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Global Health Research Ethics

Michael Parker, Patricia Kingori
There has been a dramatic rise in the scale and scope of collaborative global health research. A number of structural and scientific factors explain this growth and there has been much discussion of these in the literature. Little, if any, attention has been paid, however, to the factors identified by scientists and other research actors as important to successful research collaboration. This is surprising given that their decisions are likely to play a key role in the sustainability and effectiveness of global health research initiatives...
2016: PloS One
Maria Claudia Rodríguez, Perla Villamor, Tatiana Castillo
INTRODUCTION: Pain is a disease by itself and it's a public health concern of major implication in children, not just because of the emotional component of the child and his family, but also due to the potential morbidity and mortality involving it. A proper assessment of pain it's a challenge in the pediatric population, due to their lack of understanding and verbalization of hurt. Additionally, a satisfactory treatment of pediatric pain can be arduous due to a lack of clinical knowledge, insufficient pediatric research, and the fear to opioid side effects and addiction...
November 2016: International Journal of Pediatric Otorhinolaryngology
Kabir Sheikh, Mukund Uplekar
BACKGROUND: The unregulated availability and irrational use of tuberculosis (TB) medicines is a major issue of public health concern globally. Governments of many low- and middle-income countries (LMICs) have committed to regulating the quality and availability of TB medicines, but with variable success. Regulation of TB medicines remains an intractable challenge in many settings, but the reasons for this are poorly understood. The objective of this paper is to elaborate processes of regulation of quality and availability of TB medicines in three LMICs - India, Tanzania, and Zambia - and to understand the factors that constrain and enable these processes...
March 9, 2016: International Journal of Health Policy and Management
Christoffer Torgaard Thomsen, Michael Eriksen Benros, Lene Halling Hastrup, Per Kragh Andersen, Domenico Giacco, Merete Nordentoft
INTRODUCTION: Patient-controlled hospital admission for individuals with severe mental disorders is a novel approach in mental healthcare. Patients can admit themselves to a hospital unit for a short stay without being assessed by a psychiatrist or contacting the emergency department. Previous studies assessing the outcomes of patient-controlled hospital admission found trends towards reduction in the use of coercive measures and length of hospital stay; however, these studies have methodological shortcomings and small sample sizes...
2016: BMJ Open
Stephanie O M Dyke, Emily Kirby, Mahsa Shabani, Adrian Thorogood, Kazuto Kato, Bartha M Knoppers
We propose a standard model for a novel data access tier - registered access - to facilitate access to data that cannot be published in open access archives owing to ethical and legal risk. Based on an analysis of applicable research ethics and other legal and administrative frameworks, we discuss the general characteristics of this Registered Access Model, which would comprise a three-stage approval process: Authentication, Attestation and Authorization. We are piloting registered access with the Demonstration Projects of the Global Alliance for Genomics and Health for which it may provide a suitable mechanism for access to certain data types and to different types of data users...
September 28, 2016: European Journal of Human Genetics: EJHG
Rachel Tanner, Helen McShane
Tuberculosis (TB) remains a serious global health threat and an improved vaccine is urgently needed. New candidate TB vaccines are tested using preclinical animal models such as mice, guinea pigs, cattle and non-human primates. Animals are routinely infected with virulent Mycobacterium tuberculosis (M.tb) in challenge experiments to evaluate protective efficacy, raising ethical issues regarding the procedure of infection itself, symptoms of disease and humane end-points. We summarise the importance and limitations of animal models in TB vaccine research and review current alternatives and modifications in the context of the NC3Rs framework for replacing, reducing and refining the use of animals for scientific purposes...
September 26, 2016: ALTEX
Sonja L Myhre, Jane Kaye, Lee A Bygrave, Margunn Aanestad, Buthaina Ghanem, Patricia Mechael, J Frederik Frøen
BACKGROUND: The limited availability of maternal and child health data has limited progress in reducing mortality and morbidity among pregnant women and children. Global health agencies, leaders, and funders are prioritizing strategies that focus on acquiring high quality health data. Electronic maternal and child health registries (eRegistries) offer a systematic data collection and management approach that can serve as an entry point for preventive, curative and promotive health services...
September 23, 2016: BMC Pregnancy and Childbirth
Corinna Klingler, Georg Marckmann
BACKGROUND: With Germany facing a shortage of doctors, hospitals have been increasingly recruiting physicians from abroad. Studies in other countries have shown that migrant physicians experience various difficulties in their work, which might impact the quality of patient care, physician job satisfaction, and, accordingly, retention. The experiences of migrant doctors in Germany have not been systematically studied so far and will likely differ from experiences migrant physicians make in other contexts...
2016: Human Resources for Health
Célina Lichtl, Sandra Claudia Gewalt, Stefan Noest, Joachim Szecsenyi, Kayvan Bozorgmehr
INTRODUCTION: There is an increasing number of forced migrants globally, including refugees, asylum seekers, internally displaced persons and undocumented migrants. According to international law, forced migrants should enjoy access to health services free of discrimination equivalent to the host population, but they face barriers to healthcare worldwide. This may lead to a delay in care and result in preventable hospital treatment, referred to as potentially preventable hospitalisation (PPH) or ambulatory care sensitive hospitalisation (ACSH)...
2016: BMJ Open
Philippa May, Asha Bowen, Steven Tong, Andrew Steer, Sam Prince, Ross Andrews, Bart Currie, Jonathan Carapetis
BACKGROUND: Impetigo, scabies, and fungal skin infections disproportionately affect populations in resource-limited settings. Evidence for standard treatment of skin infections predominantly stem from hospital-based studies in high-income countries. The evidence for treatment in resource-limited settings is less clear, as studies in these populations may lack randomisation and control groups for cultural, ethical or economic reasons. Likewise, a synthesis of the evidence for public health control within endemic populations is also lacking...
