A multicenter study of the awareness and attitudes of Egyptian faculty towards research ethics: a pilot study

The awareness and attitudes of faculty towards research ethics committees (RECs) and research ethics practices are largely unknown. Accordingly, we conducted a cross-sectional survey study involving various faculties (Medicine, Nursing, Pharmacy, and Dentistry) from four universities in Egypt. A large majority (> 85%) held positive attitudes towards RECs, but almost a third thought that RECs would delay research. More than half had not received prior training in research or medical ethics, but more than 90% thought that this subject matter should be taught to postgraduates. A large majority recognized the need for informed consent and confidentiality protections in research, but some held attitudes regarding certain research ethics practices that were questionable. We conclude that a curriculum in research ethics should be developed for university faculty and that further qualitative studies should explore the basis of several of the attitudes regarding practices in research ethics.     

Two Methods for Engaging with the Community in Setting Priorities for Child Health Research: Who Engages?

ObjectiveThe aims of this study were to assess participatory methods for obtaining community views on child health research.BackgroundCommunity participation in research is recognised as an important part of the research process; however, there has been inconsistency in its implementation and application in Australia. The Western Australian Telethon Kids Institute Participation Program employs a range of methods for fostering active involvement of community members in its research. These include public discussion forums, called Community Conversations. While participation levels are good, the attendees represent only a sub-section of the Western Australian population. Therefore, we conducted a telephone survey of randomly selected households to evaluate its effectiveness in eliciting views from a broader cross-section of the community about our research agenda and community participation in research, and whether the participants would be representative of the general population. We also conducted two Conversations, comparing the survey as a recruitment tool and normal methods using the Participation Program.ResultsWhile the telephone survey was a good method for eliciting community views about research, there were marked differences in the profile of study participants compared to the general population (e.g. 78% vs 50% females). With a 26% response rate, the telephone survey was also more expensive than a Community Conversation. The cold calling approach proved an unsuccessful recruitment method, with only two out of a possible 816 telephone respondents attending a Conversation.ConclusionWhile the results showed that both of the methods produced useful input for our research program, we could not conclude that either method gained input that was representative of the entire community. The Conversations were relatively low-cost and provided more in-depth information about one subject, whereas the telephone survey provided information across a greater range of subjects, and allowed more quantitative analysis.     

Assessing formal teaching of ethics in physiology: an empirical survey, patterns, and recommendations

Ethics should be an important component of physiological education. In this report, we examined to what extent teaching of ethics is formally being incorporated into the physiology curriculum. We carried out an e-mail survey in which we asked the e-mail recipients whether their institution offered a course or lecture on ethics as part of the physiology teaching process at their institution, using the following query: "We are now doing an online survey in which we would like to know whether you offer a course or a lecture on ethics as part of your physiology teaching curriculum." The response rate was 53.3%: we received 104 responses of a total of 195 sent out. Our responses came from 45 countries. While all of our responders confirmed that there was a need for ethics during medical education and scientific training, the degree of inclusion of formal ethics in the physiology curriculum varied widely. Our survey showed that, in most cases (69%), including at our Medical University of Graz, ethics in physiology is not incorporated into the physiology curriculum. Given this result, we suggest specific topics related to ethics and ethical considerations that could be integrated into the physiology curriculum. We present here a template example of a lecture "Teaching Ethics in Physiology" (structure, content, examples, and references), which was based on guidelines and case reports provided by experts in this area (e.g., Benos DJ. Ethics revisited. Adv Physiol Educ 25: 189-190, 2001). This lecture, which we are presently using in Graz, could be used as a base that could lead to greater awareness of important ethical issues in students at an early point in the educational process.     

Phosphoinositide-metabolizing enzymes at the interface between membrane traffic and cell signalling

Phosphoinositides (PIs) have long been known to have important roles in cell signalling. During the past decade, it has become clear that these lipids also act as constitutive signals that aid in defining organelle identity, and are short-lived recruiters and regulators of cytoskeletal and membrane dynamics. Recent studies have provided important clues as to how regulated activation of PI-metabolizing enzymes and recruitment of their binding proteins might cooperate in targeting distinct pools of PIs to different cell physiological functions.     

Human genetic databanks in Australia: indications of inconsistency and confusion

This paper reports on a survey of human biotechnology organizations in Australia. The study provides insights into the nature, use and practices involved with human genetic databanking in the country. The survey was conducted at a time when databanks were becoming increasingly important to an expanding genomics industry, and while the nature and extent of industry regulation was being debated. The data revealed a surprising level of confusion and inconsistency in the interpretation of terminology and in ethical practice, even among those organizations subject to the relevant government ethics guidelines. It is argued that despite the extensive level of public consultation, recommendations for reform and actual reform in the intervening years, human genetic databanking remains an under-regulated sector of the human biotechnology industry in Australia, and at least as far as the private sector is concerned, will remain so in the foreseeable future.     

