MedWorm: Medical Ethics Research

Stem cells: Back to the future

New Scientist - Health — Thu, 16 May 2013 07:00:00 +0100

The unexpected return of therapeutic cloning could reopen ethical arguments that seemed to have been laid to rest (Source: New Scientist - Health)

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Terrorism and jihad in Indonesia: Questions and possible ways forward

Asian Journal Of Social Psychology — Thu, 16 May 2013 04:00:00 +0100

We critically examine the three papers on terrorism and jihad in Indonesia contained in this issue. First, we argue that thorough discussion and definition of key terms (including religious violence and jihad) would have led to a much stronger framework for understanding the voices of the activists and their supporters. Second, the authors could have engaged more systematically with the international literature on intergroup relations and conflict to discuss how psychological and social processes of radicalization are similar or different in the Indonesian context. Third, we highlight methodological and ethical shortcomings in the three papers that call into question a number of the conclusions drawn by the authors. We outline future research questions and provide suggestions to strengthen...

Ethical considerations for experiments involving elite athletes and "doping"

Journal of Applied Physiology — Thu, 16 May 2013 04:00:00 +0100

(Source: Journal of Applied Physiology)

Rehabilitation of Children With Traumatic Brain Injury: A Critical Review

Pediatric Neurology — Wed, 15 May 2013 11:18:50 +0100

Abstract: The purpose of this critical review of the English literature published between 1975 and 2009 was to assess the quality of the evidence for the efficacy of rehabilitation intervention after traumatic brain injury in children. “Evidence for intervention studies” was used to classify the research strength of design and report. Only a minority (16/439) of the published studies has been related to traumatic brain injury in children and has used a scientific or quasiscientific design. Only one study met the criteria of class I “evidence for intervention” studies. However, this study included adults, as well as children. The other 15 studies, although reporting positive results, had many methodologic deficiencies, and consequently their validity is questionable. Although the me...

Initiation of long-acting reversible contraceptive methods (IUDs and implant) at pregnancy termination reduces repeat abortion

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Commentary on: Cameron S, Glasier A, Chen Z. Effect of contraception provided at termination of pregnancy and incidence of subsequent termination of pregnancy. BJOG 2012;119:1074–80. Context Despite the availability of effective modern contraceptive methods, unplanned pregnancy continues to be a major problem worldwide. In 2008, the worldwide abortion rate was found to be 28/1000 women aged 15–44, unchanged from 2003 rates of 29/1000 women.1 Immediate initiation of long-acting reversible contraceptive (LARC) methods following pregnancy termination has been identified as an effective strategy to reduce repeat unintended pregnancy and abortion. Access to these LARC methods—intrauterine devices (IUDs) and implants—continues to be problematic, especially in the setting ...

'We do not see the lens through which we look': screening mammography evidence and non-financial conflicts of interest

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

It has become clear that conflicts of interest can influence scientific judgement and reporting of research results in the medical literature.1 In this issue of EBM, Rasmussen et al2 studied citation of systematic reviews of breast cancer screening3–5 that found smaller benefits and greater harms than did prior reviews. They then compared how the reviews were cited by general versus specialty journals. In most papers citing the reviews, the key, perhaps controversial, findings regarding overdiagnosis and breast cancer mortality were not discussed. But in those papers that did describe those findings, papers published in general medical journals were more likely than those published in specialty journals to explicitly agree with the findings about overtreatment and overdiagnosis, or t...

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Citations of scientific results and conflicts of interest: the case of mammography screening

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Conclusions Articles in specialty journals were more likely to explicitly reject results from the Cochrane reviews, and less likely to accept the results and methods, than articles in general medical journals. Several specialty journals are published by interest groups and some authors have vested interests in mammography screening. (Source: Evidence-Based Medicine)

Medical apps for smartphones: lack of evidence undermines quality and safety

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Increasing numbers of healthcare professionals are using smartphones and their associated applications (apps) in daily clinical care. While these medical apps hold great potential for improving clinical practice, little is known about the possible dangers associated with their use. Breaches of patient confidentiality, conflicts of interests and malfunctioning clinical decision-making apps could all negatively impact on patient care. We propose several strategies to enhance the development of evidence-based medical apps while retaining their open nature. The increasing use of medical apps calls for broader discussion across medicine's organising and accrediting bodies. The field of medical apps is currently one of the most dynamic in medicine, with real potential to change the way evidence-...

Opposite impacts of dietary versus supplemental calcium on cardiovascular health

Evidence-Based Medicine — Wed, 15 May 2013 04:00:00 +0100

Commentary on: Li K, Kaaks R, Linseisen J, et al.. Associations of dietary calcium intake and calcium supplementation with myocardial infarction and stroke risk and overall cardiovascular mortality in the Heidelberg cohort of the European prospective investigation into cancer and nutrition study (EPIC-Heidelberg). Heart 2012;98:920–5. Context Calcium supplementation is widely used to maintain bone health. Growing data suggests that calcium supplementation, but not dietary calcium intake, may harm cardiovascular (CV) health.1 2 There is no randomised controlled trial (RCT) that addressed CV events as primary endpoints and such an RCT is unlikely to be conducted considering ethical issues.3 Methods The Heidelberg prospective cohort of the European Prospective Investigation into Cancer ...

