Consent For Participation Research Articles

Lecture Critique De La Loi Camerounaise Relative a La Recherche Medicale Impliquant La Personne Humaine

The use of humans for medical research raises sensitive issues, as a number of interests may come into conflict, and human dignity may be threatened. Hence, there is a need to protect research participants. For this reason, the mere existence of the new law is a step forward in that it fills a legislative gap. But this is not its only merit, as the law attempts to strike a balance between the interests involved by prohibiting certain practices and requiring the free and informed consent of research participants, even for research conducted on cadavers.

Unlocking the potential of genetic research in pulmonary arterial hypertension: Insights from clinicians, researchers, and study team.

Genetic research and testing are increasingly important for understanding and treating pulmonary arterial hypertension. We aimed to explore how attitudes toward genetic research among clinical and research teams impacted the engagement in genetic research and the integration of genetic insights into clinical practice. We conducted 53 semistructured interviews and focus groups with patients, clinicians, and researchers from nine UK Pulmonary Hypertension centers, who had genetic research experience. Transcripts were thematically coded using inductive analysis. In this study, we focus on the researchers', clinicians', and study team's perspectives. From the interview data, several key themes emerged, ranging from study design, recruitment, and consent procedures to the return of individual genetic results. Additionally, participants reflected on both the successes of these studies and the future directions of genetic research. The analysis highlighted the critical importance of fostering collaborative networks firmly rooted in existing clinical and research infrastructure in rare disease study setups. Furthermore, the significance of trust-building, personalized communication, and transparency among stakeholders was underscored. The study offered valuable insights into the motivating and hindering factors to participant recruitment and consent procedures. Lastly, the findings gathered from processes surrounding the return of individual genetic results, genetic counselling, and the recruitment of relatives provided invaluable lessons regarding the integration of genetics into clinical practice. This in-depth analysis yields a crucial understanding of attitudes to genetic research among various stakeholders and sheds light on the complexities of genetic research and the evidence-practice gap.

Efficacy of Vasantik Vaman Karma (Therapeutic Emesis) on Oxidative Stress Markers in Healthy VolunteersA Pilot Randomised Controlled Study

Introduction: Vamana karma is a therapeutic emesis procedure recommended for maintaining health in healthy individuals. It is said to be conducted during the Vasant rutu (spring season) and is referred to as Vasantik Vaman. During this season, there is an aggravation of Kapha dosha, which can lead to various diseases. The bio-purification of the body in Vasant rutu through the Vaman procedure helps to detoxify and rejuvenate the body. To make this practice evidence-based, the present study was planned to evaluate the efficacy of Vamana karma, which is also considered a shodhana karma, in reducing oxidative stress. Aim: To compare the efficacy of Vasantik Vamana karma on Malondialdehyde (MDA) and Superoxide Dismutase (SOD) levels as markers of oxidative stress in healthy volunteers, compared to a non interventional group. Materials and Methods: The present randomised controlled study was conducted in the Department of Kriyasharir, Mahatma Gandhi Ayurved College, Hospital and Research Centre, under the auspices of Datta Meghe Institute of Higher Education University, Wardha, Maharashtra, India, from March 2023 to April 2023 during the Vasant rutu. A total of 58 healthy individuals aged between 20 years and 40 years were sensitised regarding the procedure and benefits of Vasantik Vamana karma. After sensitisation, 30 volunteers who provided written consent for participation in the study were enrolled, examined and randomly divided into two groups: Group A (non interventional) and Group B (interventional). Both groups were assessed on the 0th day and the 15th day for oxidative stress markers, specifically free radicals (MDA) and antioxidant (SOD) levels. Statistical analysis was done using descriptive and inferential statistics, including Student’s paired and unpaired t-tests. Results: The mean±Standard Deviation (SD) age of participants was 21.23±0.37 years, with participation almost equal from both genders. Before the intervention, SOD and MDA levels were similar in both the control and interventional groups. After the intervention of Vasantik Vamana karma, Group B showed an increase in SOD levels and a decrease in MDA levels, which were statistically highly significant according to the paired t-test (p-value≤0.001) in comparison to the non interventional group. In the non interventional group, p-value=0.951 for SOD levels and 0.551 for MDA levels by paired t-test, which were not significant. When both groups were compared using an unpaired test, at pre-intervention, both groups were at the same level, but after the intervention, statistically significant results were observed in Group B (p-value≤0.001). Conclusion: The present study concluded that Vasantik Vamana karma, as a bio-purification process, Vasantik Vamana karma has proven to be highly effective in detoxifying the body by reducing oxidative stress in healthy volunteers.

