had strikingly different attitudes and approaches when caring for patients. The care of one patient in particular continues to challenge my understanding of illness and moral responsibility in the practice of medicine. In this paper, I illustrate the care of this patient in order to evaluate the dominant ethics I was taught in medical school, in theory and in practice, and argue neither principlism nor the ethics of care fully captures the moral responsibility of physicians. Emphasising fidelity to the healing relationship, a core principle derived from Pellegrino's virtue theory, I conclude that this approach to clinical ethics fully explains physician responsibility. Pellegrino deconstructs the practice of medicine to clari...

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Incorporating ethical principles into clinical research protocols: a tool for protocol writers and ethics committees

Mon, 21 Mar 2016 23:00:00 +0100

A novel Protocol Ethics Tool Kit (‘Ethics Tool Kit’) has been developed by a multi-stakeholder group of the Multi-Regional Clinical Trials Center of Brigham and Women's Hospital and Harvard. The purpose of the Ethics Tool Kit is to facilitate effective recognition, consideration and deliberation of critical ethical issues in clinical trial protocols. The Ethics Tool Kit may be used by investigators and sponsors to develop a dedicated Ethics Section within a protocol to improve the consistency and transparency between clinical trial protocols and research ethics committee reviews. It may also streamline ethics review and may facilitate and expedite the review process by anticipating the concerns of ethics committee reviewers. Specific attention was given to issues arising in mul...



A new method for making treatment decisions for incapacitated patients: what do patients think about the use of a patient preference predictor?

Mon, 21 Mar 2016 23:00:00 +0100

Conclusions The majority of respondents endorsed the possibility of incorporating a PPP into the process of shared decision-making based on its potential to increase surrogates’ predictive accuracy and/or reduce surrogate distress. These data provide strong patient support for further research to assess whether, in practice, the use of a PPP can increase the chances that incapacitated patients receive the treatments they prefer and reduce the burden of making decisions on their surrogates. (Source: Journal of Medical Ethics)



Challenging the principle of proportionality

Mon, 21 Mar 2016 23:00:00 +0100

The first objective of this article is to examine one aspect of the principle of proportionality (PP) as advanced by Alan Gewirth in his 1978 book Reason and Morality. Gewirth claims that being capable of exercising agency to some minimal degree is a property that justifies having at least prima facie rights not to get killed. However, according to the PP, before the being possesses the capacity for exercising agency to that minimal degree, the extent of her rights depends on to what extent she approaches possession of agential capacities. One interpretation of PP holds that variations in degree of possession of the physical constitution necessary to exercise agency are morally relevant. The other interpretation holds that only variations in degree of actual mental capacity are morally rel...



Prisoners as research participants: current practice and attitudes in the UK

Mon, 21 Mar 2016 23:00:00 +0100

The use of prisoners as research participants is controversial. Efforts to protect them in response to past exploitation and abuse have led to strict regulations and reluctance to involve them as participants. Hence, prisoners are routinely denied the opportunity to participate in research. In the absence of comprehensive information regarding prisoners’ current involvement in research, we examined UK prisoners’ involvement through review of research applications to the UK National Research Ethics Service. We found that prisoners have extremely limited access to research participation. This analysis was augmented by a survey of those involved in research and research governance (UK researchers and Research Ethics Committee members). Our results suggest that pragmatic concerns r...



Having a child together in lesbian families: combining gestation and genetics

Mon, 21 Mar 2016 23:00:00 +0100

The increasing acceptance of lesbian couples in medically assisted reproduction has led to new, unusual requests. This paper discusses the request for egg transfer from one partner to the other. In the first part, different analogies (egg donation, embryo donation, surrogacy and mitochondrial replacement) are made in order to find out whether one of these can help us determine whether this procedure is acceptable. It is shown that there are major difficulties with all analogies. In the second part, two balances are developed between the medical risks and costs of in vitro fertilisation (IVF) and intrauterine insemination on the one hand and the medical risks of IVF and the psychosocial benefits on the other hand. The final conclusion is that the disadvantages of the procedure can be compen...

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What do we do about women athletes with testes?

Mon, 21 Mar 2016 23:00:00 +0100

Elite sport and the measures imposed to prevent ‘men’ from ‘cheating’ by posing as women in women's events cast interesting light on notions of sex and gender. Some women have testes, organs that produce testosterone, because they are trans women or they have an intersex state. Testosterone is recognised as a performance-enhancing substance in at least some circumstances, and therefore, women with testes may possess an advantage when competing in some sport against women without testes, though this has never been subjected to rigorous scientific testing. The International Olympic Committee and the International Association of Athletics Federation have decreed that such individuals can compete only if they undergo medical and surgical treatment, which is likely to me...



