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Search Results: 1 - 10 of 461854 matches for " A Strode "
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Child consent in South African law: Implications for researchers, service providers and policy-makers
A Strode, C Slack, Z Essack
South African Medical Journal , 2010,
Abstract: Children under 18 are legal minors who, in South African law, are not fully capable of acting independently without assistance from parents/legal guardians. However, in recognition of the evolving capacity of children, there are exceptional circumstances where the law has granted minors the capacity to act independently. We describe legal norms for child consent to health-related interventions in South Africa, and argue that the South African Parliament has taken an inconsistent approach to: the capacity of children to consent; the persons able to consent when children do not have capacity; and restrictions on the autonomy of children or their proxies to consent. In addition, the rationale for the differing age limitations, capacity requirements and public policy restrictions has not been specified. These inconsistencies make it difficult for stakeholders interacting with children to ensure that they act lawfully.
Scaling up HIV testing in resourceconstrained settings: Debates on the role of VCT and Routine ‘Opt-in or Opt-out\' HIV Testing
A Strode, H van Rooyen, M Heywood, A Karim
Southern African Journal of HIV Medicine , 2005,
Abstract: Scaling up of the numbers of people voluntarily undergoing HIV testing has become vital, especially in resource-constrained settings, where the need for knowledge of HIV status for both prevention and care is critical. The reality is that for most people in Africa, access to HIV testing and to voluntary counselling and testing (VCT) has been very limited, and this has human rights implications – missing the opportunity to be diagnosed with a disease that is now well understood, manageable and treatable means certain death. The key challenge in our current context is how scaling up of HIV testing should be done. In responding to this challenge, we are guided by Gruskin and Loff,1 who state that ‘A human rights approach mandates that any public strategy, whether or not rights are to be restricted, be informed by evidence and widely debated. This approach protects against unproved and potentially counterproductive strategies, even those motivated by the genuine despair in the face of overwhelming public health challenges.\' This article describes the arguments and discussion raised during a session on models for increasing access to HIV testing at the 2nd National Conference on HIV/AIDS held in Durban in June 2005. It describes the legal framework for HIV testing in South Africa, frames the issues at the heart of the debate, and describes and discusses the various models of HIV testing, routine HIV testing, VCT and mandatory or compulsory HIV testing, within the context of HIV prevention and care. It concludes with recommendations. Southern African Journal of HIV Medicine Vol. 6 (3) 2005: pp. 45-48
Compensation for research-related injury in South Africa: A critique of the good clinical practice (GCP) guidelines
C Slack, P Singh, A Strode, Z Essack
South African Journal of Bioethics and Law , 2012,
Abstract: This article examines the current South African Department of Health Good Clinical Practice (2006) guideline recommendations regarding compensation for harm incurred in clinical trials. It applies the case of a phase IIb HIV vaccine trial in South Africa, for which enrolments and vaccinations were suspended early, based on data from an international companion study that indicated no evidence of efficacy and greater susceptibility to HIV infection in a subgroup of vaccinees. The case application indicates certain substantive and procedural limitations within the South African Department of Health Good Clinical Practice (2006) guideline recommendations on compensation for harm, which should be re-considered in order to improve protections for trial participants.
