Insights into the perception that research ethics committees are a barrier to research with seriously ill children: A study of committee minutes and correspondence with researchers studying seriously ill children

BACKGROUND: Research ethics committees are commonly perceived as a 'barrier' to research involving seriously ill children. Researchers studying seriously ill children often feel that committees view their applications more harshly compared to applications for research with other populations. Whether or not this is the case in practice is unknown. AIM: The aim of this study was to explore committees' concerns, expectations and decisions for research applications involving seriously ill children submitted for review in the United Kingdom. DESIGN: Content analysis of committee meeting minutes, decision letters and researcher response letters. SETTING/PARTICIPANTS: Chief investigators for National Institute of Health Research portfolio studies involving seriously ill children were contacted for permission to review their study documents. RESULTS: Of the 77 applications included in this study, 57 received requests for revisions at first review. Committee expectations and concerns commonly related to participant information sheets, methodology, consent, recruitment or formatting. Changes were made to 53 of these studies, all of which were subsequently approved. CONCLUSION: Our findings suggest that committees review applications for research involving seriously ill children with the same scrutiny as applications for research with other populations. Yet, the perception that committees act as a barrier to this type of research persists. We suggest that this perception remains due to other factors including, but not limited to, the high levels of formatting or administrative revisions requested by committees or additional study requirements needed for research involving children, such as multiple versions of consent forms or participant information sheets

Attitude and Graduation: Appraisal Resources in a Decision of the African Court on Human and Peoples’ Rights

Court Judgments are classified within the legal genre of case-law, which is intended to be objective and impartial. However, despite efforts to conceal speakers’ presence and subjectivity in this context, stance must be taken in pronouncing judgment. This study seeks to understand how linguistic attitude and graduation resources are expressed in legal texts and to examine the mechanisms used for this purpose. The text chosen for analysis is a 2017 judgment of the African Court on Human and Peoples’ Rights (ACHPR) titled: the “African Commission on Human and Peoples’ Rights V. Republic of Kenya”. The applicant, in respect of the Ogiek community of the Greater Mau Forest in the Republic of Kenya, submits to the ACHPR, denouncing violation of Articles 1, 2, 4, and 17 (2) and (3) of the African Charter on Human and Peoples’ Rights by the Republic of Kenya. In order to determine the semantic nature of the linguistic elements set up in this judgement, the Attitude and Graduation systems of the Appraisal theory (Martin and White 2005) in Systemic Functional Linguistics, as well as some conceptual instruments of Raccah’s (2005) Semantic Structure of Points of View (SSPV) are applied to the selected corpus. Keywords: Attitude system, Graduation system, Appraisal framework, points of view, ACHPR, Court judgement DOI: 10.7176/JLLL/77-04 Publication date:March 31st 202

A COMPARISON OF MOOD STRUCTURES IN TWO TV TALK SHOWS WITH GUESTS OF DIFFERENT SOCIAL STATUS

Language cannot be separated from the social context and culture. In everyday communication, people act and react differently depending on interactants, topics involved, and means of communication. This study, therefore, analyses two Talk Shows with guests of different power status- Ellen with Vice President Joe Biden and Ellen with Special Education teacher Jenna Albi. The analysis is carried out using Halliday’s Mood analysis framework, as revised by Matthiessen (2014) and Eggin (2004). The present study compares Ellen’s use of Mood structures and their functions in the interaction with different social beings. It reveals that in the talk with the Vice President, Ellen uses questions most (28.37%), followed by statements (20%)  while in the talk with the Special Education teacher, Ellen prioritizes statements (43%) over questions (14%). On the other hand, she does not enjoy any Commands (0%) in the talk with the Vice President but does so with the teacher (18%). It turns out that, unlike in Fairclough’s (2001) finding, participants with high power status tend to answer questions rather than asking questions

Interactions of mitochondrial and skeletal muscle biology in mitochondrial myopathy

\ua9 2023 The Author(s). Mitochondrial dysfunction in skeletal muscle fibres occurs with both healthy aging and a range of neuromuscular diseases. The impact of mitochondrial dysfunction in skeletal muscle and the way muscle fibres adapt to this dysfunction is important to understand disease mechanisms and to develop therapeutic interventions. Furthermore, interactions between mitochondrial dysfunction and skeletal muscle biology, in mitochondrial myopathy, likely have important implications for normal muscle function and physiology. In this review, we will try to give an overview of what is known to date about these interactions including metabolic remodelling, mitochondrial morphology, mitochondrial turnover, cellular processes and muscle cell structure and function. Each of these topics is at a different stage of understanding, with some being well researched and understood, and others in their infancy. Furthermore, some of what we know comes from disease models. Whilst some findings are confirmed in humans, where this is not yet the case, we must be cautious in interpreting findings in the context of human muscle and disease. Here, our goal is to discuss what is known, highlight what is unknown and give a perspective on the future direction of research in this area

Patient safety and interactive medical devices: Realigning work as imagined and work as done

Medical devices are essential tools for modern healthcare delivery. However, significant issues can arise if medical devices are designed for ‘work as imagined’ when this is misaligned with ‘work as done’. This problem can be compounded as the details of device design, in terms of usability and the way a device supports or changes working practices, often receives limited attention. The ways devices are designed and used affect patient safety and quality of care: inappropriate design can provoke user error, create system vulnerabilities and divert attention from other aspects of patient care. Current regulation involves a series of pre-market checks relating to device usability, but this assumes that devices are always used under the conditions and for the purposes intended (i.e. work as imagined); there are many reasons for devices being used in ways other than those assumed at development time. Greater attention needs to be paid to learning points in actual use and user experience (i.e. work as done). This needs to inform manufacturers’ designs, management procurement decisions and local decisions about how devices are used in practice to achieve co-adaptation; without these, we foster risks and inefficiencies in healthcare

