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Article ; Online: Unmet Spiritual Care Needs in Women Undergoing Core Needle Breast Biopsy.

Van Denburg, Alyssa N / Shelby, Rebecca A / Winger, Joseph G / Zhang, Lei / Soo, Adrianne E / Pearce, Michelle J / Soo, Mary Scott

Journal of breast imaging

2024 Volume 2, Issue 2, Page(s) 134–140

Abstract: Objective: Spiritual care is an important part of healthcare, especially when patients face a possible diagnosis of a life-threatening disease. This study examined the extent to which women undergoing core-needle breast biopsy desired spiritual support ... ...

Abstract	Objective: Spiritual care is an important part of healthcare, especially when patients face a possible diagnosis of a life-threatening disease. This study examined the extent to which women undergoing core-needle breast biopsy desired spiritual support and the degree to which women received the support they desired. Methods: Participants (N = 79) were women age 21 and older, who completed an ultrasound- or stereotactic-guided core-needle breast biopsy. Participants completed measures of spiritual needs and spiritual care. Medical and sociodemographic information were also collected. Independent sample t-tests and chi-square tests of examined differences based on demographic, medical, and biopsy-related variables. Results: Forty-eight participants (48/79; 60.8%) desired some degree of spiritual care during their breast biopsy, and 33 participants (33/78; 42.3%) wanted their healthcare team to address their spiritual needs. African American women were significantly more likely to desire some type of spiritual support compared to women who were not African American. Among the 79 participants, 16 (20.3%) reported a discrepancy between desired and received spiritual support. A significant association between discrepancies and biopsy results was found, χ 2(1) = 4.19, P = .04, such that 2 (7.4%) of 27 participants with results requiring surgery reported discrepancies, while 14 (26.9%) of 52 participants with a benign result reported discrepancies. Conclusion: Most women undergoing core-needle breast biopsy desired some degree of spiritual care. Although most reported that their spiritual needs were addressed, a subset of women received less care than desired. Our results suggest that healthcare providers should be aware of patients' desires for spiritual support, particularly among those with benign results.
Language	English
Publishing date	2024-02-29
Publishing country	United States
Document type	Journal Article
ISSN	2631-6129
ISSN (online)	2631-6129
DOI	10.1093/jbi/wbz089
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Article ; Online: The Unspeakable Nature of Death & Dying During Childhood: A Silenced Phenomenon in Pediatric Care.

Campbell, Sydney / Moola, Fiona J / Gibson, Jennifer L / Petch, Jeremy / Denburg, Avram

Omega

2022 Volume 89, Issue 1, Page(s) 88–107

Abstract: In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the ... ...

Abstract	In pediatric settings, the concept of hope is frequently positioned as a fundamental aspect of care and at odds with the possibility and proximity of death. This arguably fosters silence about death and dying in childhood despite evidence indicating the benefits of open communication at the end of life. In this paper, we describe the unspeakable nature of death and dying in childhood, including its conceptual and clinical causes and dimensions, its persistence, and the associated challenges for children and youth facing critical illnesses, their families, and society. We explore how the tension between hope and death can be reframed and apply our analysis to the context of medical assistance in dying for mature minors in Canada. Considering the lack of related literature, this paper offers initial reflections to form a framework for the unspeakable nature of death and dying in childhood and to advance the crucial need for research.
MeSH term(s)	Adolescent ; Humans ; Child ; Communication ; Canada ; Terminal Care
Language	English
Publishing date	2022-01-14
Publishing country	United States
Document type	Journal Article
ZDB-ID	207363-8
ISSN	1541-3764 ; 0030-2228
ISSN (online)	1541-3764
ISSN	0030-2228
DOI	10.1177/00302228211067034
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Article ; Online: Development of a Value Assessment Framework for Pediatric Health Technologies Using Multicriteria Decision Analysis: Expanding the Value Lens for Funding Decision Making.

Gauvreau, Cindy L / Schreyer, Leighton / Gibson, Paul J / Koo, Alicia / Ungar, Wendy J / Regier, Dean / Chan, Kelvin / Hayeems, Robin / Gibson, Jennifer / Palmer, Antonia / Peacock, Stuart / Denburg, Avram E

Value in health : the journal of the International Society for Pharmacoeconomics and Outcomes Research

2024

Abstract: Objectives: A health technology assessment (HTA) does not systematically account for the circumstances and needs of children and youth. To supplement HTA processes, we aimed to develop a child-tailored value assessment framework using a multicriteria ... ...