2016: Systematic Reviews
Karina J Lewis, Leo Ross, Michel W Coppieters, Bill Vicenzino, Annina B Schmid
INTRODUCTION: Carpal tunnel syndrome (CTS) is a prevalent upper limb condition that results in significant individual and socioeconomic costs. Large patient numbers, long outpatient waiting times and traditional referral pathways in public health systems create delays in accessing treatment for this condition. Alternative care pathways aimed at streamlining access to treatment and reducing the need for surgical intervention warrant further investigation. METHODS: A randomised, single-blind controlled clinical trial will be conducted...
2016: BMJ Open
Nina DI Pietro, Jantina DE Vries, Angelina Paolozza, Dorothy Reid, James N Reynolds, Amy Salmon, Marsha Wilson, Dan J Stein, Judy Illes
Fetal alcohol spectrum disorder (FASD) is increasingly recognized as a growing public health issue worldwide. Although more research is needed on both the diagnosis and treatment of FASD, and a broader and more culturally diverse range of services are needed to support those who suffer from FASD and their families, both research and practice for FASD raise significant ethical issues. In response, from the point of view of both research and clinical neuroethics, we provide a framework that emphasizes the need to maximize benefits and minimize harm, promote justice, and foster respect for persons within a global context...
October 2016: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
Patience Aniteye, Beverley O'Brien, Susannah H Mayhew
BACKGROUND: Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns which mean it is highly stigmatized and this poses a threat to both providers and researchers. This study sought to explore challenges to providing safe abortion services from the perspective of health providers in Ghana. METHODS: A descriptive qualitative study using in-depth interviews was conducted...
2016: BMC Health Services Research
Kathryn Dambrino Mitchell, Leslie J Higgins
PURPOSE: Opioid overdose deaths have become an escalating epidemic in the United States. To combat this complex issue, naloxone distribution to the public has been initiated in many states as a harm reduction strategy. While supportive legislation develops and community programs expand, research- and policy-focused literature surrounding this timely topic require exploration, compilation, and analysis. The purpose of this systematic review is to identify trends in the current literature, gaps in the findings, nursing implications, and opportunities for further exploration...
July 2016: Journal of Addictions Nursing
Ting-Shun Wang, Chi-Feng Hsieh, Tsen-Fang Tsai
BACKGROUND: Recent global data show an increasing prevalence of psoriasis and psoriatic arthritis in western countries. OBJECTIVE: The current study analyzed the trend of prevalence rates of psoriasis and psoriatic arthritis in Taiwan and examined biologic prescription patterns by different specialties. METHODS: Data were accessed from the national payer National Health Insurance Research Database in Taiwan. This study protocol was approved by Joint Institutional Review Board established by Medical Research Ethics Foundation (No 13-S-001)...
August 25, 2016: Journal of Dermatological Science
Christian Compagnone, Michael E Schatman, Richard L Rauck, Jan Van Zundert, Monika Kraus, Dragan Primorac, Frances Williams, Massimo Allegri, Gloria Saccani Jordi, Guido Fanelli
In recent decades, there has been a revision of the role of institutional review boards with the intention of protecting human subjects from harm and exploitation in research. Informed consent aims to protect the subject by explaining all of the benefits and risks associated with a specific research project. To date, there has not been a review published analyzing issues of informed consent in research in the field of genetic/Omics in subjects with chronic pain, and the current review aims to fill that gap in the ethical aspects of such investigation...
August 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
Miguel Ángel Royo-Bordonada, Fernando J García López
BACKGROUND: The recent Ebola virus disease (EVD) outbreak, with 28,646 reported cases and 11,323 deaths, was declared a public health emergency of international interest by the World Health Organisation. In Spain, a single reported case triggered a public health crisis of a markedly media-centred nature. The approach to the first EVD epidemic has given rise to various ethical considerations around the world. We address the most relevant ethical considerations emanating from the management of EVD in Spain...
2016: BMC Medical Ethics
Brynne Gilmore, Ben Jack Adams, Alex Bartoloni, Bana Alhaydar, Eilish McAuliffe, Joanna Raven, Miriam Taegtmeyer, Frédérique Vallières
INTRODUCTION: Understanding what enhances the motivation and performance of community health workers (CHWs) in humanitarian emergencies represents a key research gap within the field of human resources for health. This paper presents the research protocol for the Performance ImprovEment of CHWs in Emergency Settings (PIECES) research programme. Enhancing Learning and Research in Humanitarian Action (ELRHA) funded the development of this protocol as part of their Health in Humanitarian Crises (R2HC) call (No...
2016: BMJ Open
Gitanjli Arora, Jonathan Ripp, Jessica Evert, Tracy Rabin, Janis P Tupesis, James Hudspeth
To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, offering safe and mentored international rotations, and creating GH experiences that are of service to resource-limiting settings. Academic GH partnerships allow for the opportunity to collaborate on education and research and improve health care and health systems, but must ensure mutual benefit to U...
August 16, 2016: Journal of General Internal Medicine
Jeff Levin
Interconnections between the faith-based and medical sectors are multifaceted and have existed for centuries, including partnerships that have evolved over the past several decades in the U.S. This paper outlines ten points of intersection that have engaged medical and healthcare professionals and institutions across specialties, focusing especially on primary care, global health, and community-based outreach to underserved populations. In a time of healthcare resource scarcity, such partnerships-involving religious congregations, denominations, and communal and philanthropic agencies-are useful complements to the work of private-sector medical care providers and of federal, state, and local public health institutions in their efforts to protect and maintain the health of the population...
December 2016: Preventive Medicine Reports
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