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Parental Consent (parental + consent)

Distribution by Scientific Domains

Medical Sciences	62%
Humanities and Social Sciences	18%

Selected Abstracts

Judicial Waivers of Parental Consent for Abortion: Tennessee's Troubles Putting Policy into Practice,

LAW & POLICY, Issue 3 2005
HELENA SILVERSTEIN
According to the U.S. Supreme Court, minors seeking abortions are entitled to petition for relief from state-mandated parental consent. To facilitate the actualization of this right, Tennessee included procedural mechanisms that go beyond those in effect in most states in its parental consent statute. This paper examines whether these additional mechanisms allow Tennessee to succeed where other states have failed. Our findings indicate that these mechanisms mitigate to some extent the sort of implementation failure observed in other states. However, the magnitude of this mitigation is not sufficient to establish that parental consent statutes can be implemented in accordance with Supreme Court requirements. [source]

Presence of both parents during consent process in non-therapeutic neonatal research increases positive response

ACTA PAEDIATRICA, Issue 10 2010
Irina Korotchikova
Abstract Aim:, To investigate factors that influenced parental consent/non-consent in a non-therapeutic electroencephalogram (EEG) study in healthy newborns. Methods:, Parents of healthy newborns were approached to participate in a neonatal EEG study within 36 h of birth. The rationale and risks/benefits of the study were explained. Any concerns were discussed, and detailed information about the EEG study was provided in the consent form. In the case of refusing/withdrawing consent, an informal interview was used to investigate the reasons, which were subsequently analysed and grouped according to the four principles of the consent process. Results:, A total of 123 parents were included in the study. Parental consent was obtained in 72/123 (59%) cases, 10/123 (8%) parents subsequently withdrew their consent and 41/123 (33%) parents refused to participate in the study. Consent was more likely if both parents were present (p < 0.0001). When the mothers were approached alone, obtaining consent was significantly more difficult within the first 6 hours of delivery, compared to a later approach (37% vs. 67% respectively; p = 0.009). Refusals were classified into issues of voluntariness (7%), informed choice (10%), understanding (54%) and competence (29%). Conclusion:, Parents of healthy newborns demonstrated a positive attitude towards non-therapeutic neonatal research with maximal consent occurring when both parents were present. Parental perception of harm was the main reason for declining consent. [source]

A simple, and potentially low-cost method for measuring the prevalence of childhood obesity

CHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2006
K. Routh
Abstract Background, Recent official publications have highlighted obesity as one of the biggest threats to public health and the prevalence of obesity in children is widely believed to be rising rapidly. However, there are no data on the prevalence of childhood obesity at a local level. We have developed a simple low-cost method of gaining such data by working with local schools. Method, We designed our method on the observation that numeracy and data handling skills are often taught in schools by getting children to measure their height and weight. We recruited seven schools and offered them a numeracy lesson plan suitable for year 5 (aged 9,10) children together with healthcare staff to attend the lesson. As part of the lesson, each child's height and weight was measured and recorded anonymously. Parental consent was obtained on an ,opt out' basis. The method was evaluated by questionnaire. Results, We gained data on body mass index for 252 children. In total, 20% of the children were overweight, and 7% obese. The brief questionnaire survey indicated that both teachers and school nurses were happy with the method and would repeat it. Weighing was carried out sensitively. Conclusion, Our findings were in line with national studies of the prevalence of childhood obesity. The method was simple, low-cost and acceptable to schools and school nurses. There seems no reason why this project cannot be used more widely across the Primary Care Trust (PCT) and beyond. We now propose to roll out the method across all primary schools in Birmingham. [source]

Pros and cons of using the mental health act for severe eating Disorders in Adolescents