Abstract	Objectives: A health technology assessment (HTA) does not systematically account for the circumstances and needs of children and youth. To supplement HTA processes, we aimed to develop a child-tailored value assessment framework using a multicriteria decision analysis approach. Methods: We constructed a multicriteria-decision-analysis-based model in multiple phases to create the Comprehensive Assessment of Technologies for Child Health (CATCH) framework. Using a modified Delphi process with stakeholders having broad disciplinary and geographic variation (N = 23), we refined previously generated criteria and developed rank-based weights. We established a criterion-pertinent scoring rubric for assessing incremental benefits of new drugs. Three clinicians independently assessed comprehension by pilotscoring 9 drugs. We then validated CATCH for 2 childhood cancer therapies through structured deliberation with an expert panel (N = 10), obtaining individual scores, consensus scores, and verbal feedback. Analyses included descriptive statistics, thematic analysis, exploratory disagreement indices, and sensitivity analysis. Results: The modified Delphi process yielded 10 criteria, based on absolute importance/relevance and agreed importance (median disagreement indices = 0.34): Effectiveness, Child-specific Health-related Quality of Life, Disease Severity, Unmet Need, Therapeutic Safety, Equity, Family Impacts, Life-course Development, Rarity, and Fair Share of Life. Pilot scoring resulted in adjusted criteria definitions and more precise score-scaling guidelines. Validation panelists endorsed the framework's key modifiers of value. Modes of their individual prescores aligned closely with deliberative consensus scores. Conclusions: We iteratively developed a value assessment framework that captures dimensions of child-specific health and nonhealth gains. CATCH could improve the richness and relevance of HTA decision making for children in Canada and comparable health systems.
Language	English
Publishing date	2024-03-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	1471745-1
ISSN	1524-4733 ; 1098-3015
ISSN (online)	1524-4733
ISSN	1098-3015
DOI	10.1016/j.jval.2024.03.012
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Article ; Online: Assessing the Effects of Healthy and Neuropathological Aging on Personality with the Iowa Scales of Personality Change.

Zirbes, Christian / Jones, Andrew / Manzel, Kenneth / Denburg, Natalie / Barrash, Joseph

Developmental neuropsychology

2021 Volume 46, Issue 5, Page(s) 393–408

Abstract: Personality changes in older adults with brain disease may be confounded by effects of normal aging. In this cross-sectional study, ratings with the Iowa Scales of Personality Change for 62 healthy older adults (OA-H, aged 60+) were compared to matched ... ...

Abstract	Personality changes in older adults with brain disease may be confounded by effects of normal aging. In this cross-sectional study, ratings with the Iowa Scales of Personality Change for 62 healthy older adults (OA-H, aged 60+) were compared to matched older adults with brain diseases (OA-BD). OA-H did not show any significant personality changes from middle age to older adulthood. However, between 10% and 20% of OA-H developed a disturbance in
MeSH term(s)	Aged ; Aging ; Cross-Sectional Studies ; Humans ; Iowa ; Middle Aged ; Personality ; Personality Disorders/diagnosis
Language	English
Publishing date	2021-07-20
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	632665-1
ISSN	1532-6942 ; 8756-5641
ISSN (online)	1532-6942
ISSN	8756-5641
DOI	10.1080/87565641.2021.1956500
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Article: Re-examining medical assistance in dying for mature minors in Canada: Reflections for health leaders.

Campbell, Sydney / Denburg, Avram / Moola, Fiona / Carnevale, Franco A / Petch, Jeremy

Healthcare management forum

2022 Volume 36, Issue 3, Page(s) 170–175

Abstract: In Canada, Medical Assistance in Dying (MAiD) is legal for many Canadians based on several criteria, though minors who are deemed sufficiently capable to make medical decisions (i.e. mature minors) remain ineligible. In this article, we provide insight ... ...

