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  1. Article: Age differences and brain maturation provide insight into heterogeneous results in autism spectrum disorder.

    O'Hearn, Kirsten / Lynn, Andrew

    Frontiers in human neuroscience

    2023  Volume 16, Page(s) 957375

    Abstract: Studies comparing individuals with autism spectrum disorder (ASD) to typically developing (TD) individuals have yielded inconsistent results. These inconsistencies reflect, in part, atypical trajectories of development in children and young adults with ... ...

    Abstract Studies comparing individuals with autism spectrum disorder (ASD) to typically developing (TD) individuals have yielded inconsistent results. These inconsistencies reflect, in part, atypical trajectories of development in children and young adults with ASD compared to TD peers. These different trajectories alter group differences between children with and without ASD as they age. This paper first summarizes the disparate trajectories evident in our studies and, upon further investigation, laboratories using the same recruiting source. These studies indicated that cognition improves into adulthood typically, and is associated with the maturation of striatal, frontal, and temporal lobes, but these age-related improvements did not emerge in the young adults with ASD. This pattern - of improvement into adulthood in the TD group but not in the group with ASD - occurred in both social and non-social tasks. However, the difference between TD and ASD trajectories was most robust on a social task, face recognition. While tempting to ascribe this uneven deficit to the social differences in ASD, it may also reflect the prolonged typical development of social cognitive tasks such as face recognition into adulthood. This paper then reviews the evidence on age-related and developmental changes from other studies on ASD. The broader literature also suggests that individuals with ASD do not exhibit the typical improvements during adolescence on skills important for navigating the transition to adulthood. These skills include execution function, social cognition and communication, and emotional recognition and self-awareness. Relatedly, neuroimaging studies indicate arrested or atypical brain maturation in striatal, frontal, and temporal regions during adolescence in ASD. This review not only highlights the importance of a developmental framework and explicit consideration of age and/or stage when studying ASD, but also the potential importance of adolescence on outcomes in ASD.
    Language English
    Publishing date 2023-02-02
    Publishing country Switzerland
    Document type Journal Article ; Review
    ZDB-ID 2425477-0
    ISSN 1662-5161
    ISSN 1662-5161
    DOI 10.3389/fnhum.2022.957375
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  2. Article ; Online: Amplifying voices: providing quality critical care to Canada's remote and rural children during pediatric transport.

    O'Hearn, Katie / Shaheen-Hussain, Samir / Muttalib, Fiona

    CJEM

    2022  Volume 24, Issue 3, Page(s) 243–244

    MeSH term(s) Canada ; Child ; Critical Care ; Humans ; Quality of Health Care ; Rural Population
    Language English
    Publishing date 2022-04-11
    Publishing country England
    Document type Editorial ; Comment
    ISSN 1481-8043
    ISSN (online) 1481-8043
    DOI 10.1007/s43678-022-00300-5
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  3. Article ; Online: Visual working memory performance is intact across development in autism spectrum disorder.

    Lynn, Andrew / Luna, Beatriz / O'Hearn, Kirsten

    Autism research : official journal of the International Society for Autism Research

    2022  Volume 15, Issue 5, Page(s) 881–891

    Abstract: Autism spectrum disorder (ASD) is associated with atypical visual processing and deficits in working memory (WM). Visual WM performance typically improves between childhood and adulthood, but such improvement may be atypical in ASD. To better understand ... ...

    Abstract Autism spectrum disorder (ASD) is associated with atypical visual processing and deficits in working memory (WM). Visual WM performance typically improves between childhood and adulthood, but such improvement may be atypical in ASD. To better understand how visual WM develops, we used a well-established change detection task across multiple visual features. We examined visual WM for color, shape, and pattern in children, adolescents, and adults with and without ASD. VWM capacity and performance for all visual features improved across age similarly for both the TD and ASD groups. While performance was better on set size 4 trials than set size 8 trials for color, shape, and no change trials, such an effect was not evident for pattern change trials. Overall, the present findings suggest that VWM for different visual features may be intact across development in ASD. The ability to hold multiple objects in mind (WM) improves across typical development, but it remains unclear whether such improvement occurs in ASD. We found that developmental improvements in WM for different types of object details (e.g., color, shape, and pattern) is generally similar for both ASD and typical development. LAY SUMMARY: The ability to hold multiple objects in mind (working memory [WM]) improves across typical development, but it remains unclear whether such improvement occurs in autism spectrum disorder (ASD). We found that developmental improvements in WM for different types of object details (e.g., color, shape, pattern) is generally similar for both ASD and typical development.
    MeSH term(s) Adolescent ; Adult ; Autism Spectrum Disorder/complications ; Child ; Cognition ; Humans ; Memory, Short-Term
    Language English
    Publishing date 2022-02-06
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2481338-2
    ISSN 1939-3806 ; 1939-3792
    ISSN (online) 1939-3806
    ISSN 1939-3792
    DOI 10.1002/aur.2683
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  4. Article ; Online: Operationalization of assent for research participation in pre-adolescent children: a scoping review.