Rescuing the duty to rescue

Mon, 21 Mar 2016 23:00:00 +0100

Clinicians and health researchers frequently encounter opportunities to rescue people. Rescue cases can generate a moral duty to aid those in peril. As such, bioethicists have leveraged a duty to rescue for a variety of purposes. Yet, despite its broad application, the duty to rescue is underanalysed. In this paper, we assess the state of theorising about the duty to rescue. There are large gaps in bioethicists’ understanding of the force, scope and justification of the two most cited duties to rescue—the individual duty of easy rescue and the institutional rule of rescue. We argue that the duty of easy rescue faces unresolved challenges regarding its force and scope, and the rule of rescue is indefensible. If the duty to rescue is to help solve ethical problems, these theoreti...



Having hands and moral status: a reply to Curtis and Vehmas

Mon, 21 Mar 2016 23:00:00 +0100

Curtis and Vehmas apply the form of Moore's ‘Proof of an External World’ to justify continuing to believe that all and only humans have full moral status in the absence of a plausible account of why. I note that the strategy is better suited for the sceptical problems Moore applies it to and suggest that resorting to it reflects too great a pessimism about the accounts available. (Source: Journal of Medical Ethics)



The Moorean argument for the full moral status of those with profound intellectual disability: a rejoinder to Roberts

Mon, 21 Mar 2016 23:00:00 +0100

In a recent paper we argued that a Moorean strategy can be employed to justify our continuing to believe the following proposition, even in the presence of philosophical views that entail it is false, without any philosophical argument against those views, and without any positive philosophical argument in its favour: H>A: Humans have an equal moral status that is higher than the moral status of non-human animals. The basic idea is that our confidence in the truth of this proposition is greater than our confidence in the propositions that make up those philosophical views that entail that it is false, and that this is sufficient to justify rejecting those views and to continue to believe H>A. Roberts has recently responded to our argument by claiming that (i) although the Moorean str...



Correction

Mon, 21 Mar 2016 23:00:00 +0100

Curtis B, Vehmas S. A Moorean argument for the full moral status of those with profound intellectual disability. J Med Ethics 2016;42:41–5. A section of text is missing from the article at page 43, the correct text should state: In a common interpretation of what Moore is up to here, first championed by William Lycan [reference 11], Moore is making a simple dialectical move against the sceptic. In order to see what this is, consider a typical sceptical argument for the conclusion that we do not know that we have hands: Premise 1. If S knows that S has hands, then S knows that all propositions incompatible with S knowing that S has hands are false. Premise 2. S does not know that all propositions incompatible with S knowing that S hands are false, as the proposition that the external ...

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The Mediterranean refugee crisis: ethics, international law and migrant health

Mon, 21 Mar 2016 23:00:00 +0100

Europe is experiencing levels of forced migration not seen since the Second World War. Its sources lie in the fragile, strife-torn states of the Middle East and Africa: four million people have fled Syria since the conflict began; 12 million of those remaining require humanitarian assistance. Large numbers of people are fleeing violence in Iraq, Afghanistan and Eritrea. Although millions have been displaced by violence, others are seeking relief from endemic poverty and brutally restricted life-choices. Overwhelmingly their chosen routes into Europe are perilous—according to the UN High Commissioner for Refugees (UNHCR) over 590 000 people have arrived in Europe by sea this year.1 Nor do their difficulties end once they reach Europe. The asylum systems of the frontline countrie...



Editorial Note

Mon, 21 Mar 2016 23:00:00 +0100

(Source: Ethical Theory and Moral Practice)



Taking the Perceptual Analogy Seriously

Mon, 21 Mar 2016 23:00:00 +0100

Abstract This paper offers a qualified defense of a historically popular view that I call sentimental perceptualism. At a first pass, sentimental perceptualism says that emotions play a role in grounding evaluative knowledge analogous to the role perceptions play in grounding empirical knowledge. Recently, András Szigeti and Michael Brady have independently developed an important set of objections to this theory. The objections have a common structure: they begin by conceding that emotions have some important epistemic role to play, but then go on to argue that understanding how emotions play that role means that there must be some alternative, emotion-independent route to obtaining knowledge of value. If there has to be such an emotion-independent route, then the perceptual anal...



Saving or Subordinating Life? Popular Views in Israel and Germany of Donor Siblings Created through PGD

Mon, 21 Mar 2016 23:00:00 +0100

Abstract To explore how cultural beliefs are reflected in different popular views of pre-implantation genetic diagnosis for human leukocyte antigen match (popularly known as “savior siblings”), we compare the reception and interpretations, in Germany and Israel, of the novel/film My Sister’s Keeper. Qualitative analysis of reviews, commentaries and posts is used to classify and compare normative assessments of PGD for HLA and how they reproduce, negotiate or oppose the national policy and its underlying cultural and ethical premises. Four major themes emanated from the comparison: loss of self-determination and autonomy; loss of dignity through instrumentalization; eugenics and euthanasia; and saving life. In both countries, most commentaries represented a dominant position,...