Detection of uterine abnormalities using three-dimensional vaginal ultrasound in infertile women undergoing assisted reproductive techniques

Abstract Background: Uterine shape and cavity abnormalities form a common cause of subfertility, for which thorough assessment is considered as a core part in infertility evaluation. A variety of modalities (invasive and none invasive) such as hysterosalpingography, transvaginal sonography, diagnostic hysteroscopy, two-dimensional hysterosonography, and three-dimensional hysterosonography can be used for the diagnosis of uterine abnormalities. Objectives: To address the detection rate of uterine and endometrial abnormalities in infertile women undergoing assisted reproductive techniques (ART) using three-dimensional vaginal ultrasonography. Materials and Methods: A cross-sectional observational study that involved 211 subfertile women who were arranged to undergo ART for different causes of infertility. After taking their verbal consent for participation in this study, all women examined by 2D vaginal U/S for initial assessment of their pelvic anatomy then followed by three-dimensional U/S with or without saline infusion for further assessment of the uterine and endometrial cavity morphology. Women with ultrasound detected endometrial abnormalities further underwent hysteroscopic assessment, histopathological specimens were taken and were treated as recommended by their gynecologist. Results: Twenty-two percent of the studied group discovered to have uterine and/or endometrial abnormalities including endometrial polyps and uterine myomas are the most commonly detected abnormalities while congenital uterine malformation detected in 3.8% of the total patients using three-dimensional ultrasonography. Conclusion: Uterine and endometrial abnormalities are common in subfertile patients, the prevalence of uterine and endometrial abnormalities (endometrial polyps or irregularities, uterine myomas including submucous one) was 22%, whereas congenitally maldeveloped uteri were detected in 3.8% of women undergoing ART (using 3D U/S) which may have a negative impact on ART outcome.

Visualising Medical Research: Exploring the Influence of Infographics on Professional Dissemination.

This study explores the impact of infographics on the professional dissemination of medical research. Recognising the burgeoning volume of data in the medical domain, this research aims to bridge the gap by investigating the efficacy of infographics in rendering complex medical concepts understandable to diverse audiences, including policymakers, patients, and the public. The study uses a cross-sectional survey to assess medical professionals' familiarity with infographic design and data visualisation principles. Setting. The research targets medical professionals with published articles across various subfields, including Clinical Medicine, Epidemiology, Pharmacology, Healthcare Management, Medical Imaging, and Public Health. Data collection involves an online survey distributed to potential participants through professional networks and research institutions. The survey encompasses Likert-scale questions and demographic variables. Ethical considerations include obtaining approval from the institutional review board, ensuring participant consent, and maintaining data anonymity and confidentiality. Demographic analysis reveals a diverse participant profile, with 58.7% male and 41.3% female respondents, spanning various age groups, professional experiences, and geographic locations. Assessing familiarity with infographic design and data visualisation principles demonstrates respondents' proficiency in certain areas while highlighting potential areas for improvement. The study underscores the multifaceted benefits of infographics in research dissemination, as medical professionals perceive. Infographics can effectively convey various kinds of medical research information across diverse platforms and channels.

