When research seems like clinical care: a qualitative study of the communication of individual cancer genetic research results

<p>Abstract</p> <p>Background</p> <p>Research ethicists have recently declared a new ethical imperative: that researchers should communicate the results of research to participants. For some analysts, the obligation is restricted to the communication of the general findings or conclusions of the study. However, other analysts extend the obligation to the disclosure of individual research results, especially where these results are perceived to have clinical relevance. Several scholars have advanced cogent critiques of the putative obligation to disclose individual research results. They question whether ethical goals are served by disclosure or violated by non-disclosure, and whether the communication of research results respects ethically salient differences between research practices and clinical care. Empirical data on these questions are limited. Available evidence suggests, on the one hand, growing support for disclosure, and on the other, the potential for significant harm.</p> <p>Methods</p> <p>This paper explores the implications of the disclosure of individual research results for the relationship between research and clinical care through analysis of research-based cancer genetic testing in Ontario, Canada in the late 1990s. We analyze a set of 30 interviews with key informants involved with research-based cancer genetic testing before the publicly funded clinical service became available in 2000.</p> <p>Results</p> <p>We advance three insights: First, the communication of individual research results makes research practices <it>seem </it>like clinical services for our respondents. Second, while valuing the way in which research enables a form of clinical access, our respondents experience these quasi-clinical services as inadequate. Finally, our respondents recognize the ways in which their experience with these quasi-clinical services is influenced by research imperatives, but understand and interpret the significance and appropriateness of these influences in different ways.</p> <p>Conclusion</p> <p>Our findings suggest that the hybrid state created through the disclosure of research results about individuals that are perceived to be clinically relevant may produce neither sufficiently adequate clinical care nor sufficiently ethical research practices. These findings raise questions about the extent to which research can, and <it>should</it>, be made to serve clinical purposes, and suggest the need for further deliberation regarding any ethical obligation to communicate individual research results.</p

Fixed point theorems for cyclic self-maps involving weaker Meir-Keelerfunctions in complete metric spaces and applications

We obtain fixed point theorems for cyclic self-maps on complete metric spaces involving Meir-Keeler and weaker Meir-Keeler functions, respectively. In this way, we extend several well-known fixed point theorems and, in particular, improve some very recent results on weaker Meir-Keeler functions. Fixed point results for well-posed property and for limit shadowing property are also deduced. Finally, an application to the study of existence and uniqueness of solutions for a class of nonlinear integral equations is presented.The second author thanks for the support of the Ministry of Economy and Competitiveness of Spain under grant MTM2012-37894-C02-01, and the Universitat Politecnica de Valencia, grant PAID-06-12-SP20120471.Nashine, HK.; Romaguera Bonilla, S. (2013). Fixed point theorems for cyclic self-maps involving weaker Meir-Keelerfunctions in complete metric spaces and applications. Fixed Point Theory and Applications. 2013(224):1-15. https://doi.org/10.1186/1687-1812-2013-224S1152013224Kirk WA, Srinavasan PS, Veeramani P: Fixed points for mapping satisfying cyclical contractive conditions. Fixed Point Theory 2003, 4: 79–89.Banach S: Sur les operations dans les ensembles abstraits et leur application aux equations integerales. Fundam. Math. 1922, 3: 133–181.Boyd DW, Wong SW: On nonlinear contractions. Proc. Am. Math. Soc. 1969, 20: 458–464. 10.1090/S0002-9939-1969-0239559-9Caristi J: Fixed point theorems for mappings satisfying inwardness conditions. Trans. Am. Math. Soc. 1976, 215: 241–251.Di Bari C, Suzuki T, Vetro C: Best proximity points for cyclic Meir-Keeler contractions. Nonlinear Anal. 2008, 69: 3790–3794. 10.1016/j.na.2007.10.014Karapinar E: Fixed point theory for cyclic weaker ϕ -contraction. Appl. Math. Lett. 2011, 24: 822–825. 10.1016/j.aml.2010.12.016Karapinar E, Sadarangani K: Corrigendum to “Fixed point theory for cyclic weaker ϕ -contraction” [Appl. Math. Lett. Vol. 24(6), 822–825.]. Appl. Math. Lett. 2012, 25: 1582–1584. 10.1016/j.aml.2011.11.001Karapinar E, Sadarangani K:Fixed point theory for cyclic ( ϕ − φ ) -contractions. Fixed Point Theory Appl. 2011., 2011: Article ID 69Nahsine HK: Cyclic generalized ψ -weakly contractive mappings and fixed point results with applications to integral equations. Nonlinear Anal. 2012, 75: 6160–6169. 10.1016/j.na.2012.06.021Păcurar M: Fixed point theory for cyclic Berinde operators. Fixed Point Theory 2011, 12: 419–428.Păcurar M, Rus IA: Fixed point theory for cyclic φ -contractions. Nonlinear Anal. 2010, 72: 2683–2693.Piatek B: On cyclic Meir-Keeler contractions in metric spaces. Nonlinear Anal. 2011, 74: 35–40. 10.1016/j.na.2010.08.010Rus IA: Cyclic representations and fixed points. Ann. “Tiberiu Popoviciu” Sem. Funct. Equ. Approx. Convexity 2005, 3: 171–178.Chen CM: Fixed point theory for the cyclic weaker Meir-Keeler function in complete metric spaces. Fixed Point Theory Appl. 2012., 2012: Article ID 17Chen CM: Fixed point theorems for cyclic Meir-Keeler type mappings in complete metric spaces. Fixed Point Theory Appl. 2012., 2012: Article ID 41Meir A, Keeler E: A theorem on contraction mappings. J. Math. Anal. Appl. 1969, 28: 326–329. 10.1016/0022-247X(69)90031-6Matkowski J: Integrable solutions of functional equations. Diss. Math. 1975, 127: 1–68.Karapinar E, Romaguera S, Tas K: Fixed points for cyclic orbital generalized contractions on complete metric spaces. Cent. Eur. J. Math. 2013, 11: 552–560. 10.2478/s11533-012-0145-0De Blasi FS, Myjak J: Sur la porosité des contractions sans point fixed. C. R. Math. Acad. Sci. Paris 1989, 308: 51–54.Lahiri BK, Das P: Well-posedness and porosity of certain classes of operators. Demonstr. Math. 2005, 38: 170–176.Popa V: Well-posedness of fixed point problems in orbitally complete metric spaces. Stud. Cercet. ştiinţ. - Univ. Bacău, Ser. Mat. 2006, 16: 209–214. Supplement. Proceedings of ICMI 45, Bacau, Sept. 18–20 (2006)Popa VV: Well-posedness of fixed point problems in compact metric spaces. Bul. Univ. Petrol-Gaze, Ploiesti, Sec. Mat. Inform. Fiz. 2008, 60: 1–4