Interannual variability of long-range transport as seen at the Mt. Bachelor Observatory
D. R. Reidmiller,D. A. Jaffe,D. Chand,S. Strode
Atmospheric Chemistry and Physics Discussions , 2008,
Abstract: Interannual variations in background tropospheric trace gases (such as carbon monoxide, CO) are largely driven by variations in emissions (especially wildfires), transport pathways and tropospheric oxidizing capacity. Understanding this variability is essential to quantify the intercontinental contribution to US air quality. We investigate the interannual variability of long-range transport of Asian pollutants to the Northeast Pacific via measurements from the Mt. Bachelor Observatory (MBO: 43.98° N, 121.69° W; 2.7 km above sea level) and GEOS-Chem chemical transport model simulations in spring 2005 vs. the INTEX-B campaign during spring 2006. Measurements of CO at MBO were significantly enhanced during spring 2005 relative to the same time in 2006 (the INTEX-B study period); a monthly mean decline in CO of 41 ppbv was observed between April 2005 and April 2006. Meteorological indices show that long-range transport of CO from the heavily industrialized region of East Asia was significantly greater in 2005 than in 2006. In addition, spring 2005 was an anomalously strong biomass burning season in Southeast Asia. Data presented by Yurganov et al. (2008) using MOPITT satellite retrievals from this area reveal an average CO burden anomaly (referenced to March 2000–February 2002 mean values) between October 2004 through April 2005 of 2.6 Tg CO vs. 0.6 Tg CO for the same period a year later. The Naval Research Laboratory's global aerosol transport model shows that emissions from these fires were efficiently transported to MBO throughout April 2005. Asian dust transport, however, was substantially greater in 2006 than 2005, particularly in May. Monthly mean aerosol light scattering coefficient at 532 nm (σsp) at MBO more than doubled from 2.7 Mm 1 in May 2005 to 6.2 Mm 1 in May 2006. We also evaluate CO interannual variability throughout the western US via Earth System Research Laboratory ground site data and throughout the Northern Hemisphere via MOPITT and TES satellite observations. Both in the Northeast Pacific and on larger scales, we reveal a significant decrease (from 2–21%) in springtime maximum CO between 2005 and 2006, evident in all platforms and the GEOS-Chem model. We attribute this to (a) anomalously strong biomass burning in Southeast Asia during winter 2004 through spring 2005, and (b) the transport pattern in 2006 which limited the inflow of Asian pollution to the lower free troposphere over western North America.
Using the concept of ‘parental responsibilities and rights’ to identify adults able to provide proxy consent to child research in South Africa
AE Strode, CM Slack
South African Journal of Bioethics and Law , 2011,
Abstract: There are circumstances where independent consent to research by children is appropriate (for example, where the participants are older adolescents and the research approximates minimal risk). However, in many instances an important safeguard will be a dual consenting process involving an appropriate adult alongside the potential child participant (according to their evolving capacities). But what adults are appropriate in what instances? We attempt to use principles set out in the Children’s Act (2010) to address this question. This article differentiates between those adults who according to the Children’s Act (2010) have full parental responsibilities and rights (i.e. parents/guardians) and those who have no parental responsibilities and rights (i.e. caregivers). We argue that some responsibilities accorded to caregivers are substantially similar to the authority to provide proxy consent to research in which the research risks approximate those risks present in the child’s everyday life. In these instances, we argue that where parents and guardians are not available, caregivers should be considered by research ethics committees as a possible source of proxy consent for younger children. This approach might not be logically extended to caregiver consent for clinical trial enrolment, for which alternative arguments may need to be debated.