A Study to Assess the Knowledge and Attitude regarding Voluntary Blood Donation among College Going Male Students, a Quasi-experimental Study

Introduction: Voluntary blood donation in developing countries like India is constrained by misconception, fear, and widespread myths regarding blood donation.(1) Donated blood is an essential component in the management of many diseases. It is the main lifesaving for an individual with loss of large volumes of blood from accidents, hemorrhages or surgery.(2) Blood and its product demands is increasing, which can be ensured by increasing awareness and interest in blood donation in different groups of people. Youth is one of those groups. Misconception and low levels of awareness lead to unsatisfactory voluntary blood donation practices among them. The aim is to assess the knowledge and attitude of college students towards voluntary blood. Material and Methods: After prior permission from the College Authority, all the students who were present on the day of the study and who acknowledged their consent for participation were enrolled in the study. A pre-tested, semi-open-ended questionnaire was used as a study tool first as a pre-test to check their prior knowledge and attitude, followed by a health talk. Then, the same questionnaire was used to check their improvement of knowledge about blood donation. Results: As per the Wilcoxon rank test there is a significant improvement in the knowledge of study participants after health talk; out of a total 105 male students, 102 show positive rank (W+). Conclusion: Health education regarding voluntary blood donation is effective in improving the knowledge and attitude of youth. This will further improve the situation of voluntary blood donation by youth.

알코올중독 치료기관 간호사의 근무 경험

Objectives: To analyze work experiences of nurses working in alcohol addiction treatment facilities, data were collected through focus group interviews. The objective of this study was to identify role conflicts and enhance their adaptive abilities. Methods: This study was conducted from July 1st, 2022 to September 30th, 2022. Twelve nurses working in two alcohol addiction treatment facilities (selected using intentional sampling methods) participated in this study after obtaining their consent for participation and recording. Data collected through focus group interviews were transcribed and analyzed according to qualitative research methods. Results: Three main themes and 17 subthemes categorized into seven categories were found. The three themes were 'doubts about the work itself,' 'confusing role conflicts,' and 'adaptation and competency enhancement.' The seven categories were: 'initial shock of work,' 'work burden due to exhaustion,' 'doubts about the nursing profession,' 'Conflict of roles where one cannot complain', 'adaptation through personal coping methods,' 'regaining confidence in the role of a nurse' and 'support for competency enhancement.' Conclusions: Nurses in alcohol addiction treatment facilities had different experiences of exhaustion and support depending on the hospital culture they worked in. Nurses recognized that having a clear understanding of their roles was more important than anything else.

PSYCHOLOGICAL EFFECTS OF SEDATIVE ON CRITICALLY ILL PATIENTS

This study aimed to assess the psychological effects experienced by patients admitted to the intensive care unit (ICU). Following ethical approval, the study was conducted as a cross-sectional survey at Bahria International Hospital ICU between January 2022 and December 2022. The inclusion criteria required patients to be over 18 years of age, have stayed in the ICU for at least 24 hours, be aware during the assessment, and provide informed consent for research participation. Patients who failed to complete the assessment or were transferred out of the ICU were excluded from the study. The data was analyzed using a non-probability sampling technique and the SPSS-24 version. A chi-square value of less than 0.5 was considered significant. The data from a total of 161 patients was evaluated. Of these, 72 patients (44%) were diagnosed with depression, while 89 patients (55.2%) had medical cases. Males outnumbered females, with 94 (58%) male patients and 67 (42%) female patients. 26 patients (17%) had a hospital stay of over 2 weeks, compared to 135 (83%) who were discharged within 2 weeks. One hundred fifty-one patients (93%) did not show signs of anxiety, while 10 (6%) tested positive. Nine patients tested positive for amnesia, while 152 did not. One hundred fifty-five patients (96%) reported no hallucinations, while 6 patients (4%) believed they had experienced hallucinations. Seventy-four patients (46%) tested negative for post-traumatic stress disorder (PTSD), while 87 patients (54%) claimed to experience PTSD. Of the ICU admissions, 89 (55%) were due to medical cases, while 27 (16.7%) were surgical. The study highlights the need for implementing a bedside screening instrument and physician approval to improve the identification and early detection of psychological effects in critically ill ICU patients. The first step towards preventing and developing a future ICU free from psychological effects is identifying the incidence and risk factors associated with such impacts. The complex psychosocial impacts experienced by critically ill ICU patients require more attention and research.