    Cayouette, Florence / O'Hearn, Katie / Gertsman, Shira / Menon, Kusum

    BMC medical ethics

    2022  Volume 23, Issue 1, Page(s) 106

    Abstract: Background: Seeking assent from children for participation in medical research is an ethical imperative of numerous institutions globally. However, none of these organizations provide specific guidance on the criteria or process to be used when ... ...

    Abstract Background: Seeking assent from children for participation in medical research is an ethical imperative of numerous institutions globally. However, none of these organizations provide specific guidance on the criteria or process to be used when obtaining assent. The primary objective of this scoping review was to determine the descriptions of assent discussed in the literature and the reported criteria used for seeking assent for research participation in pre-adolescent children.
    Methods: Medline and Embase databases were searched until November 2020 using the term "assent" in the title or abstract. Inclusion criteria were (1) studies enrolling children which specifically described operationalization of the assent process and (2) studies of the assent process which provided a description of assent. Data collected included participant information, patient criteria for seeking assent, guidelines referenced, description of assent reported, how assent was obtained and assent information presented, and reported assent rate. For qualitative articles focusing on the assent process, important themes were identified.
    Results: A total of 116 articles were included of which 79 (68.9%) operationalized assent and 57 studies (%) described the assent process. The most commonly reported criterion used to determine the ability of a child to assent was age (35.4%, 28/79). The reported minimal age for obtaining pediatric assent varied considerably across and within jurisdictions (5-13 years; median 7.5 years, IQR 7.0, 9.75). Cognitive ability was reported as a criterion for obtaining assent in 5.1% (4/79) of studies. Assent rates were only reported in 17.7% (14/79) of citations and ranged from 32.0 to 100%. Analysis of the 57 studies describing the assent process identified several themes, including age thresholds, assessment of capacity, variable knowledge of pediatric assent and parental roles.
    Conclusion: We found significant variation in criteria used for assessment of patient capacity, delivery of information used to obtain assent and documentation of the assent process. While we acknowledge that individual children, settings and jurisdictions may require different approaches to obtaining assent, there should be agreement on important principles to be followed with resulting common guidance on assessing capacity, delivering information and documentation of the assent process for publication.
    MeSH term(s) Child ; Adolescent ; Humans ; Child, Preschool ; Informed Consent ; Research Design ; Biomedical Research ; Parents
    Language English
    Publishing date 2022-11-03
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2041552-7
    ISSN 1472-6939 ; 1472-6939
    ISSN (online) 1472-6939
    ISSN 1472-6939
    DOI 10.1186/s12910-022-00844-2
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  5. Article: Reporting of social determinants of health in randomized controlled trials conducted in the pediatric intensive care unit.

    Huang, Emma / Albrecht, Lisa / O'Hearn, Katie / Nicolas, Naisha / Armstrong, Jennifer / Weinberg, Maya / Menon, Kusum

    Frontiers in pediatrics

    2024  Volume 12, Page(s) 1329648

    Abstract: Introduction: The influence of social determinants of health (SDOH) on access to care and outcomes for critically ill children remains an understudied area with a paucity of high-quality data. Recent publications have highlighted the importance of ... ...

