913 resultados para bioethics committees
Resumo:
Tutkielmani aiheena on Sarbanes-Oxley -lain vaikutukset suomalaisten pörssiyhtiöiden sisäiseen valvontaan. Tavoitteenani on tutkia, millaisia vaikutuksia Sarbanes-Oxley -lailla on ollut hyvään johtamis- ja hallintojärjestelmään Suomessa ja ennen kaikkea sisäiseen valvontaan. Päästäkseni tavoitteeseen olen tutkinut, mitkä lait, säädökset ja ohjeistukset säätelevät corporate governancea Suomessa ja millainen on näiden ohjeiden sisältö. Olen suorittanut tutkimuksen normatiivisena, eli tavoitteeni on selvittää, millainen hyvän johtamis- ja hallintojärjestelmän pitäisi Suomessa olla, ja miten Sarbanes-Oxley on vaikuttanut näihin vaatimuksiin. Tutkimus on puhtaasti teoreettinen eikä sisällä empiiristä osaa. Corporate governancea ohjaa Suomessa lainsäädäntö ja monet erilaiset lain-säädäntöä täydentävät säädökset. Tärkeimmiksi corporate governancea koskeviksi arvoiksi nousevat riippumattomuus, avoimuus, tiedon läpinäkyvyys ja ennen kaikkearehellisyys. Sarbanes-Oxley laki on tuonut paljon uusia vaatimuksia lain piirissä oleville yhtiöille. Se sisältää paljon ohjeistusta koskien riippumattomuutta.Sarbanes-Oxley - laki on lisännyt tarkastusvaliokunnan roolia yritysten toiminnassa. Yhtiön johdolta SOX vaatii muodollisia todistuksia osallisuudesta talousraportoinnin prosessissa. Sarbanes-Oxley -laki lisää myös yhtiön raportointivaatimuksia merkittävästi, ja tästä syystä tietoa yhtiöistä onkin saatavilla enemmän kuin koskaan. Sarbanes-Oxley -laki on vaikuttanut suuresti yhtiöiden sisäiseen valvontaan. SOX vaatii, että yhtiön on raportoitava sen sisäisessä valvonnassa havaituista heikkouksista. Yhtiön täytyy myös tutkia sen sisäisen valvontajärjestelmän tehokkuutta säännöllisesti. Johdon tai sisäisen tarkastuksen on tehtävä tästä valvonnasta oma raporttinsa. Corporate governancea koskeva lainsäädäntö ja muuohjeistus muuttuu jatkuvasti sekä Suomessa että muualla maailmalla. Kehitystä on seurattava sekä kotimaassa että ulkomailla ja ohjeistusta päivitettävä tarvittaessa.
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OBJECTIVE: To investigate the prevalence of discontinuation and nonpublication of surgical versus medical randomized controlled trials (RCTs) and to explore risk factors for discontinuation and nonpublication of surgical RCTs. BACKGROUND: Trial discontinuation has significant scientific, ethical, and economic implications. To date, the prevalence of discontinuation of surgical RCTs is unknown. METHODS: All RCT protocols approved between 2000 and 2003 by 6 ethics committees in Canada, Germany, and Switzerland were screened. Baseline characteristics were collected and, if published, full reports retrieved. Risk factors for early discontinuation for slow recruitment and nonpublication were explored using multivariable logistic regression analyses. RESULTS: In total, 863 RCT protocols involving adult patients were identified, 127 in surgery (15%) and 736 in medicine (85%). Surgical trials were discontinued for any reason more often than medical trials [43% vs 27%, risk difference 16% (95% confidence interval [CI]: 5%-26%); P = 0.001] and more often discontinued for slow recruitment [18% vs 11%, risk difference 8% (95% CI: 0.1%-16%); P = 0.020]. The percentage of trials not published as full journal article was similar in surgical and medical trials (44% vs 40%, risk difference 4% (95% CI: -5% to 14%); P = 0.373). Discontinuation of surgical trials was a strong risk factor for nonpublication (odds ratio = 4.18, 95% CI: 1.45-12.06; P = 0.008). CONCLUSIONS: Discontinuation and nonpublication rates were substantial in surgical RCTs and trial discontinuation was strongly associated with nonpublication. These findings need to be taken into account when interpreting surgical literature. Surgical trialists should consider feasibility studies before embarking on full-scale trials.
