Informed consent comprehension in African research settings

ObjectivePrevious reviews on participants' comprehension of informed consent information have focused on developed countries. Experience has shown that ethical standards developed on Western values may not be appropriate for African settings where research concepts are unfamiliar. We undertook this review to describe how informed consent comprehension is defined and measured in African research settings.MethodsWe conducted a comprehensive search involving five electronic databases: Medline, Embase, Global Health, EthxWeb and Bioethics Literature Database (BELIT). We also examined African Index Medicus and Google Scholar for relevant publications on informed consent comprehension in clinical studies conducted in sub-Saharan Africa. 29 studies satisfied the inclusion criteria; meta-analysis was possible in 21 studies. We further conducted a direct comparison of participants' comprehension on domains of informed consent in all eligible studies.ResultsComprehension of key concepts of informed consent varies considerably from country to country and depends on the nature and complexity of the study. Meta-analysis showed that 47% of a total of 1633 participants across four studies demonstrated comprehension about randomisation (95% CI 13.9–80.9%). Similarly, 48% of 3946 participants in six studies had understanding about placebo (95% CI 19.0–77.5%), while only 30% of 753 participants in five studies understood the concept of therapeutic misconception (95% CI 4.6–66.7%). Measurement tools for informed consent comprehension were developed with little or no validation. Assessment of comprehension was carried out at variable times after disclosure of study information. No uniform definition of informed consent comprehension exists to form the basis for development of an appropriate tool to measure comprehension in African participants.ConclusionsComprehension of key concepts of informed consent is poor among study participants across Africa. There is a vital need to develop a uniform definition for informed consent comprehension in low literacy research settings in Africa. This will be an essential step towards developing appropriate tools that can adequately measure informed consent comprehension. This may consequently suggest adequate measures to improve the informed consent procedure.ObjectifLes normes éthiques élaborées selon les valeurs occidentales ne sont peut-être pas appropriées au contexte africain où les concepts de recherche ne sont pas familiers. Cette revue décrit comment la compréhension du consentement éclairé est définie et mesurée dans les cadres de recherche africains.MéthodesDes recherches ont été effectuées sur Medline, Embase, Global Health, EthxWeb, base de données de la Bioéthique Littérature, Index Medicus African et Google Scholar pour des publications pertinentes sur la compréhension du consentement éclairé dans les études cliniques menées en Afrique sub-saharienne. 29 études répondaient aux critères d'inclusion; une méta-analyse a été possible pour 21 études. La compréhension des participants sur les domaines du consentement éclairé dans toutes les études admissibles a été comparée directement.RésultatsLa compréhension des concepts clés du consentement éclairé varie considérablement selon les pays et dépend de la nature et de la complexité de l’étude. La méta-analyse a montré que 47% des participants ont compris la randomisation (IC95%: 13,9 - 80,9%), 48% ont compris le placebo (IC95%: 19,0 - 77,5%), 30% ont compris le concept de méprise thérapeutique (IC95%: 4,6 - 66,7%). Les outils de mesure de la compréhension du consentement éclairé étaient développés avec peu ou pas de validation.ConclusionsLa compréhension des concepts clés du consentement éclairé est faible en Afrique. Il y a une nécessité vitale d’élaborer une définition uniforme pour la compréhension du consentement éclairé dans les cadres de recherche avec un faible niveau d'alphabétisation en Afrique.ObjetivoLos estándares éticos desarrollados basándose en valores occidentales podrían no ser apropiados para emplazamientos Africanos en donde los conceptos de investigación no son familiares. En esta revisión se describe como la comprensión del consentimiento informado se define y mide en un centro de investigación Africano.MétodosSe buscaron publicaciones relevantes sobre la comprensión del consentimiento informado en estudios clínicos en África subsahariana en Medline, Embase, Global Health, EthxWeb, Bioethics Literature Database, African Index Medicus y Google Scholar. 29 estudios satisfacían los criterios de inclusión y el metaanálisis era posible para 21. La comprensión del consentimiento informado por parte de los participantes se comparó directamente en todos los estudios elegibles.ResultadosLa comprensión de conceptos claves del consentimiento informado varió de forma considerable entre países, y dependía de la naturaleza y de la complejidad del estudio. El meta-análisis mostró que un 47% entendía la aleatorización (IC 95% 13.9-80.9%); un 48% entendía el placebo (IC 95% 19.0-77.5%); y un 30% entendió el concepto terapéutico errado (IC 95% 4.6-66.7%). Las herramientas para medir la comprensión del consentimiento informado se desarrollaron con poca o ninguna validación.ConclusionesEn África, la comprensión de conceptos claves del consentimiento informado es pobre. Existe una necesidad vital de desarrollar una definición uniforme para la comprensión del consentimiento informado en lugares con bajos niveles de alfabetización en África

A Study on Foreign Direct Investment on Special Reference towards FDI Developed Countries

