Research ethics committees: a regional approach

Guidelines for Institutional Review Boards (IRBs) or research ethics committees exist at national and international levels. These guidelines are based on ethical principles and establish an internationally acceptable standard for the review and conduct of medical research. Having attained a multinational consensus about what these fundamental guidelines should be, IRBs are left to interpret the guidelines and devise their own means of implementing them. Individual and community values bear on the interpretation of the guidelines so different IRBs attain different levels of effectiveness. In the Caribbean and Pan American regions there are few IRBs. Obstacles to the establishment and function of IRBs are exacerbated in developing regions like these by differences in language, literacy, and local value systems; education, administrative expertise, facilities, and access to information are also limited. A regional IRB network might facilitate more uniform ethical review in developing countries, and simplify IRB procedures. This revised version was published online in August 2006 with corrections to the Cover Date.     

Evidence-based guidelines for being supportive of people who stutter in North America

PurposeWhile many resources, particularly those available on the Internet, provide suggestions for fluent speakers as they interact with people who stutter (PWS), little evidence exists to support these suggestions. Thus, the purpose of this study was to document the supportiveness of common public reactions, behaviors, or interventions to stuttering by PWS.Methods 148 PWS completed the Personal Appraisal of Support for Stuttering-Adults. Additionally, a comparison of the opinions of adults who stutter based on gender and their involvement in self-help/support groups was undertaken. Results Many of the Internet-based suggestions for interacting with PWS are aligned with the opinions of the participants of this study. Significant differences were found amongst people who stutter on the basis of gender and involvement in self-help groups.Conclusions Lists of “DOs and DON’Ts” that are readily available on the Internet are largely supported by the data in this study; however, the findings highlight the need for changing the emphasis from strict rules for interacting with people who stutter to more flexible principles that keep the needs of individual PWS in mind.     

Balancing Ethical Principles in Emergency Medicine Research

This paper attempts to provide a broader view into the ethical issues surrounding the field of emergency medicine (EM) research. It starts from defining bioethically relevant features of EM and presents this field in the context of different models of health care provider–patient relationship. The paper also provides a short overview of the “post-Nuremberg” evolution of the main international research ethics guidelines relevant to EM research which demonstrates a tendency of liberalization of research on incapable persons. This tendency culminates with the exceptions to informed consent for EM research which is supposed to be balanced by other research ethics principles, especially a careful rationing of risks and benefits. This finally brings us towards a critical analysis of the minimal risk standard which is one of the main fundamental safeguards in EM research. An earlier version of this paper was presented at The 7th International Conference on Bioethics on “The Ethics of Research in Emergency Medicine”, held on June 2, 2006, Warsaw, Poland.     

Spiritual Need Six: Community Building

SUMMARY

Community building includes but is greater than providing fellowship. Community building promotes connection, belonging, and a sense of togetherness. Based upon the needs of older adults, community building is defined as an engagement that is mutually supportive and stimulating. Community building doesn't just happen naturally. There are important guidelines and categorization that assist in effective planning. Community building can happen any time a person is personally engaged with another and thus, with some intentionality, can happen at worship, committee meetings, as well as pot lucks and fun activities.     

Toward Empirically Based Standards for Abuser Intervention

Summary

This article describes the development of operational guidelines for Abuser Intervention Programs in Maryland. Unlike in many states which have adopted quite specific standards regarding program format, duration, etc., the Maryland guidelines address a fairly narrow range of issues. These include outreach to victims, communication with the courts, and the need for intervention programs to address domestic abuse directly in their program content. Maryland has also established a research task force on Abuser Intervention Programs, whose goal is to use empirical data to inform the use of best practices in the state, to facilitate empirical research at abuser intervention programs in Maryland, and to develop more detailed program standards in the future.     