EUROPEAN EATING DISORDERS REVIEW, Issue 1 2009
Agnes Ayton
Abstract Background In England and Wales the compulsory treatment of young people with severe eating disorders is controversial. There is a concern that such treatment may impair patient autonomy and negatively influence the outcome. In this study, based in a specialist hospital, we compared patients treated under parental consent with those detained under the Mental Health Act: their characteristics and outcome up to 12 months after discharge. Results 34 patients were informal (treated under parental consent) (age: 16.2,±,1.3 years) and 16 were treated under Section 3 of the Mental Health Act (age: 16.2,±,1) in a 3-year period. Detained patients had an earlier age of onset (12.2,±,5 vs. 14.3,±,1.8) and more previous hospitalisation. On admission, their psychosocial functioning (Children's Global Assessment Scale (C-GAS): 13.6,±,2 vs. 26.9,±,9; Health of the Nation Outcome Scale for Children and Adolescents (HONOSCA): 41.7,±,5 vs. 31.9,±,5) were worse than voluntary patients', they had a higher level of co-morbid depression (BDI: 38.1,±,15.6 vs. 26.6,±,12.4) and a higher rate of suicidal behaviour. All physical and psychosocial measures improved substantially and clinically significantly by discharge and there was no statistically significant difference at this stage between the two patient groups. Two informal patients died within a year after discharge (6.3%), but there were no deaths amongst the detained patients. Comments In contrast with previous findings in adults, the outcome for detained patients was similar to that for informal patients, despite the former having more severe presentation on admission. There was no evidence of higher mortality in the detained group. Copyright © 2008 John Wiley & Sons, Ltd and Eating Disorders Association. [source]

Fluoroscopic guidance of Arndt endobronchial blocker placement for single-lung ventilation in small children

ACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 7 2008
B. MARCINIAK
Background: Thoracoscopic surgery may require single-lung ventilation (SLV) in infants and small children. A variety of balloon-tipped endobronchial blockers exist but the placement is technically challenging if the size of the tracheal tube does not allow the simultaneous passage of the fibreoptic scope and the endobronchial blocker. This report describes a technique for endobronchial blocker insertion using fluoroscopic guidance in children undergoing SLV. Methods: After approval from the local Medical Ethics Committee and parental consent, 18 patients aged 2 years or younger scheduled for thoracic surgery requiring SLV were prospectively included. Following induction of anesthesia, a 5 Fr endobronchial blocker (Cook® Arndt endobronchial blocker) was inserted first into the trachea under direct laryngoscopy. Correct placement in the main bronchus was assessed by fluoroscopy and tracheal intubation next to the endobronchial blocker. Optimal position and balloon inflation was verified using a fibreoptic scope. The duration and number of insertion attempts as well as age, weight and size of the tracheal tube were recorded. Results: Eighteen patients were studied. Median (range) age and weight were 12 (0.2,24) months and 11.2 (4,15) kg, respectively. SLV was successfully achieved in all patients using a 5 Fr endobronchial blocker outside a 3.5,4.5 mm ID tracheal tube within 11.2 (±2.2) min. No side effects were observed during the procedure. Conclusion: Fluoroscopic-guided insertion of extraluminal endobronchial blocker is an effective and reliable tool to place Arndt endobronchial blockers in small children. [source]

Strategies for Implementing School-Located Influenza Vaccination of Children: A Systematic Literature Review

JOURNAL OF SCHOOL HEALTH, Issue 4 2010
John Cawley PhD
BACKGROUND: The Advisory Committee on Immunization Practices (ACIP) recommends influenza vaccinations for all children 6 months to 18 years of age, which includes school-aged children. Influenza immunization programs may benefit schools by reducing absenteeism. METHODS: A systematic literature review of PubMed, PsychLit, and Dissertation Abstracts available as of January 7, 2008, was conducted for school-located vaccinations, using search words "School Health Services" and "Immunization Programs"; limited to "Child" (6-12 years) and "Adolescent" (13-18 years) for PubMed and "mass or universal" and (immuniz* or immunis* or vaccin*) and (school or Child or Adolescen*) for PsychLit and Dissertation Abstracts. Fifty-nine studies met the criteria for review. RESULTS: Strategies such as incentives, education, the design of the consent form, and follow-up can increase parental consent and number of returned forms. Minimizing out-of-pocket cost, offering both the intramuscular (shot) and intranasal (nasal spray) vaccination, and using reminders can increase vaccination coverage among those whose parents consented. Finally, organization, communication, and planning can minimize the logistical challenges. CONCLUSIONS: Schools-based vaccination programs are a promising option for achieving the expanded ACIP recommendation; school-located vaccination programs are feasible and effective. Adhering to lessons from the peer-reviewed scientific literature may help public health officials and schools implement the expanded recommendation to provide the greatest benefit for the lowest cost. Given the potential benefits of the expanded recommendation, both directly to the vaccinated children and indirectly to the community, prospective, well-controlled trials to establish the cost-effectiveness of specific vaccination strategies should be high priorities for future research. [source]

