Access to death certificates: What should research ethics committees require for approval?

PURPOSE: To present and discuss the reactions of research ethics committees (RECs) in a number of countries when asked for approval Of a study requiring access to death certificates to identify the physicians signing the certificates and to send them a four-page questionnaire about medical decisions made at the patient's end-of-life that could possibly have hastened death. METHODS: A simple questionnaire were sent to the responsible national investigator in an international study (Australia, Belgium, Denmark, Italy, the Netherlands, Sweden, Switzerland) asking about the interactions between the national research group and the national/regional REC(s). RESULTS: Different laws or guidelines were used by the RECs. Denmark, the Netherlands, and Switzerland did not require an application to a REC. In Australia and Sweden, the RECs wanted changes in the research protocol, and one national research group had to refrain from publishing its results because the attrition rate became too high, probably due to the required changes in the protocol. RECOMMENDATIONS: Generally, similar demands from all RECs in relation to one project are strongly desirable. In epidemiological research, in which Voluntary completion of an anonymous questionnaire demonstrates consent, additional prior informed consent about being approached should not be required.

Florida Board of Governors Meeting Florida International University Medical School Approval

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The Basis of Support for Hugo Chávez: Measuring the Determinants of Presidential Job Approval in Venezuela

Since 1999, Venezuela has experienced a dramatic transformation of its political system with the coming to power of Hugo Chávez and his movement, known in Venezuela as Chavismo. Chávez has dismantled the previous political system and established neo-populist structures that rely on his personal appeal and the close collaboration of the armed forces. Chávez has relied heavily on significant support from the poor and those who felt economically and politically excluded by the “Punto Fijo system.” President Chávez has built an impressive record of electoral victories; winning every electoral contest except one since coming to power in 1999. He continues to receive relatively high levels of support among sectors of Venezuelan society. However, there is evidence of growing discontent with high crime rates, high levels of inflation, and significant corruption in the public administration. Using data from the AmericasBarometer surveys conducted in 2007, 2008 and 2010, this paper seeks to examine the basis of Chávez’s popular support. In general, the AmericasBarometer findings suggest that Venezuelans support for President Chávez is closely linked to the access to social programs and that as long as the government is able to fund these social programs or missions, particularly MERCAL and Barrio Adentro, it will possess an important tool to garner and sustain support for President Chávez. Our analysis, however, also indicates that evaluations of the national economic situation, more than crime or insecurity, are a key factor that could undermine support for the regime.

A descriptive study of the ratio of approval to disapproval demonstrated by music teachers and classroom teachers in first, second, and third grades

The purpose of this study was to determine the approval to disapproval ratios of feedback given by music and classroom teachers to first, second and third grades. Eight teachers from a South Florida Elementary School were selected for this study. Twelve 20-minute videos were taken for further examination. Analyses of data using percentage formulas were used to determine the ratio of each of the teacher reinforcement. Classroom teachers gave 2.3% social approval feedback, 59% academic approval feedback, 22% social disapproval feedback, 16.5% academic disapproval feedback, and 0% errors. Music teachers gave .7% social approval feedback, 67% academic approval feedback, 22% social disapproval feedback, 10% academic disapproval feedback, and 0% errors. Today's teachers are 8% more academically approving than thirty years ago. Results also show that today's music teachers are still more approving than classroom teachers.

Utilizing Electronic Signatures and Electronic Form Filling to Streamline Document Approval Process

This CPM project focuses on the document approval process that the Division of State Human Resources consulting team utilizes as it relates to classification and compensation requests, e.g. job reclassifications, PD update requests, and salary requests. The ultimate goal is to become more efficient by utilizing electronic signatures and electronic form filling to streamline the current process of document approvals.

"Get new lawyers!"

In James Rubin's account of the Kosovo war, he describes an exchange between Secretary Albright and Robin Cook (the British Foreign Secretary). Cook was explaining that it is difficult for Britain to commit to the war without UN Security Council approval because the legal advice he had received was that such action would be illegal under international law. Albright's response was, simply, "get new lawyers". Rubin "credits" Blair with a "push" that swung the British to "finally agree" that a UN Security Council resolution was "not legally required". Robin Cook later stated in Parliament and that the war was legal. Interestingly, Blair did not. This article does not look at whether or not such an exchange took place; rather look at the ethical issues that such a situation would generate. The article suggests what the ethical obligations of the key legal players in such institutional dramas should be—including governments seeking advice, the lawyers giving it, the ministers reporting it and the opposition in Parliament. The article sets out the particular responsibilities of the lawyers and officials of a Westminster system. It also sets out some of the institutional mechanisms for making it more likely that those obligations are fulfilled—as always through the interaction of obligations by different players that make it more risky for any player to breach his or her ethical obligations. Analogous duties would be faced by the relevant actors in other systems.

Reduction of Secondary Degeneration after Spinal Cord Injury by Acute Delivery of Proinflammatory Growth Factors

