Maintaining integrity through clinical supervision

This article suggests that there is a relationship between successfully maintaining integrity in nursing and the practical provision of opportunities for shared reflection offered by good clinical supervision. In order to establish this case, I will first give some definitions and then proceed to consider how these ideas relate conceptually. The article makes no attempt to offer empirical research as confirmation, but provides a conceptual and moral argument making use of anecdotes for purposes of clarification and illumination. It is the author's belief that, if it is understood and implemented properly, clinical supervision offers a radical challenge to nursing's existing culture. If nurses are interested in the survival of the profession, it is perhaps a challenge that has to be addressed.     

From authorship to contributorship. Promoting integrity in research publication

Shared authorship in nursing research presents practical and ethical dilemmas and does not effectively capture individual research participation and accountability. This study, which defined author contributions and practices in multiauthored nursing research, contributed to a better understanding of contemporary author participation and the inherent challenges faced by nurse scholars in determining authorship credit. A method of "contributorship" is proposed which would delineate individual contributions to the research project while maintaining professional integrity, scientific accountability, and scholarly recognition.     

Questions of construct breadth and openness of research in integrity testing.

Responds to comments by D. S. Ones et al and by S. O. Lilienfeld et al (see PA, Vol 82:31500 and 31497) regarding W. J. Camara and D. L. Schneider's (see record 1994-23870-001) article on integrity testing. Camara and Schneider express their ongoing concern about the underlying construct measured by integrity tests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Current opportunities in clinical research

The dissolution rates and bioavailability of norfloxacin in seven batches of norfloxacin capsules produced by five pharmaceutical factories were studied with rotating basket and UV-spectrophotometry. The results showed that the T50, Td and m of the samples had obvious differences, and the correlation between the dissolution rate and bioavailability differed very obviously. The method used is simple and convenient. So UV-spectrophotometry is one of the methods for the assay of norfloxacin preparations in vitro and in vivo.     

MR spectroscopy in clinical research

MR spectroscopy (MRS) offers unique possibilities for non-invasive evaluation of biochemistry in vivo. During recent years there has been a growing body of evidence from clinical research studies on human beings using 31P and 1H MRS. The results indicate that it is possible to evaluate phosphorous energy metabolism, loss of neurones, and lactate production in a large number of brain diseases. Furthermore, 31P and 1H MRS may be particularly clinically useful in evaluation of various disorders in skeletal muscle. In the heart 31P MRS seems at the moment the most suitable for evaluation of global affections of the myocardium. In the liver 31P MRS appears to be rather insensitive and non-specific, but absolute quantification of metabolite concentrations and using metabolic "stress models" may prove useful in the future. The clinical role of MRS in oncology is still unclear, but it may be useful for non-invasive follow-up of treatment. Taken together, the evidence obtained so far certainly shows some trends for clinical applications of MRS. Methods are now available for the clinical research necessary for establishing routine clinical MRS examinations.     

Ethics and research: ethical considerations in clinical research

Two subjects are discussed: the use of placebo controls in clinical trials and informed consent. Particularly in trials of drugs for disorders for which there exist effective treatments, the use of placebo is still controversial, although anyhow in violation of the Declaration of Helsinki. Informed consent aims at giving a subject all the necessary information to allow him to decide, with full knowledge, whether to accept a particular treatment or experimental protocol. Its importance would seem, albeit essential, to be rather illusory.     

Professional and social responsibilities of clinical pharmacology

According to the decision of the Scientific and educational board of the Medical Faculty in Novi Sad the Institute for pharmacology toxicology and clinical pharmacology introduced the clinical pharmacology in 1975. Postgraduate studies were organized for those wishing to specialize, i.e. to get their M.Sc. degree in clinical pharmacology. Besides the youngest members of the Institute (now they are all associate professors) these studies were successfully completed by many doctors from other clinics or those employed in pharmaceutical industry. The publications which the Institute published from the field of pediatric clinical pharmacology were the very first ones not only in our country but also in world proportions. International methods for the evaluation (DDD, ATC code) of the scope and structure of drugs usage were introduced and modified according to our conditions and requirements. The studies on the usage of drugs were among the first pharmacoepidemiological studies in country and abroad. On the basis of these activities the Institute was two times the organizer of the scientific meeting sponsored by WHO. As a response to a sudden increase of the need for information on drugs due to disturbed supply and distribution of drugs from abroad (through humanitarian aid) a telephone and modem information service has been organized within the Institute. The printing of the book titled Drugs in Use was initiated (five editions since 1992) together with the issues on computer discs. The publishing of the journal Pharmaca Iugoslavica was also started under the auspices of the Association of Health Care Organizations. The service for adverse events registration was also organized. Through its activities in planning and organization of pharmacokinetic and clinical investigations, development of new analytic methods and performance of pharmacokinetic studies the Institute contributed to the development of new drugs and gave new theoretical solutions in pharmacokinetics. The Institute also initiated the establishment of the Committee for drugs of the Medical Faculty. Its professors are members of the Commission for Social Insurance, Federal Commission for Drugs and Federal Commission for Poisons. Through all mentioned activities the Institute has greatly influenced not only our but also general medical community.     