    Abstract Introduction: The influence of social determinants of health (SDOH) on access to care and outcomes for critically ill children remains an understudied area with a paucity of high-quality data. Recent publications have highlighted the importance of incorporating SDOH considerations into research but the frequency with which this occurs in pediatric intensive care unit (PICU) research is unclear. Our objective was to determine the frequency and categories of SDOH variables reported and how these variables were defined in published PICU randomized controlled trials (RCTs).
    Methods: We searched Medline, Embase, Lilacs, and Central from inception to Dec 2022. Inclusion criteria were randomized controlled trials of any intervention on children or their families in a PICU. Data related to study demographics and nine WHO SDOH categories were extracted, and descriptive statistics and qualitative data generated.
    Results: 586 unique RCTs were included. Studies had a median sample size of 60 patients (IQR 40-106) with 73.0% of studies including ≤100 patients and 41.1% including ≤50 patients. A total of 181 (181/586, 30.9%) studies reported ≥1 SDOH variable of which 163 (163/586, 27.8%) reported them by randomization group. The most frequently reported categories were food insecurity (100/586, 17.1%) and social inclusion and non-discrimination (73/586, 12.5%). Twenty-five of 57 studies (43.9%) investigating feeding or nutrition and 11 of 82 (13.4%) assessing mechanical ventilation reported baseline nutritional assessments. Forty-one studies investigated interventions in children with asthma or bronchiolitis of which six reported on smoking in the home (6/41, 14.6%).
    Discussion: Reporting of relevant SDOH variables occurs infrequently in PICU RCTs. In addition, when available, categorizations and definitions of SDOH vary considerably between studies. Standardization of SDOH variable collection along with consistent minimal reporting requirements for PICU RCT publications is needed.
    Language English
    Publishing date 2024-02-01
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2711999-3
    ISSN 2296-2360
    ISSN 2296-2360
    DOI 10.3389/fped.2024.1329648
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  6. Article: Assent in Pediatric Critical Care Research: A Cross-Sectional Stakeholder Survey of Canadian Research Ethics Boards, Research Coordinators, Pediatric Critical Care Researchers, and Nurses.

    O'Hearn, Katie / Cayouette, Florence / Cameron, Saoirse / Martin, Dori-Ann / Tsampalieros, Anne / Menon, Kusum

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2022  Volume 24, Issue 4, Page(s) e179–e189

    Abstract: Objectives: Survey of four stakeholder groups involved in defining and obtaining assent for research in Canadian PICUs to better understand their perspectives and perceived barriers to assent.: Design: Cross-sectional survey.: Setting: Fourteen ... ...

    Abstract Objectives: Survey of four stakeholder groups involved in defining and obtaining assent for research in Canadian PICUs to better understand their perspectives and perceived barriers to assent.
    Design: Cross-sectional survey.
    Setting: Fourteen tertiary-care pediatric hospitals in Canada.
    Participants: Research Ethics Board Chairs, pediatric critical care nurses, research coordinators, and researchers.
    Interventions: None.
    Measurements and main results: A total of 193 participants responded. Thirty-seven percent (59/159) thought it was "Never/Almost Never" (59/159, 37%) feasible to obtain assent during the first 48 hours of PICU admission, and 112 of 170 (66%) indicated there are unique barriers to assent at the time of enrollment in PICU studies. Asking children for assent was most frequently rated as Important/Very Important for interviews/focus groups with the child (138/180, 77%), blood sample collection with a needle poke for research (137/178, 77%), and studies involving genetic testing with results communicated to the child/legal guardian (134/180, 74%). In two scenarios where a child and legal guardian disagreed about study participation, most respondents indicated that whether the child should still be enrolled would depend on the patient's age (34-36%), and/or the risk of the study (24-28%). There was a lack of consensus over how the assent process should be operationalized, and when and for how long children should be followed to seek assent for ongoing study participation. Most stakeholders (117/158, 74%) thought that children should have the opportunity to decide if their samples could stay in a biobank once they are old enough to do so.
    Conclusions: There was an overall lack of consensus on the feasibility of, and challenges associated with, obtaining assent at the time of study enrollment and on how key aspects of the assent process should be operationalized in the PICU. This highlights the need for guidelines to clarify the assent process in pediatric critical care research.
    MeSH term(s) Child ; Humans ; Cross-Sectional Studies ; Canada ; Ethics, Research ; Critical Care ; Nurses, Pediatric
    Language English
    Publishing date 2022-12-13
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000003135
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  7. Article ; Online: A critical review of belumosudil in adult and pediatric patients with chronic graft-versus-host disease.

    Salhotra, Amandeep / Sandhu, Karamjeet / O'Hearn, James / Ali, Haris / Nakamura, Ryotaro / Modi, Badri G

    Expert review of clinical immunology

    2022  Volume 19, Issue 3, Page(s) 241–251

    Abstract: Introduction: Chronic graft-versus-host disease (cGVHD) is a complication of allogeneic hematopoietic cell transplantation (allo-HCT) and is the main cause of late non-relapse mortality (NRM). Three new agents are now approved to treat cGVHD, of which ... ...