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The Prostate Cancer Programme of the European School of Oncology developed the concept of specialised interdisciplinary and multiprofessional prostate cancer care to be formalized in Prostate Cancer Units (PCU). After the publication in 2011 of the collaborative article "The Requirements of a Specialist Prostate Cancer Unit: A Discussion Paper from the European School of Oncology", in 2012 the PCU Initiative in Europe was launched. A multiprofessional Task Force of internationally recognized opinion leaders, among whom representatives of scientific societies, and patient advocates gathered to set standards for quality comprehensive prostate cancer care and designate care pathways in PCUs. The result was a consensus on 40 mandatory and recommended standards and items, covering several macro-areas, from general requirements to personnel to organization and case management. This position paper describes the relevant, feasible and applicable core criteria for defining PCUs in most European countries delivered by PCU Initiative in Europe Task Force.
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BACKGROUND: Information about the impact of cancer treatments on patients' quality of life (QoL) is of paramount importance to patients and treating oncologists. Cancer trials that do not specify QoL as an outcome or fail to report collected QoL data, omit crucial information for decision making. To estimate the magnitude of these problems, we investigated how frequently QoL outcomes were specified in protocols of cancer trials and subsequently reported. DESIGN: Retrospective cohort study of RCT protocols approved by six research ethics committees in Switzerland, Germany, and Canada between 2000 and 2003. We compared protocols to corresponding publications, which were identified through literature searches and investigator surveys. RESULTS: Of the 173 cancer trials, 90 (52%) specified QoL outcomes in their protocol, 2 (1%) as primary and 88 (51%) as secondary outcome. Of the 173 trials, 35 (20%) reported QoL outcomes in a corresponding publication (4 modified from the protocol), 18 (10%) were published but failed to report QoL outcomes in the primary or a secondary publication, and 37 (21%) were not published at all. Of the 83 (48%) trials that did not specify QoL outcomes in their protocol, none subsequently reported QoL outcomes. Failure to report pre-specified QoL outcomes was not associated with industry sponsorship (versus non-industry), sample size, and multicentre (versus single centre) status but possibly with trial discontinuation. CONCLUSIONS: About half of cancer trials specified QoL outcomes in their protocols. However, only 20% reported any QoL data in associated publications. Highly relevant information for decision making is often unavailable to patients, oncologists, and health policymakers.
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AIM: In the past few years, spectacular progress in neuroscience has led to the emergence of a new interdisciplinary field, the so-called "neurolaw" whose goal is to explore the effects of neuroscientific discoveries on legal proceedings and legal rules and standards. In the United States, a number of neuroscientific researches are designed specifically to explore legally relevant topics and a case-law has already been developed. In Europe, neuroscientific evidence is increasingly being used in criminal courtrooms, as part of psychiatric testimony, nourishing the debate about the legal implications of brain research in psychiatric-legal settings. Though largely debated, up to now the use of neuroscience in legal contexts had not specifically been regulated by any legislation. In 2011, with the new bioethics law, France has become the first country to admit by law the use of brain imaging in judicial expertise. According to the new law, brain imaging techniques can be used only for medical purposes, or scientific research, or in the context of judicial expertise. This study aims to give an overview of the current state of the neurolaw in the US and Europe, and to investigate the ethical issues raised by this new law and its potential impact on the rights and civil liberties of the offenders. METHOD: An overview of the emergence and development of "neurolaw" in the United States and Europe is given. Then, the new French law is examined in the light of the relevant debates in the French parliament. Consequently, we outline the current tendencies in Neurolaw literature to focus on assessments of responsibility, rather than dangerousness. This tendency is analysed notably in relation to the legal context relevant to criminal policies in France, where recent changes in the legislation and practice of forensic psychiatry show that dangerousness assessments have become paramount in the process of judicial decision. Finally, the potential interpretations of neuroscientific data introduced into psychiatric testimonies by judges are explored. RESULTS: The examination of parliamentary debates showed that the new French law allowing neuroimaging techniques in judicial expertise was introduced in the aim to provide a legal framework that would