Review by a local medical research ethics committee of the conduct of approved research projects,by examination of patients' case notes,consent forms,and research records and by interview.

OBJECTIVE: To monitor the conduct of medical research projects that have already been approved by the local medical research ethics committee. DESIGN: Follow up study of ethically approved studies (randomly selected from all the studies approved in the previous year) by examination of patients'' case notes, consent forms, and research records and by interview of the researchers at their workplace. SETTING: Tayside, Scotland (mixed rural and urban population). SUBJECTS: 30 research projects approved by Tayside local medical research ethics committee. MAIN OUTCOME MEASURES: Adherence to the agreed protocol, particularly for recruitment (obtaining and recording informed consent) and for specific requirements of the ethics committee, including notification of changes to the protocol and of adverse events. RESULTS: In one project only oral consent had been obtained, and in a quarter of the studies one or more consent forms were incorrectly completed. Inadequate filing of case notes in five studies and of consent forms in six made them unavailable for scrutiny. Adverse events were reported, but there was a general failure to report the abandoning or non-starting of projects in two studies the investigators failed to notify a change in the responsible researcher. CONCLUSIONS: Monitoring of medical research by local medical research ethics committees promotes and preserves ethical standards, protects subjects and researchers, discourages fraud, and has the support of investigators. We recommend that 10% of projects should undergo on-site review, with all others monitored by questionnaire. This would require about six person hours of time and a salary bill of 120 pounds per study monitored.     

Publication: an ethical imperative.

Publication of medical research is both a monitor of the researcher''s ethics and an audit of the local or regional ethics committee that approved it. Selectivity of publication or of the intention to publish lessens this audit. Opinions differ about what is ethically allowable in clinical and benchtop medical research. Ethical permission and ethical monitoring of medical research are subject to a hierarchy of pyramidal controls, starting in hospital and ending with the local, institutional, or regional ethics committee. Currently, such committees function with widely varying degrees of efficiency and quality of output, and with differing viewpoints on many ethical issues. Without an a priori insistence by institutional ethics committees that there be an intention to publish all medical research involving human subjects, ethics committees cannot routinely be subject to the scrutiny or audit which they themselves demand of researchers.     

Comparative analysis of ER stress response into HIV protease inhibitors: Lopinavir but not darunavir induces potent ER stress response via ROS/JNK pathway

HIV protease inhibitor (PI)-induced ER stress has been associated with adverse effects. Although it is a serious clinical problem for HIV/AIDS patients, comparative analyses of ER stress induction by clinically used PIs have rarely been done. Especially, there is no report on the differential ER stress response between lopinavir (LPV) and darunavir (DRV), although these PIs are the most clinically used PIs. We show here that LPV induces the most potent CHOP expression, ER stress marker, among the 9 Food and Drug Administration (FDA)-approved PIs in human peripheral blood mononuclear cells, several human epithelial cells, and mouse embryonic fibroblasts. LPV induced the most potent ROS production and JNK activation in 9 PIs. A comparison among the most clinically used PIs, ritonavir (RTV), LPV, and DRV, revealed that LPV potently and RTV moderately but not DRV induced ER stress via ROS-dependent JNK activation rather than proteasome inhibition. Finally, we analyzed ER stress induction in tissues of mice intraperitoneally injected with RTV, LPV, and DRV. RTV and LPV but not DRV showed ER stress induction in several mice tissues. In conclusion, we first identify LPV as the most potent ER stress inducing PI among 9 FDA-approved PIs in human cells, and although clinical verification is necessary, we show here that DRV has the advantage of less ROS and ER stress induction potential compared with LPV in vitro and in vivo.     

Becoming a Developer: Processes of Personhood in Urban Community-driven Development,Indonesia

ABSTRACT

Community-driven development in Indonesia requires the recruitment of volunteers: local residents with the will to develop themselves and others. By revealing the processes of personhood in light of volunteers’ own theories of self, I aim to disrupt simple readings of subjectification in the anthropology of development. Local volunteers understand their recruitment as having the opportunity to occupy a social position that is aligned with their jiwa (nature), and their participation as satisfying their hati (seat of emotion). Rather than assess the success or failure of state actions to regulate or constitute citizens through discursive and affective means, I take seriously this understanding of development as a process of locating and recruiting people predisposed to becoming the subjects of state development. Doing so prompts new lines of enquiry that have been overlooked in understanding processes of subjectification in development: namely the reason why some people are recruited as development subject, while the majority are not.     