Abstract	In Canada, Medical Assistance in Dying (MAiD) is legal for many Canadians based on several criteria, though minors who are deemed sufficiently capable to make medical decisions (i.e. mature minors) remain ineligible. In this article, we provide insight into recent philosophical and legal evidence related to MAiD for mature minors. We begin by providing an overview of literature pertaining to MAiD for mature minors in particular (including evidence from Belgium and the Netherlands), followed by a discussion on the lessons that can be learnt from Canada's MAiD implementation process (in general) and other forms of paediatric end-of-life care. As a whole, we aim to highlight some key takeaway messages for health leaders to consider as deliberations on MAiD for mature minors continue.
MeSH term(s)	Humans ; Child ; Canada ; Suicide, Assisted ; Minors ; Terminal Care ; Medical Assistance
Language	English
Publishing date	2022-11-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	2140831-2
ISSN	2352-3883 ; 0840-4704
ISSN (online)	2352-3883
ISSN	0840-4704
DOI	10.1177/08404704221134588
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Article: The Moral Foundations of Child Health and Social Policies: A Critical Interpretive Synthesis.

Denburg, Avram E / Giacomini, Mita / Ungar, Wendy J / Abelson, Julia

Children (Basel, Switzerland)

2021 Volume 8, Issue 1

Abstract: Background: Allusions to the uniqueness and value of childhood abound in academic, lay, and policy discourse. However, little clarity exists on the values that guide child health and social policy-making. We review extant academic literature on the ... ...

Abstract	Background: Allusions to the uniqueness and value of childhood abound in academic, lay, and policy discourse. However, little clarity exists on the values that guide child health and social policy-making. We review extant academic literature on the normative dimensions of child health and social policy to provide foundations for the development of child-focused public policies. Methods: We conducted a critical interpretive synthesis of academic literature on the normative dimensions of child health and social policy-making. We employed a social constructivist lens to interpret emergent themes. Political theory on the social construction of target populations served as a bridge between sociologies of childhood and public policy analysis. Results: Our database searches returned 14,658 unique articles; full text review yielded 72 relevant articles. Purposive sampling of relevant literature complemented our electronic searches, adding 51 original articles, for a total of 123 articles. Our analysis of the literature reveals three central themes: potential, rights, and Conclusions: Foundational understanding of the moral language and dominant policy frames applied to children can enrich analyses of social policies for children. Most societies paint children as potent, vulnerable, entitled, and embedded. It is the admixture of these elements in particular policy spheres, across distinct places and times, that often determines the form of a given policy and societal reactions to it. Subsequent work in this area will need to detail the degree and impact of variance in the values mix attached to children across sociocultural contexts and investigate tensions between what are and what ought to be the values that guide social policy development for children.
Language	English
Publishing date	2021-01-13
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2732685-8
ISSN	2227-9067
ISSN	2227-9067
DOI	10.3390/children8010043
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Article: A Comprehensive Approach to Assessment of Testamentary Capacity.

Kenepp, Amanda / Johnson, Ellen / Lee, Grace J / Sunderaraman, Preeti / Denburg, Natalie L / Nguyen, Christopher M

Frontiers in psychology

2021 Volume 12, Page(s) 789494

Abstract: The growing aging population raises important implications for legal and clinical systems, including testamentary capacity (TC) assessment. Yet, there are limited comprehensive and standardized assessment measures for TC readily available for clinical ... ...

Abstract	The growing aging population raises important implications for legal and clinical systems, including testamentary capacity (TC) assessment. Yet, there are limited comprehensive and standardized assessment measures for TC readily available for clinical use. A review of current assessment methods and standardized approaches for TC assessment is provided. Although several guidelines regarding TC assessment have been proposed in prior literature, existing standardized approaches do not appear to meet full criteria for TC. A comprehensive approach to assessment of testamentary capacity is proposed.
Language	English
Publishing date	2021-12-23
Publishing country	Switzerland
Document type	Systematic Review
ZDB-ID	2563826-9
ISSN	1664-1078
ISSN	1664-1078
DOI	10.3389/fpsyg.2021.789494
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Article ; Online: Intravascular Hemolysis and AKI in Children Undergoing Extracorporeal Membrane Oxygenation.