Foreign direct investment (FDI) has been one of the defining characteristics of the world economy during the last two decades. Some developing economies have emerged as major recipients of FDI flows in recent years, while many others have attempted to attract such flows, often by offering fiscal and financial value to foreign investors. This work reviews and discusses recent empirical studies on key development issues related to FDI. The literature review focuses on five main areas of interest to host economies: the FDI-growth nexus; FDI-trade linkages; FDI and technology transfer; FDI, privatization and corporate governance; and host- government policies for attracting FDI. Three of the conclusions reached in this study deserve special attention. First, a vast majority of existing empirical studies indicate that FDI does make an appositive contribution to both income growth and factor productivity in host economies. FDI tends to “crowd in” domestic investment, as the creation of complementary activities outweighs the displacement of domestic competitors. Similarly, in the North-South context, the relationship between FDI and trade is more one of complementarily than of substitution, owing to backward and forward linkages. Second, host countries will not be able to capture the full benefits associated with FDI until they reach a certain threshold level regarding educational attainment, provision of infrastructure services, local technological capabilities and the development of local financial markets. Third, their role of FDI in development goes beyond the traditional areas of growth, trade and technology transfer to cover emerging areas of policy concern, such as mergers and acquisitions, privatization, corporate governance and “policy competition.” The study concludes by stressing that host-government policies should attach greater importance to the stability and redictability of the local business environment in which MNE affiliates operate

The Natural Progression of Gambiense Sleeping Sickness: What Is the Evidence?

Gambiense human African trypanosomiasis (HAT, sleeping sickness) is widely assumed to be 100% pathogenic and fatal. However, reports to the contrary exist, and human trypano-tolerance has been postulated. Furthermore, there is uncertainty about the actual duration of both stage 1 and stage 2 infection, particularly with respect to how long a patient remains infectious. Understanding such basic parameters of HAT infection is essential for optimising control strategies based on case detection. We considered the potential existence and relevance of human trypano-tolerance, and explored the duration of infectiousness, through a review of published evidence on the natural progression of gambiense HAT in the absence of treatment, and biological considerations. Published reports indicate that most gambiense HAT cases are fatal if untreated. Self-resolving and asymptomatic chronic infections probably constitute a minority if they do indeed exist. Chronic carriage, however, deserves further study, as it could seed renewed epidemics after control programmes cease

2-(1,2,3,4-Tetra­hydro-9H-carbazol-1-yl­idene)propane­dinitrile

In the title compound, C15H11N3, the cyclo­hexene ring adopts a sofa conformation. An intra­molecular N—H⋯N hydrogen bond generates an S(7) ring motif. In the crystal, mol­ecules are linked by inter­molecular N—H⋯N, C—H⋯N and C—H⋯π inter­actions into a three-dimensional network

Heat Transfer Analysis of Flat Plate Subjected to Multi-Jet Air Impingement using Principal Component Analysis and Computational Technique

The aim of this work is to investigate experimentally the variation in temperature, heat transfer coefficient and Nusselt number of a hot plate subjected to multi-jet air impingement cooling to use the multi-objective optimization technique to arrive at optimum conditions. A flat plate of 15 cm x 10 cm is heated through a heating foil with a constant heat flux of 7667 W/m2. Air jets with and without swirling action are considered, fixing the distance of target surface from nozzle exit at 2D, 4D and 6D. Reynolds numbers 18000, 20000and 22000 and pipe diameters 8mm, 10mm and 12 mm have been considered for investigation. Experiments are designed and analyzed using Taguchi’s technique, coupled with principal component analysis for multi-variate optimization by calculating multi-response performance index (MRPI). Based on the observations made, it is concluded that lower H/D ratio and higher Reynolds number result in higher heat transfer coefficient, in accordance with the first principles. Heat transfer coefficient obtained for jets with swirl is compared with that of jet without swirling for the same Reynolds number and H/D ratio. Furthermore, it is concluded that introducing swirl results in increase of heat transfer coefficients for all the test conditions for 10mm and 12mm diameter jets. However for 8mm jet, introduction of swirl reduced the heat transfer rate for all the test conditions. From Analysis of Variance (ANOVA), it is found that significant contributions on outputs are due to the effect of H/D ratio and Reynolds number. Confirmation experiments with optimum condition result in improved heat transfer coefficient and Nusselt number. Numerical simulation has also been performed with the optimum condition. It is observed that the simulation results are in consistence with the experimental results

4-Amino­pyridinium picrate

In the title compound, C5H7N2 +·C6H2N3O7 −, the 4-amino­pyridinium cation is essentially planar (r.m.s. deviation = 0.002 Å). The three nitro groups in the picrate anion are twisted away from the attached benzene ring [dihedral angles = 24.1 (1), 9.3 (3) and 21.4 (1)°]. In the crystal structure, the ions are linked into a three-dimensional network by N—H⋯O and C—H⋯O hydrogen bonds

4-tert-Butyl­pyridinium picrate

In the title compound, C9H14N+·C6H2N3O7 −, the three nitro groups of the picrate anion are twisted out of the plane of the attached benzene ring; the dihedral angles are 32.8 (2), 10.5 (4) and 12.3 (4)°. The pyridinium cations and picrate anions are linked via bifurcated N—H⋯(O,O) hydrogen bonds. The ionic pairs are linked into a ribbon-like structure along [101] by C—H⋯O hydrogen bonds

Low Temperature Measurements by Infrared Spectroscopy in CoFe2_2O4_4 Ceramic

In this paper results of new far-infrared and middle-infrared measurements (wavenumber range of 4000cm-1 - 100cm-1) in the range of the temperature from 300K to 8K of the CoFe2O4 ceramic are presented. The bands positions and their shapes are the same in the wide temperature range. The quality of the sample was investigated by X-ray, EDS and EPMA studies. The CoFe2O4 reveals the cubic structure (Fd-3m) in the temperature range from 85K to 360 K without any traces of distortion. On the current level of knowledge the polycrystalline CoFe2O4 does not exhibit phase transition in the temperature range from 8 K to 300 K.Comment: 10 pages, 6 figure