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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
281

Challenges in the Ethical Conduct and Ethics Review of Cluster Randomized Trials: A Survey of Cluster Randomization Trialists

Chaudhry, Shazia Hira January 2012 (has links)
Unique characteristics of cluster randomized trials (CRTs) complicate the interpretation of standard research ethics guidelines. Variable interpretation by research ethics committees may further complicate review and conduct. An international web-based survey was administered to corresponding authors of 300 randomly sampled CRT publications. We investigated ethics review and consent practices, investigator experiences with ethics review, and the perceived need for CRT-specific ethics guidelines. The response rate was 64%. Ethics review and consent were under-reported in publications. Ethics approval was obtained in 91%, and consent from individual and cluster level participants in 79% and 82% of trials. Consent varied by level of experimental intervention, data collection, and cluster size. Respondents cited variability among ethics committees (46%), and negative impacts of ethics review on their studies (38%). The majority perceived a need for ethics guidelines (73%), and guidance for ethics committees (70%). CRT-specific ethics guidelines are required to ensure practices meet ethical standards.
282

L'influence des droits de la consommation et de la concurrence sur la théorie des vices du consentement / Influence of consumption and competition laws under the theory of the defect of consent

Jakouloff, Karim 05 December 2013 (has links)
La théorie des vices du consentement offre une protection générique des contractants contre tout risque d'altération du consentement. Constatant son insuffisance, les droits de la consommation et de la concurrence ont, pour leur part, choisi d'adopter un ensemble de règles spécifiques visant à protéger, d'une part, les consommateurs et d'autre part, les professionnels en situation de faiblesse, contre ces mêmes risques. Au sein du droit de la consommation, cela s'est fait sous l'impulsion du droit européen, la directive du 11 mai 2005 relative aux pratiques commerciales déloyales ayant largement dicté le contenu des dispositions protectrices aujourd'hui applicables aux consommateurs. Ainsi, le Titre II du Livre Ier du Code de la consommation, consacré aux pratiques commerciales, comprend un Chapitre préliminaire consacré aux pratiques commerciales déloyales, suivi d'un Chapitre Ier, dont la Section 1 traite des pratiques commerciales trompeuses, puis d'un Chapitre II, dont la Section 5 traite des pratiques commerciales agressives. Le droit de la concurrence a, quant à lui, recouru spontanément à cette option. Son Livre IV comprend ainsi un Titre IV, dont le Chapitre II est relatif à la prohibition des pratiques restrictives de concurrence. Celles-ci, prohibées per se, n'ont a priori pas de lien apparent avec la théorie des vices du consentement. Pourtant, à y regarder de plus près, certaines d'entre elles s'attachent, de manière très indirecte, à rééquilibrer l'équilibre des forces en présence au stade de la négociation d'un contrat de distribution entre professionnels. Celles-ci vont en effet s'attacher à prohiber les comportements de certains professionnels qui, disposant d'un avantage économique certain, pourraient être tentés d'en jouer afin d'obtenir de leurs partenaires contractuels, économiquement dépendants, des avantages contractuels injustifiés. Ce faisant, c'est bien le consentement de ces derniers qui se trouve être préservé.En développant une telle législation, les droits spéciaux se sont écartés de leurs finalités réciproques. Ainsi, s'il est vrai que le droit de la consommation offre un ensemble de dispositions visant à prévenir la survenance de vices du consentement – approche inédite au sein de la théorie des vices du consentement de droit commun, qui ne s'attache qu'à réprimer les abus ayant effectivement altéré le consentement des contractants –, il propose également une abondance de dispositions curatives à la maniabilité souvent délicate. Leur compréhension ainsi que leur mise en œuvre nécessite donc une certaine habileté, au point de mettre en péril l'effectivité de la protection qu'elles visent à garantir. Quant au droit de la concurrence, le développement de dispositions visant à prohiber per se des comportements susceptibles de ne nuire qu'aux intérêts particuliers des professionnels en situation de faiblesse et non à l'ensemble du marché tend manifestement à détourner la matière de sa finalité