Safety climate scale for vineyards: an external validity study.

Agriculture entered the discussions about safety climates late, despite being one of the most hazardous industries. We recently developed a safety climate scale in Bordeaux vineyards, for which we provided good evidence of reliability and construct validity (Grimbuhler and Viel 2019). In this study, we aimed to establish the external validity of this safety climate scale with the help of an independent national sample of vineyard professionals. We approached vineyard managers and operators during compulsory training and certification procedures for pesticide-related activities. Trainees giving informed consent for participation in the study were asked to complete a safety climate questionnaire at the start and end of a training session. In total, 406 vineyard managers or operators completed the questionnaire at the start of the study, 37 of whom declined to complete the questionnaire at the end of the training session, leaving 369 subjects available for pretraining/post-training comparisons. Statistical comparisons were based on t-tests and mixed models for repeated measures. A mean safety climate score of 82.91 (SD: 9.06) was obtained in the initial survey in the Bordeaux region, whereas the safety climate score was estimated at 83.78 (SD 10.39) in this nationwide survey (P = 0.23). A significant increase was observed after the training course, for the safety climate score (7.5%, P < 10-15) and for each of its 7 dimensions (P < 10-4 or less), in both univariate and multivariate analyses. However, the magnitude of these increases varied with dimension, ranging from 2.4% for rules and best practices to 15.5% for communication and feedback. External validity was demonstrated by transferability and sensitivity to intervention. This safety climate scale can now be considered to provide a good inference of the safety culture, with a meaning generalizable across vineyards.

Strategies, methods and policy support to improve students' academic achievement and career development across academic periods

This study explores the strategies, methods and impacts of personalized education implemented at different school stages (from kindergarten to high school). Aiming to solve the problem that the traditional education model ignores individual differences among students and based on empirical analysis, this study explores the effect of personalized education on students' academic achievement, career planning and personal development through cross-stage long-term tracking methods. Using cross-stage long-term tracking methods and experimental grouping of the entire K12 school, combined with artificial intelligence and big data tools, quantitative and qualitative data are analyzed to develop new assessment tools and scales. Data analysis will cover descriptive statistics, multivariate analysis, content analysis, and case studies to evaluate the impact of personalized education on students and test multiple hypotheses. The study also highlights the importance of ethical standards to ensure informed consent and privacy protection of participants.

Inferior vena cava collapsibility index as a predictor of hypotension after induction of general anesthesia in hypertensive patients

BackgroundHypertensive patients are more susceptible to develop hypotension after the induction of general anesthesia (GA), most likely due to hypovolemia. An inferior vena cava collapsibility index (IVCCI) > 40–50% can predict hypotension after the induction of GA in the general population by variable accuracies. The current study aimed to investigate IVCCI% as a predictor of postinduction hypotension in hypertensive patients undergoing noncardiac surgery.MethodsUltrasound IVCCI % was assessed for all controlled hypertensive patients immediately before induction of GA. After induction of GA, patients were diagnosed with postinduction hypotension if their systolic arterial pressure (SAP) dropped by ≥ 30% of the baseline value and/or mean arterial pressure (MAP) dropped to < 65 mmHg up to 15 min after intubation. The receiver operating characteristic (ROC) curve of IVCCI% was compared to patients’ classification either developing hypotension after induction of GA or not as a gold standard.ResultsOf the 153 patients who completed the study, 62 (40.5%) developed hypotension after the induction of GA, and 91 (59.5%) did not. An IVCCI > 39% predicted the occurrence of postinduction hypotension with high accuracy (84%) (AUC 0.908, P < 0.001). The area of uncertainty (by gray zone analysis) of IVCCI lies at values from 39 to 45%. This gray zone included 21 patients (13.7% of all patients).ConclusionAn inferior vena cava collapsibility index > 39% before anesthetic induction can be a simple noninvasive reliable predictor of hypotension after the induction of GA for hypertensive patients not treated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs) and undergoing noncardiac surgery.Trial registrationThis clinical trial was approved by the Institutional Review Board (IRB) at Zagazig University (ZUIRB #9424 dated 03/04/2022), and patients’ informed consent for participation in the study was obtained during the period from May 2022 to May 2023. All study procedures were carried out in accordance with the ethical standards of the Helsinki Declaration of 2013.