Guidelines with Strategies for Enhancement of Resilience and Psycho-Social Well-Being in Professional Nurses

There are currently no guidelines available for enhancement of resilience in professional nurses. This study aims to provide broad guidelines with specific strategies that may enhance resilience and psycho-social well-being in professional nurses. These guidelines are based findings from previous qualitative research on resilience in professional nurses in the public and private sector in South Africa. We used Kumpfer's (1999) theoretical model of resilience to frame the guidelines. Resilience among professional nurses appears to vary in manifestation across settings of practice.     

Children’s mental health: Time to stop using psychiatric diagnosis

Hegemonic mental health service approaches stress the need for ‘accurate’ diagnosis in order to understand what the correct ‘treatment’ should be. I review the evidence on how far diagnosis in psychiatry has helped advance scientific knowledge and clinical practice and conclude that it hasn’t. I then examine how National Institute for Health and Care Excellence (NICE) guidelines in relation to children’s behaviour problems reflects the lack of progress that results from adopting a diagnostic approach. Taking mental health practice beyond reliance on narrow non-evidence-based diagnostic algorithms can be developed by adopting existing projects such as the Partners for Change Outcome Management Systems project.     

U.S. Complicity and Japan's Wartime Medical Atrocities: Time for a Response

Shortly before and during the Second World War, Japanese doctors and medical researchers conducted large-scale human experiments in occupied China that were at least as gruesome as those conducted by Nazi doctors. Japan never officially acknowledged the occurrence of the experiments, never tried any of the perpetrators, and never provided compensation to the victims or issued an apology. Building on work by Jing-Bao Nie, this article argues that the U.S. government is heavily complicit in this grave injustice, and should respond in an appropriate way in order to reduce this complicity, as well as to avoid complicity in future unethical medical experiments. It also calls on other U.S. institutions, in particular the Presidential Commission for the Study of Bioethical Issues, to urge the government to respond, or to at least inform the public and initiate a debate about this dark page of American and Japanese history.     

Improving the Reporting of Health and Psychological Research

A growing body of empirical evidence has consistently demonstrated that much publically and privately funded research is reported in a way that makes it difficult for the findings to be included in evidence syntheses or used by researchers, clinicians, policy makers, and the public. Poorly reported studies thus represent a significant waste of scarce resources. Reporting guidelines are one strategy that has been increasingly used as a method to improve the completeness or usability of primary and secondary research across a broad range of disciplines including psychology. We present a synopsis of two studies investigating the impact of the Transparent Reporting of Evaluation with Nonrandomised Designs statement and factors that affect authors' and journal editors' use of it and other reporting guidelines. We also make recommendations for future guideline development or revisions based on our experiences, provide details of resources for psychologists, and make suggestions for future research and recommendations for improving the transparency of reporting of psychological research.     

An investigation of the theoretical content of physical activity brochures

New evidence-based physical activity (PA) guidelines and recommendations for constructing messages supplementing the guidelines have been put forth. As well, recent reviews have identified theoretical constructs that hold promise as targets for intervention: self-regulation, outcome expectancies and self-efficacy. The purpose of this study was to examine the integration of messages targeting self-regulation, self-efficacy and outcome expectancies in existing physical activity brochures. Twenty-two PA brochures from Canadian and American National Health Organizations were assessed for their use self-efficacy, self-regulatory processes and outcome expectancies. Brochures were analyzed line-by-line using a modified version of the validated Content Analysis Approach to Theory-Specified Persuasive Educational Communication (CAATSPEC; Abraham, Southby, Quandte, Krahé, & van der Sluijs, 2007). Two independent raters coded a third of the brochures (n = 7). Inter-rater reliability was acceptable for 17 of the 20 categories (rs > .79). Discrepancies in all categories were discussed and agreement was reached. The remaining brochures were coded by one of the two raters. Usage of the three key theoretical constructs accounted for only 36.43% of brochure content (20.23% self-efficacy, 10.40% outcome expectancies, 5.80% self-regulation). Brochures lacked the use of a variety of theoretical strategies, specifically goal-setting, planning and verbal persuasion and rarely highlighted the affective benefits of physical activity. In the future brochures should aim to place increased emphasis on self-regulation, self-efficacy, and affective outcome expectancies.