    Abstract Introduction: Chronic graft-versus-host disease (cGVHD) is a complication of allogeneic hematopoietic cell transplantation (allo-HCT) and is the main cause of late non-relapse mortality (NRM). Three new agents are now approved to treat cGVHD, of which belumosudil has a unique and dual mechanism of action of i) targeting the Rho-GTPase-associated coiled-coil kinase 2 (ROCK2) in T helper follicular cells (TFH) and TH17 cells, this results in downregulation of proinflammatory cytokines (interleukin -21 and 17), the former in a STAT3-dependent mechanism, ii) inhibition of tissue fibrosis by targeting stress-induced polymerization of G-actin fibrils by inhibiting the Rho-ROCK-MRTF pathway.
    Areas covered: In this review we describe the epidemiology of cGVHD, its cardinal symptoms, preventive and therapeutic options, including second-line approved therapies in the United States (US). Clinical trial data that led to approval of belumosudil is discussed, in addition to the clinical scenarios in which the approved drugs may be most applicable.
    Expert opinion: Belumosudil is approved for treatment of adult and pediatric patients ≥ 12 years with cGVHD after failing two lines of therapy based on results of the ROCKstar study that showed high overall response rates (ORR), favorable adverse effect profiles, and low rates of severe infections. With the availability of three new agents for treatment of cGVHD, treating physicians have more therapeutic options for patients and have additional options of development new clinical trials using a combination of recently approved drugs.
    MeSH term(s) Humans ; Adult ; United States ; Child ; Bronchiolitis Obliterans Syndrome ; Graft vs Host Disease/drug therapy ; Hematopoietic Stem Cell Transplantation ; Th17 Cells ; Chronic Disease
    Chemical Substances belumosudil
    Language English
    Publishing date 2022-11-30
    Publishing country England
    Document type Review ; Journal Article
    ZDB-ID 2274260-8
    ISSN 1744-8409 ; 1744-666X
    ISSN (online) 1744-8409
    ISSN 1744-666X
    DOI 10.1080/1744666X.2023.2152330
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  8. Article ; Online: Measuring continuing medical education conference impact and attendee experience: a scoping review.

    Albrecht, Lisa / Pratt, Misty / Ng, Rhiannon / Olivier, Jeremy / Sampson, Margaret / Fahey, Neal / Gibson, Jess / Lobos, Anna-Theresa / O'Hearn, Katie / Newhook, Dennis / Sutherland, Stephanie / McNally, Dayre

    International journal of medical education

    2024  Volume 15, Page(s) 15–33

    Abstract: Objectives: The aim was to comprehensively identify published research evaluating continuing medical education conferences, to search for validated tools and perform a content analysis to identify the relevant domains for conference evaluation.: ... ...

    Abstract Objectives: The aim was to comprehensively identify published research evaluating continuing medical education conferences, to search for validated tools and perform a content analysis to identify the relevant domains for conference evaluation.
    Methods: We used scoping review methodology and searched MEDLINE® for relevant English or French literature published between 2008 and 2022 (last search June 3, 2022). Original research (including randomized controlled trials, non-randomized studies, cohort, mixed-methods, qualitative studies, and editorial pieces) where investigators described impact, experience, or motivations related to conference attendance were eligible. Citations were assessed in triplicate, and data extracted in duplicate.
    Results: Eighty-three studies were included, 69 (83%) of which were surveys or interview based, with the majority conducted at the end of or following conference conclusion. Of the 74 tools identified, only one was validated and was narrowly focused on a specific conference component. A total of 620 items were extracted and categorized into 4 a priori suggested domains (engagement-networking, education-learning, impact, scholarship), and an additional 4 identified through content analysis (value-satisfaction, logistics, equity-diversity-inclusivity, career influences). Time trends were evident, including the absence of items related to equity-diversity-inclusivity prior to 2019, and a focus on logistics, particularly technology and virtual conferences, since 2020.
    Conclusions: This study identified 8 major domains relevant for continuing medical education conference evaluation. This work is of immediate value to individuals and organizations seeking to either design or evaluate a conference and represents a critical step in the development of a standardized tool for conference evaluation.
    MeSH term(s) Humans ; Education, Medical, Continuing ; Educational Status ; Learning ; Motivation ; Qualitative Research
    Language English
    Publishing date 2024-02-29
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2042-6372
    ISSN (online) 2042-6372
    DOI 10.5116/ijme.65cc.8c88
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  9. Article ; Online: Consent in Canadian-Led Critical Care Research During the COVID-19 Pandemic: A Scoping Review

    Krewulak, Karla / Albrecht, Lisa / Cameron, Saoirse / Gibson, Jessica / Martin, Dori-Ann / Porteous, Rebecca / Sampson, Margaret / O’Hearn, Katie

    medRxiv

    Abstract: Introduction: Despite the importance of critical care research during the SARS-CoV-2 pandemic, several pandemic-related factors made the process of obtaining prior written informed consent for research infeasible. To overcome these challenges, research ... ...