The effect of demographic and clinical data on anxiety and depression levels in breast cancer patients receiving radiotherapy.

The aim of this study is to investigate the effects of sociodemographic and clinical data on depression and anxiety levels in patients who undergoing radiotherapy for breast cancer. A total of 111 patients with breast cancer treated in the Radiation Oncology Department of Kayseri City Education and Research Hospital were included in this study. The study was planned prospectively as a survey research based study. Ethics committee approval was obtained. After obtaining the necessary consent for voluntary participation, patients were interviewed face-to-face. The research survey included the Hospital Anxiety and Depression Scale (HADS), as well as demographic and clinical information. Statistical analysis was performed with the collected data. According to the results of repeated measures analysis of variance, the mean difference between the 3-month and 6-month measurements of the depression scale values on the first day of radiotherapy was statistically significant (P &lt; 0.001). Mean differences were statistically notable for age and marital status variables in anxiety and for age, education level, marital status, employment status, family history of cancer, menopause, surgery, chemotherapy and hormone therapy variables in depression. When the change in the presence (&gt; 10 depression scale) or absence (&lt; 10 depression scale) of depression at three different times of radiotherapy (first day, 3 and 6 months) was examined, a statistically notable difference was found between the depression scale values of patients receiving radiotherapy on the first day, 3 months after radiotherapy and 6 months after radiotherapy (P &lt; 0.05). According to the results of our study, the psychological health of women with breast cancer was affected during and after radiotherapy. As a response, psychiatric counseling should be considered as a part of the treatment for depression and anxiety that occur during and after treatment in breast cancer patients.

Exploring perceptions and experiences of stigma in Canada during the COVID-19 pandemic: a qualitative study

BackgroundThe COVID-19 pandemic fueled stigmatization and discrimination, particularly towards individuals of Chinese or East Asian ethnicity. We conducted interviews with members of the public in Canada in order to describe and understand stigma perceptions and experiences during the COVID-19 pandemic.MethodsWe used a phenomenological approach to describe stigma experiences of Canadian residents during the COVID-19 pandemic and compared the stigma perceptions and experiences of East Asian and non-East Asian individuals. Participants were invited to take part in a single, semi-structured interview. The interview guide was rooted in the Health Stigma and Discrimination Framework (HSDF). Interviews were conducted in English, Mandarin, and Cantonese. Following participant consent, interviews were audio recorded and transcribed verbatim. Data were double coded and analyzed using qualitative content analysis guided by a framework approach.ResultsA total of 55 interviews were conducted between May and December 2020. Fifty-five percent of the sample identified as East Asian, 67.3% identified as women, and mean age was 52 years (range 20–76). Fear of infection, fear of social and economic ramifications, and blame for COVID-19 were reported drivers of stigma. Participants described preexisting perceptions on cultural norms and media influence as facilitators of stigma that propagated harmful stereotypes, particularly against Chinese and East Asian individuals. Participants observed or experienced stigmatization towards place of residence, race/ethnicity, culture, language, occupation, and age. Stigma manifestations present in the public and media had direct negative impacts on East Asian, particularly Chinese, participants, regardless of whether or not they personally experienced discrimination.ConclusionsWe used the HSDF as a rooting framework to describe perceptions and impact of stigma, particularly as they related to race/ethnicity-based stigmatization in Canada. Participants reported a number of drivers and facilitators of stigma that impacted perceptions and experiences. These findings should be used to develop sustained strategies to mitigate stigma during public health emergencies or other major crises.

