MSc (Med)Bioethics and Health Law, Faculty of Health Sciences, University of the Witwatersrand, 2009 / The application of informed consent in research in developing countries continues to be a topical and complex issue. The debate concerning informed consent has become even more relevant in light of the groundswell of international collaborative research that is conducted in developing countries. The discussion centres on the uncertainties of the application of informed consent in developing countries based on the normative criteria set out in international codes and regulations. Although the ethical and legal basis of obtaining valid informed consent is incontestable, contextual differences between developed and developing countries is a key problem. For example, it is debated if the tenets of ‘Western’ research ethics, mainly in the application of a written informed consent model can truly be applied in the African context. The question is whether the participants of research when conducted in developing countries actually are “informed” in the consent process. There are perceptions that the protective instruments that guide researchers on how to obtain informed consent from research participants are not robust and sensitive enough for developing countries needs. In literature, some have questioned the relevance of its purist application in the context of developing countries as ‘overly paternalistic’. Others have argued from the view point that the Eurocentric approach recommended in obtaining informed consent in developing countries has the potential to undermine cultural norms and traditions. In the latter argument, concerns are raised about the principle of respect for persons / ‘autonomy’ and its applicability in so-called communitarian societies. To overcome some unique hurdles, there are voices that call for tailor-made processes for obtaining informed consent to suit the prevailing context, suggesting therefore that there should be some variance in its application. The importance of the issue of informed consent becomes critical as much international collaborative research takes place in Africa where health services are often inadequate and research is perceived by participants as a means of ameliorating some of their suffering. Given the philosophical and the ‘universal’ ethical foundations at the heart of the international regulations and codes on the issue of informed consent, there is a need to further explore the foundation of these perceptions as they raise various ethical issues which need to be discussed. The question concerned in this research report is “is there unfinished business not addressed in the process of obtaining informed consent in developing countries?” In order to answer this question, it is necessary to look at some of the requisites for the application of informed consent principles. I will examine whether the content of the commonly cited ethical codes and regulations (originally initiated in developed countries) are sufficiently broad enough to explain the aims of obtaining informed consent, the steps to be taken in obtaining informed consent and the structures necessary for its facilitation. In addition I will examine whether the intent of the codes and regulations take cognizance of socio-cultural variations. In other words, is the environment sufficiently conducive to apply the concept and are the guidelines flexible enough to deal with “unusual circumstances”. In consideration of the latter, I consider the question of the adequacy of structures to ensure the essence of respect for persons is not lost in dealing with “unusual circumstances”. I contend that if the answer is in the affirmative it is only then can it be said that the principles of informed consent are being adequately addressed and meet the moral, ethical, and legal obligations of research activities.

Thesis (M.B.A.)--Boston University

MA (Research) / N/A

Background : - The past two decades has seen an increasing emphasis placed on basing health care on the best available evidence. However, existing research has come under increasing scrutiny, which suggests its quality was often poor. This problem has been exacerbated by the ever increasing volume of health care literature. To address these difficulties systematic reviews have emerged as one of the most important ways by which research is summarised and communicated to its end-users. However, as these reviews have been primarily concerned with effectiveness, they have focused almost exclusively on randomised controlled trials. As a result, systematic reviews have excluded much of the research of nurses. Purpose : - The purpose of this study was to develop a process to systematically collect, appraise, summarise and synthesise the findings of a range of different types of research. Conceptual Framework : - To aid in the development of these expanded review methods, a conceptual framework was developed that addressed effectiveness, appropriateness and feasibility. Method : - A search of the literature was undertaken to identify published reviews of different types of research, and discussions in the health care literature related to the conduct of research reviews. These reviews and discussion papers served as the basis for developing the expanded review methods. Evaluation : - To evaluate the expanded review methods, two systematic reviews were conducted. The protocol and results of the first review on the use of music in hospitals are presented to demonstrate how the conceptual framework and expanded review methods enabled a broader evaluation of the topic. Selected results from the second review on the use of physical restraint are presented to demonstrate how the findings from a number of methodologically different types of research were incorporated into a systematic review. Conclusion : - The conduct of the two systematic reviews clearly demonstrated that the proposed expanded review process was able to rigorously collect and summarise a range of different types of research. Additionally, the conceptual framework underpinning these reviews enabled each of the studies to be located logically and coherently during the synthesis of data. / Thesis (Ph.D.)--Department of Clinical Nursing, 2001.

Thesis (M.S.)--Ohio State University, 2009. / Title from first page of PDF file. Includes vita. Includes bibliographical references (p. 68-76).

In this article open access is defined, and the resources and issues of greatest relevance to the medical librarian are discussed. The economics of open access publishing is examined from the point of view of the university library. Open access resources, both journals and articles in repositories, are already significant and growing rapidly. There are close to 2300 fully open-access peer review journals listed in the Directory of Open Access Journals (DOAJ) (320 health sciences titles are included). DOAJ is adding titles at a rate of 1.5 per day. An OAIster search of resources in repositories includes more than 7.6 million items (a rough estimate of the number of articles in repositories, although not all items are full text), and this number will exceed one billion items before the end of 2007. Medical research funders, including the US National Institutes of Health, the Wellcome Trust, the UK Medical Research Council, and the Canadian Institutes of Health Research, either have implemented or are considering open access policies. This will drive greater growth in open access resources, particularly in the area of medicine. There are implications and leadership opportunities for librarians in the open access environment.

MA (Research) / N/A

Thesis (M. P. H.)--University of Hong Kong, 2008. / Includes bibliographical references (leaf 89-94) Also available in print.

Yes / Vascular calcification is a complex biological process that is a hallmark of atherosclerosis. While macrocalcification confers plaque stability, microcalcification is a key feature of highrisk atheroma and is associated with increased morbidity and mortality. Positron emission tomography and X-ray computed tomography (PET/CT) imaging of atherosclerosis using 18F-sodium fluoride (18F-NaF) has the potential to identify pathologically high-risk nascent microcalcification. However, the precise molecular mechanism of 18F-NaF vascular uptake is still unknown. Here we use electron microscopy, autoradiography, histology and preclinical and clinical PET/CT to analyse 18F-NaF binding. We show that 18F-NaF adsorbs to calcified deposits within plaque with high affinity and is selective and specific. 18F-NaF PET/CT imaging can distinguish between areas of macro- and microcalcification. This is the only currently available clinical imaging platform that can non-invasively detect microcalcification in active unstable atherosclerosis. The use of 18F-NaF may foster new approaches to developing treatments for vascular calcification.

This thesis discusses the development of penicillin during World War II, made possible by a complex relationship between private industry, academic researchers, and government research facilities and funding. It also examines the media response to the emergence of penicillin, the wide-spread war-time preoccupation with venereal disease, and the discovery of the potency of penicillin in treating such illnesses. It argues that the societal importance of penicillin was leveraged by policy makers in the post-war period to expand government funding for medical research and the role of the US Public Health Service. This was part of an overall trend of post-war expansion in government. / History