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

The Presence of Conspecific Decoys Enhances the Attractiveness of an NaCl Resource to the Yellow-Spined Locust, Ceracris kiangsu

Adults of the yellow-spined bamboo locust, Ceracris kiangsu Tsai (Orthoptera: Oedipodidae), aggregate and gnaw at human urine-contaminated materials, a phenomenon termed puddling. Several urine-borne chemicals, including NaCl, are known to stimulate adult C. kiangsu to consume filter paper. Because in nature C. kiangsu adults may use cues to locate puddling resources, we tested the influence of conspecific decoys (dried C. kiangsu) on foraging and consumption of 3% NaCl—treated filter paper. In a two—choice test experiment in the laboratory, female adults showed no preference for filter papers (not treated with NaCL) with or without decoys. In contrast, C. kiangsu females consumed significantly more NaCl—treated filter paper on which conspecific decoys were attached than those without decoys in both the laboratory and in a bamboo forest. When the bait was changed to 3% NaCl plus the insecticide bisultap, significantly more C. kiangsu were killed in the bamboo forest when decoys were present, however the results were not significant when the experiment was done in the laboratory. Hence, moving towards conspecifics seems to facilitate NaCl resource foraging in C. kiangsu, suggesting that the presence of conspecifics promotes feeding on puddling resources

Raising the participation age in historical perspective : Policy learning from the past?

The raising of the participation age (RPA) to 17 in 2013 and 18 in 2015 marks a historic expansion of compulsory education. Despite the tendency of New Labour governments to eschew historical understanding and explanation, RPA was conceived with the benefit of an analysis of previous attempts to extend compulsion in schooling. This paper assesses the value of a historical understanding of education policy. The period from inception to the projected implementation of RPA is an extended one which has crossed over the change of government, from Labour to Coalition, in 2010. The shifting emphases and meanings of RPA are not simply technical issues but connect to profound historical and social changes. An analysis of the history of the raising of the school leaving age reveals many points of comparison with the contemporary situation. In a number of key areas it is possible to gain insights into the ways in which the study of the past can help to comprehend the present: the role of human capital, the structures of education, in curriculum development and in terms of preparations for change

Education and inequality in Finland, Spain and Brazil

Production of INCASI Project H2020-MSCA-RISE-2015 GA 691004Finland, Spain and Brazil are three very internally complex and heterogeneous realities, with contradictions and permanent reforms to their education systems. In a first quantitative approach each country can be placed in a continuum of the education system that goes from most successful in terms of reaching a high level of education all across the population, in conditions of equity and facilitating youths' incorporation into the labour market, to least successful, with Finland and Brazil occupying either end of the spectrum respectively and Spain occupying an intermediate situation. Although there are differences, they share certain tensions in their respective education systems. On the one hand, about the conception of education, ranging from more utilitarian, human capital theories, to the more humanist and civic-minded perspective. On the other hand, the challenge of comprehensiveness between an academic and a vocational path. In addition, there is also the challenge of improving the education level of the population while also improving equality. The tensions differ from country to country, since their education traditions and cooperation and conflict strategies between the education agents, with varying levels of resources and different alliances with political actors vary, as does the social consensus

A ‘home-international’ comparative analysis of widening participation in UK higher education

Since devolution of education policy to the four ‘home’ nations of the UK, distinct approaches to addressing social inequalities in higher education participation have developed across the four jurisdictions (England, Wales, Scotland and Northern Ireland). From a critical examination of 12 policy documents, this paper presents a comparative policy analysis of the qualitatively distinct ways that inequalities in higher education are conceptualised across the ‘home’ nations. Basil Bernstein’s theoretical ideas are drawn on to help unearth distinctions in their beliefs about the underlying nature of educational inequalities. These can be understood in relation to their degree of closeness to either neoliberal or social democratic ideological positions, and we show that the ‘home’ nations of the UK place differing emphases on what form of higher education they aim to widen access to, and how they intend to achieve thi