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All posts; Tags Include "Ethics"

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  • April 17, 2013
  • 05:30 PM

Is Nitroglycerin Bad for Severe Sepsis?

by Rogue Medic in Rogue Medic

Yesterday at "The Paramedic's Edge," this was the topic of discussion of a possible use of NTG (NiTroGlycerin – GTN GlycerylTriNitrate in Commonwealth countries).

NTG is a vasodilator and sepsis is a vasodialtion problem. There are other problems with sepsis, but vasodilation may be the primary problem.... Read more »

SPRONK, P., INCE, C., GARDIEN, M., MATHURA, K., & ZANDSTRA, D. (2003) Nitroglycerin for septic shock. The Lancet, 361(9360), 880-880. DOI: 10.1016/S0140-6736(03)12692-X  

Spronk, P., Ince, C., Gardien, M., Mathura, K., Straaten, H., & Zandstra, D. (2002) Nitroglycerin in septic shock after intravascular volume resuscitation. The Lancet, 360(9343), 1395-1396. DOI: 10.1016/S0140-6736(02)11393-6  

  • April 10, 2013
  • 01:33 AM

Counterintuitive Conservation

by Emarkham in GeneticCuckoo

An analysis of the proposal to legalize the trade in rhino horn in order to reduce the poaching of the remaining wild rhinos. Legalizing the trade of rhino horn is claimed to reduce the demand on the black market and is likely to be the best method for conserving the remaining rhinos, however other factors can influence the potential success of this. ... Read more »

E Markham. (2013) Counterintuitive Conservation. Blogspot. info:/

  • April 8, 2013
  • 12:25 PM

Genetic privacy webinar series continues

by Mary in OpenHelix

There have been a number of heated discussions about genetic privacy recently. Lately the discussion of the Henrietta Lacks (HeLa) genome paper erupted into wide-ranging awareness of some of the issues and complexities around genome data and family relationships. The paper by Yaniv Erlich’s team about re-identification of study participants using genealogy site details also [...]... Read more »

Presidential Commission for the Study of Bioethical Issues. (2012) Privacy and Progress in Whole Genome Sequencing. info:other/

Gymrek, M., McGuire, A., Golan, D., Halperin, E., & Erlich, Y. (2013) Identifying Personal Genomes by Surname Inference. Science, 339(6117), 321-324. DOI: 10.1126/science.1229566  

  • April 8, 2013
  • 05:08 AM

Publish and Perish: Aspects of Science Fraud

by GDW in The Beast, the Bard and the Bot

If you want to make it in the academic world, you better publish. A lot. Preferably in so-called high-impact journals. Otherwise, no job and no funding (or the other way around). Hence the use of the phrase ‘publish or perish’ to capture the enormous importance of generating sufficient publications in sufficiently respectable journals. And most [...]... Read more »

  • March 31, 2013
  • 07:56 PM

Are Cognitive Factors Related to Criminal Reoffending?

by The Neurocritic in The Neurocritic

Image from Graphic SociologyCan Brain Activity Predict Criminal Reoffending?  The previous post discussed a functional MRI study suggesting that the level of error-related activation in the anterior cingulate cortex (ACC) might have value in predicting whether a recently released prisoner will be rearrested within 4 years (Aharoni et al. 2013):The odds that an offender with relatively low anterior cingulate activity would be rearrested were approximately double that of an offender with high........ Read more »

Aharoni, E., Vincent, G., Harenski, C., Calhoun, V., Sinnott-Armstrong, W., Gazzaniga, M., & Kiehl, K. (2013) Neuroprediction of future rearrest. Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.1219302110  

  • March 28, 2013
  • 05:13 PM

Can Brain Activity Predict Criminal Reoffending?

by The Neurocritic in The Neurocritic

Is it possible for a brain scan to predict whether a recently paroled inmate will commit another crime within 4 years? A new study by Aharoni et al. (2013) suggests that the level of activity within the anterior cingulate cortex might provide a clue to whether a given offender will be rearrested.Dress this up a bit and combine with a miniaturized brain-computer interface that continuously uploads EEG activity to the data center at a maximum security prison. There, machine learning algorith........ Read more »

Aharoni, E., Vincent, G., Harenski, C., Calhoun, V., Sinnott-Armstrong, W., Gazzaniga, M., & Kiehl, K. (2013) Neuroprediction of future rearrest. Proceedings of the National Academy of Sciences. DOI: 10.1073/pnas.1219302110  

  • March 26, 2013
  • 11:30 AM

Does the Goal of a Pulse Lead to Bad Resuscitation Decisions

by Rogue Medic in Rogue Medic

The paper does address some interesting aspects of resuscitation.

