Denna undersökning handlar om att identifiera vad för faktorer som påverkar högskolestudenters beslut vid godkännande av cookies vid besök av e-handel. Undersökningen utfördes genom mixed metod forskningsmetod. Metoderna skedde i form av kvantitativ och kvalitativ i form av enkätundersökning samt intervjuer. Syftet med undersökningen var att förstå vilka faktorer som påverkar studenters godkännande av cookies när de besöker e-handel. Motiven till denna undersökning är att allt fler människor spenderar en stor del av sin tid på en växande bransch där de ständigt bemöts av popuppnotifikationer av cookies som kräver deras godkännande och medför att per automatik att många godkänner utan grund på informerat samtycke. Detta är något som behöver undersökas för att identifiera vad för faktorer som påverkar högskolestudenter informerade samtyckes godkännande av cookies.

No description available.

Background: The cluster randomized trial design randomly assigns groups of people to different treatment arms. This dissertation aimed to (1) develop machine learning algorithms to identify cluster trials in bibliographic databases, (2) assess reporting of methodological and ethical elements in hemodialysis-related cluster trials, and (3) assess how well two covariate-constrained randomization methods balanced baseline characteristics compared with simple randomization. Methods: In study 1, we developed three machine learning algorithms that classify whether a bibliographic citation is a CRT report or not. We only used the information available in an article citation, including the title, abstract, keywords, and subject headings. In study 2, we conducted a systematic review of CRTs in the hemodialysis setting to review the reporting of key methodological and ethical issues. We reviewed CRTs published in English between 2000 and 2019 and indexed in MEDLINE or EMBASE. In study 3, we assessed how well two covariate-constrained randomization methods balanced baseline characteristics compared with simple randomization. Results: In study 1, we successfully developed high-performance algorithms that identified whether a citation was a CRT. Our algorithms had greater than 97% sensitivity and 77% specificity in identifying CRTs. For study 2, we found suboptimal conduct and reporting of methodological issues of CRTs in the hemodialysis setting and incomplete reporting of key ethical issues. For study 3, where we randomized 72 clusters, constraining the randomization using historical information achieved a better balance on baseline characteristics than simple randomization; however, the magnitude of benefit was modest. Conclusions: This dissertation's results will help researchers quickly identify cluster trials in bibliographic databases (study 1) and inform the design and analyses of future Canadian trials conducted within the hemodialysis setting (study 2 & 3). / Thesis / Doctor of Philosophy (PhD) / The cluster trial design randomly assigns groups of people to different treatment arms rather than individuals. Cluster trials are commonly used in research areas such as education, public health, and health service research. Examples of clusters can include villages/communities, worksites, schools, hospitals, hospital wards, and physicians. This dissertation aimed to (1) develop machine learning algorithms to identify cluster trials in bibliographic databases, (2) assess reporting of methodological and ethical elements in hemodialysis-related cluster trials, and (3) identified best practices for randomly assigning hemodialysis centers in cluster trials. We conducted three studies to address these aims. The results of this dissertation will help researchers quickly identify cluster trials in bibliographic databases (study 1) and inform the design and analyses of future Canadian trials conducted within the hemodialysis setting (study 2 & 3).

1 Proxy decision making for incompetent patients Abstract The author of this thesis discusses the applicable Czech legislation on the proxy decision making for incompetent patients and the provision of medical care without informed consent. The thesis is divided into six parts, while the first part is devoted to the definition of the basic terms that are directly related to this topic and which are repeatedly used herein. These basic terms are the following: health services and healthcare, informed consent and the patient. The second chapter is devoted to sources of law, which are divided into three levels - international sources, European Union law and national sources. Within the national regulation, attention is focused mainly on Act No. 372/2011 Coll., On health services and conditions of their provision, as amended. It also outlines the issue of the duality of legal regulation, that was caused by the adoption of Act No. 89/2012 Coll., Civil Code. The third chapter deals with surrogate consent, attention is paid mainly to resolving conflicts of opinions and to the best interests pricniple, as to the key factor when granting the proxy consent. The fourth chapter is devoted to the institute of previously expressed wishes. The fifth chapter analyses the issue of providing health services to vulnerable...