Spinal manipulation under anesthesia: a narrative review of the literature and commentary

Chiropractic and Osteopathy — Tue, 14 May 2013 04:00:00 +0100

This article will provide a narrative review of the MUA literature, followed by a commentary about the current lack of high quality research evidence, the anecdotal and consensus basis of existing clinical protocols, as well as related professional, ethical and legal concerns for the chiropractic practitioner. The limitations of the current medical literature related to MUA via conscious/deep sedation need to be recognized and used as a guide to clinical experience when giving consideration to this procedure. More research, in the form of controlled clinical trials, must be undertaken if this procedure is to remain a potential treatment option for chronic spine pain patients in the chiropractic clinical practice. (Source: Chiropractic and Osteopathy)

Dental caries prevalence, oral health knowledge and practice among indigenous Chepang school children of Nepal.

BMC Oral Health - Latest articles — Tue, 14 May 2013 04:00:00 +0100

Conclusions: Caries prevalence of 5--6 --year- old Chepang school children is above the recommended target set by FDI/WHO. The study reported 31% schoolchildren aged 8-16-year old suffered oral pain and decayed component constituted almost the entire dmft/DMFT index. The brushing habit was reportedly low with only 24% of the children brushing twice daily. A nationwide scientifically proven, cost effective school based interventions is needed for prevention and control of caries in schoolchildren in Nepal. (Source: BMC Oral Health - Latest articles)

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Distraction by a monotube fixator to achieve limb lengthening: predictive factors for tibia trauma

Journal of Trauma Management and Outcomes — Tue, 14 May 2013 04:00:00 +0100

Conclusion: Distraction by a monotube fixator appears effective in achieving correction >38.0% original tibia lengthening following traumatic bone gap. Predictive factors for poor outcome were useful for prognostication. (Source: Journal of Trauma Management and Outcomes)

Knowing, Caring, and Telehealth Technology: "Going the Distance" in Nursing Practice

Journal of Holistic Nursing — Tue, 14 May 2013 04:00:00 +0100

The use of technology in delivery of health care services is rapidly increasing, and more nurses are using telehealth to provide care by distance to persons with complex health challenges. The rapid uptake of telehealth modalities and dynamic evolution of technologies has outpaced the generation of empirical knowledge to support nursing practice in this emerging field, specifically in relation to how nurses come to know the person and engage in holistic care in a virtual environment. Knowing the person and nursing care have historically been associated with physical presence and close proximity in the nurse–client relationship, and the use of telehealth can limit the ways in which a nurse can observe the person, potentiate perceptions of distance, and lead to a reductionist perspecti...

Attitudes and views of the general public towards research participation

Internal Medicine Journal — Tue, 14 May 2013 04:00:00 +0100

ConclusionAttitudes of the public towards research participation are beleaguered by misconceptions. Stakeholders in clinical research must educate the general public regarding research methods and ethics. (Source: Internal Medicine Journal)

Bullet point ethics as policy advice?

Bioethics — Tue, 14 May 2013 04:00:00 +0100

(Source: Bioethics)

Limbic encephalitis: a clinician's guide

Archives of Disease in Childhood - Education and Practice — Mon, 13 May 2013 04:00:00 +0100

Cases of limbic encephalitis are being increasingly recognised by paediatric neurologists. As they usually present initially to paediatricians it is vital they are aware of the presentation, important investigations and management (table 1), as the prompt instigation of immunosuppression in the correct cases will prevent seizures and medial temporal lobe atrophy and significantly improve outcome. This is an excellent guide and includes some excellent MRI images with the various hippocamapl/temporal lobe changes.1 Key clinical features of limbic encephalitis: Cognitive, and particularly memory impairment Temporal lobe seizures MRI signal change within limbic structures, particularly in the hippocampus. Competing interestsNone. Provenance and peer reviewCommissioned; internally peer re...

Answers to Epilogue questions

Archives of Disease in Childhood - Education and Practice — Mon, 13 May 2013 04:00:00 +0100

From questions on page 92. Answers to question 1 2004—Standard 4 in the National Service Framework for Children, Young People and Maternity Services (Department of Health, 2004) 2006—Transition: Getting it Right for Young People (Department of Health, 2006) 2007—Aiming High for Disabled Children (AHDC): Better Support for Families (Department for Education, 2007) and A Transition Guide for All Services: Key Information for Professionals about the Transition Process for Disabled Children (Department of Health, 2007) 2007—You're Welcome quality criteria (Department of Health, 2007) 2008—Transition: Moving on Well (Department of Health, 2008) Answers to question 2 Fidelity, confidentiality, competency, honesty, a global perspective, non-judgemental approach, cont...

Answers to Dermatophile questions

Archives of Disease in Childhood - Education and Practice — Mon, 13 May 2013 04:00:00 +0100

From questions on page 106. ANSWER TO Question 1 The answer is (D), kerion. This is a manifestation of tinea capitis, ringworm of the scalp. It can occur in more severe cases and in the very young, resulting in a boggy mass on the scalp with loss of hair. Diagnosis can be difficult as potassium hydroxide preparations can be negative in the presence of such inflammation; culture is frequently needed to prove scalp infection. Treatment must be in the form of an oral antifungal drug indicated for tinea capitis for sufficient duration. Use of a topical antifungal shampoo is recommended concurrently to decrease spread of the disease.1 ANSWER TO Question 2 The answer is (A), alopecia areata. Alopecia areata is a common, usually patchy and often unpredictable hair loss on the scalp and the ...