ROSC (Return Of Spontaneous Circulation) is the goal for many people.

ROSC is a red herring.

Those of us who think ROSC is important do not seem to understand how much long-term damage we can do in our attempts to get ROSC, or to get ROSC quickly.

This study helps to point out some of the inconsistencies with our ROSC fetish.... Read more »

Koscik, C., Pinawin, A., McGovern, H., Allen, D., Media, D., Ferguson, T., Hopkins, W., Sawyer, K., Boura, J., & Swor, R. (2013) Rapid Epinephrine Administration Improves Early Outcomes in Out-of-Hospital Cardiac Arrest. Resuscitation. DOI: 10.1016/j.resuscitation.2013.03.023  

  • March 22, 2013
  • 11:00 AM

Equipoise and Ethics and IRBs, Oh My!

by Rogue Medic in Rogue Medic

In the comments to what I wrote yesterday about seizures and a study comparing lorazepam (Ativan), diazepam (Valium), and placebo,[1] Brooks Walsh had the following comment –

"Although I’ve read the study before, I am only wondering now how the IRB for Alldredge 2001 thought there was 'equipoise' between placebo and benzos."... Read more »

Alldredge BK, Gelb AM, Isaacs SM, Corry MD, Allen F, Ulrich S, Gottwald MD, O’Neil N, Neuhaus JM, Segal MR, Lowenstein DH. (2001) A Comparison of Lorazepam, Diazepam, and Placebo for the Treatment of Out-of-Hospital Status Epilepticus. New England Journal of Medicine, 345(25), 1860-1860. DOI: 10.1056/NEJM200112203452521  

Callaway, C. (2012) Questioning the Use of Epinephrine to Treat Cardiac Arrest. JAMA: The Journal of the American Medical Association, 307(11), 1198. DOI: 10.1001/jama.2012.313  

Hagihara A, Hasegawa M, Abe T, Nagata T, Wakata Y, Miyazaki S. (2012) Prehospital Epinephrine Use and Survival Among Patients With Out-of-Hospital Cardiac Arrest. JAMA: The Journal of the American Medical Association, 307(11), 1161. DOI: 10.1001/jama.2012.294  

  • March 14, 2013
  • 10:30 PM

Should We Use Immobilization For Penetrating Injuries To The Neck - Comments at Paramedic's Edge

by Rogue Medic in Rogue Medic

Are you required to backboard a patient who was shot in the neck no matter how the patient is presenting? [1]

That is the entire question that was asked at The Paramedic’s Edge.

There are really several questions being asked.... Read more »

  • March 10, 2013
  • 11:00 PM

Japanese man dies after 25 hospitals reject him

by Rogue Medic in Rogue Medic

In January, in Japan, 25 hospitals refused to permit an ambulance to transport a man who was pronounced dead when he finally arrived at a hospital.

Were the patients already in the ED (Emergency Department) less stable than this patient?

Was this patient going to be the straw that breaks the camel’s back and result in the deaths of other patients already in the ED?

What kind of evidence do we have to justify diversion?
... Read more »

Khaleghi, M., Loh, A., Vroman, D., Chan, T., & Vilke, G. (2007) The Effects of Minimizing Ambulance Diversion Hours on Emergency Departments. The Journal of Emergency Medicine, 33(2), 155-159. DOI: 10.1016/j.jemermed.2007.02.014  

Burke, L., Joyce, N., Baker, W., Biddinger, P., Dyer, K., Friedman, F., Imperato, J., King, A., Maciejko, T., Pearlmutter, M.... (2013) The Effect of an Ambulance Diversion Ban on Emergency Department Length of Stay and Ambulance Turnaround Time. Annals of Emergency Medicine, 61(3), 303-3110. DOI: 10.1016/j.annemergmed.2012.09.009  

  • March 5, 2013
  • 05:30 PM

Bougies and ALS Airways

by Rogue Medic in Rogue Medic

The last paper we were working on for the EMS Research Podcast was this paper on the use of a bougie in the intubation of a simulated patient with spinal immobilization.

Is BAI (Bougie-Assisted Intubation) an improvement over traditional intubation (ETI or EndoTracheal Intubation)?... Read more »

  • February 28, 2013
  • 12:55 AM

Does Intubation Prevent Aspiration of Stomach Contents?

by Rogue Medic in Rogue Medic

This is a study that looked at the rate of aspiration among patients intubated in the PH (PreHospital or EMS) setting and compared them to patients intubated in the ED = (Emergency Department) setting.