première.Remédier à de telles constatations implique d'envisager la possibilité de délester les droits spéciaux d'une partie des dispositions légales visant à protéger le consentement des contractants y étant soumis, au profit de la théorie des vices du consentement. Une telle solution conduirait à recentrer les droits de la consommation et de la concurrence autour de leurs finalités respectives que sont, pour l'un, la protection des intérêts personnels des consommateurs et, pour l'autre, la protection du marché. Encore faudrait-il que les contractants, aujourd'hui protégés par ces dispositions spéciales, ne voient pas la qualité de leur protection diminuer. S'en assurer nécessitera de déterminer la nature des améliorations que devra subir la théorie des vices du consentement afin de pouvoir assimiler une part du contentieux de droit spécial. Ces améliorations, inspirées par l'étude des droits spéciaux, pourront ainsi bénéficier à l'ensemble des contractants soumis au droit commun. / The theory of the defect of consent offers a generic protection of the contracting party against all risk of consent modification. Having noticed its inadequacy, the laws of consumerism and competition have chosen to adopt a set of specific rules aiming to protect on one hand the consumer, and on the other hand the professional, both in a weak negotiating position, against these same risks. Within the consumerism law, this has been achieved under the European Rights impetus. The 11 May 2005 directive concerning unfair business-to-consumer commercial practices has largely dictated the content of the protective measures nowadays applicable to customers. In the same way, the Second Title of the First Book of Consumer Code, dedicated to commercial practices, consists of a preliminary chapter establishing the unfair business-to-consumer commercial practices. It follows by the 1st chapter, where the 1st section deals with misleading commercial practices, whilst the 2nd chapter, 5th section deals with aggressive commercial practices. Hence the competition law has resorted spontaneously to this option. Fourth Book includes fourth Chapter, where the second Chapter relates to the ban of competitive restrictive practices. These ones, forbidden per se, apparently have no link to this theory of the defect of consent. However, if we look closer, some of them have indirectly the aim to balance present forces at the negotiation stage via a distribution contract between professionals. In fact some will be keen to ban certain professional's behavior that, having a certain economical advantage, could be tempted to play in such a way so as to acquire unjustified contractual advantages from contractual partners, economically dependent. In doing so, the latter would need to have their consent protected.By developing such legislation, special laws have distanced themselves from their mutual purpose. Thus, if it is true that the consumerism law offers a set of rules aiming to prevent any defect of consent should it arise, it equally proposes a multitude of preventive rules but of a delicate maneuver – this being an original approach within the theory of defect of consent of common law, trying to repress the abuse effectively altering the contractual consent. Their comprehension as well as the putting it into practice would require a certain skill, to the point of risking the protection effectiveness that it aims to provide. As to the competition law, a set of rules aiming to forbid per se sensitive behavior, it would endanger only particular interests of professionals in a weak negotiating position, and not the whole market, manifestly tending to divert the matter from its initial result.To find a solution to these observations would imply to take into account the possibility of cutting off special rights of certain legal rules aiming to protect contractual consent they are under the obligation of, in favor of the theory of defect of consent. Such solution would lead to re-focusing on consumer and competition laws around their respective result, which are on one hand the protection of consumer's personal interests, and on the other hand market protection. It would then mean that the contracting party, sheltered by special rules, would not see their protection level diminish. To be re-assured there's the need to determine the nature of the improvements the theory of defect of consent would require, so as to include a part of the litigation of special law. The latter, inspired by a study of special law, could then benefit of the whole contractual under the common law.
283

