A Catholic Perspective: Triage Principles and Moral Distress in Pandemic Scarcity.

Unlabelled: Striving to be faithful to the moral core of medicine and to spiritual, moral, and social teaching of the church, Catholic physicians see their role as an extension of the healing ministry of Jesus. When faced with a situation in which a large number of gravely ill people are seeking care, but optimal treatment such as ventilation in intensive care unit cannot be offered to all because of scarcity of resources, Catholic physicians recognize the need to consider the common good and to assign a priority to patients for whom such treatments would be most probably lifesaving. Making these evaluations, physicians will use only objective medical criteria regarding the benefits and risks to patients and will be mindful that all persons deserve equal respect for their dignity.

Aboriginal Health Care and Bioethics: A Reflection on the Teaching of the Seven Grandfathers.

Contemporary bioethics recognizes the importance of the culture in shaping ethical issues, yet in practice, a process for ethical analysis and decision making is rarely adjusted to the culture and ethnicity of involved parties. This is of a particular concern in a health care system that is caring for a growing Aboriginal population. We raise the possibility of constructing a bioethics grounded in traditional Aboriginal knowledge.

Framework for ethical decision-making based on mission, vision and values of the institution.

The authors led the development of a framework for ethical decision-making for an Academic Health Sciences Centre. They understood the existing mission, vision, and values statement (MVVs) of the centre as a foundational assertion that embodies an ethical commitment of the institution. Reflecting the Patient and Family Centred Model of Care the institution is living, the MVVs is a suitable base on which to construct an ethics framework.

Controlling pain and reducing misuse of opioids: ethical considerations.

Objective: To help family physicians achieve an ethical balance in their opioid prescribing practices.

Quality Of Evidence: MEDLINE was searched for English-language articles published between 1985 and 2011. Most available evidence was level III.

Examining the suitability of the principle of subsidiarity for bioethics.

The political and social principle of subsidiarity can be useful as a general principle of bioethics. The principle states that only those decisions and tasks that cannot be effectively decided upon or performed by a supported or subsidized lower level authority ought to be relegated to a more central or higher authority. The concept of subsidiarity has been embedded tacitly in Western political thought for two millennia, but it has been articulated expressly only in the twentieth century.

Polychlorinated dibenzo-p-dioxins, dibenzofurans and polychlorinated biphenyls levels in human breast milk from different regions of Turkey.

Human breast milk offers the optimal nutrition for all infants and have been widely used in biomonitoring programs to assess human exposure to lipophylic environmental contaminants such as polychlorinated dibenzo-p-dioxins (PCDD), polychlorinated dibenzofurans (PCDF) and polychlorinated biphenyls (PCB). There are no previous reports from Turkey on chemically determined levels of PCDDs, PCDFs, and PCBs in human breast milk expressed as World Health Organization (WHO) toxic equivalents (TEQ). To get an overview of the levels of these contaminants in Turkish human milk, samples from 51 Turkish women living in the Ankara, Istanbul, Antalya, Kahramanmaraş, and Afyon provinces were analyzed by high resolution gas chromatography/high resolution mass spectrometry (HRGC/HRMS) throughout 2007.

Vertical distribution of organochlorine pesticides in humus along Alpine altitudinal profiles in relation to ambiental parameters.

In forest soils along vertical profiles located in different parts of the Alps, concentrations of persistent organic pollutants (POPs), namely organochlorine pesticides (OCPs) like dichlorodiphenyltrichloroethanes (DDTs), hexachlorobenzene (HCB), hexachlorocyclohexanes (HCH), heptachlor, aldrin, dieldrin and mirex, were measured. Though local characteristics of the sites are influenced by numerous factors like orographic and meteorological parameters, forest stand characteristics and humus parameters, we ascertained a marked vertical increase of concentrations of some organochlorine compounds in the soil. On the basis of climatological values of each site, we found that the contamination increase with altitude can be ascribed to a certain 'cold condensation effect'.

Simultaneous monitoring of profiles of polycyclic aromatic hydrocarbons in contaminated air with semipermeable membrane devices and spruce needles.

Gaseous emissions of combusted electronic scrap, PVC, carpet and wood were monitored for polycyclic aromatic hydrocarbons (PAHs) by simultaneous use of semipermeable membrane devices (SPMDs) and shoots of spruce needles (Picea abies). It was found that phenanthrene, acenaphthylene and fluorene were the dominating PAHs in all samples. SPMDs and needles mainly sequestered PAH associated with the vapor phase.

Concentrations of polychlorinated dibenzo-p-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like PCBs in adipose tissue of infertile men.

Some epidemiological studies suggested the occurrence of an alteration in the male reproductive function in the past 50 years, particularly a decrease in the sperm count and quality, an increase in the malformations frequency of the reproductive apparatus (cryptorchidism and hypospadias) and of testicular cancers. Especially according the laboratory animals studies, polychlorinated biphenyls (PCBs), polychlorinated dibenzo-p-dioxins (PCDDs), and polychlorinated dibenzofurans (PCDFs) have been suspected to play a crucial and deleterious role in the alteration of human fertility. For this reason, we measured adipose tissue concentrations of PCDDs/Fs and dioxin-like PCBs in 23 fertile and 22 infertile men living in Ankara, Turkey.

Monitoring of PCDD/Fs in a mountain forest by means of active and passive sampling.

Polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/F) are sampled and investigated in a forested area in Middle-Europe. The campaigns, consisting in active and passive samplings, were conducted in the Bavarian and Bohemian Forest at four sites chosen for their similar soil and forest stand characteristics. Passive sampling was conducted using both semi-permeable membrane devices (SPMDs) and needles of well-exposed dominant spruce trees.