protect the subject against potential misuses of neuroscience. The underlying fear above all, was that this technology be used as a lie detector, or as a means to predict the subject's behaviour. However, the possibility of such misuse remains open. Contrary to the legislator's wish, the defendant is not fully guaranteed against uses of neuroimaging techniques in criminal courts that would go against their interests and rights. In fact, the examination of the recently adopted legislation in France shows that assessments of dangerousness and of risk of recidivism have become central elements of the criminal policy, which makes it possible, if not likely that neuroimaging techniques be used for the evaluation of the dangerousness of the defendant. This could entail risks for the latter, as judges could perceive neuroscientific data as hard evidence, more scientific and reliable than the soft data of traditional psychiatry. If such neuroscientific data are interpreted as signs of potential dangerousness of a subject rather than as signs of criminal responsibility, defendants may become subjected to longer penalties or measures aiming to ensure public safety in the detriment of their freedom. CONCLUSION: In the current context of accentuated societal need for security, the judge and the expert-psychiatrist are increasingly asked to evaluate the dangerousness of a subject, regardless of their responsibility. Influenced by this policy model, the judge might tend to use neuroscientific data introduced by an expert as signs of dangerousness. Such uses, especially when they subjugate an individual's interest to those of society, might entail serious threats to an individual's freedom and civil liberties.
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Un equip d"investigadors de la Universitat de Harvard crea una interfície que recull els impulsos nerviosos d"una persona i els envia al cervell d"una rata, de tal manera que es podria provocar que mogués la cua.
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Analysis of stratigraphic terminology and classification, shows that time-related stratigraphic units, which by definition have a global extent, are the concern of international cornrnissions and committees of the intemational Union of Geological Sciences (IUGS) . In contrast, lithostratigraphic, and other closely related units, are regional in extent and are catalogued in the International Stratigraphic Lexicon (ISL), the last volume of which, was published in 1987. Tlie intemational Commission on Stratigraphy (ICS) is currently attempting to revitalize the publication of ISL, given that the information contained in published volumes has never been updated, and that there has been a significant increase in stratigraphic research in recent decades. The proliferation of named units in the South Pyrenean and Ebro Basin Paleogene is evaluated to illustrate the extent of the problem. Moreover, new approaches to stratigraphic analysis have led to the naming of genetic units according to similar guidelines followed in the naming of descnptive or lithostratigraphic units. This has led to considerable confusion. The proposal to revitalize the ISL is accepted as part of the solution, that should also include the publication of critica1 catalogues, and the creation of norms for genetic unit terminology.
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Regulation has in many cases been delegated to independent agencies, which has led to the question of how democratic accountability of these agencies is ensured. There are few empirical approaches to agency accountability. We offer such an approach, resting upon three propositions. First, we scrutinize agency accountability both de jure (accountability is ensured by formal rights of accountability 'fora' to receive information and impose consequences) and de facto (the capability of fora to use these rights depends on resources and decision costs that affect the credibility of their sanctioning capacity). Second, accountability must be evaluated separately at political, operational and managerial levels. And third, at each level accountability is enacted by a system of several (partially) interdependent fora, forming together an accountability regime. The proposed framework is applied to the case of the German Bundesnetzagentur's accountability regime, which shows its suitability for empirical purposes. Regulatory agencies are often considered as independent, yet accountable. This article provides a realistic framework for the study of accountability 'regimes' in which they are embedded. It emphasizes the need to identify the various actors (accountability fora) to which agencies are formally accountable (parliamentary committees, auditing bodies, courts, and so on) and to consider possible relationships between them. It argues that formal accountability 'on paper', as defined in official documents, does not fully account for de facto accountability, which depends on the resources possessed by the fora (mainly information-processing and decision-making capacities) and the credibility of their sanctioning capacities. The article applies this framework to the German Bundesnetzagentur.