Tension gastrothorax: a rare cause of breathlessness

Emergency Medicine Journal — Mon, 13 May 2013 04:00:00 +0100

A 67-year-old lady presented to the emergency department with a 4 day history of breathlessness for which she had started clarithromycin. She had a history of a hiatal hernia repair in 1996 and had recently started inhalers for presumed chronic obstructive pulmonary disease (COPD). Her pulse was 101 bpm, blood pressure 174/120 mm Hg, respiratory rate 36 and O2 saturations 88% on air. She was clammy, dyspnoeic and auscultation of her chest revealed global wheeze. She was treated for an exacerbation of COPD. A chest radiograph showed a massive gastrothorax with mediastinal shift (figure 1). Attempts to pass a nasogastric tube were unsuccessful and she rapidly deteriorated, becoming drowsy, dropping her blood pressure to 108/60 mm Hg and O2 saturations to 86% on ...

An 80-year-old man with acute onset of right upper limb weakness

Emergency Medicine Journal — Mon, 13 May 2013 04:00:00 +0100

An 80-year-old man with a history of hypertension was referred under the suspicion of stroke. He suffered from acute onset of right upper limb weakness 4 h before presenting to our emergency department. He did not have dysarthria, facial palsy or positive pronator sign. But decreased right radial pulse and cold upper limb with cyanosis were noted. Emergent CT angiography was performed and revealed isolated spontaneous right subclavian artery dissection (figure 1A), which extended to axillary artery with compression of true lumen by thrombosed false lumen (figure 1B). He then received heparinisation treatment and the weakness of his right upper limb gradually recovered. Isolated spontaneous subclavian artery dissection is extremely rare.1 The initial clinical presentation is often misd...

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BET 3: In well-appearing children suspected of meningococcal disease can procalcitonin reduce the need for empiric antibiotic treatment?

Emergency Medicine Journal — Mon, 13 May 2013 04:00:00 +0100

Report by: David Herd, CED Fellow Search checked by: Katie Cole Grimes, Specialty Registrar Institution: Starship Children's Hospital (Auckland, NZ), Manchester Royal Infirmary (UK) Abstract A short-cut review of the literature was carried out to establish whether the biological marker procalcitonin could safely rule out the diagnosis of meningococcal disease (MCD) in children. Using the below outlined search method and after the exclusion of the non-relevant papers, two were found to be relevant to the specific question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these are shown in table 3. The clinical bottom line is that the currently available evidence is not sufficient to support the sole use of pr...

Counselling for sight loss: Using systematic case study research to build a client informed practice model

British Journal of Visual Impairment — Mon, 13 May 2013 04:00:00 +0100

There is compelling evidence to suggest that acquired sight loss negatively impacts on emotional well-being. Despite increasing recognition of the need to provide emotional support for people with sight loss, we still do not fully understand what counselling interventions help and why they help. The aim of this study was to examine the process and outcome of counselling for a 70-year-old client who had experienced complete, irreversible, post-operative sight loss in order to gain a deeper understanding of client-defined helpful aspects of therapy. A Hermeneutic Single-Case Efficacy Design study was undertaken having received ethical approval from the University’s Research Ethics Committee. The client received six sessions of counselling from a vision-impaired counsellor working withi...

Arabin cervical pessary in pregnant women at high‐risk of premature birth: an MR imaging observational follow‐up study

Ultrasound in Obstetrics and Gynecology — Mon, 13 May 2013 04:00:00 +0100

ConclusionIn patients at high risk of premature delivery, correct placement of the Arabin cervical pessary should be immediately controlled, which can be easy and fast done with MRI. Our study provides some evidence that in singleton pregnancies with short cervix, cervical pessary delays birth by a mechanical effect on the utero‐cervical angle. (Source: Ultrasound in Obstetrics and Gynecology)

Evaluating the impact of a quality of life assessment with feedback for clinicians in patients with schizophrenia: randomised controlled trial.

The British Journal of Psychiatry for Mental Science — Sat, 11 May 2013 11:56:51 +0100

CONCLUSIONS: Quality of life feedback positively influences patient satisfaction, which confirms the relevance of measuring QoL in clinical practice. The absence of a significant effect of QoL feedback on clinical outcomes also suggests that clinicians did not use these data optimally. Our findings suggest a nocebo effect of QoL assessment without feedback that should be considered by researchers and clinicians. PMID: 23661768 [PubMed - as supplied by publisher] (Source: The British Journal of Psychiatry for Mental Science)

Changes in capacity to consent over time in patients involved in psychiatric research.

The British Journal of Psychiatry for Mental Science — Sat, 11 May 2013 11:56:51 +0100

CONCLUSIONS: Informed consent may be most effectively construed as an ongoing dialogue with participants at each study visit. PMID: 23661766 [PubMed - as supplied by publisher] (Source: The British Journal of Psychiatry for Mental Science)

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Diffusion tensor imaging and magnetic resonance spectroscopy assessment of cancellous bone quality in femoral neck of healthy, osteopenic and osteoporotic subjects at 3T: Preliminary experience

Bone — Sat, 11 May 2013 04:10:58 +0100

Conclusion: DTI-1H-MRS protocol performed in femoral neck seems to be highly sensitive and specific in identifying healthy subjects.A MR exam is more expensive when compared to a DXA investigation. However, even though DXA BMD evaluation has been the accepted standard for osteoporosis diagnosis, DXA result has a low predictive value on patients' risk for future fractures. Thus, new approaches for examining patients at risk for developing osteoporosis would be desirable.Preliminary results showed here suggest that future studies on a larger population based on DTI assessment in the femoral neck, in combination with 1H-MRS investigations, might allow screening of high-risk populations and the establishment of cut-off values of normality, with potential application of the method to single sub...

