GW24-e2932 Clinical research on the relationship between day-night rhythm

Heart ◽  
2013 ◽  
Vol 99 (Suppl 3) ◽  
pp. A200.3-A201
Author(s):  
Shan HaiYan ◽  
Li Xue-lian ◽  
Yu Kai ◽  
Qi Hui-meng
Keyword(s):  
Clinical Research ◽  
The Relationship

Computerisation of hospitals and community areas

1994 ◽  
Vol 61 (1) ◽  
pp. 31-37
Author(s):  
N. Martini
Keyword(s):  
Health Care ◽  
Clinical Research ◽  
Information Management ◽  
Critical Points ◽  
Health Care Systems ◽  
Basic Question ◽  
Technology And Culture ◽  
Care Systems ◽  
Scientific Documentation ◽  
The Relationship

The application of modern computerised technologies to hospitals and communities represents one of the most critical points for Medicine and Health Care Systems in different countries. The benefits but also the limits of this impact bring up the basic question of the relationship between technology and culture. In order to analyse this relationship the drug has been assumed as “indicator” in the different phases of scientific documentation and information, management of expenditure and clinical research.

Reviews in Medical Ethics

2008 ◽  
Vol 36 (2) ◽  
pp. 419-424
Author(s):  
Ana S. Iltis
Keyword(s):  
Clinical Trials ◽  
Medical Ethics ◽  
Clinical Research ◽  
Intended Audience ◽  
Institutional Review ◽  
Law And Ethics ◽  
Ethics Research ◽  
Depth Study ◽  
The Relationship ◽  
Shed Light

What the Doctor Didn’t Say, by Jerry Menikoff and Edward P. Richards, is a courageous and well-written volume that examines some of the fundamental debates pertaining to the ethics of clinical research. The volume deserves a careful reading by anyone with a potential role in clinical research: clinicians who might serve as investigators or refer patients to clinical trials; research staff; Institutional Review Board (IRB) members and administrators; sponsors who design clinical trials; and the book’s intended audience, namely, potential research participants and their families. A cursory reading of this volume might lead one to think that Menikoff and Richards have declared war on clinical research. They have not. Instead, they offer an in-depth study of the conduct and oversight of clinical research through the lens of law and ethics. They shed light on old issues and initiate discussion of new questions, challenging readers to think critically about the relationship between medical ethics, research ethics, the law, and the conduct of clinical research.

scholarly journals In-Session Reflective Functioning: Relationship With the Presence and Depth of Work on Conflict or Personality Functioning

2021 ◽  
Vol 12 ◽  
Author(s):  
Cecilia de la Cerda ◽  
Paula Dagnino
Keyword(s):  
Clinical Research ◽  
Reflective Functioning ◽  
Mental States ◽  
Psychodynamic Therapy ◽  
Personality Functioning ◽  
Change Mechanism ◽  
High Level ◽  
The Relationship

Mentalizing, conceived as the capacity to attribute intentional mental states as implicit or underlying behavior of an individual or others, has gained interest within psychodynamic clinical research due to its potential as a change mechanism. Variations and qualities of mentalization have been studied through reflective functioning (RF). But only few studies are analyzing it throughout the psychotherapeutic interaction, identifying its level for therapists and patients. In contrast, brief psychodynamic therapy has a long tradition for establishing a focus to be worked upon. Lately, a multischematic focus has arisen, considering both conflict and personality functioning focuses as key elements on successful psychotherapies. This study aimed to identify mentalizing manifestations of patients and therapists through change episodes of one successful brief psychodynamic therapy and establish the relationship between these mentalizing manifestations and the type and depth of the therapeutic focus being worked on (conflict or personality functioning). Only 37.5% of speaking turns were able to be coded with RF; 77% of these had moderate to high RF and 22% had low or failure RF. The patient had 91% of low or failure RF, while the therapist only had 9% of low or failure RF. As for moderate to high RF, patients had 39%, while therapists had 61%. The patient showed a similar number of low or failure RF interventions and moderate to high RF interventions in conflict episodes. Meanwhile, the therapist only performs moderate to high-level RF interventions. In episodes in which personality functioning is worked on, both patient and therapist show a greater presence of interventions of moderate to high levels of RF. Finally, mentalizing interactions and non-mentalizing interactions were found on segments with conflict, and only mentalizing interactions were found on personality functioning segments.

scholarly journals Enrolment in clinical research at UCLH and geographically distributed indices of deprivation

2021 ◽  
Vol 6 ◽  
pp. 342
Author(s):  
Holger Engleitner ◽  
Ashwani Jha ◽  
Daniel Herron ◽  
Amy Nelson ◽  
Geraint Rees ◽  
...  
Keyword(s):  
Clinical Research ◽  
Lower Layer ◽  
Disease Prevalence ◽  
Healthcare Research ◽  
Research And Innovation ◽  
Local Disease ◽  
University College London ◽  
Geographically Distributed ◽  
The Relationship ◽  
Research Studies