Assessment of Acute Pain in Nursing Practice in Latvia
Iveta Strode,Sandra Seimane
International Journal of Collaborative Research on Internal Medicine & Public Health , 2011,
Abstract: Background: International Association for the Study of Pain defines pain as annoying sensations and emotions associated with actual or potential tissue damage or is described as such damage. Pains always are considered to be subjective sensations with multidimensional nature composed from physical, emotional and cognitive components. One of the main tasks in pain syndrome effective therapy is the option to perform objective assessment of pain intensity and quality utilizing principle of continuity. Independent surveys on pain management in postoperative period are performed in different countries of the world. Studies analyze effectiveness of both - medical and non-medical measurements in order to reduce pain syndrome. Very few investigations of chronic and acute pain influence on recovery process, progress and outcome of illness, assessment of pain intensity and quality are performed in Latvia. In the case of acute pain chronification, pain perception and management can be changed; pains become inadequately long lasting and may combine with psychogenic pains. According to the data obtained by the World Health Organization, fifty percent patients after injuries or operations have severe and insufferable pains despite the development of acute pain treatment and care. Insufficiently controlled postoperative pains become a risk factor for development of various abnormalities. Aim of the study: To study the usage of postoperative period pain intensity and quality assessment scales in the clinical practice of nursing, as well as availability of these methodsMaterial and methods: Survey utilizes quantitative research method. As an investigation tool was chosen questionnaire. Survey was carried out in the surgical profile wards in Riga and regional clinics of Latvia. Questionnaire embraced 309 nurses, working in the surgical profile.Results: Assessment of acute pains should be considered as the fifth vital sign providing more successful achievement of aims in pain care. Respondents recognize that in pain assessment pain evaluation scales are rarely used. In clinical practice prevails assessment of patient’s subjective condition. Only 5% of nurses – respondents utilize visual analogue scale, 22% - verbal pain scale, 16% - numerical pain rating scale. Investigation data confirm the role of professional experience of nurse in organization of pain assessment and care work, because 98% of respondents mention pain assessment as a constituent of nursing. Conclusions: One of the main objectives in effective therapy of pain syndrome is the possibility to perform object
Interannual variability of long-range transport as seen at the Mt. Bachelor observatory
D. R. Reidmiller, D. A. Jaffe, D. Chand, S. Strode, P. Swartzendruber, G. M. Wolfe,J. A. Thornton
Atmospheric Chemistry and Physics (ACP) & Discussions (ACPD) , 2009,
Abstract: Interannual variations in background tropospheric trace gases (such as carbon monoxide, CO) are largely driven by variations in emissions (especially wildfires) and transport pathways. Understanding this variability is essential to quantify the intercontinental contribution to US air quality. We investigate the interannual variability of long-range transport of Asian pollutants to the Northeast Pacific via measurements from the Mt. Bachelor Observatory (MBO: 43.98° N, 121.69° W; 2.7 km a.s.l.) and GEOS-Chem chemical transport model simulations in spring 2005 vs. the INTEX-B campaign during spring 2006. Measurements of CO at MBO were significantly enhanced during spring 2005 relative to the same time in 2006 (the INTEX-B study period); a decline in monthly mean CO of 41 ppbv was observed between April 2005 and April 2006. A backtrajectory-based meteorological index shows that long-range transport of CO from the heavily industrialized region of East Asia was significantly greater in early spring 2005 than in 2006. In addition, spring 2005 was an anomalously strong biomass burning season in Southeast Asia. Data presented by Yurganov et al. (2008) using MOPITT satellite retrievals from this area reveal an average CO burden anomaly (referenced to March 2000–February 2002 mean values) between October 2004 through April 2005 of 2.6 Tg CO vs. 0.6 Tg CO for the same period a year later. The Naval Research Laboratory's global aerosol transport model, as well as winds from NCEP reanalysis, show that emissions from these fires were efficiently transported to MBO throughout April 2005. Asian dust transport, however, was substantially greater in 2006 than 2005, particularly in May. Monthly mean aerosol light scattering coefficient at 532 nm (σsp) at MBO more than doubled from 2.7 Mm 1 in May 2005 to 6.2 Mm 1 in May 2006. We also evaluate CO interannual variability throughout the western US via Earth System Research Laboratory ground site data and throughout the Northern Hemisphere via MOPITT and TES satellite observations. Both in the Northeast Pacific and on larger scales, we reveal a significant decrease (from 2–21%) in springtime maximum CO between 2005 and 2006, evident in all platforms and the GEOS-Chem model. We attribute this to (a) anomalously strong biomass burning in Southeast Asia during winter 2004 through spring 2005, and (b) the transport pattern in March and April 2006 which limited the inflow of Asian pollution to the lower free troposphere over western North America.
