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[PMID]:28903155
[Au] Autor:Radix A; Davis AM
[Ad] Endereço:Callen Lorde Community Health Center, New York, New York.
[Ti] Título:Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons.
[So] Source:JAMA;318(15):1491-1492, 2017 Oct 17.
[Is] ISSN:1538-3598
[Cp] País de publicação:United States
[La] Idioma:eng
[Mh] Termos MeSH primário: Disforia de Gênero/tratamento farmacológico
Hormônios Esteroides Gonadais/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Disforia de Gênero/diagnóstico
Hormônio Liberador de Gonadotropina/uso terapêutico
Seres Humanos
Consentimento Informado por Menores
Competência Mental
Encaminhamento e Consulta
Procedimentos de Readequação Sexual
[Pt] Tipo de publicação:JOURNAL ARTICLE; PRACTICE GUIDELINE
[Nm] Nome de substância:
0 (Gonadal Steroid Hormones); 33515-09-2 (Gonadotropin-Releasing Hormone)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171024
[Lr] Data última revisão:
171024
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170914
[St] Status:MEDLINE
[do] DOI:10.1001/jama.2017.13540


  2 / 151 MEDLINE  
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[PMID]:28614032
[Au] Autor:Nicholas S; Stephens R
[Ad] Endereço:Locum Consultant Anaesthetist, The Whittington Hospital, London.
[Ti] Título:Implications of consent for medical practice.
[So] Source:Br J Hosp Med (Lond);78(6):C92-C95, 2017 Jun 02.
[Is] ISSN:1750-8460
[Cp] País de publicação:England
[La] Idioma:eng
[Mh] Termos MeSH primário: Consentimento Livre e Esclarecido/legislação & jurisprudência
Competência Mental/legislação & jurisprudência
[Mh] Termos MeSH secundário: Diretivas Antecipadas/legislação & jurisprudência
Pesquisa Biomédica/legislação & jurisprudência
Confidencialidade/legislação & jurisprudência
Seres Humanos
Consentimento Informado por Menores/legislação & jurisprudência
Procurador/legislação & jurisprudência
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170615
[St] Status:MEDLINE
[do] DOI:10.12968/hmed.2017.78.6.C92


  3 / 151 MEDLINE  
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[PMID]:28562274
[Au] Autor:Burgart AM; Strickland J; Davis D; Baratz AB; Karkazis K; Lantos JD
[Ad] Endereço:Department of Anesthesia, Perioperative, and Pain Medicine.
[Ti] Título:Ethical Controversy About Hysterectomy for a Minor.
[So] Source:Pediatrics;139(6), 2017 Jun.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:One of the most complicated ethical issues that arises in children's hospitals today is the issue of whether it is ever permissible to perform a procedure for a minor that will result in permanent sterilization. In most cases, the answer is no. The availability of good, safe, long-acting contraception allows surgical options to be postponed when the primary goal of such surgical options is to prevent pregnancy. But what if a minor has congenital urogenital anomalies or other medical conditions for which the best treatment is a hysterectomy? In those cases, the primary goal of therapy is not to prevent pregnancy. Instead, sterility is an unfortunate side effect of a medically indicated treatment. Should that side effect preclude the provision of a therapy that is otherwise medically appropriate? We present a case that raises these issues, and asked experts in law, bioethics, community advocacy, and gynecology to respond. They discuss whether the best option is to proceed with the surgery or to cautiously delay making a decision to give the teenager more time to carefully consider all of the options.
[Mh] Termos MeSH primário: Histerectomia/ética
Consentimento Informado por Menores
Esterilização Reprodutiva/ética
Anormalidades Urogenitais/cirurgia
Útero/anormalidades
Vagina/anormalidades
[Mh] Termos MeSH secundário: Adolescente
Feminino
Fertilidade
Seres Humanos
Histerectomia/legislação & jurisprudência
Gravidez
Esterilização Reprodutiva/legislação & jurisprudência
Útero/cirurgia
Vagina/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170907
[Lr] Data última revisão:
170907
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170601
[St] Status:MEDLINE