There is one huge difference between these settings – EMS was not authorized to use any form of chemically assisted intubation or RSI (Rapid Sequence Induction/Intubation). At the time of this study, the only drugs available to snow the patient would have been morphine, midazolam (Versed)........ Read more »

Ufberg, J., Bushra, J., Karras, D., Satz, W., & Kueppers, F. (2005) Aspiration of gastric contents: association with prehospital intubation. The American Journal of Emergency Medicine, 23(3), 379-382. DOI: 10.1016/j.ajem.2005.02.005  

  • February 12, 2013
  • 10:00 PM

Good Can Come From Bad: Genetic Testing For The BRCA Breast Cancer Genes

by Jalees Rehman in The Next Regeneration

Our ability to test for the presence of genetic mutations has become extremely cost-efficient and private companies, such as 23andMe now offer genetic testing for consumers who want to find out about their predisposition for genetic diseases. The results of such tests are sent directly to the consumers, without the involvement of genetic counselors or other healthcare providers. This has lead to a growing concern about how people will respond to finding out that they are carriers of mutations th........ Read more »

  • February 10, 2013
  • 12:00 PM

Advanced Airway vs. BVM During CPR – Which is Worse?

by Rogue Medic in Rogue Medic

The authors wanted to find out what method is (worst) best for ventilating patients during out-of-hospital treatment of cardiac arrest.
Endotracheal tube?
Supraglottic airway (laryngeal mask airway, laryngeal tube, and esophageal-tracheal twin-lumen airway device)?
BVM (Bag Valve Mask)?
This assumes that ventilations provide some sort of benefit to the patient. There is no evidence to support this myth.... Read more »

  • February 4, 2013
  • 10:47 AM

Privacy and Progress in Whole Genome Sequencing: webinar series

by Mary in OpenHelix

Hey folks–as a public service announcement I’m posting this email from the Genetic Alliance folks. They’ve assembled a terrific webinar series that cover hot topics in genomics research and privacy issues. I’m posting part of the email, but then will direct you to their page for the full list of upcoming webinars. I’ve read the [...]... Read more »

Presidential Commission for the Study of Bioethical Issues. (2012) Privacy and Progress in Whole Genome Sequencing. info:other/

Gymrek, M., McGuire, A., Golan, D., Halperin, E., & Erlich, Y. (2013) Identifying Personal Genomes by Surname Inference. Science, 339(6117), 321-324. DOI: 10.1126/science.1229566  

  • February 3, 2013
  • 10:00 PM

Is the Difference in Penetrating Trauma Mortality Truly Significant? Part I

by Rogue Medic in Rogue Medic

MV observed the following the lack of distinction in scene time for penetrating trauma mortality, which I did not give the proper attention in "EMS Time and Survival from Blunt and Penetrating Trauma." I will try to correct my mistake here.... Read more »

  • February 3, 2013
  • 12:47 PM

Should You Give A Damn About Your Reputation? (Part 1)

by Jesse Marczyk in Pop Psychology

According to Nowak (2012) and his endlessly-helpful mathematical models, once one assumes that cooperation can be sustained via one’s reputation, one ends up with the conclusion that cooperation can, indeed, be sustained (solely) by reputation, even if the same two … Continue reading →... Read more »

Sigmund, K. (2012) Moral assessment in indirect reciprocity. Journal of Theoretical Biology, 25-30. DOI: 10.1016/j.jtbi.2011.03.024  

  • February 2, 2013
  • 01:04 PM

LMAYQ: Let me do your homework for you

by TheCellularScale in The Cellular Scale

Sometimes reading the textbook is just too hard. And sometimes it's much easier just to type your exact homework question into a search engine and find the answer. Before we get started you might want to take a look at Smith and Wren (2010) "What is Plagiarism and how can I avoid it?" This edition of Let Me Answer Your Questions will address 'homework questions.' As always, you can find previous LMAYQ questions here.Tough Homework Questions are for the Internet (source)1. "cells that f........ Read more »

Smith N Jr, & Wren KR. (2010) Ethical and legal aspects part 2: plagiarism--"what is it and how do I avoid it?". Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses / American Society of PeriAnesthesia Nurses, 25(5), 327-30. PMID: 20875892  

  • February 1, 2013
  • 01:31 PM

Predatory Prawns

by Emarkham in GeneticCuckoo

A new ecological method of control for an African parasitic disease, an analysis of the benefits and limitations of this approach. ... Read more »

E Markham. (2013) Predatory Prawns. Blogspot. info:/

  • January 31, 2013
  • 11:00 PM

EMS Time and Survival from Blunt and Penetrating Trauma

by Rogue Medic in Rogue Medic

People will tell you that they just know the we need to load and go. Some even claim that the mythological Golden Hour is real. Maybe there will be an episode of Ancient Aliens about R Adams Cowley identifying the meaning of trauma and writing it on a cocktail napkin in a bar.
... Read more »

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