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Tutkimus ”Ilmarisen Suomi” ja sen tekijät tarjoaa uutta tietoa ja historiallisen tulkinnan huipputeknologisen Suomen rakentamisesta sodanjälkeisenä aikana. Kirja kertoo ESKO-tietokoneen tekijöiden monipuolisesta toiminnasta sekä koneen kohtalosta 1950-luvulla. ESKOa rakennuttanut Matematiikkakonekomitea (19541960) suunnitteli laitteesta Suomen ensimmäistä tietokonetta, mutta kirjassa esitetyn tulkinnan mukaan komitealla oli myös laajempia, kansallisia ihanteita ja tavoitteita, kuten kansallisen keskuslaskutoimiston perustaminen. Varhaisia tietokoneita kutsuttiin niiden käyttöä kuvaavasti matematiikkakoneiksi. Kirja on ensimmäinen perusteellinen esitys ja samalla ensimmäinen tutkimus ESKOsta ja sen tekijöiden hankkeesta 1950-luvulla. Matematiikkakonekomitean johdossa toimivat aikansa huipputiedemiehet Rolf Nevanlinna ja Erkki Laurila. Väitöstutkimuksessa kysytään, miten maan ensimmäisen tietokoneen hankkimista perusteltiin, mitä Matematiikkakonekomitea oikeastaan teki ja millaisia erityisesti kansallisia motiiveja koneen tekijöiden toiminta ilmaisi. Tutkimuksessa käytetään monipuolisesti arkistoaineistoa, kirjallisuutta ja haastatteluja Suomesta, Saksasta ja Ruotsista. Tarkastelussa hyödynnetään erityisesti teknologian historian ja yhteiskuntatieteellisen tieteen- ja teknologiantutkimuksen tutkimuskirjallisuutta. Kirjassa tarkastellaan yksityiskohtaisesti sitä, miten ESKOn tekijät yhdistivät tekniikan ja kansalliset perustelut sekä rakensivat uudenlaista, teknisesti taitavaa ”Ilmarisen Suomea” yhdessä ja kilvan muiden tahojen kanssa tuottaen teknologiasta kansallista projektia suomalaisille. Matematiikkakonekomitean ja ESKO-hankkeen tutkimisen perusteella suomalaisten ja teknologian suhteesta voidaan sanoa, että tekniikasta ei vain tullut kansallinen asia suomalaisille, vaan tekniikasta nimenomaan tehtiin kansallinen projekti, joka ei suinkaan ollut erityisen yksimielinen edes sodanjälkeisenä aikana. Tutkimuksen mukaan kotimainen komitea sai paljon aikaan ja tuotti vielä merkittävämpiä seurauksia. Näin siitä huolimatta, että ESKO valmistui pahasti myöhässä, vuonna 1960. Komitea myötävaikutti niin IBM:n menestykseen Suomessa, valtiojohtoisen tiedepolitiikan alkuun kuin Nokian edeltäjän Kaapelitehtaan elektroniikkaosaamisen syntyyn.
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OBJECTIVES: To investigate the frequency of interim analyses, stopping rules, and data safety and monitoring boards (DSMBs) in protocols of randomized controlled trials (RCTs); to examine these features across different reasons for trial discontinuation; and to identify discrepancies in reporting between protocols and publications. STUDY DESIGN AND SETTING: We used data from a cohort of RCT protocols approved between 2000 and 2003 by six research ethics committees in Switzerland, Germany, and Canada. RESULTS: Of 894 RCT protocols, 289 prespecified interim analyses (32.3%), 153 stopping rules (17.1%), and 257 DSMBs (28.7%). Overall, 249 of 894 RCTs (27.9%) were prematurely discontinued; mostly due to reasons such as poor recruitment, administrative reasons, or unexpected harm. Forty-six of 249 RCTs (18.4%) were discontinued due to early benefit or futility; of those, 37 (80.4%) were stopped outside a formal interim analysis or stopping rule. Of 515 published RCTs, there were discrepancies between protocols and publications for interim analyses (21.1%), stopping rules (14.4%), and DSMBs (19.6%). CONCLUSION: Two-thirds of RCT protocols did not consider interim analyses, stopping rules, or DSMBs. Most RCTs discontinued for early benefit or futility were stopped without a prespecified mechanism. When assessing trial manuscripts, journals should require access to the protocol.