  4 / 151 MEDLINE  
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[PMID]:28557746
[Au] Autor:Rose CD
[Ad] Endereço:Division of Rheumatology, Nemours Alfred I. duPont Hospital for Children, Thomas Jefferson University, Wilmingtom, Delaware; and Chair, Nemours Wilmington Institutional Review Board, Nemours Office of Human Research Protection, Wilmington, Delaware crose@nemours.org.
[Ti] Título:Ethical Conduct of Research in Children: Pediatricians and Their IRB (Part 1 of 2).
[So] Source:Pediatrics;139(5), 2017 May.
[Is] ISSN:1098-4275
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:As human experimentation continues to grow into an ever more complex and sophisticated endeavor, the relevant ethical and regulatory structures become more intricate. When pediatricians and general practitioners are invited by pharmaceutical companies to enroll their offices in a clinical trial or a multicenter observational study or when they develop their own research questions, they frequently find themselves at a loss in the human research environment. The legal and regulatory complexity may have an unintended deterring effect at a time when office-based high quality pediatric research is urgently needed to support evidence-based medicine. Unfortunately, in many instances, unaware practitioners become involved in low-risk research activities without knowing it and become entangled in legal, auditing, and compliance procedures. This paper, written in 2 parts, aims at providing a general guidance on the principles that regulate human research with a focus on pediatrics. Part 1 discusses the history, the legal framework, and the consent process and highlights some practical aspects of initial protocol submission, continued review, and institutional review board determinations with the main focus on multicenter clinical trials (industry-sponsored research). Part 2 focuses on pediatric research regulation, also known as subpart-D, and minimal risk research, which encompasses many research activities aimed at addressing questions that may emerge in pediatricians' practices (investigator-initiated research).
[Mh] Termos MeSH primário: Pesquisa Biomédica/ética
Comitês de Ética em Pesquisa
Pediatras/ética
[Mh] Termos MeSH secundário: Pesquisa Biomédica/história
Pesquisa Biomédica/legislação & jurisprudência
Criança
Ensaios Clínicos como Assunto/ética
Descoberta de Drogas/ética
História do Século XX
Experimentação Humana/ética
Experimentação Humana/história
Experimentação Humana/legislação & jurisprudência
Seres Humanos
Consentimento Informado por Menores/ética
Estudos Multicêntricos como Assunto/ética
Estados Unidos
[Pt] Tipo de publicação:HISTORICAL ARTICLE; JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170810
[Lr] Data última revisão:
170810
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170531
[St] Status:MEDLINE


  5 / 151 MEDLINE  
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[PMID]:28421884
[Au] Autor:Miller VA; Feudtner C; Jawad AF
[Ad] Endereço:1 The Children's Hospital of Philadelphia, PA, USA.
[Ti] Título:Children's Decision-Making Involvement About Research Participation: Associations With Perceived Fairness and Self-Efficacy.
[So] Source:J Empir Res Hum Res Ethics;12(2):87-96, 2017 Apr.
[Is] ISSN:1556-2654
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The primary objective of this study was to examine the associations of children's involvement in decisions about research participation with their perceptions of the decision-making process and self-efficacy. Participants were children (ages 8-17) who enrolled in research studies in the prior 2 months. Children completed a questionnaire that yielded three decision-making involvement subscales: Researcher Engages Child, Researcher Supports Autonomy, and Child Participates. Children reported on fairness of the decision-making process and health-related decision self-efficacy. After adjusting for age, higher scores on Researcher Engages Child were associated with greater self-efficacy, and higher scores on Researcher Supports Autonomy were associated with greater perceived fairness. These data underscore the potential importance of researcher-child interactions about research participation when assent is sought, including proactively involving children in the decision by asking for their opinions and communicating their central role in the decision, which are likely to be more meaningful to children than receiving information or signing a form.
[Mh] Termos MeSH primário: Atitude
Pesquisa Biomédica/ética
Tomada de Decisões
Consentimento Informado por Menores/ética
Participação do Paciente
Autoeficácia
Justiça Social
[Mh] Termos MeSH secundário: Adolescente
Criança
Comunicação
Feminino
Seres Humanos
Consentimento Informado por Menores/psicologia
Masculino
Participação do Paciente/psicologia
Percepção
Autonomia Pessoal
Relações Profissional-Paciente
Pesquisadores
Justiça Social/psicologia
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171003
[Lr] Data última revisão:
171003
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:170420
[St] Status:MEDLINE
[do] DOI:10.1177/1556264617696921


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[PMID]:28220724
[Au] Autor:Miller VA; Werner-Lin A; Walser SA; Biswas S; Bernhardt BA
[Ad] Endereço:1 The Children's Hospital of Philadelphia, PA, USA.
[Ti] Título:An Observational Study of Children's Involvement in Informed Consent for Exome Sequencing Research.
[So] Source:J Empir Res Hum Res Ethics;12(1):6-13, 2017 Feb.
[Is] ISSN:1556-2654
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:The goal of this study was to examine children's involvement in consent sessions for exome sequencing research and associations of involvement with provider and parent communication. Participants included 44 children (8-17 years) from five cohorts who were offered participation in an exome sequencing study. The consent sessions were audiotaped, transcribed, and coded. Providers attempted to facilitate the child's involvement in the majority (73%) of sessions, and most (75%) children also verbally participated. Provider facilitation was strongly associated with likelihood of child participation. These findings underscore that strategies such as asking for children's opinions and soliciting their questions show respect for children and may increase the likelihood that they are engaged and involved in decisions about research participation.
[Mh] Termos MeSH primário: Tomada de Decisões
Exoma
Pesquisa em Genética
Consentimento Informado por Menores
Participação do Paciente
Análise de Sequência de DNA
[Mh] Termos MeSH secundário: Adolescente
Adulto
Criança
Comunicação
Feminino
Pessoal de Saúde
Seres Humanos
Consentimento Livre e Esclarecido
Masculino
Pais
[Pt] Tipo de publicação:JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:170222
[St] Status:MEDLINE
[do] DOI:10.1177/1556264616674096