Background: There has been tremendous progress in the use of genomics1 in biomedical research and medical care since the launch of the Human Genome Project in 1990. However, it has also introduced new ethical challenges regarding the feedback of findings generated in genomic sequencing. While some would argue in support of the return of individual findings generated from genomics research, participants' preferences regarding which findings should be fed back differs. Most literature discusses feedback of findings in high income countries and very few address this issue in lower and middle-income countries (LMICs). As a result, it remains unclear whether and how individual findings from genomic studies in Africa should be fed back, who should provide these results and when. Methods: In order to contribute to addressing this gap, an empirical study was conducted to explore expectations and preferences for feedback of individual genetic findings in an HIV-TB genomics research project in Botswana. A qualitative study methodology involving deliberative focus group discussions (dFGDs) and in-depth interviews (IDIs) was used. Participants for this study were adolescents involved in an HIV-TB genomics study being conducted at the Botswana-Baylor Children's Clinical Centre of Excellence (BBCCCE). Parents and caregivers of children enrolled in that same genomic study were also enrolled in this study. A total of 93 participants (44 adolescents and 49 parents and caregivers) were enrolled in 12 dFGDs (6 groups of adolescents and 6 groups of parents and caregivers). Each group of participants met twice within a week, resulting in a total of 24 dFGD meetings. Participants of the dFGDs and in-depth interviews were selected purposively. Additionally, indepth interviews were conducted with 12 dFGD participants (6 adolescents and 6 parents or caregivers). The dFGDs and IDIs were conducted in Setswana, audio-recorded, transcribed and translated into English. Data were imported into NVivo 12 and analysed using the framework approach for qualitative data analysis. Results: The study findings revealed that participants' desire to receive individual genetic results is underpinned by their cultural values, mainly solidarity and reciprocity. Participants viewed research participation as a mutual relationship and considered the return of research results to be one way of reciprocating their efforts. This seems to be underpinned by the principle of Ubuntu which advocates for solidarity and reciprocity within communities. Participants noted that when reciprocity obligations are respected, participants feel valued and expressed that not respecting reciprocity expectations could undermine participants' trust and participation in future studies. Almost all participants wanted to receive individual genetic results. While parents and caregivers wanted to receive individual genetic results regardless of their severity, preventability or actionability, adolescents were reluctant to receive results for genetic conditions that are severe and non-preventable, especially if they are also unactionable. Participants advanced different reasons for feedback of results including for awareness, improving lifestyle, accepting one's' situation, and preparing for the future. The findings also reveal the importance of taking into account participants' context, relations and empowerment when making decisions about whether and which results ought to be fed back. When asked about practical considerations for feedback of results, both adolescents and parents expressed that they would prefer to receive individual genetic results in person, with adolescents preferring researchers to provide feedback, while parents preferred feedback from doctors associated with the study. Adolescents and parents both expressed that feedback should be supported by counselling, but they differed on the timing of feedback. Most participants shared that they would like to be informed about the possibility of discovering individual genetic results during the consent process and that consent be obtained for feedback during the enrolment process. They further expressed that in cases where prior consent to feedback was not obtained, then participants should be re-contacted where lifesaving genetic information is discovered. Participants emphasized the need for researchers to ensure that participants' decisions regarding feedback of results are well-informed. Autonomy, transparency, and communication were identified as key values to uphold during the consent process. Conclusion: In conclusion, expectations of solidarity and reciprocity could translate into an obligation to feedback selected individual genetic results in African genomics research. Decisions on practicalities for feedback of results should take into account participants' context and considerations of participants' preferences. For example, in settings like BBCCCE it might be feasible for the study team to relay participants' results to treating doctors in the same centre, while also organising counselling services if necessary. However, in cases where a study is done in a public facility with limited resources, that could be difficult to implement. Consequently, researchers may have to take up the responsibility of feeding back individual results as well as providing genetic counselling in such settings. To make these decisions, researchers should engage with relevant stakeholders including policymakers and local Institutional Review Boards (IRBs) so as to make informed decisions regarding the feasibility and acceptability of their approach to feedback of results. Obtaining participants' consent for feedback of results is important to ensure that their rights and wellbeing are protected in research. This is critical in building trust relationships between participants and researchers. Lastly, although this study is focused in Botswana, these findings could also be generalised to similar contexts in Africa and provide an authoritative voice to H3Africa to be able to mandate projects with potential to generate individual genetic results to make provisions to feedback these results to study participants.

No description available.

AI is entering clinical care and the healthcare sector in a big way, at the same time, a growing number of scholars are concerned that this technology cannot adhere to current bioethical principles. In particular, there are increasing concerns that AI poses a threat to the autonomy of patients by being irreconcilable with the practice of informed consent. In this essay, I shall defend the thesis that some applications of AI can be reconciled with a revised version of informed consent – what I call AI Adapted Informed Consent. This solution shall not rest on the idea of making black box AI more transparent or explicable. Instead, I shall argue that black box AI does not necessarily withhold the kind of information necessary for informed consent. Rather, patients can be given epistemic access to the kind of information necessary to make an informed decision, as well as being informed as to how the AI is used in the medical decision-making and in the assessment of their medical situation. Hence, this solution offers a re-interpretation of informed consent as information about contextual functioning and role of AI in medical decision-making. Drawing on republican interpretations of freedom as nondomination, I argue that demands for informed consent can only be restrained if it preserves the voluntariness of our decisions. Hence, I shall conclude that my adapted informed consent thesis allows for the possibility that some applications of black box AI in clinical care can be reconciled with informed consent and due respect for patient autonomy – if three specific conditions can be met.

No description available.

No description available.

Para avaliar a efetividade do processo de obtenção do termo de consentimento livre e esclarecido (TCLE) no contexto da pesquisa clínica em seres humanos, foram realizadas análises sistematizadas sobre os principais elementos de sustentação do TCLE (bioética na pesquisa em seres humanos, direitos humanos do sujeito da pesquisa, história da obtenção do TCLE, e regulamentações brasileiras na pesquisa em seres humanos), assim como também análises sistematizadas sobre a efetividade dos principais processos envolvidos na obtenção do TCLE (comunicação médico-paciente, tomada de decisão pelo sujeito da pesquisa, e interpretação das expressões de probabilidade no TCLE pelo sujeito da pesquisa). Ainda que estes três processos envolvidos na obtenção do TCLE apresentem, individualmente, alguns procedimentos efetivos, verificou-se que a obtenção de um TCLE verdadeiramente autônomo é utópica e, portanto, o processo de obtenção do TCLE é considerado não-efetivo / In order to evaluate the effectiveness of the process for obtaining the informed consent (IC) within the context of clinical research in human beings, systematic-like analysis were performed on the key elements supporting the IC (bioethics within the research in human beings, human rights for the research subject, history of the obtainment for the IC, and Brazilian regulation within research in human beings), as well as systematic-like analysis on the effectiveness of the major processes involved in the obtainment for the IC (physician-patient communication, decision-making for the research subject, and interpretation of the probability expressions in the IC by the research subject). Eventhough these three processes involved in the obtainment for the IC present, individually, a few effective procedures, the obtainment of a truly autonomous IC is utopia and thus the process for obtaining the IC is considered non-effective