Judicial Waivers of Parental Consent for Abortion: Tennessee's Troubles Putting Policy into Practice,

Isoflurane is associated with a similar incidence of emergence agitation/delirium as sevoflurane in young children , a randomized controlled study

PEDIATRIC ANESTHESIA, Issue 1 2007
ROLAND RICHARD MEYER MD
Summary Background:, Children may be agitated or even delirious especially when recovering from general anesthesia using volatile anesthetics. Many trials have focused on the newer agents sevoflurane and desflurane but for the widely used isoflurane little is known about its potential to generate agitation. We investigated the emergence characteristics of small children after sevoflurane or isoflurane with caudal anesthesia for postoperative pain control. Methods:, After institutional approval and parental consent, anesthesia was randomly performed with sevoflurane (n = 30) or isoflurane (n = 29) in children at the age of 3.8 ± 1.8 years during surgical interventions on the lower part of the body. After induction, all children received caudal anesthesia with bupivacaine (0.25%, 0.8 ml·kg,1). Postoperatively, the incidences of emergence agitation (EA) and emergence delirium (ED) were measured by a blinded observer using a ten point scale (TPS; EA = TPS > 5 ED = TPS > 7) as well as vigilance, nausea/vomiting and shivering. Results:, The two groups were comparable with respect to demographic data, duration of surgery and duration of anesthesia. There were also no differences in the period of time from the end of surgery until extubation, duration of stay in the PACU, postoperative vigilance and vegetative parameters. Incidence of EA was 30% (9/30) for sevoflurane and 34% (10/29) for isoflurane during the first 60 min in the PACU (P = 0.785). Likewise, the incidence of ED was not different between the groups (20% and 24%, respectively). Conclusions:, In our randomized controlled study, we found no difference in the incidence of EA or ED between sevoflurane and isoflurane. Therefore, the decision to use one or the other should not be based upon the incidence of EA or ED. [source]

The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children

PEDIATRIC ANESTHESIA, Issue 12 2005
YATINDRA KUMAR BATRA MD MNAMS
Summary Background:, Laryngospasm is a well-known problem typically occurring immediately following tracheal extubation. Propofol is known to inhibit airway reflexes. In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children. Methods:, After approval from the Institutional Ethics Committee and informed parental consent, we enrolled 120 children ASA physical status I and II, aged 3,14 years who were scheduled to undergo elective tonsillectomy with or without adenoidectomy under standard general anesthesia. Before extubation, the patients were randomized and received in a blinded fashion either propofol 0.5 mg·kg,1 or saline (control) intravenously. Tracheal extubation was performed 60 s after administration of study drug, when the child was breathing regularly and reacting to the tracheal tube. Results:, Laryngospasm was seen in 20% (n = 12) of the 60 children in the control group and in only 6.6% (n = 4) of 60 children in the propofol group (P < 0.05). Conclusions:, During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg·kg,1) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy. [source]

Issues in monitoring medication effects in the classroom

PSYCHOLOGY IN THE SCHOOLS, Issue 9 2009
Laura Anderson
The task of medication monitoring in the schools has increased for school psychologists, yet there is little research specific to pediatric psychoactive medication. The current article reviews issues pertinent to school-based medication monitoring. Feasibility, acceptability, and perception of effectiveness are reviewed as fundamental considerations before implementing a medication-monitoring plan in the schools. The importance of individualization, ecological implementation, and development of socially valid objectives is stressed along with the need for additional research, tools, and measures in this area. Practical considerations for school psychologists include discussion of parental consent and confidentiality, multilevel assessment and monitoring, data recording, and determining clinical significance. © 2009 Wiley Periodicals, Inc. [source]

Perceived Challenges to Obtaining Informed Consent for a Time-sensitive Emergency Department Study of Pediatric Status Epilepticus: Results of Two Focus Groups

