刑事案件中未成年人的保护

当今社会，未成年人犯罪已经成为一个越来越受关注的问题。本文通过对刑事案件中未成年人的定罪条件宽松化、量刑轻刑化和执刑人性化等方面的论述，阐述了从实体方面和从程序方面保护刑事案件中未成年人利益的建议。     

Mifepristone abortion in minors

Approximately one-third of pregnant teenagers in the U.S. choose abortion. This prospective study evaluated whether medical abortion with mifepristone and misoprostol is physically and emotionally acceptable in adolescents. Adolescents 14- to 17-years-old, with pregnancies ≤56 days gestation, and seeking abortion services with parental consent from at least one parent were enrolled. Mifepristone (200 mg) was administered, followed 2 days later by 800 μg of misoprostol administered vaginally. Follow-up visit occurred on Day 4–8 to confirm abortion completion. Questionnaires regarding acceptability of the procedure as well as emotional coping were administered at the initial visit, at the follow-up visit, and by phone at 4 weeks postabortion.

All 28 adolescents had complete medical abortions without complications or surgical intervention, and five minors did not require misoprostol. At the Day 4–8 follow-up visit, 75% of teens found the procedure acceptable, and that increased to 96% by the 4-week visit. Although 57% reported stress and 43% reported fear initially, by 4 weeks postabortion only 21% of the teens reported stress, and 8% were still experiencing fear. In addition, the minors’ satisfaction with their abortion decision increased from 43% to 79% by 4 weeks postabortion. Medical abortion with mifepristone and misoprostol was highly effective and well tolerated, physically and emotionally, by adolescents in our sample. A larger clinical trial is needed to generalize these findings to other adolescent populations seeking medical abortion services.     

Atención a menores con progenitores en conflicto en materia de información y consentimiento relativos a la salud de los hijos. Protocolo asistencial en el contexto de la legislación vigente

Among the main social and legislative changes as regards family matters that have taken place in Spain in the last few years, are included: (i) the gradual increase in legal disputes between parents, and (ii) the introduction of Law 26/2015 on Child Protection, which modified Law 41/2002 on the Freedom of the Patient. These searched for a balance between the rights of minors and the powers of the parents, particularly when the former had not reached 16 years or had sufficient maturity or, having reached it, the decision puts their life or health at severe risk. Likewise, it has led to a jurisprudence that determines that, for any minor, there are particularly sensitive, “special” or “important” health care actions, such as psychotherapy or surgical treatments, which require, with exceptions, the consent of both parents for it to be carried out. All this, however, subject to the discretion of the doctor responsible, who must always look after the best interests of the minor. For this reason, healthcare for minors, occasionally, lead to complex conflicts as regards information and consent by the parents, particularly when they do not agree. A review is presented on the current legislative framework and the main legal concepts that regulate the healthcare of minors as regards information and consent relative to health, as well a healthcare protocol for the care of minors in situations of conflict between parents, developed in the Gregorio Marañón Hospital of Madrid, and endorsed by the Official Medical Collegiate of Madrid.     

未成年人眼球开放性损伤随访期致盲原因分析

目的　探讨未成年人眼球开放性损伤随访期内的致盲原因。方法　分析 42例 42眼未成年人眼球开放性损伤1～ 3年随访期的临床资料 ,并与出院时的临床资料进行比较。结果　随访期最佳矫正视力 <0 0 5者 2 5例 2 5眼 ,盲目率5 9 5 %。与出院时的盲目率 3 6 8%比较 ,经 χ2 检验 ,P <0 0 5 ( χ2 =4 8)。结论　未成年人眼球开放性损伤随访期内盲目率上升 ,主要致盲原因是角膜白斑、角膜新生血管、外伤性白内障、青光眼、玻璃体浑浊、视网膜脱离等并发症。     

54例肠造口刺激性皮炎患儿的护理

肠造口刺激性皮炎不仅引起患儿疼痛不适、周围皮肤感染,影响二期手术的进行,还会增加患儿或照顾者的心理压力。通过对54例患儿肠造口刺激性皮炎的原因进行分析,找出引起儿童肠造口周围皮炎的主要原因,根据具体原因选用适合的造口护理用品和粘贴方法,并根据皮炎的程度采取不同的处理方法,详细指导患儿家属造口护理知识与技能,定时门诊复查及追踪指导。所有患儿肠造口刺激性皮炎均在2～8d内愈合,未再发生刺激性皮炎。     

Les effets de l’incarcération chez les mineurs

Aim of this study

In this article we wish to question the effects of incarceration on minors. The history of prison reveals that it is the work of a humanist and philanthropic discourse that ensued from the effects of revolutionary ideas. However, from the moment of its reform – that transformed it from a place of confinement to a penal institution – it has only demonstrated its dysfunctional aspect. Our objective is to initiate a reflection on the effects of incarceration, whether it be collective or individual and in particular when it involves adolescents.

钙剂对未成年健康人群骨密度影响的Meta分析

目的评估钙剂对未成年健康人群骨密度的影响。 方法以主题词"calcium supplementation、bone density、randomized controlled trials"在Pubmed,Medline,Embase,CINAHL,AMED,MANTIS,ISI Web of Science,CENTRAL等数据库搜索文献,选取1966年至2017年钙剂应用于未成年健康人群3个月以上,随访期6个月以上并且具有骨密度相关研究结果的随机对照研究进行meta分析。Meta分析用固定效应模型,提取数据和评估结果均由2位研究人员进行。 结果共纳入21个随机对照研究,3 072例未成年健康人群。钙剂对股骨颈骨密度[SMD＝0.09, 95%CI(－0.06,0.21)]和腰椎骨密度[SMD＝0.07,95%CI(－0.03,0.22)]的提高无明显作用(P >0.05)。停止补钙后,上肢骨骨密度仍显著增高[SMD＝0.14,95%CI(0.01,0.28),P<0.05],全身骨矿物含量则无明显变化[SMD＝0.00,95%CI(－0.40,0.40), P >0.05]。钙剂提高女性的骨密度较男性显著,钙剂对骨密度的影响与青春期前后,钙剂摄入基线,种族无明显关联。 结论钙剂对上肢骨密度的影响不能够减少未成年人群发生骨折的概率,对公共卫生预防未成年人群骨折有参考意义。     

Ethical principles and legal requirements for pediatric research in the EU: an analysis of the European normative and legal framework surrounding pediatric clinical trials

The involvement of minors in clinical research is inevitable to catch up with the lack of drugs labeled for pediatric use. To encourage the responsible conduct of pediatric clinical trials in the EU, an extensive legal framework has been developed over the past decade in which the practical, ethical, legal, social, and commercial issues in pediatric research are addressed. In this article, the European legal framework surrounding pediatric clinical trials is analyzed from the perspective of the major ethical concerns in pediatric research. The four principles of biomedical ethics will be used as a conceptual framework (1) to map the ethical issues addressed in the European legal framework, (2) to study how these issues are commonly handled in competent adults, (3) to detect workability problems of these paradigmatic approaches in the specific setting of pediatric research, and (4) to illustrate the strong urge to differentiate, specify, or adjust these paradigmatic approaches to guarantee their successful operation in pediatric research. In addition, a concise comparative analysis of the European regulation will be made. To conclude our analysis, we integrate our findings in the existing ethical discussions on issues specific to pediatric clinical research.