Cluster randomized trial assessing the effects of rapid ethical assessment on informed consent comprehension in a low-resource setting

Background Maximizing comprehension is a major challenge for informed consent processes in low-literacy and resource-limited settings. Application of rapid qualitative assessments to improve the informed consent process is increasingly considered useful. This study assessed the effects of Rapid Ethical Assessment (REA) on comprehension, retention and quality of the informed consent process. Methods A cluster randomized trial was conducted among participants of HPV sero-prevalence study in two districts of Northern Ethiopia, in 2013. A total of 300 study participants, 150 in the intervention and 150 in the control group, were included in the study. For the intervention group, the informed consent process was designed with further revisions based on REA findings. Informed consent comprehension levels and quality of the consent process were measured using the Modular Informed Consent Comprehension Assessment (MICCA) and Quality of Informed Consent (QuIC) process assessment tools, respectively. Result Study recruitment rates were 88.7 % and 80.7 % (p = 0.05), while study retention rates were 85.7 % and 70.3 % (p < 0.005) for the intervention and control groups respectively. Overall, the mean informed consent comprehension scores for the intervention and control groups were 73.1 % and 45.2 %, respectively, with a mean difference in comprehension score of 27.9 % (95 % CI 24.0 % - 33.4 %; p < 0.001,). Mean scores for quality of informed consent for the intervention and control groups were 89.1 % and 78.5 %, respectively, with a mean difference of 10.5 % (95 % CI 6.8 -14.2 %; p < 0.001). Conclusion Levels of informed consent comprehension, quality of the consent process, study recruitment and retention rates were significantly improved in the intervention group. We recommend REA as a potential modality to improve informed consent comprehension and quality of informed consent process in low resource settings

Daylight optimization for green office building: a study of west facing window design and configuration

Window placement and shading device configuration plays an important role when designing with daylight. In the tropical context, windows-especially on the west façade, can create unwanted illumination and induce glare. Excessive interior lighting can cause discomfort and stress amongst the users while poorly lit areas can have physical and mental consequences. Thus, the openings are to be configured as such that the interior can be naturally-lit while providing the optimum lighting for the required activities. In order to design a naturally-lit green office building, an experiment was conducted to determine the best opening configuration of a north-west facing building. For this purpose, a study model was constructed with adjustable slot-in louvres on the western side. A lux meter was used to measure the illuminance of the interior for different configurations of windows which varied according to the spacing, position, material and number of louvres. The daylight factor was calculated and the findings were found to be consistent with other literature on this topic. The results were established for several configurations which could be incorporated into design according to the design requirements. Finally, the findings were adapted and adjusted with respect to the building context and surroundings in designing the shading device for a green office building