Determinants of Consent in the SHARE Accelerometer Study

The eighth wave of the Survey of Health, Aging and Retirement in Europe comprises a subsample of respondents who were asked to participate in a measurement of physical activity using thigh-worn accelerometers. This paper describes the process for obtaining consent, identifies determinants of consent, and analyzes the aggregated results of the accelerometer measurements for bias due to sample selection. The overall consent rate in the Survey of Health, Aging and Retirement in Europe accelerometer study was 54%, with variations between countries ranging from 34% to 70%. Multivariate logistic regressions show that various factors are correlated with consent such as respondents’ age, self-reported moderate activity, computer literacy, willingness to answer questions, and the interviewers’ age. After introducing inverse probability weights, there appears to be only a small and insignificant influence of participant selection and consent.

Exploring community pharmacists’ views around HRT and the menopause

Abstract Introduction The number of women in England prescribed HRT has increased dramatically in the last seven years.1 Meanwhile, from 2018, HRT product shortages have resulted in the release of Serious Shortage Protocols allowing community pharmacists to supply alternative HRT products where appropriate.2 Furthermore, in 2022, the first over-the-counter medication for vaginal atrophy in menopause was licensed.3 With so many recent changes, it seemed an opportune time to determine community pharmacists’ views on the topic. Aim The aim of this study was to explore community pharmacists’ views around HRT and the menopause. Methods A qualitative approach using semi-structured interviews was chosen to allow for exploration of views. A list of community pharmacies from Stoke-on-Trent and Staffordshire was obtained from the NHS website. They were grouped into independent and multiple pharmacies in both urban and rural areas. Twenty pharmacies were then randomly selected from across the lists, emailed and invited to participate in the study; a participant information sheet and consent form was attached. This was followed up with a telephone call one week later, and a day and time for interview was agreed. Telephone interviews were undertaken, with consent obtained verbally, and the interview digitally recorded. The interview guide was developed based on the literature review and aim of the study. The guide addressed experiences of patient queries regarding HRT and the menopause, views of the OTC vaginal tablet and their confidence in discussing menopause with patients. Interviews were transcribed verbatim and thematically analysed. Ethical approval was obtained from Keele School of Pharmacy and Bioengineering Ethics Committee. Results Nine interviews were undertaken in October 2022, lasting 10 to 15 minutes. Five interviewees were male, five from urban areas, all from different companies and experience ranged from 3 months to 45 years. Four themes emerged from the transcripts, namely: increase in queries; managing shortages; lack of knowledge on Gina®; and limited professional interest in the topic. Patients were found to rarely ask about menopausal symptoms, with most queries related to risks associated with HRT or advice on various formulations. All pharmacists found dealing with shortages to be time-consuming and potentially stressful. Many of the pharmacists had not heard of the new vaginal tablet and did not stock it. Those who did, felt it was expensive and unlikely to sell. All stated they would like further training on the menopause but only one would consider specialising as a future area of prescribing. Discussion/Conclusion This was a small study with relatively short interviews, due to the time constraints facing working pharmacists. Despite this, similarity in responses suggest that data saturation may have been reached. This study confirms previous reports of increasing queries relating to HRT, particularly around shortages, and the stress associated with dealing with them. The pharmacists stated they would like further training on the topic, although CPPE packages on menopause are available. Despite the increased attention and prescribing of HRT, there was little desire to specialise and prescribe in this area; this should be explored further.

In utero/peripartum antiretroviral therapy exposure and mental health outcomes at 8-18 years old: A longitudinal comparative study of children with perinatally acquired HIV, children perinatally HIV exposed but uninfected, and children unexposed uninfected from Uganda.