Simultaneous monitoring of PCDD/Fs and PCBs in contaminated air with semipermeable membrane devices and fresh spruce needles.

The contaminated air with burning plastic floor and electronic scrap was monitored with semipermeable membrane devices (SPMDs) and fresh unpolluted spruce needles at the same time for polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) and polychlorinated biphenyls (PCBs). It was found that there were more polychlorinated dibenzofurans (PCDFs) than polychlorinated dibenzo-p-dioxins (PCDDs) collected from contaminated air. The total amounts of PCBs were much higher than that of PCDD/Fs, but the contribution of them to the WHO-TEQ was less than that of PCDD/Fs.

Concentration of polychlorinated dibenzo-p-dioxins, polychlorinated dibenzofurans and dioxin-like PCBs in human adipose tissue from Turkish men.

There is no previous report from Turkey on chemically determined polychlorinated dibenzo-para-dioxins (PCDDs), polychlorinated dibenzofurans (PCDFs), and dioxin-like polychlorinated biphenyls (PCBs) in human tissues expressed as World Health Organization (WHO) toxic equivalents (TEQs). The objective of this study was to determine the occurrence of PCDDs/Fs, and dioxin-like PCBs in the general adult Turkish population. For this reason we measured adipose tissue concentrations of PCDDs/Fs and dioxin-like PCBs in 23 Turkish men living in Ankara,Turkey in 2004.

Preparing for an influenza pandemic: ethical issues.

In the near future, experts predict, an influenza pandemic will likely spread throughout the world. Many countries have been creating a contingency plan in order to mitigate the severe health and social consequences of such an event. Examination of the pandemic plans of Canada, the United Kingdom and the United States, from an ethical perspective, raises several concerns.

Concentration measurements of PCDD/F in air and spruce needles in the Bavarian Forest and Bohemian Forest (Sumava): first results.

The aim of this project was to assess the concentration ranges of persistent organic pollutants (POPs) in air by means of active and passive sampling devices located in remote areas along the southern part of the German-Czech border. During the measuring program we also used spruce needles of different ages as biomonitors. The first results, which are restricted to PCDD/F measurements, indicate that the concentrations in both air and needles measured at four sites in the Bavarian Forest and Sumava crest region are lower than in many other regions of Bavaria and lower than during former measuring campaigns in adjacent regions of Austria and Bohemia.

Physician's ethical responsibilities when there is a discrepancy between demand and supply of medical services.

Background: The discrepancy between the demand for and the supply of physician's services is the result of actions of multiple parties, including physicians. This situation raises ethical challenges for physicians, because it involves the profession's core values.

Objective: To discuss physicians' ethical obligations regarding the quantity of services that they might provide.

Practice guideline on prophylactic cranial irradiation in small-cell lung cancer.

Purpose: To develop an evidence-based clinical practice guideline that would address the following questions: (a) What is the role of prophylactic cranial irradiation (PCI) in patients with limited or extensive stage small-cell lung cancer (SCLC) who have achieved complete remission in response to induction therapy (chemotherapy or chemoradiotherapy)? (b) What dose and fractionation schedules of PCI are optimal? (c) Does the use of PCI in patients with SCLC in complete remission affect quality of life? Survival, disease-free survival, quality of life, and adverse effects were the outcomes of interest.

Methods And Materials: A systematic review of the published literature was undertaken to provide the data for an evidence-based practice guideline.

Results: Six randomized controlled trials and one fully published individual patient data meta-analysis were included in the systematic review of the evidence.

Chromatographic properties of the ion-exclusion column IonPac ICE-AS6 and its application in environmental analysis, Part II: application in environmental analysis.

Biological processes, geochemical reactions, anthropogenic emissions, and transformation reactions of xenobiotics are responsible for the widespread occurrence of aliphatic carboxylic acids in the environment. To study the performance of the ion-exclusion chromatography column IonPac ICE-AS6 in the analysis of environmental and environmental-technical samples, organic acids are investigated in composting seepage, silage effluents, aqueous extracts of sewage sludge, molasses hydrolysate, and alkaline cellulose hydrolysates. With respect to the diverse sample matrix and composition, different chromatographic conditions are applied.

Chromatographic properties of the ion-exclusion column IonPac ICE-AS6 and application in environmental analysis. Part I: Chromatographic properties.

The chromatographic performance of the Dionex IonPac ICE-AS6 ion exclusion column is investigated. Therefore, capacity factors, efficiency, peak symmetry, resolution, and selectivity are determined for various mono- and polyfunctional aliphatic carboxylic acids under selected chromatographic conditions. Except for the stronger acids (pKa1 < 3.

The creation of a database for cancer screening: is the consent of clients required?

Professional caregivers have an obligation to maintain the privacy and confidentiality of all personal information given to them by their patients or clients. Such information is to be released to a party who is not participating in the care of the patient only with the express consent of the patient. The question is whether or not the express consent of a client of an organized cancer screening program is ethically required before the client's personal information is entered into a centralized database.

Variations in the management and outcome of non-small cell lung cancer in Ontario.

Prospectively gathered information in the Ontario Cancer Foundation's computerized clinical database was analysed to provide a description of the management of 12,399 patients with unresected non-small cell lung cancer (NSCLC) registered at seven regional cancer centres in Ontario between 1982 and 1991. Overall, 44% received initial thoracic radiotherapy, 19% received initial radiotherapy to metastatic sites, and 36% received no immediate radiotherapy. Of those who received thoracic radiation 41% received doses > or = 40 Gy and 59% received doses < 40 Gy.