Guidance to 2018 good practice : ARIA digitally-enabled, integrated, person-centred care for rhinitis and asthma

AimsMobile Airways Sentinel NetworK (MASK) belongs to the Fondation Partenariale MACVIA-LR of Montpellier, France and aims to provide an active and healthy life to rhinitis sufferers and to those with asthma multimorbidity across the life cycle, whatever their gender or socio-economic status, in order to reduce health and social inequities incurred by the disease and to improve the digital transformation of health and care. The ultimate goal is to change the management strategy in chronic diseases.MethodsMASK implements ICT technologies for individualized and predictive medicine to develop novel care pathways by a multi-disciplinary group centred around the patients.StakeholdersInclude patients, health care professionals (pharmacists and physicians), authorities, patient's associations, private and public sectors.ResultsMASK is deployed in 23 countries and 17 languages. 26,000 users have registered.EU grants (2018)MASK is participating in EU projects (POLLAR: impact of air POLLution in Asthma and Rhinitis, EIT Health, DigitalHealthEurope, Euriphi and Vigour).Lessons learnt(i) Adherence to treatment is the major problem of allergic disease, (ii) Self-management strategies should be considerably expanded (behavioural), (iii) Change management is essential in allergic diseases, (iv) Education strategies should be reconsidered using a patient-centred approach and (v) Lessons learnt for allergic diseases can be expanded to chronic diseases.Peer reviewe

Allergic Rhinitis and its Impact on Asthma (ARIA) Phase 4 (2018): Change management in allergic rhinitis and asthma multimorbidity using mobile technology

Allergic Rhinitis and its Impact on Asthma (ARIA) has evolved from a guideline by using the best approach to integrated care pathways using mobile technology in patients with allergic rhinitis (AR) and asthma multimorbidity. The proposed next phase of ARIA is change management, with the aim of providing an active and healthy life to patients with rhinitis and to those with asthma multimorbidity across the lifecycle irrespective of their sex or socioeconomic status to reduce health and social inequities incurred by the disease. ARIA has followed the 8-step model of Kotter to assess and implement the effect of rhinitis on asthma multimorbidity and to propose multimorbid guidelines. A second change management strategy is proposed by ARIA Phase 4 to increase self-medication and shared decision making in rhinitis and asthma multimorbidity. An innovation of ARIA has been the development and validation of information technology evidence-based tools (Mobile Airways Sentinel Network [MASK]) that can inform patient decisions on the basis of a self-care plan proposed by the health care professional

Semifixed sets of maps in hyperspaces with application to set differential equations

For maps phi on hyperspaces the existence of semifixed sets, i.e., of sets A satisfying one of the relations A subset of phi(A), A superset of phi(A), A boolean AND phi(A) not equal empty set, is considered. An application to set differential equations is also presented

Banach-saks-mazur and Kakutani-Ky Fan theorems in spaces of multifunctions and applications to set differential inclusions

Some multivalued versions of the theorems of Banach-Saks-Mazur and Kakutani-Ky Fan are proved. These results are used in existence problems for set differential inclusions