Produce Industry s Food Safety Push Takes Toll on the Environment

Scientific American - Official RSS Feed — Fri, 10 May 2013 22:41:00 +0100

Clean greens are healthy greens. [More] (Source: Scientific American - Official RSS Feed)

'Sometimes I want to play by myself': Understanding what friendship means to children with autism in mainstream primary schools

Autism — Fri, 10 May 2013 04:00:00 +0100

Research has shown that friendship impacts the overall experience of mainstream school for autistic children. Using a unique combination of quantitative, qualitative and social network methods, we investigated the extent and nature of autistic children’s friendships from their perspective and from those of their mothers, teachers and classroom peers. Consistent with previous research, children with autism (n = 12), aged between 9 and 11 years, rated their friendships to be of poorer quality than their non-autistic classroom peers (n = 11). There was, however, much variability in autistic children’s ratings, which, unexpectedly, was related to neither children’s cognitive ability nor their theory of mind ability. Encouragingly, the children generally reported satisfaction ...

Piloting the 'Children's acceptability of oral formulations (CALF) medicines survey to determine perceptions and practices with paediatrics medicines

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions This study supports the importance of eliciting children's unique perspectives relative to medicines use and acceptability. It also highlights that children and their parents/carers often manipulate dosage forms to aid administration; the frequency and clinical significance of these should be further evaluated. The questionnaires appear fit for purpose in relation to the capabilities of respondents, and show promise for the next stage of larger-scale data collection. (Source: Archives of Disease in Childhood)

Adherence of paediatric nurses to double checking process steps during medication administration in a children's hospital: an observational study

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions There was a variation between paediatric nurses adherence to double checking steps during medication administration. Independent double checks were not apparent for all steps in practice. The majority of medication administration errors observed failed to be prevented by the double checking process. (Source: Archives of Disease in Childhood)

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Ethanol intake of paediatric intensive care patients

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Polypharmacy in PICU patients increases the exposure to alcohol. Some commercially available medicines provide excessive ethanol intake, providing the clinician with ethical, potentially economical dilemmas of prescribing an unlicensed medicine to minimise ethanol exposure. Further research is required to evaluate the scope of the problem, effects of exposure and provision of alcohol free formulations. (Source: Archives of Disease in Childhood)

Two years experience of the treatment of molybdenum cofactor deficiency

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Until recently the provision of care to children with MOCD has largely been palliative. The experience in these two children suggest that the longer term treatment of the disease is possible and that near normal development can be possible in a disease that was previously fatal. The ongoing use of cPMP in these patients presents some challenges in supply of a product appropriate for use. (Source: Archives of Disease in Childhood)

Characteristics influencing location of death for children with life-limiting illness

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Conclusions Most children in New Zealand with a life-limiting illness die in hospital with a significant influence resulting from ethnic background, diagnosis and referral to the PPC service. These findings have implications for resourcing PPC services and end-of-life care. (Source: Archives of Disease in Childhood)

Towards evidence based medicine for paediatricians

Archives of Disease in Childhood — Thu, 09 May 2013 04:00:00 +0100

Getting it straight from the start For more than a decade Archimedes has presented clinical queries and appraised the evidence that emerges, leading on to a clinical conclusion to the dilemma. What is strikingly common is that many questions can start in a muddle, and a failure to get an ‘evidence-based answer’ might actually be a failure to ask an accurate question. In a recent trans-disciplinary teaching session, one anaesthetist summarised the formulation of evidence-based medicine (EBM) questions as ‘Does drug A compared to drug B make outcome X happen more or less in patient group Z?’—a brilliant anagram of the ‘PICO’ formula into Intervention, Comparator, Outcome, Patients. Now if your question doesn't fit, or can be fudged to fit, this...

How the observed create ethical dilemmas for the observers: Experiences from studies conducted in clinical settings in the UK and Australia

Nursing and Health Sciences — Thu, 09 May 2013 04:00:00 +0100

In this study, the authors explored the less overt and often understated ethical challenges that can arise when conducting observational research in a clinical setting. Reflecting on two recent studies conducted in different clinical settings, the authors described the challenges of blurring role boundaries, the risk of collecting redundant data, and the impact of reverse power relationships between researchers, clinicians, and managers. From their experiences, the authors suggested that the preparatory work undertaken with clinicians and managers onsite, which typically focuses on how the researchers will maintain the ethical robustness of the research and protect the rights of participants and the vulnerable, should also highlight the sometimes overlooked ethical issues associated with p...

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‘Be our guest’: challenges and benefits of using ‘family conversations’ to collect qualitative data about infant feeding and parenting

Journal of Clinical Nursing — Thu, 09 May 2013 04:00:00 +0100

ConclusionsBeing able to balance the needs of the researcher and the research participants is an important challenge that is a core component of conducting ethical research. Relevance to clinical practiceThis paper highlights the viability of ‘family conversations’ as a data collection method for midwifery and nursing research and the need for midwives and child and family health nurses to more actively engage with a woman's support network with education and other strategies to assist in creating an environment for new mothers that is conducive to the continuation of breastfeeding and thriving as a mother. (Source: Journal of Clinical Nursing)

Image‐directed, tissue‐preserving focal therapy of prostate cancer: a feasibility study of a novel deformable mr‐us registration system