ACADEMIC EMERGENCY MEDICINE, Issue 8 2009
James M. Chamberlain MD
Abstract Objectives:, The objective was to describe the perspective of research personnel on issues of informed consent in a time-sensitive clinical study under emergency circumstances. Methods:, The authors convened concurrent focus groups of research staff and investigators involved in a pharmacokinetic study of lorazepam for status epilepticus (SE). Moderators led discussion with open-ended questions on selected issues of parental consent, communication and understanding, patient assent, and comparison to other types of studies. Focus group transcripts were analyzed to identify themes and subthemes from the discussions. Results:, Most themes and subthemes were identified in both research staff and investigator focus groups. Focus group discussion points were categorized into three main themes: barriers to and enablers of informed consent, barriers to and enablers of actual enrollment, and overall ethical concerns about the research. Many of the issues identified were unique to emergency research. Conclusions:, From the perspectives of research staff and investigators enrolling patients in a time-sensitive emergency department study, the authors identified several areas of concern that should be addressed when planning future emergency studies. [source]

Obtaining active parental consent for school-based research: a guide for researchers

AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009
Luke Wolfenden
Abstract Objective: Schools increasingly require researchers to obtain active parental consent for students to participate in health research. We sought to identify effective strategies for the recruitment of child research participants through schools. Method: A search of Medline, PsycINFO, Educational Resources Information Center, ProQuest 5000 and the Cochrane Library electronic databases was conducted for the period 1988 to 2008. Results: The review found evidence that the following strategies may be effective in enhancing participation rates: 1) promotion of the research to school principals, teachers, parents and students; 2) dissemination of study information using methods allowing direct contact with parents (i.e. telephone or face-to-face); 3) provision of incentives to teachers, students and at a class level; 4) making reminder contacts; and 5) having a member of the research team co-ordinate and closely monitor the recruitment process. Conclusion and Implications: Application of these strategies should reduce the risk of non-response and other biases that result from selective non-participation. Further randomised controlled trials of these and other strategies are required to strengthen the evidence base. [source]

Perinatal mortality: clinical value of postmortem magnetic resonance imaging compared with autopsy in routine obstetric practice

BJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 4 2003
Marianne E. Alderliesten
Objective To compare postmortem magnetic resonance imaging (MRI) with autopsy in perinatal deaths. To determine the acceptance and feasibility of postmortem perinatal MRI. Design Cohort study. Setting Large teaching hospital. Population Fetuses and neonates from 16 weeks gestational age until 28 days after birth, stillbirths as well as intrapartum and neonatal deaths. Methods MRI was performed prior to autopsy in a consecutive cohort of perinatal deaths after full parental consent. Agreement between MRI and autopsy was calculated. The consent rate for both examinations was recorded separately, as well as the time between the perinatal death and the MRI. Main outcome measure Full agreement between MRI and autopsy. Results Of 58 cases, 26 parents consented to both examinations (45%). Autopsy showed 18 major malformations, of which 10 were detected with MRI. The positive predictive value of MRI was 80% (4/5) and the negative predictive value was 65% (13/20). Additional consent for MRI was given in eight cases (14%). In 84%, the MRI could be performed within 48 hours. Conclusions MRI is of value if autopsy is refused, but diagnostic accuracy is insufficient to recommend substitution of full autopsy. The acceptance rate of MRI only is better than that of autopsy. [source]

Baby K's unlawful removal: practice issues in the emergency protection of children

CHILD ABUSE REVIEW, Issue 3 2010
Mike Freel
Abstract This paper addresses the legal and practice issues raised by a particular case in the UK. In January 2008, less than three hours after his birth, Baby K was removed from his mother's care by hospital staff and placed in a separate ward. At a High Court hearing later that morning, it was ruled that the removal of Baby K was unlawful. Important practice issues are raised by this ruling. After setting out the circumstances under which Baby K was removed from his mother, this paper considers a number of issues raised by the case: (i) what constitutes lawful removal under domestic law; (ii) European jurisprudence and domestic law in relation to emergency removal at birth; (iii) parental consent to removal; (iv) professionals' liability for breaches of human rights; and (v) the role of child protection plans in safeguarding children. Copyright © 2010 John Wiley & Sons, Ltd. [source]