Current trends in clinical psychiatric research

SCHIZOPHRENIA: The long-standing dopaminergic hypothesis is based on well-established findings, mainly related to a dysfunction of the mesolimbic C2 and D3 receptors, negative signs of prefrontal hypodopaminergia concerning the D2 and D4 receptors. Immune disorders are also involved as well as a possible neurodevelopmental component. Finally genetic factors play an important role. DEPRESSIVE STATES: Three monoaminergic systems appear to be implicated: the catecholaminergic, serotaminergic and homovanilic systems. It is not known whether the disorder of the serotaminergic system results from pre-existing fragilization or a symptom-related modification. HYPOTHESES CONCERNING DEPRESSION: According to the chronobiology hypothesis, certain biological rhythms (cortisol, temperature, perhaps melatonin) are desynchronized, a disequilibrium which disappears after cure. The fragilization hypothesis is based on the progressive development of a stress-related pathological organization in the hippocampo-hypothalamo-adrenal axis. PERSPECTIVES: The development of new psychotropes remains a challenge to meet the unsatisfied demands in psychiatrics. Drugs with rapid action and minimal side effects are needed.     

Conflict of commitment in clinical research.

Some aspects of the problem of research in a psychological or psychiatric clinic are explored. "History leaves little doubt that, so far as we are scientific, we must push for further analysis of our data. At the same time the clinical commitment to the whole person is also irrevocable. The conflict of commitment appears to be an inevitable feature of clinical research. By making psychologists and psychiatrists aware of the inevitability and historical origins of the conflict, one may hope to avoid some of the more unfortunate of its possible manifestations." Major sections are: Research manifestations." Major sections are: Research commitment, Clinical commitment—whole childism, Darwin versus Lamarch—being versus becoming, Lamarckian philosophy in the clinic, Independence of errors, and Function versus ontology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Participation of African Americans in clinical research

Low apical leakage along root fillings following an application of calcium hydroxide was reported in a few methylene blue dye penetration studies. It has been found recently that methylene blue is decolored by calcium hydroxide, indicating that the short penetration of methylene blue may not be due to a tight seal only. Of the 80 roots of human maxillary central incisors used in this study, 40 roots (group 1) received calcium hydroxide root canal dressing whereas another 40 roots (group 2) did not. All the roots were then obturated with gutta-percha and Tubli-Seal sealer. Leakage along 20 filled roots in each group was measured using a modified fluid transport model at 48 h, 2, 4, 8 and 16 weeks after obturation; whereas leakage of another 20 filled roots in each group was measured using dye penetration with 1% methylene blue. Using the fluid transport model, no significant difference was found between the two groups at any time interval (P = 0.4847, 0.3875, 0.9490, 0.4786, 0.9148 respectively after 48 h, 2, 4, 8 and 16 weeks); using the methylene blue penetration method, leakage in group 1 (with root canal dressing) was significantly less than that in group 2 (without root canal dressing) (P = 0.0374). The contradiction in results from the different models indicated that problems existed with the models.     

Coping strategies in psychiatric clinical research.

Suggests that classical and elementary approaches to design and analysis of research frequently are based on expectations of the behavior of Ss and of measures of response that are unrealistic in the context of psychiatric clinical research. A broad range of strategies in sampling, measurement, design, execution, implementation, and analysis are examined, and specific strategies are suggested that tend to be successful in the real world of psychiatric clinical research. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonselection and nonresponse bias in clinical research

In summary, nonselection and nonresponse bias can have a potent impact on the validity of clinical veterinary research studies and should be carefully assessed by investigators and readers. The risk of nonselection and nonresponse bias has been compared to "lowering yourself into a dark pit and trusting you won't be bitten by a snake ... before you go into the pit, you should stand outside and listen for a hissing sound ... if you hear one, do not go on ... if you do not hear anything, you may proceed with caution, being confident that at worst you will be bitten by a quiet snake."