Le consentement en procédure pénale / Consent in criminal procedure

Antoine, Virginie 25 November 2011 (has links)
L'introduction du consentement en procédure pénale démontre la volonté du législateur d'impliquer l'auteur dans l'application de la réponse pénale. Le justiciable participe à la justice pénale par le biais de son consentement. L'introduction d'un consentement en procédure pénale mettrait ainsi en lumière la volonté du législateur de développer une justice plus centrée sur l'auteur et ses prérogatives, donc plus proche du justiciable, plus humaine. Pourtant, l'abandon progressif d'un modèle de justice transcendantale pour une justice dite consensuelle ne présente pas que des avantages pour le justiciable. En effet, la mise en place d'une justice intégrant le consentement de l'auteur n'est pas sans danger pour les droits et libertés fondamentaux de ce dernier. La mise en place progressive d'une justice dite plus pacificatrice et moins stigmatisante se fait au prix d'un sacrifice de certains droits processuel et du respect de la dignité. / Le citizen participates in the criminal justice by means of his consent. The introduction of consent in criminal procedure would so bring to light the will of the legislator to develop a justice more centred on the author and its privileges, thus closer of citizen, more human. Nevertheless, the progressive abandonment (relinquishment) of a model of transcendental justice for a consensual said justice does not present that advantage for the citizen. Indeed, the implementation of a justice integrating (joining) the consent of the author is not without danger for the fundamental rights and the liberties of this last one. The progressive implementation of a pacificatorier said justice and less stigmatisante is made at the price (prize) of a sacrifice of certain rights processuel and a respect for the dignity.
284

An Analysis of the Doctrine of presumed consent and the principles of required response and required request in organ procurement

Fourie, Etienne Jean 07 February 2007 (has links)
The transplantation process establishes a three-phase structure namely, procurement, preservation and allocation of human organs and tissue. These three phases are co-dependent upon the successful completion of each individual phase within that structure. This dissertation focus specifically on the first phase of the transplantation process and endeavours to analyse the doctrine of presumed consent as applied in the procurement of human organs and tissue. Thereafter, the focus point is directed upon organ procurement incentives such as the principle of required response and required request that ensure the effective application of these systems should be interconnected with organ procurement systems. Finally, a capita selecta of issues pertaining to the final two stages of the transplantation process are investigated and proposed problem areas are reflected upon. The doctrine of presumed consent as an organ procurement system proposes that individuals who fail to raise an objection in respect of organ donation during their lifetime, will upon death be presumed that they provided consent to the removal of their organs. This system operates in absolute contrast to the doctrine of informed consent as applied in South African law, establishes that an ommissio to act would constitute an implicit statement of informed consent. The application of the doctrine of presumed consent can be classified as either a hard application or a soft application. A strong application declares that upon death a who failed to raise an objection to organ donation will be considered to given consent to organ procurement and any interference by the next-of-kin are disregarded. The weak application functions in a similar way than the hard application, with the exception that the next-of-kin has the right to override the decision. This dissertation analyses whether the element of consent in the doctrine of presumed consent can be classified as a justification ground as the doctrine of informed consent of whether it infringes upon section 12(2)(b) of the South African Constitution (Act 108 of 1996). To establish the true nature of the doctrine of consent, specific reference is made the duty of disclosure that rested upon the health practitioner to inform patients about information about a proposed treatment. Arguments are raised that the nature, scope and accessibility of information about issues relating to organ donation will determine if informed consent is present in the doctrine of presumed consent. The introduction of the doctrine of presumed consent as organ procurement system could provide South Africa with an essential framework to increase organ procurement and awareness about organ donation provided that sufficient information can be accessed in an easy and effective manner. The following concepts are analysed in the dissertation: The doctrine of presumed consent The principle of required response The principle of required request The doctrine of informed consent Organ procurement incentives Routine salvaging Organ procurement systems Organ preservation and safeguarding Organ allocation systems Human Tissue and organs The moment of death / Dissertation (Magister Legum (Public Law))--University of Pretoria, 2007. / Public Law / unrestricted
285

Avaliação de como os sujeitos da pesquisa entendem a sua participação em ensaios clínicos num hospital terciário / Assessment of how the subjects understand their participation in clinical trials in a tertiary care hospital