Healthcare should be judged by its equity as well as its quality. Both aspects depend not only on the characteristics of service delivery but also on the research and innovation that ultimately shape them. Conducting a fully-inclusive evaluation of the relationship between enrolment in primary research studies at University College London Hospitals NHS Trust and indices of deprivation, here we demonstrate a quantitative approach to evaluating equity in healthcare research and innovation. We surveyed the geographical locations, aggregated into Lower Layer Super Output Areas (LSOAs), of all England-resident UCLH patients registered as enrolled in primary clinical research studies. We compared the distributions of ten established indices of deprivation across enrolled and non-enrolled areas within Greater London and within a distance-matched subset across England. Bayesian Poisson regression models were used to examine the relation between deprivation and the volume of enrolment standardized by population density and local disease prevalence. A total of 54593 enrolments covered 4401 LSOAs in Greater London and 10150 in England, revealing wide geographical reach. The distributions of deprivation indices were similar between enrolled and non-enrolled areas, exhibiting median differences from 0.26% to 8.73%. Across Greater London, enrolled areas were significantly more deprived on most indices, including the Index of Multiple Deprivation; across England, a more balanced relationship to deprivation emerged. Regression analyses of enrolment volumes yielded weak biases, in favour of greater deprivation for most indices, with little modulation by local disease prevalence. Primary clinical research at UCLH has wide geographical reach. Areas with enrolled patients show similar distributions of established indices of deprivation to those without, both within Greater London, and across distance-matched areas of England. We illustrate a robust approach to quantifying an important aspect of equity in clinical research and provide a flexible set of tools for replicating it across other institutions.

scholarly journals Stress Allostasis in Substance Use Disorders: Promise, Progress, and Emerging Priorities in Clinical Research

2020 ◽  
Vol 16 (1) ◽  
pp. 401-430
Author(s):  
Gaylen E. Fronk ◽  
Sarah J. Sant'Ana ◽  
Jesse T. Kaye ◽  
John J. Curtin
Keyword(s):  
Substance Use ◽  
Drug Use ◽  
Clinical Research ◽  
Substance Use Disorders ◽  
Clinical Implications ◽  
Treatment Development ◽  
Etiologic Role ◽  
Stress Biology ◽  
The Relationship ◽  
Biology Research

Clinicians and researchers alike have long believed that stressors play a pivotal etiologic role in risk, maintenance, and/or relapse of alcohol and other substance use disorders (SUDs). Numerous seminal and contemporary theories on SUD etiology posit that stressors may motivate drug use and that individuals who use drugs chronically may display altered responses to stressors. We use foundational basic stress biology research as a lens through which to evaluate critically the available evidence to support these key stress–SUD theses in humans. Additionally, we examine the field's success to date in targeting stressors and stress allostasis in treatments for SUDs. We conclude with our recommendations for how best to advance our understanding of the relationship between stressors and drug use, and we discuss clinical implications for treatment development.

ACE2 as a key target for treatment of COVID-19 related cardiovascular diseases: current progress and prospect

2021 ◽  
Vol 22 ◽  
Author(s):  
Shuainan Li ◽  
Benzhi Cai ◽  
Wenya Ma ◽  
Fan Yang ◽  
Yan Xu ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Clinical Research ◽  
Protective Factor ◽  
Organ Damage ◽  
Negative Regulator ◽  
Recent Outbreak ◽  
Heart Injury ◽  
The Relationship ◽  
Entry Receptor

: ACE2 has long been known as an injury protective protein, it can protect a variety of organ damage such as heart, liver, kidney and lung. Especially in cardiovascular diseases, ACE2, as a negative regulator of RAAS, is an extremely important protective factor that mainly plays a role by converting Ang Ⅱ to Ang-(1-7). Nevertheless, with the recent outbreak of COVID-19, it was exposed that another identity of ACE2 is the entry receptor for SARS-CoV-2, which previously served as the entry receptor for SARS. With the in-depth clinical research, it was found that the severity and susceptibility of COVID-19 are related to cardiovascular disease, and SARS-CoV-2 binding to ACE2 receptor is also potentially associated with heart injury symptoms. Therefore, in this article, we mainly review the relationship between ACE2, COVID-19 and cardiovascular system diseases/heart injury.

The Clinical Investigator as Fiduciary: Discarding a Misguided Idea

2005 ◽  
Vol 33 (3) ◽  
pp. 586-598 ◽  
Author(s):  
E. Haavi Morreim
Keyword(s):  
Clinical Research ◽  
Standard Care ◽  
Standard Treatment ◽  
Medical Community ◽  
Clinical Equipoise ◽  
Medical Patients ◽  
Research Subjects ◽  
Clinical Investigator ◽  
The People ◽  
The Relationship

One of the most important questions in the ethics of human clinical research asks what obligations investigators owe the people who enroll in their studies. Research differs in many ways from standard care - the added uncertainties, for instance, and the nontherapeutic interventions such as diagnostic tests whose only purpose is to measure the effects of the research intervention. Hence arises the question whether a physician engaged in clinical research has the same obligations toward research subjects that he owes his medical patients, or whether they differ in any fundamental way.Perhaps the most common answer is that the relationship is the same. Investigators, like physicians, are said to be fiduciaries of the volunteers who enroll in research trials. Each owes the best available medical care, which means that a physician can only justify enrolling his patient in research if the study meets the requirements of clinical equipoise, namely, that there is legitimate disagreement within the medical community as to whether the standard treatment or the investigational intervention is superior.

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