    Abstract Introduction: Despite the importance of critical care research during the SARS-CoV-2 pandemic, several pandemic-related factors made the process of obtaining prior written informed consent for research infeasible. To overcome these challenges, research studies utilized alternate informed consent models suggested by available guidance. Objective: To describe the consent models used in Canadian intensive care unit (ICU) and pediatric ICU (PICU) studies during the COVID-19 pandemic. Data Sources: We searched MEDLINE, EMBASE, CENTRAL, clinicaltrials.gov, and medRxiv from 01-Jan-2020 to 28-Apr-2023 using Medical Subject Headings and keywords related to the setting (ICU, PICU), study design (e.g., RCT) and study region (i.e., Canada). We included Canadian-led studies that were enrolling during the SARS-CoV-2 and reported on consent. Two independent reviewers reviewed titles/abstracts and full text articles for inclusion. Results: We included 13 studies from adult (n=12, 92.3%) and pediatric (n=1, 7.7%) populations. Some study authors reported that informed (n=3/13, 23.1%) or a priori (n=2/13, 15.4%) consent was obtained, without further details. Study authors also reported using written informed (n=4/13, 30.8%), deferred (n=3/13, 23.1%), verbal/waived/assent (each n=2/13, 15.4%), or that ethics approval was not necessary which means consent was not required (n=1/13, 7.7%). Five studies (n=5/13, 38.5%) used multiple consent models: a priori/deferred (n=2/5, 40%), written/verbal (n=2/5, 40%), or waived/assent (n=1/5, 20%). Conclusion: This scoping review underscores the importance of transparent reporting of or modifications to trial procedures during crises, such as the COVID-19 pandemic. Improved reporting practices and exploration of alternate consent models, including electronic consent, are crucial for advancing critical care trials beyond the pandemic and preparing for future health emergencies.
    Keywords covid19
    Language English
    Publishing date 2024-02-03
    Publisher Cold Spring Harbor Laboratory Press
    Document type Article ; Online
    DOI 10.1101/2024.02.01.24302151
    Database COVID19

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  10. Article: Parental Understanding of Research Consent Forms in the PICU: A Pilot Study.

    Gertsman, Shira / O'Hearn, Katharine / Gibson, Jess / Menon, Kusum

    Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies

    2020  Volume 21, Issue 6, Page(s) 526–534

    Abstract: Objectives: To describe legal guardians' understanding of key concepts in a research consent form presented within 24 hours of their child's admission to the PICU and to explore legal guardians' opinions of the format (language, length) of the consent ... ...

    Abstract Objectives: To describe legal guardians' understanding of key concepts in a research consent form presented within 24 hours of their child's admission to the PICU and to explore legal guardians' opinions of the format (language, length) of the consent form and the overall consent process.
    Design: Single-center, exploratory pilot study.
    Setting: PICU at a tertiary-care hospital in Canada.
    Subjects: Forty-one English- and French-speaking legal guardians of children less than 18 years old, who had been admitted to the PICU within the past 24 hours and were expected to stay at least 48 hours, between October 2018 and February 2019.
    Interventions: The consent form from a previous PICU trial was given and explained to legal guardians within 24 hours of their child's admission to the PICU.
    Measurements and main results: Legal guardians' understanding of key concepts in the consent form was evaluated using a questionnaire the day after the form was explained, and opinions were collected verbally and using an additional survey. The median number of questions answered incorrectly was three of seven (interquartile range = 2-4). Participants best understood the topic of the study (5% incorrect), but 80% of participants were unable to recall a single risk. The median rating of the language in the form was five of five (very easy to understand; interquartile range = 4-5), and 88% of participants said it was a reasonable length.
    Conclusions: Despite positive opinions of the consent form, most legal guardians did not understand all key components of the consent information provided to them orally and in writing within 24 hours of their child's PICU admission. Future studies are required to determine barriers to understanding and explore alternative approaches to obtaining consent in this setting.
    MeSH term(s) Adolescent ; Canada ; Child ; Consent Forms ; Humans ; Informed Consent ; Intensive Care Units, Pediatric ; Parents ; Pilot Projects ; Research
    Language English
    Publishing date 2020-04-28
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2052349-X
    ISSN 1947-3893 ; 1529-7535
    ISSN (online) 1947-3893
    ISSN 1529-7535
    DOI 10.1097/PCC.0000000000002234
    Database MEDical Literature Analysis and Retrieval System OnLINE

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