BJU International — Thu, 09 May 2013 04:00:00 +0100

ConclusionNon‐rigid MR‐US registration is feasible, efficient and can locate lesions on ultrasound.The process has potential for improved accuracy of focal treatments, and improved diagnostic sampling strategies for prostate cancer.Further work on whether deformable MR‐US registration impacts on efficacy is required. (Source: BJU International)

Nutrition labelling and the choices logo in Israel: positions and perceptions of leading health policy makers

Journal of Human Nutrition and Dietetics — Thu, 09 May 2013 04:00:00 +0100

ConclusionsThe results of the present study highlight the importance of a need for an integrated programme of nutrition promotion, including the use of social marketing based on a cooperative effort between the food industry, regulators and professionals, to recommend changes and adjustments in nutritional front of package labelling with the aim of promoting healthier nutrition consumption. (Source: Journal of Human Nutrition and Dietetics)

Prevalence of rotavirus and adenovirus associated with diarrhea among displaced communities in Khartoum, Sudan

BMC Infectious Diseases — Wed, 08 May 2013 04:00:00 +0100

Conclusions: In conclusion, most cases of viral diarrhea are found to be caused by rotavirus especially among children less than five years. Most of the identified rotavirus belonged to type A (VP6).It was also evident that most patients are those who drank untreated water obtained from donkey carts source and who had no access to latrines, and lived in poor environmental conditions would acquire diarrheal infection. (Source: BMC Infectious Diseases)

Rose Gardener's disease

Thorax — Wed, 08 May 2013 04:00:00 +0100

A 32-year-old man worked as a subsistence farmer raising pigs and tending his small garden; he also kept cats and dogs. He reported fever, night sweats, weight loss of 10 kg over 3 months, haemoptysis and skin ulcers (figure 1). Radiography and chest CT scan (figure 2) showed extensive bilateral cavities. An HIV test was negative. Bronchoalveolar lavage and biopsy of the skin lesions displayed Sporothrix schenckii. He was treated with amphotericin B and his lesions slowly healed. Sporotrichosis is a chronic pyogranulomatous infection caused by a dimorphic fungus that contaminates skin or subcutaneous tissue after trauma with plant materials such as thorns or splinters, or through cat scratches or bites.1–3 The term ‘Rose Gardener's disease’ has been coined follo...

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Foot orthoses for the management of low back pain: a qualitative approach capturing the patient's perspective

Journal of Foot and Ankle Research — Tue, 07 May 2013 04:00:00 +0100

Conclusion: Clinicians need to adopt 'psychologically informed practice' in relation to the provision of foot orthoses. Likewise, researchers should consider all the influencing factors found in this study, both in relation to their study protocol and the outcomes they plan to measure. (Source: Journal of Foot and Ankle Research)

Ars Brevis [ART OF ONCOLOGY]

Journal of Clinical Oncology — Tue, 07 May 2013 04:00:00 +0100

(Source: Journal of Clinical Oncology)

Delays in updates to ethics guidelines for research spark concern

Nature Medicine — Tue, 07 May 2013 04:00:00 +0100

Nature Medicine 19, 511 (2013). doi:10.1038/nm0513-511 Author: Alla Katsnelson (Source: Nature Medicine)

Foot orthoses for the management of low back pain: a qualitative approach capturing the patient¿s perspective

Journal of Foot and Ankle Research — Tue, 07 May 2013 04:00:00 +0100

Conclusion: Clinicians need to adopt ‘psychologically informed practice’ in relation to the provision of foot orthoses. Likewise, researchers should consider all the influencing factors found in this study, both in relation to their study protocol and the outcomes they plan to measure. (Source: Journal of Foot and Ankle Research)

Johnson & Johnson Removes Some Chemicals from Baby Shampoo, Other Products

Scientific American - Official RSS Feed — Mon, 06 May 2013 16:15:00 +0100

At a small ceremony in February, Johnson & Johnson executives were handed a scroll of 30,000 signatures from consumers. [More] (Source: Scientific American - Official RSS Feed)

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Chemicals of High Concern Found in Thousands of Children's Products

Scientific American - Official RSS Feed — Mon, 06 May 2013 16:00:00 +0100

Cobalt in plastic building blocks and baby bibs. Ethylene glycol in dolls. Methyl ethyl ketone in clothing. Antimony in high chairs and booster seats. Parabens in baby wipes. D4 in baby creams. [More] (Source: Scientific American - Official RSS Feed)

Managing Risk and Marginalizing Identities: On the Society-of-Captives Thesis and the Harm of Social Dis-Ease

International Journal of Offender Therapy and Comparative Criminology — Mon, 06 May 2013 04:00:00 +0100

This article develops the constitutive features of the society-of-captives thesis as suggested by Arrigo and Milovanovic, and Arrigo, Bersot, and Sellers. The relevance of this thesis is briefly explored in relation to the institutional and community-based treatment philosophies that currently inform the mental health and criminal justice systems. This exploration specifies how risk (being human and doing humanness differently) is managed symbolically, linguistically, materially, and culturally. The management of this risk extends to the kept as well as to their keepers, regulators, and watchers (i.e., the society of captives). This article calls for a new clinical praxis (being/doing a critical mindfulness) designed to overcome the totalizing madness (the harm of social dis-ease) that fol...

