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At least 415 records · Page 23Linked to original sources
PubMed1998

The ethics of HIV research in developing nations.

This paper discusses a dispute concerning the ethics of research on preventing the perinatal transmission of HIV in developing nations. Critics of this research argue that it is unethical because it denies a proven treatment to placebo-control groups. Since studies conducted in developed nations would not deny this treatment to subjects, the critics maintain that these experiments manifest a double standard for ethical research and that a single standard of ethics should apply to all research on human subjects. Proponents of the research, however, argue that these charges fail to understand the ethical complexities of research in developing nations, and that study designs can vary according to the social, economic, and scientific conditions of research. This essay explores some of the ethical issues raised by this controversial case in order to shed some light on the deeper, meta-ethical questions. The paper argues that standards of ethical research on human subjects are universal but not absolute: there are some general ethical principles that apply to all cases of human subjects research but the application of these principles must take into account factors inherent in particular situations.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Whose genome project?

The human genome project is a multinational project aimed at obtaining a detailed map and a complete DNA sequence of the human genome. It will have many scientific, medical, economic, ethical, legal, and social implications. A fundamental question to ask is "Whose genome project is it?" We can answer this question from different perspectives, and this aids our thinking about the issues that arise from the project. We can think of who proposed the idea, who should fund the research, who should perform the research, whose genome is mapped and sequenced, who should own the data, who should benefit from the results, and who should make these decisions. We can also compare the answers to these ethical questions with what is occurring in practice.

Altruism↗
PubMed1993

Brain death: a durable consensus?

Is it even conceivable that this global consensus [on the whole-brain definition of death] could, in time, be regarded as a very temporary and makeshift expedient, a momentary substitute for a resolution of some profoundly difficult issues which for a time, perhaps a brief time, fit with both the technical capacities and the legal needs of those who endorsed it? And that in the long run it could linger as a footnote, or perhaps a chapter heading, in the long history of man's conceptions of life and death? This suggestion is so far from conventional wisdom today that one who espouses it risks being regarded as a crank. Nevertheless, I believe that the argument in its favor, while not conclusive, is much stronger than the argument against it (and in favor of the prevailing consensus). I will state the argument briefly, with particular reference to the landmark report in 1982 in Washington of the President's Commission for the Study of Ethical Problems in Medicine, and will situate the argument in the context of trends in contemporary bioethics. I do not expect to win over, in this one pass, those who have been convinced of the validity of the conventional view. I do hope, however, to re-open the issue; in particular, to provide reasons to regard the issue as far from settled.

Advisory Committees↗
PubMed2002

The case manager's view of the helping alliance.

Although the helping alliance has been a topic of investigation in psychotherapy research for decades, few studies have examined the role of the helping alliance in assertive community treatment programs serving people with severe mental illness. In this article, we describe a series of analyses focused on the case manager's view of the helping alliance. The study addressed two primary questions: What factors facilitate a positive helping alliance in case management? What is the relationship of the helping alliance to client outcomes? Results indicated that few client variables predicted the helping alliance. Providing a wider range of services was associated with a stronger alliance at months but not at 18 months. A strong alliance at 18 months was associated with a strong alliance at 6 months. In addition, the alliance at 18 months was rated more positively for clients who were African-American and who did not have a substance use disorder. The helping alliance predicted client satisfaction, anxiety-depression, and hostility-suspicion outcomes at 6 months. However, the helping alliance did not predict any of the client outcome variables at 18 months.

Case Management↗
PubMed1976

The financing and the economic efficiency of rural health services in the People's Republic of China.

This paper studies the resource allocation in the provision of health care services at the local level in the People's Republic of China. The subject of health financing and the effectiveness and cost of this medical cooperative service in the country's rural areas are evaluated. The conclusion drawn is that, with China's agricultural economic framework, the adoption of barefoot doctor services and the promotion of herbal medicine are cost-minimizing approaches that enable local political units to be financially self-supporting with regard to medical services. Based on a few samples at brigade or commune level, the results indicate that the barefoot doctor services are economically valuable. Furthermore, the sense of security and a point of entry into the health care system that the barefoot doctors can provide for lower-income peasants are by no means a minor noneconomic benefit. Some of their experiences may be useful to other developing countries.

China↗
PubMed1992

Characteristics of women performing strength training: comparison of participants and dropouts.