INTRODUCTION Inflammation is a protective attempt to facilitate the removal of damaged tissue and to initiate the healing response in other tissues. However, after spinal cord injury (SCI), this response is prolonged leading to secondary degeneration and glial scarring. Here, we investigate the potential of sustained delivery of pro-inflammatory factors vascular endothelial growth factor (VEGF) and platelet derived growth factor (PDGF) to increase early inflammatory events and promote inflammatory resolution. Method Animal ethics approval was obtained from the Queensland University of Technology. Adult Wistar-Kyoto rats (12-16 weeks old) were subjected to laminectomies and T10 hemisections. Animals were then randomised to treatment (implantation of osmotic pump (Alzet) loaded with 5ug VEGF & 5 ug PDGF) or control groups (lesion control or lesion plus pump delivering PBS). Rats were sacrificed at one month and the spinal cords were harvested and examined by immunohistology, using anti-neurofilament-200(NF200) and anti- ionized calcium binding adapter molecule 1 (Iba1). One way ANOVA was used for statistic analysis. Results At 1 month, active pump-treated cords showed a high level of axonal filament throughout the defects as compared to the control groups. The mean lesion size, as measured by NF200, was 0.47mm2 for the lesion control, 0.39mm2 for the vehicle control and 0.078mm2 for the active pump group. Significant differences were detected between the active pump group and the two control groups (AP vs LC p= 0.017 AG vs VC p= 0.004). Iba-1 staining also showed significant differences in the post-injury inflammatory response. Discussion We have shown that axons and activated microglia are co-located in the lesion of the treated cord. We hypothesise the delivery of VEGF/PDGF increases the local vessel permeability to inflammatory cells and activates these along with the resident microglia to threshold population, which ultimately resolved the prolonged inflammation. Here, we have shown that maintaining the inflammatory signals for at least 7 days improved the morphology of the injured cord. Conclusion This study has shown that boosting inflammation, by delivery VEGF/PDGF, in the early phase of SCI helps to reduce secondary degeneration and may promote inflammation resolution. This treatment may provide a platform for other neuro-regenrative therapies.

Termination of a minor’s pregnancy : critical issues for consent and the criminal law

The recent Supreme Court decision of Queensland v B [2008] 2 Qd R 562 has significant implications for the law that governs consent and abortions. The judgment purports to extend the ratio of Secretary, Department of Health and Community Services (NT) v JWB and SMB (1991) 175 CLR 218 (Marion’s Case) and impose a requirement of court approval for terminations of pregnancy for minors who are not Gillick-competent. This article argues against the imposition of this requirement on the ground that such an approach is an unjustifiable extension of the reasoning in Marion’s Case. The decision, which is the first judicial consideration in Queensland of the position of medical terminations, also reveals systemic problems with the criminal law in that State. In concluding that the traditional legal excuse for abortions will not apply to those which are performed medically, Queensland v B provides further support for calls to reform this area of law.

Similarity not favourability : the role of donor prototypes in predicting willingness to donate organs while living

Using an extended Prototype/Willingness Model, we examined the predictors of willingness to donate an organ to a partner/family member and a stranger while living. A questionnaire assessed university students’ (N = 284) attitudes, subjective norm, prototype favourability, prototype similarity, moral norm, and willingness to donate organs in each recipient scenario. All variables, except prototype favourability, predicted willingness to donate organs in both situations. Future strategies should emphasise perceived approval from important others for living donation, the consistency of living donation with one’s own morals, and encourage perceptions of similarity between oneself and living donors to increase acceptance of living donation.

Establishment of a preclinical ovine model for tibial segmental bone defect repair by applying bone tissue engineering strategies

Currently, well-established clinical therapeutic approaches for bone reconstruction are restricted to the transplantation of autografts and allografts, and the implantation of metal devices or ceramic-based implants to assist bone regeneration. Bone grafts possess osteoconductive and osteoinductive properties, however they are limited in access and availability and associated with donor site morbidity, haemorrhage, risk of infection, insufficient transplant integration, graft devitalisation, and subsequent resorption resulting in decreased mechanical stability. As a result, recent research focuses on the development of alternative therapeutic concepts. The field of tissue engineering has emerged as an important approach to bone regeneration. However, bench to bedside translations are still infrequent as the process towards approval by regulatory bodies is protracted and costly, requiring both comprehensive in vitro and in vivo studies. The subsequent gap between research and clinical translation, hence commercialization, is referred to as the ‘Valley of Death’ and describes a large number of projects and/or ventures that are ceased due to a lack of funding during the transition from product/technology development to regulatory approval and subsequently commercialization. One of the greatest difficulties in bridging the Valley of Death is to develop good manufacturing processes (GMP) and scalable designs and to apply these in pre-clinical studies. In this article, we describe part of the rationale and road map of how our multidisciplinary research team has approached the first steps to translate orthopaedic bone engineering from bench to bedside byestablishing a pre-clinical ovine critical-sized tibial segmental bone defect model and discuss our preliminary data relating to this decisive step.

The status of Australian nurse practitioners : the first national census

A five-section questionnaire was mailed to all 234 authorised Australian nurse practitioners in late 2007. An 85% response rate was achieved (202 responses). Respondents had a mean age of 47.0 years and 84.2% were women. Only 145 nurse practitioners (72% of respondents) reported being employed in Australia at the time of the census. Emergency nurse practitioners were the most commonly employed nationally (26.9%). Nearly one third of employed nurse practitioners reported that they were still awaiting approval to prescribe medications despite this being a core legislated skill. Over 70% stated that lack of Medicare provider numbers and lack of authority to prescribe through the Pharmaceut ical Benef its Scheme was extremely limiting to their practice. These findings are consistent with the international literature describing establishment of reformative

Members abroad - Australia : Paul Sanders

I have been an academic since joining the University of Natal in 1998 and, following a period as a visiting lecturer in Brisbane in 2001, I joined the staff at QUT on an ongoing basis in 2003. I was appointed as Architecture Co-ordinator in 2006, and this role involves the leadership of the architectur discipline of 17 full time academics. I am currently enrolled in a PhD course in the field of urban morphology. This research proposes a theory on the relevance of mapping the evolutionary aspects of historical urban form to develop a measure for evaluating architecural elements and deriving parameters for new buildings. My participation in a QUT design team contributed to a recent successful invited competition bid for an Urban Transit Centre in Hangzhou, China. The Centre will include retail, business, entertainment, residential and service components at the heart of the Binjiang district on the 11.5ha core area with 32ha surrounding urban design precinct. The project has received the approval to commence and is to be implemented over the next three years!