The consent problem within DNA biobanks

Large prospective biobanks are being established containing DNA, lifestyle and health information in order to study the relationship between diseases, genes and environment. Informed consent is a central component of research ethics protection. Disclosure of information about the research is an essential element of seeking informed consent. Within biobanks, it is not possible at recruitment to describe in detail the information that will subsequently be collected because people will not know which disease they will develop. It will also be difficult to describe the specific research that will be performed using the biobank, other than to stipulate categories of research or diseases that are not included. Potential subjects can only be given information about the sorts of research that will be performed and by whom. Organisations responsible for biobanks usually argue that this disclosure of information is adequate when seeking informed consent, especially if coupled with a right to withdraw, as it would not be feasible or it would be too expensive to seek consent renewal on a regular basis. However, there are concerns about this 'blanket consent' approach'. Consent waivers have also been proposed in which research subjects entrust their consent with an independent third party to decide whether subsequent research using the biobank is consistent with the original consent provided by the subject.     

PI-loting membrane traffic

Phosphoinositides (PIs) undergo phosphorylation/dephosphorylation cycles through organelle-specific PI kinases and PI phosphatases that lead to distinct subcellular distributions of the individual PI species. Specific PIs control the correct timing and location of many trafficking events. Their ultimate mode of action is not always well defined, but it includes localized recruitment of transport machinery, allosteric regulation of PI-binding proteins and changes in the physical properties of the membrane.     

植物蛋白酶抑制剂基因结构、调控及其控制害虫的策略

各种不同类型的植物蛋白酶抑制剂基因已被分离,它们的特异产物(单基因或多基因组合),对昆虫体内各种生化和生理过程会产生不同程度的影响,在对昆虫和病原体防御体系中起重要作用。多种蛋白酶抑制剂重组,协同保护植物的方法,已成为害虫综合防治计划的一部分。尽管它们近期内尚不能代替化学杀虫剂,但可作为有效的替补。目前,大多数抑制剂的作用和机理正在详尽地研究中,该文综述了植物蛋白酶抑制剂的基因结构、调控与表达并讨论了培育转基因作物控制害虫的策略。     

Participant informed consent in cluster randomized trials: review

Background

The Nuremberg code defines the general ethical framework of medical research with participant consent as its cornerstone. In cluster randomized trials (CRT), obtaining participant informed consent raises logistic and methodologic concerns. First, with randomization of large clusters such as geographical areas, obtaining individual informed consent may be impossible. Second, participants in randomized clusters cannot avoid certain interventions, which implies that participant informed consent refers only to data collection, not administration of an intervention. Third, complete participant information may be a source of selection bias, which then raises methodological concerns. We assessed whether participant informed consent was required in such trials, which type of consent was required, and whether the trial was at risk of selection bias because of the very nature of participant information.

Methods and Findings

We systematically reviewed all reports of CRT published in MEDLINE in 2008 and surveyed corresponding authors regarding the nature of the informed consent and the process of participant inclusion. We identified 173 reports and obtained an answer from 113 authors (65.3%). In total, 23.7% of the reports lacked information on ethics committee approval or participant consent, 53.1% of authors declared that participant consent was for data collection only and 58.5% that the group allocation was not specified for participants. The process of recruitment (chronology of participant recruitment with regard to cluster randomization) was rarely reported, and we estimated that only 56.6% of the trials were free of potential selection bias.

Conclusions

For CRTs, the reporting of ethics committee approval and participant informed consent is less than optimal. Reports should describe whether participants consented for administration of an intervention and/or data collection. Finally, the process of participant recruitment should be fully described (namely, whether participants were informed of the allocation group before being recruited) for a better appraisal of the risk of selection bias.     

On the Alleged Right to Participate in High‐Risk Research

Reigning regulatory frameworks for biomedical research impose on researchers and research ethics committees an obligation to protect research participants from risks that are unnecessary, disproportionate to potential research benefits, and non‐minimized. Where the research has no potential to produce results of direct benefit to the subjects and the subjects are unable to give consent, these requirements are strengthened by an additional condition, that risks should not exceed a certain minimal threshold. In this article, I address the question of whether there should be limits of permissible risks in non‐therapeutic research involving competent and healthy subjects. Some commentators argue that competent and informed individuals should have a right to participate even in extremely risky research and that research ethics committees should never reject studies because they are too dangerous. To use David Shaw's expression, competent volunteers should have ‘a right to participate in high‐risk research’. I argue that this idea is ill‐founded, as it does not take into account the social mission and complex collaborative nature of research practice as well as the inequity of power between researchers and subjects. Imposition of limits on permissible risks for healthy volunteers is justified by the need to protect research enterprise and the need to protect the weaker party, namely the subjects. Also, I suggest that the best way to set boundaries on research risks is to leave the judgment of risk acceptability to research ethics committees.     