Silmara Meneguin 24 April 2009 (has links)
INTRODUÇÃO: Em ensaios clínicos o termo de consentimento livre e esclarecido é fundamental para a preservação da ética na pesquisa clínica e precisa ser lido e assinado pelos pacientes. No entanto, dada a sua complexidade este documento pode não ser entendido pelos mesmos. Para avaliar o entendimento destes sobre a pesquisa realizamos esta investigação. MÉTODOS: Convidamos os sujeitos participantes de ensaios clínicos de hipertensão arterial sistêmica e doença arterial coronária, fase II, III ou IV ambulatoriais e com fármacos, de jan/2002 a dez/2006, para responder questionário estruturado com 29 questões. Estes foram divididos em dois grupos, com uso (grupo I) ou não (grupo II) de placebo, após a randomização. Ao final, 80 pacientes compareceram de 106. Doutros 26 sujeitos, sete se recusaram, nove não foram localizados, oito foram excluídos e dois faleceram. As variáveis de cada questão foram consideradas por freqüência de ocorrência. A comparação entre as médias dos grupos foi realizada pelos testes t de Student ou Wilcoxon. Para avaliar associações utilizou-se o Qui-Quadrado, o teste de Razão de Verossimilhança ou Fisher. Para confirmar as informações, realizou-se também o grupo focal, tendo participado 8 do grupo I e 11 do grupo II. RESULTADOS: Avaliamos 80 sujeitos (grupo I- 47, grupo II- 33). As características sócio demográficas foram similares em ambos. Quanto à motivação para participar da pesquisa, 66,2% atribuíram-na ao benefício próprio, 42,5% pelo bem da ciência, e atendendo ao pedido médico 25,0%, em ambos os grupos. Quanto ao termo de consentimento livre e esclarecido, 50% não entenderam o seu conteúdo e 32,9% sequer o leram, mas o assinaram. No grupo I, 66,7% dos sujeitos não entenderam o significado de placebo e dos que afirmaram ter entendido (n=23) somente doze de fato comprovam o entendimento correto. Foram realizadas associações entre o não entender o significado do termo placebo com as variáveis de interesse para o estudo, e encontramos forte correlação com a escolaridade (p=0,022), evidenciando que quanto menor o nível de instrução menor também o entendimento. Houve também tendência entre ter um companheiro e ler o termo de consentimento livre e esclarecido antes de assinar (p=0,052), e o nível de escolaridade dos sujeitos e conversar sobre o termo de consentimento livre e esclarecido com o pesquisador (p=0,053). No que tange ao grupo focal, este corroborou os resultados e evidenciou que o termo de consentimento livre e esclarecido é considerado difícil pelos pacientes, porém a compreensão é favorecida pela equipe que complementa as informações de maneira clara e dispensa a leitura em virtude do vínculo de confiança estabelecido com esta. CONCLUSÕES: O termo de consentimento livre e esclarecido é pouco compreendido pelos sujeitos e para alguns a confiança no seu médico é crucial para a sua decisão em participar de um ensaio clínico com fármaco; evidenciou-se também influência do nível de instrução dos sujeitos no entendimento do termo placebo. Por outro lado, não houve repercussão na vida dos sujeitos em participar de ensaios clínicos com ou sem placebo, uma vez que a maior motivação para participar é pela expectativa do benefício terapêutico. / INTRODUCTION: To participate in a clinical trial patients have to sign an informed consent, often with misinterpretation words. Herein we addressed the issue of what do patients understand about the informed consent. METHODS: Patients that have participated in clinical trials in our institution were invited to an interview. From a data bank, between 2002 to 2006, patients were contacted by phone call. The questionnaire patients were submitted to was composed of 29 questions. To confirm some data, we did a second interview using the focal technique. Patients were allocated in two groups: Group 1- those that could have taken placebo for the treatment of their illness after a randomization, Group 2- those that did not take placebo during the treatment period but could have taken during the wash-out period. Statistics: were done with the t-Student test, or the Wilcoxon test. To evaluate associations we used the Qui-Square, Similarity test or the Fisher test and we considered a p value of 0,05. RESULTS: 80 patients, 60 (75%) males, age (average in years + SD) of 58.8 + 9.2; 47 in group 1 (58.3 ± 9.0) and 33 in group 2 (59.4 ± 9.8). Except for the job situation, both groups were similar. Of notice is the number of patients that were illiterate or have not completed the primary school. The most quoted motivation to participate was in their own benefit (66.2%), and second to the interest of science (42.5%). It is noteworthy that 50% of patients did not understand the informed consent but even in this case they did sign it. 66% did not understand the meaning of placebo that was correlated to the patients level of education (p= 0.02). Also, 36.2% of patients in group-I were not aware they could have taken tablets with no effect. In 19 patients (eight in group I and 11 in group II) submitted to the focal technique interview, what came out as the more important to their decision making to participate or not in a clinical trial, was the opinion of their assistant doctor. This was stood by almost all (90%) patients in this second interview. CONCLUSION: The informed consent was poorly understood, and for some patients the trust in their assistant doctors is crucial for their agreement to participate in a trial. This raised concerns about long and boring informed consent, and also how important are doctors´ words in the decision making of patients, probably due to their education level.
286