Captivity, Citizenship, and the Ethics of Otherwise in the Society-of-Captives Thesis: A Commentary on Arrigo

International Journal of Offender Therapy and Comparative Criminology — Mon, 06 May 2013 04:00:00 +0100

In this engagement with Professor Bruce Arrigo’s psychological jurisprudence model, I explore his critique of captivity and risk management. I am particularly interested in his claims that incarceration culminates in society’s own captivity, that the most destructive aspect of captivity is its foreclosing of human difference and potentiality, and that a praxis that is both clinical and mindful might point a way out. By way of a case anecdote, I interrogate several of the key terms in Arrigo’s formulation—citizenship, reform, revolution, and praxis—in an effort to further conjugate from the ground up such an innovative and important set of possibilities. (Source: International Journal of Offender Therapy and Comparative Criminology)

Moral Strangers and Moral Acquaintances: How to Conduct Professional Relationships in a Society of Captives: A Commentary on Arrigo

International Journal of Offender Therapy and Comparative Criminology — Mon, 06 May 2013 04:00:00 +0100

In this article, I examine Bruce Arrigo’s target article and the implications of his thesis that the mental health and criminal justice systems marginalize vulnerable individuals through a variety of symbolic and discursive practices. In particular, I direct my attention to the problem of value pluralism and how it can create problems communicating across different moral communities. I apply the insights of relational ethics and the concept of moral acquaintanceship in an attempt to bridge this gap. I then discuss the implications of this framework for Arrigo’s thesis and a story written by Amy Johnson describing the devastating effects of abuse, racism, and illness on a person of color. (Source: International Journal of Offender Therapy and Comparative Criminology)

Protocol: does sodium nitrite administration reduce ischaemia-reperfusion injury in patients presenting with acute ST segment elevation myocardial infarction? Nitrites In Acute Myocardial Infarction (NIAMI)

Journal of Translational Medicine — Mon, 06 May 2013 04:00:00 +0100

This study is funded by a grant from the UK Medical Research Council. This protocol is approved by the Scotland A Research Ethics Committee and has also received clinical trial authorisation from the Medicines and Healthcare products Regulatory Agency (MHRA) (EudraCT number : 2010-023571-26).Trial registration: ClinicalTrials.gov: NCT01388504; http://clinicaltrials.gov/show/NCT01388504 and Current Controlled Trials: ISRCTN57596739 (Source: Journal of Translational Medicine)

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Ethical Amendments to the Israeli Organ Transplant Law

American Journal of Transplantation — Mon, 06 May 2013 04:00:00 +0100

(Source: American Journal of Transplantation)

Patient and carer views on participating in clinical trials for prodromal Alzheimer's disease and mild cognitive impairment

International Journal of Geriatric Psychiatry — Mon, 06 May 2013 04:00:00 +0100

ConclusionsThe priorities of patients might be different to clinicians and those who design and regulate clinical trials. Patient views can be used to inform the ethical debate around the disclosure of biomarker status, the design of clinical trials and the content of trial information. Copyright © 2013 John Wiley & Sons, Ltd. (Source: International Journal of Geriatric Psychiatry)

In silico study of the haemodynamic effects induced by mechanical ventilation and biventricular pacemaker

Computer Methods and Programs in Biomedicine — Sat, 04 May 2013 04:10:08 +0100

Abstract: In silico modeling of the cardiovascular system (CVS) can help both in understanding pharmacological or pathophysiological process and in providing information which could not be obtained by means of traditional clinical research methods due to practical or ethical reasons. In this work the numerical CVS was used to study the effect of interaction between mechanical ventilation and biventricular pacemaker by haemodynamic and energetic point of view. Starting from literature data on patients with intra and/or inter-ventricular activation time delay and treated using biventricular pacemaker, we used in silico simulator to analyse the effects induced by mechanical ventilatory assistance (MVA). After reproducing baseline and CRT conditions, the MVA was simulated changing the mean int...

[Policy Forum] Research Ethics: Global Research Integrity Training

Science: Current Issue — Fri, 03 May 2013 07:10:09 +0100

Globalization of responsible conduct of research training should be grounded on shared professional standards.Author: Nicholas H. Steneck (Source: Science: Current Issue)

Underreporting of conflicts of interest in clinical practice guidelines: cross sectional study

BMC Medical Ethics — Fri, 03 May 2013 04:00:00 +0100

Conclusions: Conflicts of interest were common, but disclosures were very rare. Most guidelines did not describe how they were developed and many did not describe the evidence behind specific recommendations. Publicly available disclosure lists may assist guideline issuing bodies in ensuring that all conflicts are disclosed. (Source: BMC Medical Ethics)

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A multi-center study on the regenerative effects of erythropoietin in burn and scalding injuries: study protocol for a randomized controlled trial

Trials — Fri, 03 May 2013 04:00:00 +0100

DiscussionWe are seeking new insights into the mechanisms of wound healing in thermally injured patients and more detailed information about the role EPO plays, specifically in these complex interactions. We additionally expect that the biomimetic effects of EPO will be useful in the treatment of acute thermal dermal injuries.Trial registration: EudraCT Number: 2006-002886-38, Protocol Number: 0506, ISRCT Number: http://controlled-trials.com/ISRCTN95777824/ISRCTN95777824. (Source: Trials)

Lead Poisoning Comes to the Remote Amazon

Scientific American - Official RSS Feed — Thu, 02 May 2013 16:10:00 +0100

Inside the simple wood-frame house, a 6-year-old boy plays with a piece of malleable metal, biting it as his younger sister watches. In the background, piled against the wall, are two long strips of the metal – lead sheathing from an electrical cable that the family sold for scrap. [More] (Source: Scientific American - Official RSS Feed)

