Protecting young children from future pandemics: getting the basics right.
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ABSTRACT:
SUBMITTER: Lu C
PROVIDER: S-EPMC10254943 | biostudies-literature | 2023 Jun
REPOSITORIES: biostudies-literature
Publications
Protecting young children from future pandemics: getting the basics right.
Lu Chunling C Behrman Jere R JR Richter Linda M LM
BMJ paediatrics open 20230601 1
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Project description: Not available
| S-EPMC10288019 | biostudies-literature
Project description:BackgroundAt the start of the COVID-19 pandemic, guidance was needed more than ever to direct frontline healthcare and national containment strategies. Rigorous guidance based on robust research was compromised by the emergence of the pandemic and the urgency of need for guidance. Rather than aiming to "get guidance right", guidance developers needed to "get guidance right now".AimTo examine how guidance developers have responded to the need for credible guidance at the start of the COVID-19 pandemic.MethodsAn exploratory mixed-methods study was conducted among guidance developers. A web-based survey and follow-up interviews were used to examine the most pertinent challenges in developing COVID-19 guidance, strategies used to address these, and perspectives on the implications of the COVID-19 pandemic on future guidance development.ResultsThe survey was completed by 46 guidance developers. Survey findings showed that conventional methods of guidance development were largely unsuited for COVID-19 guidance, with 80% (n = 37) of respondents resorting to other methods. From the survey and five follow-up interviews, two themes were identified to bolster the credibility of guidance in a setting of extreme uncertainty: (1) strengthening end-user involvement and (2) conjoining evidence review and recommendation formulation. 70% (n = 32) of survey respondents foresaw possible changes in future guidance production, most notably shortening development time, by reconsidering how to balance between rigour and speed for different types of questions.Conclusion"Getting guidance right" and "getting guidance right now" are not opposites, rather uncertainties are always part of guidance development and require guidance developers to balance scientific robustness with usability, acceptability, adequacy and contingency. This crisis points to the need to acknowledge uncertainties of scientific evidence more explicitly and points to mechanisms to live with such uncertainty, thus extending guidance development methods and processes more widely.
| S-EPMC8657322 | biostudies-literature
Project description:We present a critical review of the literature on melodic intonation therapy (MIT), one of the most formalized treatments used by speech-language therapist in Broca's aphasia. We suggest basic clarifications to enhance the scientific support of this promising treatment. First, therapeutic protocols using singing as a speech facilitation technique are not necessarily MIT. The goal of MIT is to restore propositional speech. The rationale is that patients can learn a new way to speak through singing by using language-capable regions of the right cerebral hemisphere. Eventually, patients are supposed to use this way of speaking permanently but not to sing overtly. We argue that many treatment programs covered in systematic reviews on MIT's efficacy do not match MIT's therapeutic goal and rationale. Critically, we identified two main variations of MIT: the French thérapie mélodique et rythmée (TMR) that trains patients to use singing overtly as a facilitation technique in case of speech struggle and palliative versions of MIT that help patients with the most severe expressive deficits produce a limited set of useful, readymade phrases. Second, we distinguish between the immediate effect of singing on speech production and the long-term effect of the entire program on language recovery. Many results in the MIT literature can be explained by this temporal perspective. Finally, we propose that MIT can be viewed as a treatment of apraxia of speech more than aphasia. This issue should be explored in future experimental studies.
| S-EPMC3904283 | biostudies-other
Project description:Replication is vital for increasing precision and accuracy of scientific claims. However, when replications "succeed" or "fail," they could have reputational consequences for the claim's originators. Surveys of United States adults (N = 4,786), undergraduates (N = 428), and researchers (N = 313) showed that reputational assessments of scientists were based more on how they pursue knowledge and respond to replication evidence, not whether the initial results were true. When comparing one scientist that produced boring but certain results with another that produced exciting but uncertain results, opinion favored the former despite researchers' belief in more rewards for the latter. Considering idealized views of scientific practices offers an opportunity to address incentives to reward both innovation and verification.
| S-EPMC4865149 | biostudies-literature
Project description:(1) Background: The oncology field has drastically changed with the advent of precision medicine, led by the discovery of druggable genes or immune targets assessed through next-generation sequencing. Biomarker-based treatments are increasingly emerging, and currently, six tissue-agnostic therapies are FDA-approved. (2) Methods: We performed a review of the literature and reported the trials that led to the approval of tissue-agnostic treatments and ongoing clinical trials currently investigating novel biomarker-based approaches. (3) Results: We discussed the approval of agnostic treatments: pembrolizumab and dostarlimab for MMRd/MSI-H, pembrolizumab for TMB-H, larotrectinib and entrectinib for NTRK-fusions, dabrafenib plus trametinib for BRAF V600E mutation, and selpercatinib for RET fusions. In addition, we reported novel clinical trials of biomarker-based approaches, including ALK, HER2, FGFR, and NRG1. (4) Conclusions: Precision medicine is constantly evolving, and with the improvement of diagnostic tools that allow a wider genomic definition of the tumor, tissue-agnostic targeted therapies are a promising treatment strategy tailored to the specific tumor genomic profile, leading to improved survival outcomes.
