Ethical issues in implementation research: a discussion of the problems in achieving informed consent

Background: Improved quality of care is a policy objective of health care systems around the world. Implementation research is the scientific study of methods to promote the systematic uptake of clinical research findings into routine clinical practice, and hence to reduce inappropriate care. It includes the study of influences on healthcare professionals' behaviour and methods to enable them to use research findings more effectively. Cluster randomized trials represent the optimal design for evaluating the effectiveness of implementation strategies. Various codes of medical ethics, such as the Nuremberg Code and the Declaration of Helsinki inform medical research, but their relevance to cluster randomised trials in implementation research is unclear. This paper discusses the applicability of various ethical codes to obtaining consent in cluster trials in implementation research. Discussion: The appropriate application of biomedical codes to implementation research is not obvious. Discussion of the nature and practice of informed consent in implementation research cluster trials must consider the levels at which consent can be sought, and for what purpose it can be sought. The level at which an intervention is delivered can render the idea of patient level consent meaningless. Careful consideration of the ownership of information, and rights of access to and exploitation of data is required. For health care professionals and organizations, there is a balance between clinical freedom and responsibility to participate in research. Summary: While ethical justification for clinical trials relies heavily on individual consent, for implementation research aspects of distributive justice, economics, and political philosophy underlie the debate. Societies may need to trade off decisions on the choice between individualized consent and valid implementation research. We suggest that social sciences codes could usefully inform the consideration of implementation research by members of Research Ethics Committees

Software process reflexivity and business performance: initial results from an empirical study

Commercial software development organisations routinely operate in dynamic environments, with various situational factors that affect the software development approach undergoing recurring change. We therefore suggest that process reflexivity - the ability to reflect upon the suitability of a software process for a given context and to adapt the process according to changing situational circumstances – is an important capability for software development organizations.. In support of this position we conducted an exploratory industrial study of software development in practice. An initial analysis of our data suggests that software process reflexivity may exercise a strong influence over business success. Further work is required to fully examine our data, however, initial findings indicate that software process reflexivity is worthy of greater attentio

Academic Functioning and Mental Health in Adolescence

The current study examines patterns of academic functioning and mental health in 184 middle school children and the relation of such patterns to their prior and subsequent functioning. Data were collected from children during their second, third, fourth, eighth, and ninth grade school years. Cluster analyses were used to delineate patterns of academic functioning and mental health during eighth grade. The authors examined the relation of these patterns to academic functioning and mental health 1 year later the transition to high school, and then examined the long-term developmental roots of the eighth grade patterns using data collected during elementary school years. Results indicated variegated patterns of academic and emotional functioning at eighth grade and stability in these patterns across the high school transition. Some long-term continuity was found among children showing uniformly positive or negative functioning at eighth grade. Studying child functioning across multiple domains and time periods is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68127/2/10.1177_0743558499142002.pd

Improving the delivery of care for patients with diabetes through understanding optimised team work and organisation in primary care

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Efficacy of Online Training for Improving Camp Staff Competency

Preparing competent staff is a critical issue within the camp community. This quasi-experimental study examined the effectiveness of an online course for improving staff competency in camp healthcare practices among college-aged camp staff and a comparison group (N = 55). We hypothesized that working in camp would increase competency test scores due to opportunities for staff to experientially apply knowledge learned online. Hierarchical linear modeling was used to analyse the cross-level effects of a between-individuals factor (assignment to experimental or comparison group) and within-individual effects of time (pre-test, post-test #1, and post-test #2) on online course test scores. At post-test #2, the difference in average test scores between groups was ~30 points, with the treatment group scoring lower on average than the comparison group. Factors that may have influenced these findings are explored, including fatigue and the limited durability of online learning. Recommendations for research and practice are discussed

Exploring young people's and youth workers' experiences of spaces for ‘youth development’: creating cultures of participation

The paper focuses on the emergence of ‘positive youth development’ and its impact on older, more established practices of working with young people, such as youth work. Drawing on ethnographic fieldwork in England between 2004 and 2006, in particular young people's and youth workers' accounts of participating in youth work, the analysis engages with the social spaces in which youth work takes place and asks key questions about why young people might participate in youth spaces, what they get out of participating and how such spaces can promote cultures of participation. The analysis shows that such spaces provide young people and their communities with biographical continuity and time becomes a key component for sustaining such spaces. The argument is made for a more nuanced understanding of what young people get out of their participation in youth spaces, and for an epistemological approach to youth praxis that embraces the messiness and inequalities of lived experience

Science lives: School choices and ‘natural tendencies’

An analysis of 12 semi-structured interviews with university-based scientists and non-scientists illustrates their life journeys towards, or away from, science and the strengths and impact of life occurrences leading them to choose science or non-science professions. We have adopted narrative approaches and used Mezirow's transformative learning theory framework. The areas of discussion from the result have stressed on three main categories that include ‘smooth transition’, ‘incremental wavering transition' and ‘transformative transition’. The article concludes by discussing the key influences that shaped initial attitudes and direction in these people through natural inclination, environmental inspirations and perceptions of science

Conflito trabalho-família, auto eficácia parental e estilos parentais percebidos em pais e mães da cidade de Talca no Chile

The relationship between levels of work-family conflict, parental self-efficacy and perceived parenting styles in a group of 43 school children and both working parents is analyzed, controlling for socio-demographic variables. Also, gender differences are identified in the variables and the relationship between them in relation to the number of children. Three instruments were applied to the sample for measuring the referred variables. A significant and negative relationship is observed between levels of work-family conflict and parental self-efficacy (r = -0.484, P <0.001). The authoritarian parenting style has greater association with self-efficacy (r = 0.301, P = 0.005). A significant and negative relationship between self-efficacy and number of children (r = -0.257, P = 0.017) is reported. Finally, it is concluded that women have greater work-family conflict than men.Se analiza la relación existente entre los niveles de conflicto trabajo-familia, autoeficacia parental y estilos parentales percibidos en un grupo de 43 niños estudiantes y ambos padres trabajadores, controlando las variables sociodemográficas. Así mismo, se identifican las diferencias por género en las variables, y la relación que existe entre ellas con respecto al número de hijos. A la muestra le fueron aplicados tres instrumentos de medición de las variables referidas. Se observa una relación significativa y negativa entre los niveles de conflicto trabajo-familia y la autoeficacia parental (r= -0,484; p<0,001). El estilo parental autoritario presenta mayor asociación con autoeficacia (r=0,301; p=0,005). Se reporta una relación significativa y negativa entre autoeficacia y número de hijos (r=-0,257; p=0,017). Finalmente se reporta que las mujeres presentan mayor conflicto trabajo-familia que los hombres.Analisa-se a relação existente entre os níveis de conflito trabalho-família, auto eficácia parental e estilos parentais percebidos em um grupo de 43 crianças estudantes de pais trabalhadores, controlando as variáveis sociodemográficas. Assim mesmo, identificam-se as diferenças por gênero nas variáveis, e a relação que existe entre elas com respeito ao número de filhos. Foram aplicados à mostra três instrumentos de medição das variáveis referidas. Observa-se uma relação significativa e negativa entre os níveis de conflito trabalho-família e a auto eficácia parental (r= -0,484; p<0,001). O estilo parental autoritário apresenta maior associação com autoeficácia (r=0,301; p=0,005). Reporta-se uma relação significativa e negativa entre autoeficácia e número de filhos (r=-0,257; p=0,017). Finalmente reporta-se que as mulheres apresentam maior conflito trabalho-família que os homens

Threats and Supports to Female Students’ Math Beliefs and Achievement

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149563/1/jora12384_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149563/2/jora12384.pd