Processo de consentimento : recomendações para os pesquisadores com base nas vivências dos participantes de pesquisa clínica

Mendonça, Louise Camargo de January 2018 (has links)
A pesquisa clínica patrocinada no Brasil vem crescendo cada vez mais e gerando conhecimento científico em diversas áreas da saúde. O desenvolvimento desses ensaios clínicos envolve aspectos que vão além da geração de fármacos e produtos mais avançados. O grande alicerce da pesquisa clínica está também nos pacientes que aceitam participar de um estudo científico. Estes precisam passar por um processo de consentimento que envolve ter conhecimento sobre todos os aspectos que envolvem a sua participação no ensaio clínico. Dentro desse contexto, surge um grande desafio na área que é como realizar o processo de consentimento de maneira adequada. É preciso levar em consideração aspectos como compreensão, motivações, influências, coerção, benefícios, riscos, entre outros aspectos. O objetivo deste trabalho foi identificar quais os fatores vivenciados pelos participantes de pesquisa clínica durante o processo de consentimento. Foram aplicados questionários a respeito da sua percepção no que envolve a participação na pesquisa clínica. Com os dados gerados foi possível desenvolver um conjunto de recomendações visando o aprimoramento do processo de consentimento em projetos de pesquisa clínica. / Clinical research sponsored in Brazil has been increasing and generating scientific knowledge in several areas of health. The development of these clinical trials involves aspects that go beyond the generation of drugs and more advanced products. The key of clinical research is also in patients who accept to participate in a scientific study. These need to undergo a consent process that involves having knowledge about all aspects that involve their participation in the clinical trial. Within this context, a great challenge arises in the area that is how to carry out the consent process in an appropriate way. It is necessary to take into account aspects such as understanding, motivations, influences, coercion, benefits, risks, among other aspects. The objective of this study was to identify the factors experienced by clinical research participants during the consent process. Questionnaires were applied regarding their perception regarding the participation in clinical research. With the data generated, it was possible to develop a set of recommendations aimed at improving the consent process in clinical research projects.
287

Le tiers dans le contentieux international / Third entities in jurisdictional settlement of international disputes

Legris, Emilie 18 December 2018 (has links)
La réflexion sur le tiers dans le contentieux international a pour origine le constat d’une présence accrue des tiers dans le cadre du règlement juridictionnel des différends internationaux, questionnant la vision traditionnelle du procès international comme étant « la chose des parties ». Le tiers est défini négativement, comme toute entité qui n’est ni l’organe juridictionnel, ni les parties à l’instance. Tout au long de l’étude, il est procédé à une identification plus précise de cette notion à géométrie variable : selon la juridiction considérée et le type de procédure examiné, le tiers est un Etat, une organisation internationale, une personne privée physique ou morale. Dans le cadre d’un corpus de juridictions varié, la place du tiers dans le contentieux international est étudiée, en examinant successivement les aspects relevant de sa protection et de sa participation dans le contentieux international. En filigrane, l’étude appréhende la contribution des tiers au maintien de la paix, dans le cadre du règlement pacifique juridictionnel des différends internationaux. / The reflection on third entities in international litigation comes from the finding of an increased presence of “thirds” in the jurisdictional settlement of international disputes, thus questioning the traditional vision of the international trial as being “the thing of the parties”. The “third” is defined negatively, as any entity that is neither the jurisdiction nor the parties to the proceedings. Throughout the study, a more precise identification of this notion is developed : depending on the jurisdiction in question and the type of procedure examined, third entities are either States, international organizations, private (physical or moral) persons. Within the framework of diverse jurisdictions, the study apprehends the place given to third entities in international litigation, examining successively their protection and their participation. In the background, the study looks at the contribution of third entities to peacekeeping, as part of the peaceful settlement of disputes.
288

