Publications by authors named "Sankary L"

Introduction: Informed decisions to enrol in the clinical investigations of Alzheimer's disease and related dementias (ADRD) require careful consideration of complex risks and uncertain benefits. Decisions regarding whether to receive information about biomarker status are complicated by lack of scientific consensus regarding biomarkers as surrogate endpoints for Alzheimer's disease and how information about individual risk should be evaluated and shared with research participants. This study aims to establish stakeholder consensus regarding ethically optimal approaches to sharing individual results with ADRD research participants.

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  • Moral distress in healthcare is complex and does not have a simple solution; some view it as a problem to eliminate while others see potential value in it.
  • The authors suggest that moral distress serves as an alert for ethical issues in patient care, prompting the need for deeper investigation rather than just finding the "right" answer.
  • The paper outlines practical steps to help healthcare professionals address moral distress through peer support and self-reflection, empowering them to tackle ethical dilemmas and improve their sense of agency.
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The ethical recruitment of participants with neurological disorders in clinical research requires obtaining initial and ongoing informed consent. The purpose of this study is to characterize barriers faced by research personnel in obtaining informed consent from research participants with neurological disorders and to identify strategies applied by researchers to overcome those barriers. This study was designed as a web-based survey of US researchers with an optional follow-up interview.

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  • Upper-extremity impairment after stroke poses significant treatment challenges, prompting the exploration of neuromodulation therapies like deep brain stimulation.
  • In a phase I trial involving 12 patients with long-term upper-extremity impairment, deep brain stimulation was applied to the cerebellar dentate nucleus in conjunction with physical rehabilitation, showing promising results without major side effects.
  • Participants experienced significant improvements in motor function, as measured by the Upper-Extremity Fugl-Meyer Assessment, with gains linked to cortical reorganization in the brain, indicating that this treatment may enhance recovery and warrant further research.
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In recent years, the phenomenon of moral distress has been critically examined-and for a good reason. There have been a number of different definitions suggested, some that claimed to be consistent with the original definition but in fact referred to different epistemological states. In this paper, we re-examine moral distress by exploring its relationship with moral agency.

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The COVID-19 pandemic caught many areas of medicine in a state of unpreparedness for conducting research and completing ongoing projects during a global crisis, including the field of pain medicine. Waves of infection led to a disjointed ability to provide care and conduct clinical research. The American Society of Pain and Neuroscience (ASPN) Research Group has created guidance for pragmatic and ethical considerations for research during future emergency or disaster situations.

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Access to mental health care is a significant challenge in patients with psychogenic nonepileptic seizures (PNES). Telepsychology can curb the access barriers and improve adherence but the role of telepsychology in improving adherence has not been well investigated. The current study examines the utility of telepsychology during the COVID-19 pandemic and treatment adherence in PNES patients.

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  • The authors discuss various kinds of moral distress that healthcare professionals may face while delivering gender-affirming care to children, using real-life examples to illustrate their points.
  • They suggest strategies to cope with and manage this moral distress, helping clinicians navigate their feelings and ethical concerns.
  • The authors urge professional organizations to step up and provide more support for clinicians involved in gender-affirming care to improve their well-being and effectiveness.
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Rationale: Psychogenic Nonepileptic Seizures (PNES) are seizure-like episodes without EEG abnormality, and are of psychological origin. Cognitive Behavioral Therapy (CBT), a type of psychological counseling, is known to be the best intervention to treat PNES and the underlying psychiatric symptoms. Yet, many remain untreated because of limited access to specialized counseling programs.

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As clinical trials end, little is understood about how participants exiting from clinical trials approach decisions related to the removal or post-trial use of investigational brain implants, such as deep brain stimulation (DBS) devices. This empirical bioethics study examines how research participants experience the process of exit from research at the end of clinical trials of implanted neural devices. Using a modified grounded theory study design, we conducted semi-structured, in-depth interviews with 16 former research participants from clinical trials of DBS and responsive neurostimulation (RNS).

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Article Synopsis
  • - The COVID-19 crisis presented an ethical dilemma for healthcare organizations on prioritizing access to limited medical resources while maintaining their mission of patient-centered care.
  • - The bioethics department employed a deliberative approach, incorporating feedback from healthcare professionals and patients to guide the development of triage policies amidst uncertainty and differing ethical opinions.
  • - The article outlines the stakeholder engagement process, the perspectives collected, how they shaped the final policy, and provides recommendations for enhancing stakeholder involvement in ethical decision-making in future public health scenarios.
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Considerable variability exists in the publication of clinical research study procedures related to study enrollment and participant exit from clinical trials. Despite recent efforts to encourage research data sharing and greater transparency regarding research outcomes, reporting of research procedures remains inconsistent. Transparency about study procedures has important implications for the interpretation of study outcomes and the consistent implementation of best practices in clinical trial design and conduct.

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The Seventh Annual Deep Brain Stimulation (DBS) Think Tank held on September 8th of 2019 addressed the most current: (1) use and utility of complex neurophysiological signals for development of adaptive neurostimulation to improve clinical outcomes; (2) Advancements in recent neuromodulation techniques to treat neuropsychiatric disorders; (3) New developments in optogenetics and DBS; (4) The use of augmented Virtual reality (VR) and neuromodulation; (5) commercially available technologies; and (6) ethical issues arising in and from research and use of DBS. These advances serve as both "markers of progress" and challenges and opportunities for ongoing address, engagement, and deliberation as we move to improve the functional capabilities and translational value of DBS. It is in this light that these proceedings are presented to inform the field and initiate ongoing discourse.

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Deep brain stimulation (DBS) is an implanted neurological device effective in treating motor symptoms of Parkinson disease (PD), such as tremor, rigidity, and bradykinesia. More than 150,000 patients worldwide have been implanted with DBS devices. Questions arise at the end of life concerning how to provide best care for patients with DBS, including its continued benefit or potential complications, yet, no published articles provide guidance for hospice providers regarding the management of DBS devices in end-of-life care.

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