Effect of dexmedetomidine on acute lung injury in experimental ischemia–reperfusion model

Mon, 21 Mar 2016 23:00:00 +0100

Conclusion dexmedetomidine is effective in reduction of the experimental ischemia–reperfusion induced pulmonary tissue injury in rats, formed by extremity tourniquet application. (Source: Brazilian Journal of Anesthesiology)

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Preclinical Alzheimer's disease: Definition, natural history, and diagnostic criteria

Mon, 21 Mar 2016 23:00:00 +0100

This article is aimed at addressing all the different issues by providing for each of them an updated review of the literature and evidence, with practical recommendations. (Source: Alzheimer's and Dementia: The Journal of the Alzheimer's Association)



Cytomegalovirus retinitis

Mon, 21 Mar 2016 23:00:00 +0100

We present a case of CMV retinitis and the full treatment course with fundus pictures. Case report A 32-year-old man visited our department and presented with floaters in the right eye for a week. Ophthalmoscope examination showed retinal whitening and haemorrhages in the right eye and normal fundus in the left eye (figure 1). We checked his HIV antibody, venereal disease research laboratory, rapid plasma regain, IgG and IgM for Toxoplasma gondii, basic blood chemistry and complete blood... (Source: Postgraduate Medical Journal)



Examining the Differences in Current Regulatory Processes for Sunscreens and Proposed Safety Assessment Paradigm

Mon, 21 Mar 2016 23:00:00 +0100

Publication date: Available online 22 March 2016 Source:Regulatory Toxicology and Pharmacology Author(s): Edward V. Sargent, Jeffrey B. Travers Skin cancers including malignant melanoma which are due to UV radiation constitute a serious public health problem. Recent studies have confirmed the importance of UVA radiation in the pathogenesis of skin cancer, as well as the protective effects of broad-spectrum sunscreen use. Barriers for effective protection of the US public include the lack of effective UV filters, especially in the UVA spectrum. The major reason for the paucity of UVA-effective filters in the US is due primarily to the FDA's reluctance to approve agents which have already been on the market in Europe and elsewhere in the world for more than a decade. The underlying reaso...



Protocol for the development and validation of a questionnaire to assess concerning behaviours and mental health in individuals with autism spectrum disorders: the Assessment of Concerning Behaviour (ACB) scale

Mon, 21 Mar 2016 23:00:00 +0100

This study will be guided by the methods described in the US Food and Drug Administration Guidance for Industry Patient-reported Outcome Measures. A literature review, cognitive interviews and focus groups with individuals who have experience of working or living with ASDs will be used for item generation. A sample of children and adults with ASD will complete the ACB, in addition to other gold standard measures of concerning behaviour in order to establish the initial psychometric properties of the scale. Ethics and dissemination This study has received ethical approval from the NHS Research Ethics Committee: London-Camden and King's Cross (ref: 15/LO/0085). Study findings will be disseminated to healthcare professionals and scientists in the field through publication in peer-reviewed jo...



Social Worker Shame: A Scoping Review

Mon, 21 Mar 2016 23:00:00 +0100

While shame has historically been neglected in emotion research, there is now a large body of research evidence by which to understand the concept and the phenomenology which suggests that shame can have a pervasive and negative effect on individuals' lives and relationships. It can be considered to be an emotion that relates to a belief that the self is flawed and that one is not worthy of acceptance and belonging. This paper reports on a scoping review of shame experienced by social workers, identifying the nature and extent of the research evidence. Shame was operationalised through a working model provided by the seminal work of Lewis (1971). The search strategy sought to identify qualitative studies relating to social workers' personal experiences of practice. Data were extracted that...

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Ethical frameworks for surrogates' end-of-life planning experiences: A qualitative systematic review.

Mon, 21 Mar 2016 23:00:00 +0100

CONCLUSION: Ethical frameworks that address individuality and contextual variations related to decision making may more appropriately guide surrogate decision-making research that explores surrogates' end-of-life care planning experiences. PMID: 27005954 [PubMed - as supplied by publisher] (Source: Nursing Ethics)



Moral courage in nursing: A concept analysis.

Mon, 21 Mar 2016 23:00:00 +0100

CONCLUSION: This preliminary clarification warrants further exploring through theoretical and philosophical literature, expert opinions, and empirical research to gain validity and reliability for its application in nursing practice. PMID: 27005953 [PubMed - as supplied by publisher] (Source: Nursing Ethics)



Ethical dimensions of paediatric nursing: A rapid evidence assessment.

