Fate of clinical research studies after ethical approval--follow-up of study protocols until publication.

BACKGROUND: Many clinical studies are ultimately not fully published in peer-reviewed journals. Underreporting of clinical research is wasteful and can result in biased estimates of treatment effect or harm, leading to recommendations that are inappropriate or even dangerous. METHODS: We assembled a cohort of clinical studies approved 2000-2002 by the Research Ethics Committee of the University of Freiburg, Germany. Published full articles were searched in electronic databases and investigators contacted. Data on study characteristics were extracted from protocols and corresponding publications. We characterized the cohort, quantified its publication outcome and compared protocols and publications for selected aspects. RESULTS: Of 917 approved studies, 807 were started and 110 were not, either locally or as a whole. Of the started studies, 576 (71%) were completed according to protocol, 128 (16%) discontinued and 42 (5%) are still ongoing; for 61 (8%) there was no information about their course. We identified 782 full publications corresponding to 419 of the 807 initiated studies; the publication proportion was 52% (95% CI: 0.48-0.55). Study design was not significantly associated with subsequent publication. Multicentre status, international collaboration, large sample size and commercial or non-commercial funding were positively associated with subsequent publication. Commercial funding was mentioned in 203 (48%) protocols and in 205 (49%) of the publications. In most published studies (339; 81%) this information corresponded between protocol and publication. Most studies were published in English (367; 88%); some in German (25; 6%) or both languages (27; 6%). The local investigators were listed as (co-)authors in the publications corresponding to 259 (62%) studies. CONCLUSION: Half of the clinical research conducted at a large German university medical centre remains unpublished; future research is built on an incomplete database. Research resources are likely wasted as neither health care professionals nor patients nor policy makers can use the results when making decisions.

Land use response to agricultural policy and market movements on Finnish dairy-farms

Selostus: Tuki- ja hintamuutosten vaikutus maitotilojen pellon käyttöön

Ethics and adolescent care: an international perspective.

PURPOSE OF REVIEW: This update reviews the concepts underlying ethical issues in various contexts and countries, highlighting the evolution in the use of the core values underpinning the field and practice of bioethics as applied to healthcare. RECENT FINDINGS: It stresses the specific position of the adolescent as being a unique individual searching for autonomy and, most of the time, being competent to make decisions regarding the adolescent's own health. It briefly outlines the principles of a 'deliberative' approach in which the practitioner, while keeping in mind the legal context of the country where the practitioner is working, assesses to what extent the adolescent can be considered as competent, and then discusses with the adolescent the medical and psychosocial aspects of the various actions to be taken in a situation, as well as the basic ethical values linked with each of the various options available. The deliberation can involve relevant stakeholders, provided the issues concerning confidentiality have been fully discussed with the adolescent. SUMMARY: This process forces the practitioner, the adolescent patient and those who care for the adolescent patient to look outside their usual frameworks and make a decision that is in the best interest of the young person, and is informed by various ethical values.

Optimal beef cattle management under agricultural policy reforms in Finland

Selostus: Politiikkamuutosten vaikutus lihanautojen optimaaliseen ruokintaan ja teurastuksen ajoitukseen

Report of The Iowa Pandemic Influenza Ethics Committee, September 2007

This ethical framework document, compiled by the Iowa Pandemic Influenza Ethics Committee, provides ethical guidance to the Iowa Department of Public Health (IDPH) for a pandemic influenza situation. The ethics committee proposes the document as a foundation for decision making in preparing for and responding to pandemic influenza. The document addresses four ethical or moral focal points that public health and health care workers may need to address during a public health disaster.

Reconsidering the "policy gap":policy implementation and outcomes in Spain

By analysing entry policies and regularisation procedures in Spain from the 1990s to 2007, this article examines how the mismatch between very restrictive immigration policies and increasing foreign labour demands translated into a model of illegal migration, which in turn gave rise to the need to carry out periodical regularisation drives. This double 'policy gap' between legality and reality, and between entry policies and regularisation procedures, is explained as a policy in itself and as a way to solve in practice the apparently unsolvable dilemma between the demands for closure and the insatiable demands for foreign workers.

Utility accommodation policy of the Iowa State Highway Commission, 1970

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway.

Utility accommodation policy of the Iowa State Highway Commission, 1973

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa State Highway Commission exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1973 revision to 1970 policy.)

Policy for Accommodating Utilities on State Highway Rights-of-Way, 1985

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1985 revision to 1973 policy.)

Policy of the Iowa Department of Transportation Highway Division For Accommodating Utilities on Primary Road System, 1990

This policy covers initial placement, adjustment, relocation and replacement of utility facilities in, on, above or below all highway right of way over which the Iowa Department of Transportation exercises control of access. It embodies the basic specifications and standards needed, to insure the safety of the highway user and the integrity of the highway. (1990 revision to 1985 policy.)

Policy for Accommodating and Adjustment of Utilities on the Primary Road System, 2012

This chapter covers initial placement, adjustment, and maintenance of utility facilities in, on, above or below the right-of-way of primary highways, including attachments to primary highway structures. It embodies the basic specifications and standards needed to ensure the safety of the highway user and the integrity of the highway. (2012 revision to 2005 policy.)

Policy of the Iowa Department of Transportation Highway Division For Accommodating Utilities on the Primary Road System, 1992

This chapter covers initial placement, adjustment, improvement, relocation, replacement and maintenance of utility facilities in, on, above or below the right-of-way over of primary highways, including attachments to primary highway structures. It embodies the basic specifications and standards needed, to ensure the safety of the highway user and the integrity of the highway. (1992 revision to 1990 policy.)