News from the Front in War on Cancer--Mission Not Accomplished

Scientific American - Official RSS Feed — Thu, 02 May 2013 12:00:00 +0100

Janet Rowley noticed something odd about the glowing chromosomes revealed by her microscope. It was the early 1970s, the first years of the so-called " war on cancer ," and she was using a new staining technique to examine cells from patients with chronic myelogenous leukemia (CML), a cancer of the blood that was almost always fatal. The technique highlighted bands within the chromosomes, and she could see an extra piece on the end of chromosome 9. That fragment was nearly the same size as a "missing" chunk of chromosome 22 that other researchers had detected a decade earlier. To Rowley, it looked as if the tips of these two chromosomes had swapped places, or translocated. During the next few years she found two other cases of chromosomal translocation in different form...

Metapsychology, epistemology and ethics of clinical psychoanalysis

Psicologia em Estudo — Thu, 02 May 2013 09:15:22 +0100

Cet article traite de la différence entre la psychotérapie et la psychanalyse et analyse les objectifs respectifs des deux méthodes, en se référant à la théorie de la séduction généralisée de Jean Laplanche, ansi qu'au projet d'émancipation que cette théorie confère à la psychanalyse. Il fait valoir qu'il existe un rapport très étroit entre la théorie et la pratique en psychacanalyse, cela signifie que la pratique implique toujours le choix d'un modèle métapsychologique. L'article soutient par ailleurs que tous les modèles ne sont pas équivalents quant à leur conception de la transformation, objectif inhérent tout-à-fait à la pratique de la psychanalyse.O presente artigo analisa as diferenças entre psicoterapia e psicanálise e situa o quadro e os respectivos obj...

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The protective shield and the Paraskeuê

Psicologia em Estudo — Thu, 02 May 2013 09:15:22 +0100

A noção de paraexcitações (Reizschutz), tal como formulada por Freud, tem forte viés biológico. É possível re-escrevê-la, a partir da teoria da sedução generalizada de Jean Laplanche, mostrando sua constituição nas relações originárias com o outro. O exame da literatura sobre a noção mostra claramente a dimensão ética e estética desse conceito. Autores relacionam condutas tais como a anorexia, a toxicomania, a hipocondria e a conduta criminosa como resultado da má constituição do paraexcitações. Nesse sentido, é possível aproximar o conceito da noção grega Paraskeuê, um escudo moral produzido ao longo da vida, tal como foi estudado por Michel Foucault. Conclui-se ser desejável re-escrever o conceito, integrando-o à história das práticas do cuidado de si p...

Letter to the Editor

The Knee — Thu, 02 May 2013 04:11:21 +0100

We write to express our significant reservations regarding the article by Yanhui Jia and colleagues, “Anatomic proximity of the peroneal nerve to the posterolateral corner of the knee determined by MR imaging,” (The Knee 19 (2012) 766–768). This subject matter has been of significant interest to us for the past decade, and we have previously published on the same subject . Therefore, we were initially very interested to review the authors' paper. However, we very quickly recognized important ethical and scientific concerns regarding their work. (Source: The Knee)

Plagiarism in medical literature

The Knee — Thu, 02 May 2013 04:11:20 +0100

The editors have recently dealt with the issue of potential plagiarism in a case where the intent was innocent but the appearance was that of claiming another colleague's work. We believe that scientific progress and evolution like many human endeavors, requires taking from what is known and then improving upon that understanding. So many great ideas, patents and works have been subtle but with brilliant twists or enlightenments of a basic idea. However, the ethical issue arises when that work is claimed by another in print, without due recognition of the source. We believe that there is no place for this problem in our journal and will use measures at our disposal in the electronic publishing realm to identify a discrepancy. This places the onus upon the authors to make absolutely certain...

An evaluation of Croi MyAction community lifestyle modification programme compared to standard care to reduce progression to diabetes/pre-diabetes in women with prior gestational diabetes mellitus (GDM): study protocol for a randomised controlled trial

Trials — Thu, 02 May 2013 04:00:00 +0100

Background: Universal screening using the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria has identified a prevalence of gestational diabetes mellitus (GDM) of 12.4% in women living in Ireland. Women with prior GDM are at increased risk of developing type 2 diabetes later in life. A number of risk factors linked to the development of type 2 diabetes are potentially modifiable through lifestyle and behaviour changes, and medical management. No previous Irish studies have adequately investigated the efficacy of lifestyle intervention programmes in reducing these risk factors in women with prior GDM. Through a two-group, parallel randomised controlled trial (RCT), this study aims to assess the clinical impact, cost-effectiveness and psychological experience ...

Transgenics: A New Breed of Crops

Scientific American - Official RSS Feed — Wed, 01 May 2013 21:45:00 +0100

When the first genetically modified (GM) organisms were being developed for the farm, says Anastasia Bodnar, “we were promised rocket jet packs” -- futuristic, ultra-nutritious crops that would bring exotic produce to the supermarket and help to feed a hungry world. [More] (Source: Scientific American - Official RSS Feed)

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A Hard Look at 3 Myths about Genetically Modified Crops

Scientific American - Official RSS Feed — Wed, 01 May 2013 21:30:00 +0100

In the pitched debate over genetically modified (GM) foods and crops, it can be hard to see where scientific evidence ends and dogma and speculation begin. In the nearly 20 years since they were first commercialized, GM crop technologies have seen dramatic uptake. Advocates say that they have increased agricultural production by more than US$98 billion and saved an estimated 473 million kilograms of pesticides from being sprayed. But critics question their environmental, social and economic impacts. [More] (Source: Scientific American - Official RSS Feed)

Telling Patients About Staffing Levels

AJN — Wed, 01 May 2013 05:00:00 +0100

Transparency or self-interest? (Source: AJN)

Informed consent or informed refusal?