In utero/peripartum antiretroviral therapy (IPA) exposure type was examined in relationship to mental health symptoms among 577 children with perinatally acquired HIV (CPHIV), children perinatally HIV exposed but uninfected (CHEU), and children HIV unexposed uninfected (CHUU). IPA exposure was categorized for CPHIV and CHEU as none, single-dose nevirapine with or without zidovudine (sdNVP±AZT), sdNVP+AZT+lamivudine (3TC), or combination antiretroviral therapy (cART). Anxiety and depressive symptoms were reported at baseline, 6-, and 12-month follow-up per behavioral assessment system for children. Multivariable linear mixed models were used to estimate differences (b) with 95% confidence intervals (95% CI) for IPA exposure types versus CHEU without IPA exposure. Depressive and anxiety symptoms were lower in CHUU relative to CHEU and CPHIV but did not differ between CPHIV and CHEU. CHEU with sdNVP±AZT exposure had greater anxiety (b = 0.51, 95% CI: [0.06, 0.96]) and depressive symptoms (b = 0.48, 95% CI: [0.07, 0.89]) than CHEU without IPA exposure. CHEU with sdNVP+AZT+3TC exposure had higher anxiety (b = 0.0.45, 95% CI: [0.03, 0.86]) and depressive symptoms (b = 0.72, 95% CI: [0.27, 1.17]) versus CHEU without IPA exposure. Depressive and anxiety symptoms were not different for CHEU and CPHIV exposed to cART (b = 0.12-0.60, 95% CI: [-0.41, 1.30]) and CHEU and CHUU (b = -0.04 to 0.08, 95% CI: [-0.24, 0.29]) without IPA exposure. Among CHEU, peripartum sdNVP±AZT and sdNVP+AZT+3TC but not cART compared to no IPA exposure was associated with clinically important elevations in anxiety and depressive symptoms. Monitoring of mental health trajectory of HIV-affected children considering IPA is needed to inform mental health interventions. Patient Contribution: Caregivers and their dependents provided consent for participation and collaborated with study team to identify mutually convenient times for protocol implementation.

Sport Structured Brain Trauma is Child Abuse

ABSTRACT This article first summarizes research regarding the relationship between sports that intentionally structure multiple types of brain trauma into their practice, such as rugby and boxing, and the range of negative health outcomes that flow from participation in such sports. The resultant brain injuries are described as ‘now’ and ‘later’ diseases, being those that affect the child immediately and then across their lifetime. After highlighting how these sports can permanently injure children, it examines this harm in relation to existing British laws and policies concerning child abuse. The conclusion drawn is that neither children nor adults on their behalf are legally able to give informed consent for participation, and that impact sport organisations effectively groom children into sustaining and accepting brain trauma. Adults providing brain-traumatizing versions of these sports are thus described as being complicit in a form of child abuse that we term brain abuse. The contradictions in existing sports policy are highlighted, where policy describes that children are to be protected from harm, and yet the very practice of such sports creates harm by design. Implications of the argument are that children should be prohibited from partaking in impact sports.

Adolescent Athletes' Self-Presentations on Social Media and Their Self-Esteem as Moderated by Their Perceptions of Responsiveness by Others.

Social media has been an increasingly utilized communication tool, and it has gained popularity among adolescent athletes. Our aim here was to investigate whether a positive and honest self-presentation on social media increased adolescent athletes' self-esteem, and we examined the moderating effect of perceived responsiveness. After receiving informed consent of participants and their parents/legal guardians, we recruited 468 adolescent athletes/participants (244 males, 224 females; Mage = 15.39years, SD = 1.61) through purposive sampling and engaged them in completing face-to-face or online self-report measures of their: (a) self-presentation on social media, (b) perceived responsiveness of others, and (c) Rosenberg self-esteem scales. Given the continuous nature of our moderating variable (i.e., perceived responsiveness), we conducted regression analysis using Hayes's PROCESS macro in SPSS software. A positive self-presentation showed no significant relationship with self-esteem, except when the level of perceived responsiveness was high. Conversely, an honest self-presentation was positively related to higher self-esteem, and the relationship between honest self-presentation and self-esteem was moderated by perceived responsiveness. Our findings extend existing psychological theory into the online environment and have practical implications. These data highlight the link between social media self-presentation and self-esteem among adolescent athletes and illustrate the crucial role of perceived responsiveness in the social media context.