  7 / 151 MEDLINE  
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[PMID]:28008638
[Au] Autor:Manson NC
[Ti] Título:When is a Choice not a Choice? 'Sham Offers' and the Asymmetry of Adolescent Consent and Refusal.
[So] Source:Bioethics;31(4):296-304, 2017 May.
[Is] ISSN:1467-8519
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In some jurisdictions there is a puzzling asymmetry between consent and refusal, where, for some kinds of treatment, the adolescent patient has the power to permit her own treatment but her refusal does not have the same kind of normative significance as refusal of treatment by a competent adult. In this journal I recently offered a clarification and defence of this asymmetry in terms of a paternalistic justification of the sharing of normative powers between adolescents and other parties. Lawlor (2016) offers a number of objections to this account. Three of his objections can be dealt with quickly. But one of them is much more challenging: the asymmetry of consent and refusal entails a practice of making sham offers (offers that purport to be responsive to the patient's choices, but which, in fact, are not). They do not really offer a choice at all. Genuine offers seem to require a commitment to be symmetrically responsive to whatever decision outcome is reached by the recipient of the offer. When we reflect upon the way that offers can be made in complex social contexts, where different parties have a 'say' in what ought to be done, the symmetry of responsiveness need not apply. Offers can be genuine, without being symmetrically responsive. Contrary to the seemingly plausible objection, the asymmetry of consent and refusal does not entail sham offers, or the offer of 'sham choices'.
[Mh] Termos MeSH primário: Consentimento Informado por Menores
Paternalismo
Direitos do Paciente
Recusa do Paciente ao Tratamento
[Mh] Termos MeSH secundário: Adolescente
Comportamento de Escolha
Seres Humanos
Consentimento Livre e Esclarecido
Normas Sociais
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:E; IM
[Da] Data de entrada para processamento:161224
[St] Status:MEDLINE
[do] DOI:10.1111/bioe.12328


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[PMID]:27995360
[Au] Autor:Tuckwell R; Wood D; Mansfield-Sturgess S; Brierley J
[Ad] Endereço:University College London Medical School, London, UK.
[Ti] Título:A European Society of Paediatric and Neonatal Intensive Care (ESPNIC) survey of European critical care management of young people.
[So] Source:Eur J Pediatr;176(2):155-161, 2017 Feb.
[Is] ISSN:1432-1076
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Adolescents have specific healthcare needs distinct from adults or younger children secondary to anatomical, physiological and socio-behavioural differences. Healthcare providers have been slow to address this, leading the UK Department of Health (2011) to publish 'You're Welcome' quality criteria for services for young people. (In the UK, the term young people is preferred to adolescent.) These generic criteria poorly fit the critical care environment, omitting key issues whilst insisting upon irrelevant standards. But as young people are infrequent patients for any individual unit, the research base to guide optimal management is poor and we could find no international or national guidance. Together with the hospital's young people's group, our intensive care team identified six areas important for critically ill young people, which are the 6Ps: privacy, permission, deep vein thrombosis (DVT) prophylaxis, personal life, puberty and practical issues. We then surveyed practice across Europe regarding these themes. Fifty-four hospitals from 16 countries participated, demonstrating disparate practice and widely differing policies to meet the requirements of critically ill young people. CONCLUSION: There is little consistency of practice in some areas such as pregnancy testing, DVT prophylaxis or partner visiting, whereas in others, such as involving young people in healthcare decisions where possible, practice is consistently good. Further research should focus on the young people's experience of critical care to refine healthcare policy. What is Known: • Adolescents have distinct health and psychosocial needs that are often poorly catered for in contemporary healthcare settings, including critical care. • As adolescents are infrequent patients for any intensive care unit, there is a poor research base and essentially no guidance, regarding optimal care. What is New: • We developed a mnemonic with adolescents and ICU staff to improve healthcare delivery to young people in critical care, the 6Ps: privacy, permission, DVT prophylaxis, personal life, puberty and practical issues. • Delivery of the adolescents' critical care varies greatly both between and within countries; the 6Ps offers a method of standardising and improving this across different countries.
[Mh] Termos MeSH primário: Serviços de Saúde do Adolescente/normas
Cuidados Críticos/métodos
Assistência à Saúde/normas
Unidades de Terapia Intensiva/normas
Inquéritos e Questionários
[Mh] Termos MeSH secundário: Adolescente
Serviços de Saúde do Adolescente/estatística & dados numéricos
Anticoncepcionais Orais
Cuidados Críticos/normas
Cuidados Críticos/estatística & dados numéricos
Assistência à Saúde/estatística & dados numéricos
Europa (Continente)
Seres Humanos
Higiene
Consentimento Informado por Menores
Unidades de Terapia Intensiva/estatística & dados numéricos
Testes de Gravidez
Privacidade
Lacunas da Prática Profissional
Qualidade da Assistência à Saúde
Trombose Venosa/prevenção & controle
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Contraceptives, Oral)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:171006
[Lr] Data última revisão:
171006
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161221
[St] Status:MEDLINE
[do] DOI:10.1007/s00431-016-2815-6