Expression of the cytochrome P450s, CYP6P3 and CYP6M2 are significantly elevated in multiple pyrethroid resistant populations of Anopheles gambiae s.s. from Southern Benin and Nigeria
Rousseau F Djouaka, Adekunle A Bakare, Ousmane N Coulibaly, Martin C Akogbeto, Hilary Ranson, Janet Hemingway, Clare Strode
BMC Genomics , 2008, DOI: 10.1186/1471-2164-9-538
Abstract: All mosquitoes sampled belonged to the M form of An. gambiae s.s. There were high levels of permethrin resistance in an agricultural area (Akron) and an urban area (Gbedjromede), low levels of resistance in mosquito samples from an oil contaminated site (Ojoo) and complete susceptibility in the rural Orogun location. The target site mutation kdrW was detected at high levels in two of the populations (Akron f = 0.86 and Gbedjromede f = 0.84) but was not detected in Ojoo or Orogun. Microarray analysis using the Anopheles gambiae detox chip identified two P450s, CYP6P3 and CYP6M2 up regulated in all three populations, the former was expressed at particularly high levels in the Akron (12.4-fold) and Ojoo (7.4-fold) populations compared to the susceptible population. Additional detoxification and redox genes were also over expressed in one or more populations including two cuticular pre-cursor genes which were elevated in two of the three resistant populations.Multiple resistance mechanisms incurred in the different breeding sites contribute to resistance to permethrin in Benin. The cytochrome P450 genes, CYP6P3 and CYP6M2 are upregulated in all three resistant populations analysed. Several additional potential resistance mechanisms were also identified that warrant further investigation. Metabolic genes were over expressed irrespective of the presence of kdr, the latter resistance mechanism being absent in one resistant population. The discovery that mosquitoes collected from different types of breeding sites display differing profiles of metabolic genes at the adult stage may reflect the influence of a range of xenobiotics on selecting for resistance in mosquitoes.National Malaria Control Programmes are becoming increasingly reliant on strategies targeting the mosquito vectors. These almost invariably involve the use of long lasting insecticide treated nets (LLINs) or indoor residual spraying (IRS). Unfortunately the emergence of mosquito populations capable of withsta
HIV vaccine research - South Africa\'s ethical-legal framework and its ability to promote the welfare of trial participants
Ann Strode, Catherine Slack, Muriel Mushariwa
South African Medical Journal , 2005,
Abstract: No abstract. South African Medical Journal Vol. 95 (8) 2005: 598-601
Enrolling adolescents in HIV vaccine trials: reflections on legal complexities from South Africa
Catherine Slack, Ann Strode, Theodore Fleischer, Glenda Gray, Chitra Ranchod
BMC Medical Ethics , 2007, DOI: 10.1186/1472-6939-8-5
Abstract: This article sets out essential requirements for the lawful conduct of adolescent research in South Africa including compliance with consent requirements, child protection laws, and processes for the ethical and regulatory approval of research.This article outlines likely complexities for researchers and research ethics committees, including determining that trial interventions meet current risk standards for child research. Explicit recommendations are made for role-players in other jurisdictions who may also be planning such trials. This article concludes with concrete steps for implementing these important trials in South Africa and other jurisdictions, including planning for consent processes; delineating privacy rights; compiling information necessary for ethics committees to assess risks to child participants; training trial site staff to recognize when disclosures trig mandatory reporting response; networking among relevant ethics commitees; and lobbying the National Regulatory Authority for guidance.Adolescents have been involved in trials for vaccines to prevent sexually transmitted infections/diseases like Human Papilloma Virus (HPV) and Herpes Simplex Virus type-2, (HSV-2), both in the developed and the developing world [1,2]. In Merck's ongoing quadrivalent HPV vaccine program, at least 12 000 young people between the ages of 9–24 have received the HPV vaccine, with approximately 20% of these being boys and girl between the ages of 9–15 (Merck, personal communication). Infants have also participated in phase I HIV vaccine trials and currently Uganda is enrolling HIV exposed infants in a phase I vaccine trial [3,4]. However, no HIV uninfected adolescents have participated in HIV vaccine trials anywhere in the world.Because adolescents are severely affected by the HIV epidemic [5-7], they should be the main recipients/beneficiaries of a successful HIV vaccine. To achieve this, there will be a need to license the vaccine for use in this age group. Adolescen
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