| S-EPMC10144220 | biostudies-literature
Project description:BackgroundAdequate pain management for preterm born neonates suffering from the extremely painful disease necrotizing enterocolitis (NEC) is essential, since neonatal exposure to pain is related to negative short-term and long-term consequences. The aim of this study was to describe the current pain management and its effectiveness in NEC patients.MethodsIn this single-center, retrospective study, neonates (gestational age < 32 weeks and/or birth weight < 1500 g) with NEC Bell's stage II or III were included. Information on pain (based on COMFORTneo and NRS scores) and analgesic therapy was collected and analyzed for the acute disease period.ResultsOf 79 patients included, 74 (94%) received intravenous analgesic therapy: most commonly morphine, fentanyl, and acetaminophen. The median COMFORTneo score was 11 (IQR 10-11), however, 49 patients had at least one COMFORTneo score ≥ 14 indicating pain. Nineteen patients had persistent high pain scores ≥ 14 with a median duration of 7.2 h (IQR 2.8-14.0).ConclusionsThis study showed that despite analgesic therapy, most NEC patients showed signs of pain, and in some, pain persisted for several hours. It suggests that current analgesic therapy frequently failed to prevent pain and existing pain was often insufficiently treated. This supports the urgent need for individualized pain management guidelines for NEC patients.ImpactThis study is unique in reporting on pain management in neonates suffering from necrotizing enterocolitis (NEC) during the full acute disease period. Despite analgesic therapy, the majority of NEC patients experience pain, and in some patients, pain persists for several hours. These findings highlight the need for improvement of neonatal pain management in NEC patients, including better pain monitoring and guidelines for individualized analgesic therapy. Improved pain management guidelines may help to prevent short-term and long-term consequences of neonatal exposure to pain, as well as excessive exposure to opioids.
| S-EPMC9700516 | biostudies-literature
Project description:Pandemics have accelerated in frequency in recent decades, with COVID-19 the latest to join the list. Emerging in late 2019 in Wuhan, China, the virus has spread quickly through the world, affecting billions of people through quarantine, and at the same time claiming more than 800,000 lives worldwide. While early reflections from the academic community have tended to target the microbiology, medicine, and animal science communities, this article articulates a viewpoint from a perspective of human interactions with Earth systems. We highlight the link between rising pandemics and accelerating global human impacts on Earth, thereby suggesting that pandemics may be an emerging element of the “Anthropocene.” Examples from Denver, Colorado, USA, show how policy responses to the COVID-19 pandemic changed human-environment interactions and created anomalous landscapes at the local scale, in relation to the quality of air and patterns of acquiring and consuming food. In recognizing the significance of novel infectious diseases as part of understanding human-landscape interactions in the Anthropocene, as well as the multi-scale interconnectedness between environment and health, this viewpoint converges toward an urgent need for new paradigms for research and teaching. The program required extends well beyond the already broad interdisciplinary scholarship essential for addressing human-landscape interactions, by integrating the work of health scientists, disease specialists, immunologists, virologists, veterinarians, behavioral scientists, and health policy experts.
| S-EPMC7451098 | biostudies-literature
Project description:The COVID-19 worldwide pandemic has forced individuals into an unnatural way of life. Families with children experience unique stressors, such as school closures, disrupted childcare arrangements, requirement of parents to uptake additional responsibilities such as homeschooling, possible financial strain, and lack of breathing space between family members. The adjustments required of parents and children during a pandemic presumably impacts the psychosocial wellbeing of parents and children in different ways. To better under the psychosocial consequences of pandemics on parents, children, and youth, this scoping review used Arksey and O'Malley (2005) five-stage framework to examine the existing research literature on Severe Acute Respiratory Syndrome (SARS), Influenza Type A virus (H1N1), and COVID-19 to answer the following two research questions: (1) What are the psychosocial consequences of pandemics on parents of children and youth? (2) What are the psychosocial consequences of pandemics on children and youth? With the application of inclusion criteria, 29 articles were selected for analysis. Four major themes, including sub-themes emerged: 1) Each family members' emotions influence one another; 2) Parents experience greater levels of psychosocial problems than adults without children; 3) During a pandemic, parents require informal (social) and formal (specialized professional) support and; 4) Psychosocial consequences of pandemics on children/youth are understudied, indicating the need for more research on children/youth under the age of 20 years. Clinical prevention and intervention suggestions to support the psychosocial wellbeing of parents, children and youth during a pandemic are discussed.
| S-EPMC9375174 | biostudies-literature
Project description: Not available
| S-EPMC6937007 | biostudies-literature
Project description:IntroductionCommonly used scoring systems rely on blood counts, histological and cytological examination of bone marrow and peripheral blood as well as cytogenetic assessments to estimate prognosis of patients with myelodysplastic syndromes (MDS) and guide therapy decisions. Next-generation sequencing (NGS) has identified recurrent genetic abnormalities in up to 90% of patients with MDS and may provide important information regarding the pathogenesis of the disease, diagnostic and prognostic evaluation, and therapy selection. Areas covered: Herein, the authors review the role of NGS in diagnosis, treatment, and prognosis of MDS at various disease stages, and discuss advantages and caveats of incorporating molecular genetics in routine management of MDS. While a vast majority of patients harbor recurrent mutations implicated in MDS pathogenesis, similar mutations can be detected in otherwise healthy individuals with other hematologic malignancies. Besides establishing a diagnosis, NGS may be used to monitor minimal residual disease following treatment. Expert opinion: As more targeted therapies become available, assessment of genetic mutations will become central to individualized therapy selection and may improve diagnostic accuracy and further guide management for each patient. However, multiple challenges remain before NGS can be incorporated into routine clinical practice.
| S-EPMC6540985 | biostudies-literature