Evidence available shows that the ethics review process in Malaysia suffers from a range of problems (Kaur, 2011). These problems may be the result of a lack of training given for REC members and relatedly, it may stem from a lack of understanding of the role of RECs. Since Malaysia is striving to promote the country as a research hub for international collaboration, it is important that the ethics review system that is in place is well set up to ensure only ethical research are being approved. The aim of this thesis is to develop three important key elements of a framework that can be used to provide practical guidance for RECs and their governance in Malaysia. These three important elements of the ethics review process are: - the role of RECs, the criteria of REC membership and the acceptability of variation in decisions made between different RECs. These analysis is then applied to the Malaysian context. My initial recommendation is for RECs to adopt the Daniels and Sabin (1997) accountability for reasonableness model to assist with the decision-making process. The adoption of the model helps to clarify the role of RECs and can be used as a basis to develop the criteria for REC membership as well as to provide a better understanding of the acceptability of variation in decisions between different RECs.

No description available.

Background: An appreciation of the broader social determinants of health and wellbeing has led to the inclusion of new public health principles and practice within health and social care. End-of-life care has been no exception and there exists a favourable policy context, significant body of theoretical work, substantial practitioner interest and numerous practice examples. Despite this context, there has been little empirical exploration and the approaches remain poorly characterised. Aims and objectives: The aim of this study was to understand the impact a new public health approach to end-of-life care project can have when initiated through a hospice. Specifically this study sought to explore how a compassionate community project is experienced, what tensions exist, what processes support or impede the work, what specific challenges such a project developed from within this sector presents and what learning exists for the wider field. Methods: A mixed methods study employing multiple methods of data collection was performed. Data collection methods included: interviews; focus groups; participant observation; documentary analysis and service records. Ethics approval was obtained. Data were analysed according to modified grounded theory and using online software tool Dedoose. Results: Twenty-one interviews, two focus groups and 19 episodes of participant observation were conducted, 11 documents and service data on 180 Compassionate Neighbours and 173 Community Members were also included. Six key actions facilitated integration of new public health approaches with service provision approaches. Impacts from the work were wide ranging and included a reduction in loneliness, improvements in wellbeing and changes to hospice practice. Further to this, three underlying drivers emerged that underpinned the work as a whole. They were seen to translate the observed actions of the project into the impacts and included: altered power dynamics, expression of reciprocity in relationships and the development of agency. Discussion: The three drivers allow a deeper appreciation of the factors involved in the development of a compassionate community. The redressing of power dynamics within traditional provider-recipient relationships allowed for more equity, and created a space for reciprocal and mutual relations to emerge. Not only were these reciprocal relations observed between those at the end of life and those visiting them, but also between participants in the project and the hospice. In order to adequately capture these new perspectives offered through this study, a new term collective social capital is introduced. This moves beyond existing conceptualisations of social capital in end-of-life care to provide novel perspectives on the role of reciprocity and interdependency between the lay and professional worlds. Conclusion: This study provides a reflexive and critical account of the processes and impacts of compassionate communities work in practice. It situates reciprocal relationships as its foundation and forces an assessment of the nature of power and agency in all interactions. Through the presentation of the new concept of collective social capital, it presents a collaborative and interdependent path forward for new public health and end-of-life care in the future.

This study was conducted with the focus on medical and nursing education programs in the U.S. in order to learn if they include training for their students on dealing with victims of human trafficking. In order to address this goal, the survey among professors and instructors of 650 randomly selected medical and nursing education programs was conducted, where they were asked if their programs' curricula include training on recognizing victims of trafficking, as well as providing them with health care services and assistance to escape from their traffickers. The analysis of 116 received responses revealed that the majority of medical and nursing education programs do not train their students on recognizing victims of trafficking, and providing them with relevant assistance. / McAnulty College and Graduate School of Liberal Arts / Graduate Center for Social and Public Policy / MA / Dissertation

<p> The purpose of this study was to determine if a cancer patient will experience less nausea and a better quality of life if a non-clinical caregiver is present with them while receiving chemotherapy. Primary data was collected at the oncology outpatient infusion center at Kaiser Permanente West Los Angeles Medical Center. Of the 39 participants, 23 had a caregiver with them and 16 came to receive treatment alone. Each participant was asked their nausea level 24 hours after they received chemotherapy. Seventy-two hours after receiving chemotherapy they were asked to complete the Functional Living Index-Emesis (FLIE) survey to evaluate their quality of life during the last 3 days. The data were analyzed by using descriptive and inferential statistics. </p><p> Although neither group of patients experienced less nausea or took less anti-nausea medication, those that did have a caregiver present with them did report that they had a better quality of life.</p>

<p> The purpose of this grounded theory study was to develop a construct that describes the motivations of physicians to lead multidisciplinary prostate cancer clinics (MPCCs). Medical leaders play a key role in increasing the number of MPCCs, which are not yet widely available to patients in the United States. Understanding what motivates these physicians to lead is an important dimension of developing, recruiting, and retaining MPCC leaders. </p><p> This study collected qualitative, empirical data from 12 MPCC medical leaders located throughout the United States. Utilizing theoretical sampling and constant comparison, the data derived from face-to-face interviews were used to create a new construct of MPCC medical leaders' motives called <i> Leader-Stage Motivation</i> (LSM). </p><p> In the LSM construct a physician experiences 11 motivational factors while leading a multidisciplinary prostate cancer clinic. These 11 factors are grouped into 5 motivational patterns: mentored self-efficacy, purpose-driven goal, multidisciplinary relatedness, time-moderated challenge, and achievement-driven goal. Each of these 5 patterns is directly related to the leader's role during 3 stages of MPCC development: leader-creator, leader-sustainer, and leader-renewer. </p><p> The LSM construct is distinct from other leadership motivation theories such as leadership motive pattern (McClelland, 1975), role motivation theory (Miner, 1978) and motivation to lead (Chan &amp; Drasgow, 2001). Unlike these previous theories LSM establishes a relationship between the leader's motivations and changing leadership roles during the life cycle of an organization. The LSM construct also provides a new model of leadership motivation that is specific to medical leaders. </p><p> This study contributes to leadership motivation research by modeling physicians' motivations to lead in one type of multidisciplinary, patient-centered environment. The LSM construct gives health care providers a development, recruitment, and retention framework for future multidisciplinary prostate cancer clinic medical leaders. Results of this study may also contribute more broadly to an understanding of what motivates physicians to lead their peers. </p>

Thesis (Ph.D.)--McMaster University, 2005. / Supervisor: William D. Coleman. Includes bibliographical references (p. [165]-190) Also available online.

Thesis (Ph. D.)--Victoria University (Melbourne, Vic.), 2006. / Includes bibliographical references.

Diss. Uppsala : Uppsala universitet, 2006.

Thesis equivalent (M.H.A.)--University of Michigan, 1972.