Mon, 21 Mar 2016 23:00:00 +0100

CONCLUSION: Few studies investigate the ethical dimensions and aspects of paediatric nursing, and they are mainly qualitative studies conducted in critical care settings based on nurses' perceptions and experiences. Paediatric nurses require specific educational interventions to help them resolve ethical issues, contribute to the decision-making process and fulfil their role as advocates of a vulnerable population (i.e. sick children and their families). Further research is needed to investigate how paediatric nurses can improve the involvement of children and their families in decision-making processes related to their care plan. PMID: 27005952 [PubMed - as supplied by publisher] (Source: Nursing Ethics)

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Examining the Differences in Current Regulatory Processes for Sunscreens and Proposed Safety Assessment Paradigm.

Mon, 21 Mar 2016 23:00:00 +0100

Authors: Sargent EV, Travers JB Abstract Skin cancers including malignant melanoma which are due to UV radiation constitute a serious public health problem. Recent studies have confirmed the importance of UVA radiation in the pathogenesis of skin cancer, as well as the protective effects of broad-spectrum sunscreen use. Barriers for effective protection of the US public include the lack of effective UV filters, especially in the UVA spectrum. The major reason for the paucity of UVA-effective filters in the US is due primarily to the FDA's reluctance to approve agents which have already been on the market in Europe and elsewhere in the world for more than a decade. The underlying reasons for these discrepancies in new sunscreen approval success between the US and abroad are complex,...



Cuba-U.S. Thaw Should Ease Scientific Collaborations

Mon, 21 Mar 2016 21:25:00 +0100

Cornell Laboratory of Ornithology researcher Eduardo Inigo-Elias, a veteran of efforts to work withi Cuban researchers, talks about what improved relations between the U.S. and Cuba could mean for... -- Read more on ScientificAmerican.com (Source: Scientific American)



Cuba–U.S. Thaw Should Ease Scientific Collaborations

Mon, 21 Mar 2016 21:25:00 +0100

Cornell Laboratory of Ornithology researcher Eduardo Inigo-Elias, a veteran of efforts to work with Cuban researchers, talks about what improved relations between the U.S. and Cuba could mean... -- Read more on ScientificAmerican.com (Source: Scientific American)



The Quality of Rare Disease Registries: Evaluation and Characterization

Mon, 21 Mar 2016 18:26:32 +0100

Conclusions: The quality of RDRs is usually associated with a good oversight and governance mechanism and with durable funding. The results suggest that RDRs would benefit from support in management, information technology, epidemiology, and statistics.Public Health Genomics (Source: Public Health Genomics)



Does Trump Have an Energy Policy?

Mon, 21 Mar 2016 13:15:00 +0100

Trump dislikes hair spray regulations and is dismissive of global warming but the rest of his energy policies seem unclear -- Read more on ScientificAmerican.com (Source: Scientific American)

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Chernobyl Didn't Kill Nuclear Power

Mon, 21 Mar 2016 12:15:00 +0100

The accident was just one factor that makes it a hard sell to fight climate change -- Read more on ScientificAmerican.com (Source: Scientific American)



Johnson & Johnson looks to settle morcellator lawsuits

Mon, 21 Mar 2016 10:05:47 +0100

Johnson & Johnson(NYSE:JNJ) is reportedly looking to settle 100s of product liability and wrongful death lawsuits brought over its now-recalled laparoscopic power morcellators used during surgeries to remove ostensibly benign uterine tumors. The morcellators, which use a cutting tip to shred and remove uterine tissue, have been implicated in the spread of a lethal cancer that can masquerade undetected as benign fibroids. The FDA in April 2014 issued a warning about the devices, later convening a special advisory panel to evaluate their continued use in the surgical suite. The watchdog agency estimates that about 0.3% of women undergoing hysterectomy or fibroid surgery are found to have undetected uterine sarcomas, including the deadly leiomyosarcoma. In November of that year, the ...



Retro Report: Artificial Hearts Ticking Along Decades After Jarvik-7 Debate

Mon, 21 Mar 2016 01:38:06 +0100

A device first tried in 1982 extended lives but raised ethical questions. While its descendants are used only as temporary “bridges” to transplants, regulators are mulling the possibility of again approving permanent implants. (Source: NYT Health)



Hospital Readmission Penalties: Coming Soon to a Nursing Home Near You!

Mon, 21 Mar 2016 00:00:00 +0100

The Protecting Access to Medicare Act of 2014 includes provisions for hospital readmission penalties for skilled nursing facilities (SNFs) starting in 2018. This presents an opportunity for care improvement but also raises several concerns regarding quality of care. The readmission measure for SNFs is similar to the current readmission measure for hospitals mandated under the Affordable Care Act, with the exception of adjustments made for sex. Because these measures for hospitals are similar, lessons can be learned from implementation of the existing hospital readmission penalties. In addition, there are three specific concerns that the authors relate to implementing the proposed measure in SNFs. There is poor communication and care coordination between care settings, including posthospita...