The Roles of Electronic Health Records for Clinical Trials in Low- and Middle-Income Countries: Scoping Review.

Clinical trials are a crucial element in advancing medical knowledge and developing new treatments by establishing the evidence base for safety and therapeutic efficacy. However, the success of these trials depends on various factors, including trial design, project planning, research staff training, and adequate sample size. It is also crucial to recruit participants efficiently and retain them throughout the trial to ensure timely completion. There is an increasing interest in using electronic health records (EHRs)-a widely adopted tool in clinical practice-for clinical trials. This scoping review aims to understand the use of EHR in supporting the conduct of clinical trials in low- and middle-income countries (LMICs) and to identify its strengths and limitations. A comprehensive search was performed using 5 databases: MEDLINE, Embase, Scopus, Cochrane Library, and the Cumulative Index to Nursing and Allied Health Literature. We followed the latest version of the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guideline to conduct this review. We included clinical trials that used EHR at any step, conducted a narrative synthesis of the included studies, and mapped the roles of EHRs into the life cycle of a clinical trial. A total of 30 studies met the inclusion criteria: 13 were randomized controlled trials, 3 were cluster randomized controlled trials, 12 were quasi-experimental studies, and 2 were feasibility pilot studies. Most of the studies addressed infectious diseases (15/30, 50%), with 80% (12/15) of them about HIV or AIDS and another 40% (12/30) focused on noncommunicable diseases. Our synthesis divided the roles of EHRs into 7 major categories: participant identification and recruitment (12/30, 40%), baseline information collection (6/30, 20%), intervention (8/30, 27%), fidelity assessment (2/30, 7%), primary outcome assessment (24/30, 80%), nonprimary outcome assessment (13/30, 43%), and extended follow-up (2/30, 7%). None of the studies used EHR for participant consent and randomization. Despite the enormous potential of EHRs to increase the effectiveness and efficiency of conducting clinical trials in LMICs, challenges remain. Continued exploration of the appropriate uses of EHRs by navigating their strengths and limitations to ensure fitness for use is necessary to better understand the most optimal uses of EHRs for conducting clinical trials in LMICs.

Strategies Proposed by Students and Pharmacists for Virtual Experiential Patient Care Practicums.

Background: The University of British Columbia (UBC) Pharmacists Clinic (the Clinic) is a pharmacist-led patient care clinic serving as a practice site for experiential education in a team-based primary care practice. Given the unprecedented circumstances surrounding COVID-19, some pharmacy practice sites have permanently transitioned select experiential education activities to a virtual format. Currently, there is limited literature on teaching practices that are conducive to students' success in a virtual environment. Objective: To determine the factors that enable successful development of a virtual patient care practicum experience at a university clinic from the perspectives of student pharmacists and practice educators. Methods: A qualitative research methodology was used to gain the perspectives of student pharmacists, who did not have experience with virtual practicums, and practice educators, who had some experience with virtual practicums at the time of the study. Separate focus group interviews were conducted using a semi-structured approach and consisted of questions aimed at gathering insight into participant perspectives on virtual practicums. The focus group sessions were audio recorded with participant consent and transcribed. A thematic analysis was conducted to analyze the data. Results: Three pharmacist practice educators and three student pharmacists participated in their respective focus groups. Six major themes were developed based on the data: (1) technology optimization, (2) patient care related activities, (3) student-practice educator relationship, (4) student skill development, (5) student support, and (6) in-person vs virtual practicum preferences. Proposed strategies to mitigate the limitations of virtual practicums included setting communication guidelines, arranging enriching learning opportunities, and having reliable internet connection. Conclusion: The participants in this study provided insight on factors to support successful development and delivery of a virtual patient care practicum. The results from this study can be applied to other health disciplines and their approach to virtual practicums during and following the COVID-19 pandemic.