The role and responsibilities of witnesses in the informed consent process

Various mechanisms to ensure the protection of subjects in human research have been suggested, including the presence of witnesses during the informed consent process. For our commentary on the use of witnesses and their potential role and responsibility during the consent process, we start by addressing current guidelines for human subjects research in four Latin American countries. By using examples from public health research, we highlight some of the practical difficulties of using witnessed consent, from becoming a meaningless ritual at one end of the spectrum to the research subject feeling intimidated or coerced to participate at the other. Apart from these practical difficulties, it is unclear what responsibility the witness could and should have. We argue that there are important ethical questions about the role of witnesses that have not been adequately addressed in national and international regulations. This work addresses these gaps and argues that more debate is required to define the role and responsibilities of witnesses in the consent process, their training requirements and whether a universal legal requirement for witnessed consent, regardless of the type of research, is desirable.     

The role of expert systems in vegetation science

An area of artificial intelligence known as experts systems (or knowledge-based systems) is being applied in many areas of science, technology and commerce. It is likely that the techniques will have an impact on vegetation science and ecology in general. This paper discusses some of those impacts and concludes that the main effects will be in areas of applied ecology especially where ecological expertise is needed either quickly (e.g. disaster management) or across a wide range of ecological disciplines (e.g. land management decisions). Expert systems will provide ecologists with valuable tools for managing data and interacting with other fields of expertise. The impact of expert systems on ecological theory will depend on the degree to which deep knowledge (i.e. knowledge based on first principles rather than on more empirical rules) is used in formulating knowledge bases.     

The recent development and evaluation of a medical expert system (ABVAB)

A medical expert system for the diagnosis of abnormal vaginal bleeding named as ABVAB had been reported. This paper will describe the recent development of ABVAB and its clinical evaluation. The overall testing results are quite satisfactory in spite of the limitations of time and small domain. This expert system, by using the fuzzy and certainty factor concepts, is able to handle imprecise and incomplete medical knowledge which has become informative. The paper also analyses the relative degrees of importance of the history and physical examination data in making a medical diagnosis.     

Prenosological approach to attaining the objectives of aviation medical expert assessment

Early diagnosis of diseases and conditions undesirable in terms of flight safety in senior pilots is tightly linked with the evaluation of disease risks. Prenosological diagnostics is focused on borderline states that may pass from health to disease (prenosology and premorbidity) and, vice versa, from disease to recovery (post-nosology). Regarding health as a vital adaptation reserve, prenosology diagnostics is concerned with the ability of the body to adapt to the environment rather than develop a disease. A constant drain of adaptation reserves may become the reason for increased risks of disease. Heart rate variability analysis is one of the instruments of prenosological diagnostics. The paper discusses the applicability of the space-medicine oriented probabilistic approach to the evaluation of adaptation risks by medical expert assessment boards certifying civil pilots. The results of two series of investigations showed increased adaptation risks and reduced functional reserves in pilots found unfit to continue their careers.     

The role of flow cytometry in medical mycology

The alarming increase in fungal diseases among hospitalized patients is a serious problem as these infections often have poor prognosis because of delayed diagnosis and lack of proper therapy. The rapid laboratory diagnosis of these diseases still remains problematic. The areas of concern include accurate identification of pathogenic fungi, rapid testing of their susceptibility to antifungals, and reliable determination of their interrelatedness to other clinical isolates. In the past few decades, flow cytometry has proven to be an adaptive technology platform for diagnostics. The applications encompass identification, serotyping, genotyping, susceptibility testing, and molecular pathogenesis studies. The recent revolution in the miniaturizing and customizing of instrumentation has now made this technology more accessible and affordable. In the near future, it is imperative to develop standardized protocols by means of interlaboratory comparisons and to share reagents for reproducibility studies. Flow cytometry remains highly attractive as an integrated application for myriad tasks in medical mycology laboratories.     

The role of game management in wildlife populations: uncertainty analysis of expert knowledge

Uncertainties about future states of wildlife populations make it difficult to pre-adapt to possible threats and ensure sustainability of resources and harvesting over the long term. This uncertainty is partly due to the unknown impact and future states of many factors that explain population sizes and variation. In this paper, the effect of local game management activities on the uncertainty of future population sizes of groups of Finnish wildlife species (ungulates, forest grouse, large predators, small predators and mountain hare) was analysed using expert knowledge and the Bayesian belief networks (BBNs) modelling techniques. As a result, the current knowledge and agreement of the relationships between wildlife population sizes and the game management activities explaining their variation as well as trends are evaluated. Information given to hunters and the number of hunters were seen as the most effective factors for the management of game populations. However, there were great uncertainties in the expectations regarding future trends in the management activities, especially in feeding, and there was disagreement in the direction of the trend in the length of the hunting season. The trends in the size of forest grouse populations were viewed as the most uncertain trend among species groups. At the same time, forest grouse were seen as the most regulated species group by local game management. Among interest variables, experts were very uncertain and they disagreed about the direction of the trend in the recreational value of hunting.