At the poles across kingdoms: phosphoinositides and polar tip growth

Phosphoinositides (PIs) are minor, but essential phospholipid constituents of eukaryotic membranes, and are involved in the regulation of various physiological processes. Recent genetic and cell biological advances indicate that PIs play important roles in the control of polar tip growth in plant cells. In root hairs and pollen tubes, PIs control directional membrane trafficking required for the delivery of cell wall material and membrane area to the growing tip. So far, the exact mechanisms by which PIs control polarity and tip growth are unresolved. However, data gained from the analysis of plant, fungal and animal systems implicate PIs in the control of cytoskeletal dynamics, ion channel activity as well as vesicle trafficking. The present review aims at giving an overview of PI roles in eukaryotic cells with a special focus on functions pertaining to the control of cell polarity. Comparative screening of plant and fungal genomes suggests diversification of the PI system with increasing organismic complexity. The evolutionary conservation of the PI system among eukaryotic cells suggests a role for PIs in tip growing cells in models where PIs so far have not been a focus of attention, such as fungal hyphae.     

Safeguard subjects

In the available literature on ecobalances, relatively little attention has until now been devoted to the discussion of the ultimate objectives of ecocontrolling, i.e. to the determination of those elements of nature which deserve highest protection. The goal of this paper is to elaborate and to provide grounds for a target-system of ecocontrol-ling based upon existing concepts in the environmental ethics. The immediate connection between ethical considerations and the target-system of ecocontrolling arises from the fact that the ethical notion of ‘intrinsic value’ (applied on elements of nature), and the concept of ‘safeguard subject’ used in literature on ecocontrolling and ecobalances appear congruent. Principally, it would be desirable that the safeguard subjects consist only of natural elements with an intrinsic value — within the chosen approach of environmental ethics. However, in order to reach an optimal operationalization, it appears unavoidable to put elements of nature with an intrinsic value and those elements that do not possess such a value (but which operationalize elements with an intrinsic value) together in the list of the safeguard subjects. Relying on the theoretical and practical analysis, a list of safeguard subjects similar that from Gonsoli et al. is proposed. The ethical frame allows for a new insight, the idea that there is a hierarchy between the different safeguard subjects, and that a limited influence on a safeguard subject of lower rank docs not have to be considered an impairment of the corresponding safeguard subject.     

GENDER AND ETHICS COMMITTEES: WHERE’S THE ‘DIFFERENT VOICE’?

Prominent international and national ethics commissions such as the UNESCO International Bioethics Committee rarely achieve anything remotely resembling gender equality, although local research and clinical ethics committees are somewhat more egalitarian. Under‐representation of women is particularly troubling when the subject matter of modern bioethics so disproportionately concerns women’s bodies, and when such committees claim to derive ‘universal’ standards. Are women missing from many ethics committees because of relatively straightforward, if discriminatory, demographic factors? Or are the methods of analysis and styles of ethics to which these bodies are committed somehow ‘anti‐female’? It has been argued, for example, that there is a ‘different voice’ in ethical reasoning, not confined to women but more representative of female experience. Similarly, some feminist writers, such as Evelyn Fox Keller and Donna Haraway, have asked difficult epistemological questions about the dominant ‘masculine paradigm’ in science. Perhaps the dominant paradigm in ethics committee deliberation is similarly gendered? This article provides a preliminary survey of women’s representation on ethics committees in eastern and western Europe, a critical analysis of the supposed ‘masculinism’ of the principlist approach, and a case example in which a ‘different voice’ did indeed make a difference.     

Study bystanders and ethical treatment of study participants—A proof of concept

The ethics of research on human subjects is often construed as a fine balance between the interests of patients in need of novel health interventions, and those of study participants who should remain safe in the process. But there is a third group in the mix. Some people belong to neither category, yet research can affect or jeopardize them. Call such people “bystanders.” This article shows that thinking about bystander protection can question whether there is an upper limit on the risks that studies may legitimately visit upon their participants. Thus, thinking about appropriate bystander protection can shed light on the appropriate protection of study participants. Core research ethics, which focuses on the latter, must consider the former as well.     

Probing phosphoinositide functions in signaling and membrane trafficking

The inositol phospholipids (PIs) comprise a family of eight species with different combinations of phosphate groups arranged around the inositol ring. PIs are among the most versatile signaling molecules known, with key roles in receptor-mediated signal transduction, actin remodeling and membrane trafficking. Recent studies have identified effector proteins and specific lipid-binding domains through which PIs signal. These lipid-binding domains can be used as probes to further our understanding of the spatial and temporal control of individual PI species. New layers of complexity revealed by the use of such probes include the occurrence of PIs at intracellular locations, the identification of phosphatidylinositol signaling hotspots and the presence of non-membrane pools of PIs in cell nuclei.