Local policies for reducing the ecological impact of households: the case study of a suburban area in France

Abstract Since Rio, governments have increased measures to promote sustainable household consumption, but this has induced limited changes in consumers' daily practices. This article argues that one of the reasons behind the poor efficiency of these policies is the low level of consideration granted to local decision-making. The article discusses the results of a study which aims at better ascertaining the practices and representations of local government leaders in promoting sustainable development in households. We shall analyse the motivations, obstacles, interaction of players, communication and action plans associated with promoting sustainable development, in which individual will and effort are the keywords. The results obtained show how important it is to introduce better management systems for information and resource exchange between the different institutions involved. The study was carried out in a suburban area of south-west France counting 71 small towns and villages, characteristic of the spatial dynamics triggered by the global phenomenon of urbanisation

Design and Evaluation of Magnetic Hall Effect Tactile Sensors for Use in Sensorized Splints

Splinting techniques are widely used in medicine to inhibit the movement of arthritic joints. Studies into the effectiveness of splinting as a method of pain reduction have generally yielded positive results, however, no significant difference has been found in clinical outcomes between splinting types. Tactile sensing has shown great promise for the integration into splinting devices and may offer further information into applied forces to find the most effective methods of splinting. Hall effect-based tactile sensors are of particular interest in this application owing to their low-cost, small size, and high robustness. One complexity of the sensors is the relationship between the elastomer geometry and the measurement range. This paper investigates the design parameters of Hall effect tactile sensors for use in hand splinting. Finite element simulations are used to locate the areas in which sensitivity is high in order to optimise the deflection range of the sensor. Further simulations then investigate the mechanical response and force ranges of the elastomer layer under loading which are validated with experimental data. A 4 mm radius, 3 mm-thick sensor is identified as meeting defined sensing requirements for range and sensitivity. A prototype sensor is produced which exhibits a pressure range of 45 kPa normal and 6 kPa shear. A proof of principle prototype demonstrates how this can be integrated to form an instrumented splint with multi-axis sensing capability and has the potential to inform clinical practice for improved splinting

Psychological comorbidities in epilepsy: a cross-sectional survey among Ghanaian epilepsy patients

Objective: To evaluate the prevalence and patterns of psychiatric disorders in epilepsy patients at the Korle-Bu Teaching hospital, Accra, Ghana.Design: The study design was a cross-sectional surveySetting: The study was conducted at the Neurology Clinic of the Department of Medicine and Therapeutics, Korle-nBu Teaching hospital, Accra, Ghana.Participants: A total of one hundred and sixty-six patients diagnosed with epilepsy aged at least 18 years and accessing services at the neurology clinic participated in the study.Main Outcome Measure: Prevalence and patterns of psychiatric disorders among patients diagnosed with epilepsy using the Brief Symptom Inventory.Results: The mean age for onset of epilepsy was 20.1 ± 16.9 years, and generalized epilepsy (73.2%) was the major type of epilepsy identified. The aetiology of the epilepsy condition was unknown in most patients (71.1%). The estimated mean Brief Symptom Inventory scores in all the nine diagnostic psychiatry characteristics (Depression, Anxiety, Somatization, Hostility, Phobic Anxiety, Obsessive Compulsive Disorder, Psychoticism, Interpersonal Sensitivity, and Paranoid Ideation) were higher in the epilepsy patients compared to the normative data scores for non-patients. Global Severity Index scores for females were significantly higher (p=0.002) than the scores for males on all the psychological outcomes except hostility.Conclusion: Psychological disorders were prevalent among epilepsy patients, with females more likely to experience psychological problems than males. The findings call for a holistic approach in managing epilepsy to highlight and manage some exceptional psychological comorbidities

Mitochondrial isolation: when size matters

Mitochondrial vitality is critical to cellular function, with mitochondrial dysfunction linked to a growing number of human diseases. Tissue and cellular heterogeneity, in terms of genetics, dynamics and function means that increasingly mitochondrial research is conducted at the single cell level. Whilst there are several technologies that are currently available for single-cell analysis, each with their advantages, they cannot be easily adapted to study mitochondria with subcellular resolution. Here we review the current techniques and strategies for mitochondrial isolation, critically discussing each technology’s limitations for future mitochondrial research. Finally, we highlight and discuss the recent breakthroughs in sub-cellular isolation techniques, with a particular focus on nanotechnologies that enable the isolation of mitochondria from subcellular compartments. This allows isolation of mitochondria with unprecedented spatial precision with minimal disruption to mitochondria and their immediate cellular environment

The visible and the invisible: Distributed Cognition for medical devices

Many interactive medical devices are less easy to use than they might be, and do not fit as well as they could in their contexts of use. Occasionally, the deficiencies lead to serious incidents; more often, they have a less visible effect on the resilience and efficiency of healthcare systems. These issues remain largely invisible as they are not reported and have rarely been studied. In this paper, we report on the use of DiCoT as an approach to representing and reasoning about medical work, and about the role of device design within that work. We focus in particular on the design and use of infusion devices. This work highlights the value of observational studies for engineering interactive medical devices, and illustrates the value of a systematic approach to gathering and analyzing qualitative data