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[PMID]:27780841
[Au] Autor:Bernthal EM; Draper HJA; Henning J; Kelly JC
[Ad] Endereço:Academic Department of Military Nursing, Royal Centre for Defence Medicine (Academia and Research) Medical Directorate, Birmingham, UK.
[Ti] Título:'A band of brothers'-an exploration of the range of medical ethical issues faced by British senior military clinicians on deployment to Afghanistan: a qualitative study.
[So] Source:J R Army Med Corps;163(3):199-205, 2017 Jun.
[Is] ISSN:0035-8665
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:AIMS: To identify and explore features of ethical issues that senior clinicians faced as deployed medical directors (DMDs) to the British Field Hospital in Afghanistan as well as to determine the ethical training requirements for future deployments. METHOD: A qualitative study in two phases conducted from November 2014 to June 2015. Phase 1 analysed 60 vignettes of cases that had generated ethical dilemmas for DMDs. Phase 2 included focus groups and an interview with 13 DMDs. FINDINGS: Phase 1 identified working with limited resources, dual conflict of meeting both clinical and military obligations and consent of children as the most prevalent ethical challenges. Themes found in Phase 2 included sharing clinical responsibilities with clinicians from other countries and not knowing team members' ways of working, in addition to the themes from Phase 1. DISCUSSION: This study has drawn together examples of scenarios to form a repository that will aid future training. Recommendations included undertaking ethics training together as a team before, during and after deployment which must include all nationalities who are assigned to the same operational tour, so that different ethical views can be explored beforehand.
[Mh] Termos MeSH primário: Ética Médica
Medicina Militar/ética
Militares
Médicos
[Mh] Termos MeSH secundário: Campanha Afegã de 2001-
Tomada de Decisão Clínica/ética
Definição da Elegibilidade/ética
Grupos Focais
Alocação de Recursos para a Atenção à Saúde/ética
Seres Humanos
Consentimento Informado por Menores/ética
Pesquisa Qualitativa
Qualidade de Vida
Assistência Terminal/ética
Reino Unido
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170829
[Lr] Data última revisão:
170829
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161027
[St] Status:MEDLINE
[do] DOI:10.1136/jramc-2016-000701


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[PMID]:27917758
[Au] Autor:Strode AE; Toohey JD; Slack CM
[Ad] Endereço:School of Law, University of KwaZulu-Natal and member of the HIV/AIDS Vaccines Ethics Group, School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa; HIV/AIDS Vaccines Ethics Group, School of Applied Human Sciences, College of Humanities, University of KwaZulu-Natal, Pietermaritzburg, South Africa. strodeA@ukzn.ac.za.
[Ti] Título:Addressing legal and policy barriers to male circumcision for adolescent boys in South Africa.
[So] Source:S Afr Med J;106(12):1173-1176, 2016 Dec 01.
[Is] ISSN:0256-9574
[Cp] País de publicação:South Africa
[La] Idioma:eng
[Ab] Resumo:With millions of adolescents becoming infected with HIV globally, it is essential that barriers to much-needed interventions are reduced for at-risk adolescents. In this article we review the legal and policy framework in South Africa for adolescent access to male circumcision. We are of the view that the framework does confer protection for adolescent boys while enabling access to male circumcision; however, we identify ambiguities and tensions that exist between the Children's Act, regulations and national guidelines. We recommend reform to further enable access by this vulnerable group to this prevention modality.
[Mh] Termos MeSH primário: Circuncisão Masculina/legislação & jurisprudência
Infecções por HIV/prevenção & controle
Política de Saúde
Consentimento Informado por Menores/legislação & jurisprudência
[Mh] Termos MeSH secundário: Adolescente
Acesso aos Serviços de Saúde
Seres Humanos
Masculino
África do Sul
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1706
[Cu] Atualização por classe:170601
[Lr] Data última revisão:
170601
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161206
[St] Status:MEDLINE
[do] DOI:10.7196/SAMJ.2016.v106.i12.11215



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