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The book adopts a unique stakeholder perspective, structured around the groups and individuals who have an interest in and co-create sports events, including organising committees, promoters, sport organisations, spectators, community groups, sponsors, host governments, the media and NGOs. Each chapter addresses a specific stakeholder, defines that stakeholder and its relationships with sports events, describes the managerial requirements for a successful event, assesses current research and directions for future research, and outlines the normative dimensions of stakeholder engagement (such as sustainability and legacy)
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Introducción: Las decisiones de gestión configuran una parte importante del contexto organizativo para la prestación de cuidados. En la literatura científica se encuentran evidencias del impacto del contexto organizativo y de la pericia de los profesionales en los resultados. Puesto que el contexto organizativo está influido por las decisiones de gestión y la toma de decisiones está directamente relacionada con el nivel de competencia de cada profesional, es de esperar que en la práctica existan múltiples visiones sobre una misma situación, que precipiten dilemas éticos en los que la enfermera gestora deberá actuar. Objetivo: Presentar una revisión reflexiva sobre los aspectos éticos de actualidad en la gestión enfermera como herramienta esencial en el desarrollo de pericia para la toma de decisiones. Método: Revisión interpretativa y discusión de la literatura científica actual sobre las cuestiones ético-morales en el ámbito de la gestión asistencial y directiva enfermera: conflictos de valores, dilemas éticos, competencia ética, sufrimiento moral, redes relacionales, whistleblowing y comportamientos negativos. Resultados y conclusiones: Gestionar el equilibrio entre los valores y las prioridades, en el marco del cumplimiento de los principios empresariales de eficiencia, efectividad y productividad puede chocar con los valores profesionales de respeto a la dignidad, equidad, beneficencia, calidad y seguridad, por lo que se requieren enfermeras gestoras con un grado elevado de competencia ética, capaces de abordar la emergencia de los dilemas que surgen en la práctica. Los directivos de las empresas sanitarias no deberían obviar la promoción de redes relacionales positivas y las políticas de gestión de los comportamientos negativos y abordar las cuestiones relacionadas con la cultura del silencio.
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Aquest article té com a objectiu relacionar el tenir cura, propi de les infermeres, amb el respecte a l"autonomia de la persona. Per mostrar aquesta relació es fa un recorregut per les teories de diferents autors i autores: C. Gilligan, M. Mayeroff, F. Kerouac, F. Collière, V. Henderson o M. Leininger, perquè el seu pensament posa de manifest que el tenir cura és un agent important per generar autonomia.
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En este artículo trataremos el tema de la autonomía del paciente/usuario desde la visión del cuidado enfermero. La ética nos obliga a reflexionar sobre la bondad de nuestras acciones, sobre lo que consideramos más adecuado y nos obliga a ser capaces de justificar los motivos de todo ello. Por tanto, vamos a exponer las razones profesionales que nos llevan a definir la autonomía como el eje fundamental de las relaciones entre las enfermeras y los usuarios o enfermos, sea cual sea la condición de la persona a cuidar.
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En el transcurso de los últimos años, el incremento de la tecnología ha modificado la atención prenatal. La posibilidad de aplicación de pruebas y estudios ha hecho posible que el diagnóstico prenatal de defectos congénitos se convierta en un objetivo del control prenatal. Ronal Dworkin defiende el principio de autonomía procreativa, según el cual todas aquellas decisiones que afedan a la propia reproducción son individuales y fundamentales. Sin embargo, las decisiones que se toman en el ámbito procreativo se inscriben en el seno de una relación asistencial que se establece a lo largo del tiempo. En este artículo se pretende realizar un breve repaso de los principios filosóficos que fundamentan el principio de autonomía, para en un segundo tiempo realizar una reflexión sobre la aplicación de este concepto de autonomía a la toma de decisiones en el caso que nos ocupa: el diagnóstico prenatal de anomalías congénitas