The physiological, anthropometric, personality and lifestyle characteristics of 122 women volunteering for a seven-week program of heavy resistance weight training were studied relative to adherence rates. Initially, volunteers were above-average in body mass and grip strength, but were below-average in chest girth and bicristal diameter. They were also physically active and only 20% smoked. Regular (R) attenders (attendance greater than 80%; 72% of the sample) were physically smaller in terms of stature, mass, girths and dimensions, but had greater strength per kg of mass or LBM compared to participants classified as infrequent (I; 24-76%) and dropout (DO; less than 20%). Conversely, I and DO members were more likely to smoke, to smoke more heavily, to drink coffee and to not eat breakfast. Most dropouts quit during the first week; among volunteers who continued, differences in assigned training intensity had no effect on adherence. Adherence was also unrelated to strength gains, anthropometric adaptations, or injury.

Adolescent↗
PubMed1992

In a canine model, lung preservation at 10 degrees C is superior to that at 4 degrees C. A comparison of two preservation temperatures on lung function and on adenosine triphosphate level measured by phosphorus 31-nuclear magnetic resonance.

Techniques for organ preservation generally use hypothermia to retard metabolic requirements. However, excessive hypothermia may also produce injury. Using a canine left lung allotransplantation procedure, we compared two preservation temperatures (4 degrees and 10 degrees C) in terms of subsequent lung function measured by temporary occlusion of the right pulmonary artery after implantation of the preserved left donor lung. The lungs were flushed with low-potassium dextran electrolyte solution, inflated with 100% oxygen, and preserved for 18 hours. To investigate possible changes of energy stores at different temperatures, we performed phosphorus 31-nuclear magnetic resonance analyses of lung samples. Sequential determinations of adenosine triphosphate levels in lung tissue preserved at 4 degrees, 10 degrees, and 22 degrees C were studied. After transplantation, lungs preserved at 10 degrees C (n = 6) provided significantly better arterial oxygen tension than those preserved at 4 degrees C (n = 6), 451 +/- 46 mm Hg versus 243 +/- 86 mm Hg (p less than 0.05), and lower pulmonary vascular resistance, 581 +/- 68 dynes.sec.cm-5 versus 1006 +/- 157 dynes.sec.cm-5 (p less than 0.05). Adenosine triphosphate levels at 4 degrees and 10 degrees C were stable and did not differ from each other at the end of the 18-hour preservation period: 0.86 +/- 0.04 mumol/gm wet weight for control versus 0.86 +/- 0.07 mumol/gm wet weight for 4 degrees C and 0.93 +/- 0.06 mumol/gm wet weight for 10 degrees C after 18 hours of preservation. Preservation at 22 degrees C caused a 28% depression of adenosine triphosphate after 18 hours of preservation. These results lead us to conclude the following: (1) Optimal temperature for lung preservation is in the vicinity of 10 degrees C, and (2) lung dysfunction caused by excessive hypothermia is not due to a failure to maintain adenosine triphosphate levels. We suspect that adenosine triphosphate is generated by oxidative phosphorylation during lung preservation.

Adenosine Triphosphate↗
PubMed1983

[Clinical evaluation of SPG (schizophyllan) as a therapeutic adjuvant after surgery of gastric cancer--controlled study by an envelope method].

SPG, a beta-1, 3 glucan extracted from cultured Schizophyllum commune Fries, was clinically evaluated for its efficacy in adjuvant immunochemotherapy for postoperative gastric cancer by the SPG cooperative study group comprising 43 hospitals. On the day of operation and the next day, patients were given intravenously 0.4 mg and 0.2 mg/kg of mitomycin C, respectively. Subsequently, they were randomly allocated to either the SPG group or control group. From the 10th to 20th postoperative days, the SPG group was intramuscularly given SPG at a dose of 20 mg twice a week or 40 mg once a week in combination with tegafur, while the control group was given only tegafur. Significant prolongation of life span of the SPG group was confirmed in Stage III. Minor side effects due to SPG were noted in 2.6% (5/190).

Adjuvants, Immunologic↗
PubMed2001

Serotonergic involvement in the psychosocial dimension of personality.

Neurotransmitter systems have been associated with aspects of personality and changes in various dimensions have been shown after antidepressant treatment. A reduction in harm avoidance and an increase in self-directedness and cooperativeness, as measured by the Cloninger's Temperament and Character Inventory (TCI), have been reported in psychiatric patients receiving treatment with serotonergic antidepressants. However, some of these changes have been associated with clinical improvement. The present study therefore used a randomized, double-blind, placebo-controlled design to examine the role of the serotonergic system on these personality factors in the normal population. Twenty healthy male volunteers were randomly allocated to either placebo (n = 9) or citalopram treatment (n = 11) for 2 weeks. Baseline depression and anxiety scores were low and did not differ between groups. The TCI was administered pre- and post-treatment. There were no baseline differences on any TCI factor between groups. Citalopram induced a significant increase in self-directedness (p < 0.05) but not cooperativeness or harm avoidance ratings after treatment. Thus, citalopram has effects on personality aspects which appear to be separate from its antidepressant properties.

Adolescent↗