American Journal of Orthodontics and Dentofacial Orthopedics — Wed, 01 May 2013 04:00:00 +0100

Karen is an anesthesiology resident and your last patient of the week. Her chief concern is the irregularity of her maxillary incisors. She describes her experience of prolonged, comprehensive orthodontic therapy as an adolescent. She says that she had “4 years of treatment with 8 teeth extracted and a night brace—the works!” She admits that the result was never ideal, even immediately after treatment. (Source: American Journal of Orthodontics and Dentofacial Orthopedics)

Rethinking placebo in psychiatry: the range of placebo effects [Articles]

Advances in Psychiatric Treatment — Wed, 01 May 2013 04:00:00 +0100

This article, the first of two on placebo effects, provides a broad overview of placebo in the field of medicine. A brief conceptual history is followed by some basic facts about placebos. Problems of definition are identified. Additive and non-additive models of treatment effects, and problems of measurement of placebo effects are described. The role of placebo in the pharmacotherapy of depression and complementary and alternative medicine is discussed. The ‘efficacy paradox’ (that placebo treatments can have larger effects than ‘evidence-based treatments’) is introduced. Finally, ethical issues are discussed. (Source: Advances in Psychiatric Treatment)

Parental Perceptions of Forgoing Artificial Nutrition and Hydration During End-of-Life Care

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

CONCLUSIONS: FANH in children at the EOL is an acceptable form of palliation for some parents and may contribute to a death that is perceived to be peaceful and comfortable. In situations in which FANH may be a reasonable possibility, physicians should be prepared to introduce the option. (Source: PEDIATRICS)

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Can a Patient Designate His Doctor as His Proxy Decision Maker?

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

We present a case in which those issues arose, and sought comments from Sabrina Derrington, a pediatric palliative care physician; Arthur Derse, an emergency department physician and lawyer; and Phil Black, a pulmonologist. (Source: PEDIATRICS)

Ethical Controversies in Organ Donation After Circulatory Death

PEDIATRICS — Wed, 01 May 2013 04:00:00 +0100

The persistent mismatch between the supply of and need for transplantable organs has led to efforts to increase the supply, including controlled donation after circulatory death (DCD). Controlled DCD involves organ recovery after the planned withdrawal of life-sustaining treatment and the declaration of death according to the cardiorespiratory criteria. Two central ethical issues in DCD are when organ recovery can begin and how to manage conflicts of interests. The "dead donor rule" should be maintained, and donors in cases of DCD should only be declared dead after the permanent cessation of circulatory function. Permanence is generally established by a 2- to 5-minute waiting period. Given ongoing controversy over whether the cessation must also be irreversible, physicians should not be re...

Online Counseling: A Narrative and Critical Review of the Literature

Journal of Clinical Psychology — Wed, 01 May 2013 04:00:00 +0100

ConclusionA growing body of knowledge to date is positive in showing that online counseling can have a similar impact and is capable of replicating the facilitative conditions as face‐to‐face encounters. A need remains for stronger empirical evidence to establish efficacy and effectiveness and to understand better the unique mediating and facilitative variables. (Source: Journal of Clinical Psychology)

Retraction

Heart — Wed, 01 May 2013 04:00:00 +0100

DiNicolantonio JJ, Di Pasquale P,Taylor RS et al. Low sodium versus normal sodium diets in systolic heart failure: Systematic review and meta-analysis This paper was published on-line in Heart on 21 August 2012. It reports a meta-analysis of six earlier papers.1–6 It has come to our attention that two of these papers contain duplicate data in tables reporting baseline data and treatment effects.3 4 The matter was considered by BMJ Publishing Ethics Committee. The Committee considered that without sight of the raw data on which the two papers containing the duplicate data were based, their reliability could not be substantiated. Following inquiries, it turns out that the raw data are no longer available having been lost as a result of computer failure. Under the circumstances, it was ...

Suggested Guidelines for the Practice of Arthroscopic Surgery

Arthroscopy — Wed, 01 May 2013 04:00:00 +0100

This statement was prepared by the Committee on Ethics and Standards and the Board of Directors of the Arthroscopy Association of North America. The decision to grant and renew privileges in diagnostic arthroscopy and or arthroscopic surgery is typically made by individual hospitals with input from medical staff committees and appropriate department chairpersons, in accordance with individual hospital and medical staff bylaws, rules and regulations. In situations where arthroscopic surgical privileges are requested, a Board Certified orthopedic surgeon or equivalent specialist, with considerable experience in the field of arthroscopic surgery should be involved in the decision making process to grant these privileges. (Source: Arthroscopy)

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Pre-symptomatic genetic testing for inherited cardiac conditions: a qualitative exploration of psychosocial and ethical implications

European Journal of Human Genetics — Wed, 01 May 2013 04:00:00 +0100

Authors: Elizabeth Ormondroyd, Stephanie Oates, Michael Parker, Edward Blair & Hugh Watkins (Source: European Journal of Human Genetics)

Personhood, harm and interest: a reply to Alberto Giubilini and Francesca Minerva