Strong, Amy E / Zee, Jarcy / Fulchiero, Rosanna / Kilbaugh, Todd J / Connelly, James / Makeneni, Spandana / Campos, Diego / Laskin, Benjamin L / Denburg, Michelle R

Kidney360

2023 Volume 4, Issue 11, Page(s) 1536–1544

MeSH term(s)	Humans ; Child ; Extracorporeal Membrane Oxygenation/adverse effects ; Hemolysis ; Retrospective Studies ; Acute Kidney Injury/diagnosis ; Acute Kidney Injury/therapy
Language	English
Publishing date	2023-10-19
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ISSN	2641-7650
ISSN (online)	2641-7650
DOI	10.34067/KID.0000000000000253
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Article: Error correction during guidance of pioneer axons in the leg of the cockroach embryo.

Rajan, I / Denburg, J L

Roux's archives of developmental biology : the official organ of the EDBO

2017 Volume 205, Issue 7-8, Page(s) 476–485

Abstract: Axons of the Til and Fe2 pioneer neurons in the legs of insect embryos possess separate and highly stereotyped proximal projections towards the CNS. However, quantitative analyses of deviations from the standard paths during the period of axon growth ... ...

Abstract	Axons of the Til and Fe2 pioneer neurons in the legs of insect embryos possess separate and highly stereotyped proximal projections towards the CNS. However, quantitative analyses of deviations from the standard paths during the period of axon growth indicate that transient errors occur unexpectedly often. The distribution of legs with axons following deviant paths among the embryos analyzed is used to determine whether these errors are caused by random developmental noise or by non-random genetic or environmental factors. During the formation of the Til pathway all the errors are characterized by defasciculation of the 2 axons, occur with an average incidence of 7% and are statistically shown to be randomly caused. In comparison, during the formation of the Fe2 pathway the errors are characterized by both defasciculation and elongation in an inappropriate distal direction, occur with an incidence of 16%, and as revealed by statistical analyses, are caused by a non-random factor. Therefore, during pathfinding by these 2 pairs of axons there is a need for error-correcting mechanisms to insure the stereotypy of the final projections. These error-correcting mechanisms are suggested to have properties similar to those producing canalization as proposed by Waddington.
Language	English
Publishing date	2017-03-16
Publishing country	Germany
Document type	Journal Article
ZDB-ID	14096-x
ISSN	0930-035X ; 0340-0794
ISSN	0930-035X ; 0340-0794
DOI	10.1007/BF00377229
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Article ; Online: Influenza Vaccine Administration and Effectiveness Among Children and Adults With Glomerular Disease.

Glenn, Dorey A / Pate, Virginia / Zee, Jarcy / Walter, Emmanuel B / Denburg, Michelle R / Hogan, Susan / Falk, Ronald J / Mottl, Amy / Layton, J Bradley

Kidney international reports

2023 Volume 9, Issue 2, Page(s) 257–265

Abstract: Introduction: Influenza infections contribute to excess healthcare utilization, morbidity, and mortality in individuals with glomerular disease (GD); however, influenza vaccination may not yield protective immune responses in this high-risk patient ... ...

Abstract	Introduction: Influenza infections contribute to excess healthcare utilization, morbidity, and mortality in individuals with glomerular disease (GD); however, influenza vaccination may not yield protective immune responses in this high-risk patient population. The objective of the present study was to describe influenza vaccine administration from 2010 to 2019 and explore the effectiveness of influenza vaccination in patients with GD. Methods: We conducted an observational cohort study using healthcare claims for seasonal influenza vaccination (exposure) as well as influenza and influenza-like illness (outcomes) from commercially insured children and adults <65 years of age with primary GD in the Merative MarketScan Research Databases. Propensity score-weighted cox proportional hazards models and ratio-of-hazard ratios (RHR) analyses were used to compare influenza infection risk in years where seasonal influenza vaccines matched or mismatched circulating viral strains. Results: The mean proportion of individuals vaccinated per season was 23% (range 19%-24%). In pooled analyses comparing matched to mismatched seasons, vaccination was minimally protective for both influenza (RHR 0.86, 95% confidence interval [CI]: 0.52-1.41) and influenza-like illness (RHR 0.86, 95% CI 0.59-1.24), though estimates were limited by sample size. Conclusion: Rates of influenza vaccination are suboptimal among patients with GD. Protection from influenza after vaccination may be poor, leading to excess infection-related morbidity in this vulnerable population.
Language	English
Publishing date	2023-11-02
Publishing country	United States
Document type	Journal Article
ISSN	2468-0249
ISSN (online)	2468-0249
DOI	10.1016/j.ekir.2023.10.031
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