Préservation de la fertilité et cancer du sein : enjeux éthiques de l'information des femmes : conception et évaluation d'un outil d'aide à la prise de décision pour les patientes / Fertility preservation and breast cancer : ethical issues related to women information : development and assessment of a web-based decision aid for patients

Benoit, Alexandra 29 November 2019 (has links)
Introduction : La prise de décision concernant la préservation de la fertilité dans un contexte de prise en charge urgente de cancer du sein est complexe. Les objectifs de ce travail étaient de définir les attentes et les besoins des patientes en matière d’information, de concevoir un outil d’aide à la décision en ligne et d’évaluer sa validité apparente et son influence sur le choix éclairé des patientes.Méthodologie : Trois méthodes de recherche ont été menées pour répondre aux hypothèses : un focus group de cinq patientes pour l’étude qualitative, l’élaboration d’un outil d’aide à la décision selon la méthode d’Ottawa et une étude randomisée monocentrique. Cette dernière a été menée auprès de patientes âgées de 18 à 40 ans, adressées pour préservation de la fertilité dans un contexte de cancer du sein, randomisées au sein du groupe IRIS (information standard) ou du groupe DECISIF (avec outil d’aide à la décision en ligne). La mesure du choix éclairé était évaluée selon trois critères, à l’aide d’un questionnaire : les connaissances, l’attitude, et la mise en place ou non de techniques de préservation de la fertilité.Résultats : L’étude qualitative a permis de mettre en évidence que l’information transmise aux femmes et l’annonce de l’infertilité potentielle était à parfaire. L’outil d’aide à la décision en ligne a été élaboré suivant les recommandations des patientes et des professionnels de santé impliqués qui ont confirmé sa validité apparente. En ce qui concerne l’étude quantitative, au total 125 patientes ont été inclues et randomisées dans le groupe IRIS (n=65) ou DECISIF (n=60). Il a été mis en évidence une amélioration des connaissances dans le groupe DECISIF (8.6/10 (±1.34)) par rapport au groupe IRIS (6.49/10 (±1.89)). Dans les deux groupes, les patientes ont une attitude favorable envers la préservation de la fertilité (96 %). La décision finale n’est pas influencée par l’appartenance à un groupe ou un autre. Ainsi, à l’issue de la consultation de préservation de la fertilité, 73.6 % (92/125), soit 69.2 % (45/65) des patientes du groupe IRIS et 78.3 % (47/60) des patientes du groupe DECISIF vont choisir de conserver leurs ovocytes, embryons et/ou tissu ovarien. La proportion de choix éclairé était statistiquement plus élevée dans le groupe DECISIF que dans le groupe IRIS (respectivement 75 % versus 38.5 %, p<0.001). Par ailleurs, le niveau de conflit décisionnel chez les patientes du groupe DECISIF était moins élevé que chez celles du groupe IRIS (respectivement 14.4 (±2.94) versus 15.1 (±2.18), p=0.13).Conclusion : Nous avons conçu un outil d’aide à la décision en ligne pour accompagner les femmes atteintes d’un cancer du sein dans leur prise de décision concernant la préservation de la fertilité. Notre travail de recherche a permis de valider scientifiquement cet outil qui améliore les connaissances des patientes et leur autonomie de décision sans influencer leur attitude envers la préservation de la fertilité. / Introduction: Decision-making regarding fertility preservation in the context of urgent breast cancer management is complex. The objectives of this study were to define patients' expectations and information needs, develop an online decision support tool, and assess its apparent validity and influence on patients' informed choice.Methodology: Three research methods were used to address the hypotheses: a focus group of five patients for the qualitative study, the development of a decision support tool using the Ottawa method and a randomized, single-centre study. The latter was conducted with patients aged 18 to 40 years referred for fertility preservation in the context of breast cancer, randomized to the IRIS group (standard information) or the DECISIF group (with online decision support tool). The measurement of informed choice was evaluated according to three criteria using a questionnaire: knowledge, attitude, and whether fertility preservation techniques were available.Results: The qualitative study revealed that the information provided to women and the announcement of potential infertility needed to be improved. The online decision support tool was developed based on recommendations from the patients and health professionals involved, who confirmed its apparent validity. For the quantitative study, a total of 125 patients were included and randomized to the IRIS (n=65) or DECISIF (n=60) group. Better knowledge was found in the DECISIF group (8.6/10 (±1.34)) compared to the IRIS group (6.49/10 (±1.89)). In both groups, patients had a positive attitude towards fertility preservation (96%). The final decision was not influenced by membership in one group or another. Thus, at the end of the fertility preservation consultation, 73.6% (92/125), i.e. 69.2% (45/65) of patients in the IRIS group and 78.3% (47/60) of patients in the DECISIF group, chose to keep their oocytes, embryos and/or ovarian tissue. The proportion of informed choice was statistically higher in the DECISIF group than in the IRIS group (respectively 75% versus 38.5%, p<0.001). In addition, the level of decision-making conflict among patients in the DECISIF group was lower than in the IRIS group (respectively 14.4 (±2.94) versus 15.1 (±2.18), p=0.13).Conclusion: We have developed an online decision support tool to assist women with breast cancer in making decisions about fertility preservation. We have now validated this tool, which improves patients' knowledge and decision-making autonomy without influencing their attitude towards fertility preservation.
289

Problematika náboru pacientů do klinických hodnocení / Patients'Recruitment Issues in Clinical Trials

Hrubá, Dagmar January 2017 (has links)
This thesis examines patient recruitment in clinical trials. It is a current and pressing issue, which is not sufficiently embedded in the thinking of doctors and patients, their patterns of communication, and more broadly in the traditional doctor-patient relationship, which continues to be burdened by post-socialist paternalism. The formal framework and ethics have been developed relatively recently, and their application causes confusion to all participants regarding how to proceed in specific situations. In addition, the choice of topic, and especially the form of dealing with the topic, was motivated by the relative lack of academic resources and publications in the field. The theoretical section of the thesis defines clinical research and its phases, and introduces basic terminology and documents closely linked to clinical research. In addition, it focuses on research ethics, thoroughly examining the issue of informed consent - a fundamental document necessary for recruiting a patient in a clinical trial. Finally, one chapter of the thesis focuses on the issue of medical literacy, the level of which is integral to the participants' understanding of the importance of clinical research, and directly affects participants' decision-making. The empirical section is divided into two parts. The...
290

Trestný čin znásilnění (vybrané problémy) / A crime of rape (selected issues)

Veselá, Eliška January 2021 (has links)
A crime of rape (selected issues) Abstract The thesis deals with the concept of the crime of rape. The ambition of the graduate was not to give an all-embiscite interpretation of this crime from the point of view of criminal law and criminology, but to deal with the basic characteristics of rape and to respond to a possible change in the current law definition of rape. The introduction to the thesis first presents the basic historical development of this crime. Historical developments are demonstrated on three fictional stories so that the reader of the thesis can better imagine the main changes that have taken place in the area of basic constituent elements of the crime. Another part of the thesis consists of an analysis of the basic constituent elements of the of rape in § 185 of the Criminal Code. The interpretation of the basic constituent elements of this offence, complements the interpretation by legal theory and the interpretation of the Supreme Court and Constitutional Court of the Czech Republic. The following chapter in the thesis deals with the construction of the legal definition of rape as sexual intercourse without expressing voluntary consent. This chapter presents a list of states that legislate the crime of rape as sexual intercourse without consent. The following is an analysis of the...

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