Quality assessment of raw and pasteurized milk in Gondar city, Northwest Ethiopia: A laboratory-based cross-sectional study.

Milk is a complete and highly nutritious source of food for human beings. However, in many developing countries, including Ethiopia, the quality of milk products has become a major health concern for consumers, particularly for infants and children. Therefore, the aim of the present study was to assess the quality of raw and pasteurized milk marketed in Gondar city, Northwest Ethiopia. A laboratory-based cross-sectional study was conducted on 90 milk samples. The samples were chosen using a simple random sampling technique. For statistical analysis, ANOVA and the Pearson correlation coefficient were used. The specific gravity of pasteurized milk, farm milk, and milk vendors were found to be 1.021, 1.027, and 1.026, respectively. Farm milk, milk vendors, and pasteurized milk had fat contents of 3.38%, 3.22%, and 3.09%, respectively. The total bacterial count in pasteurized milk, farm milk, and milk vendors was found to be 7.08, 6.73, and 6.94 log10 CFU/mL, respectively. In raw milk, hydrogen peroxide (7.7%), formalin (7.7%), and water (3.8%) were found, whereas in pasteurized milk, hydrogen peroxide (50%), formalin (50%), and water (19.8%) were found. Based on the findings of this study, the quality of both raw and pasteurized milk was found to be poor as per the milk quality standards. This may cause significant public health-related problems. Therefore, an appropriate intervention should be conducted to improve the quality of milk.

Guidelines for Ethical Review Entrustment Contract of Life Science and Medical Research Involving Humans / 中国医学伦理学

The passing of ethical review is a necessary conditions and prerequisite for the development of life science and medical research involving humans. At present, some medical and health institutions have no or insufficient ethical review capabilities. The lack of ethical review ability has become a bottleneck restricting the development of life science and medical research involving humans. According to documents such as Opinions on Deepening the Reform of the Review and Approval System and Encouraging the Innovation of Pharmaceutical and Medical Devices, Opinions on Strengthening the Ethical Governance of Science and Technology, institutions can entrust competent institutional ethics review committees or regional ethics review committees in writing to conduct ethical review. Entrustment ethical review provides a viable solution for institutions that need to carry out life science and medical research involving humans but do not have an ethics (review) committee or the ethics (review) committee is not competent to review. To conduct the entrustment ethical review, the entrustment between the principal and the trustee is required. According to The Measures for Ethical Review of Life Sciences and Medical Research Involving Humans, if medical and health institutions and their ethical review committees do not accept the formal entrustment to provide the ethical review opinions for other institutions, the local health authorities at or above the county level will impose administrative penalties and sanctions on the relevant institutions and personnel in accordance with the law. Signing the entrustment ethical review contract, implementing legal compliance entrusted ethical review to protect the rights and interests of the trustee and the principal, and protect the research participants.

Thinking from the Perspective of Medical Institutions on Measures for Ethical Review of Life Science and Medical Research Involving Humans / 中国医学伦理学

From the perspective of medical institutions, this paper sorted out the background of the promulgation and important changes of Measures for Ethical Review of Life Science and Medical Research Involving Humans, and summarized the changes that may significantly affect the ethical review of medical institutions. It involved terminology changes and expansion of the scope of ethic review, clarification of the responsibilities and independence of the ethics committee, the refinement of the ethical review process, the emphasis on the protection of personal information and the rights and interests of subjects, and first proposal to exempt from ethical review. In addition, based on the concept of strengthening the ethical governance of science and technology in the new version of regulations, this paper shared the consideration on the governance of ethical review within medical institutions, including safeguarding the dignity and rights of subject, clarifying the role and position of ethical review, exempting the implementation of ethical review, and managing entrusted ethical review. With a view to providing a certain reference for the ethics practitioners and researchers in various medical institutions.

A single centre experience of local perforator flaps in oncoplastic breast surgery; a cross-sectional study.

Background & objectives: Various oncoplastic techniques have emerged over the years to preserve breast cosmesis and symmetry without compromising the principles of tumor excision. One of the newer techniques for breast volume replacement to achieve symmetry and cosmesis is the use of fasciocutaneous pedicled chest wall perforator flaps or local perforator flaps (LPF). The objectives of this study were to document the details of the surgical procedure as well as patient-reported satisfaction and well-being following the procedure using a validated BREAST-Q tool among Pakistani women. Materials & methods: This cross-sectional study was conducted from March 2019 to February 2021 enrolling 25 female patients who underwent breast conservative surgery using LPF for breast tumors at The Aga Khan University Hospital, Karachi. Data related to the procedure was collected on a pre-designed proforma. Cosmetic outcomes and patient satisfaction were evaluated using 2 scales from BREAST-Q BCT domain version 2.0. The questionnaire was self-administered by the patients during their routine follow-up in the clinic. Data was analyzed using the Statistical Package for Social Sciences (SPSS) version 23. Mean (SD)/median (IQR) were computed for quantitative variables and frequency and percentages were calculated for qualitative variables. 2 sample t-test was applied. P-value ≤0.05 was considered significant. Results: 25 patients underwent LPF with a mean age of 47 ± 13.1 years. 8 LICAP, 7 AICAP, and 10 LTAP flaps were performed. Two postoperative complications of wound site erythema were encountered. 23 women were eligible for the BREAST-Q survey. Median (IQR) postoperative satisfaction with breasts and physical well-being chest (equivalent Rasch transformed score) was 100 (41) and 76 [18] respectively. We found high satisfaction with breasts and comparable physical well-being among Pakistani women after LPF surgeries. Conclusion: Local perforator flaps in oncoplastic breast-conserving surgery are a good option showing high satisfaction with breasts and physical well-being in Pakistani women.

The status of central ethical reviewing and challenges regarding its introduction to non-interventional studies in Japan.

In 2018, we conducted a study on 121 ethics review committee offices in Japan to examine the state of "central review" in non-interventional studies and discern any challenges regarding its introduction. Of the 452 offices that were invited to participate, 121 responded (26.8% response rate), and 35 (28.9%) had records of furnishing contracting agreements with ethical reviews by other research institutions. The merits of central reviewing include easing the burden on ethics review committees, improving the quality level and consistency of ethical reviews, and enhancing the efficiency in conducting them. The demerits include increased administrative overheads and work for researchers, such as preparing application forms and checking institutional requirements, and a lack of clarity regarding who is responsible for conducting the research, which makes it is less desirable for institutions to have their own ethics review committees. This study revealed that the comprehensive introduction of central review in non-interventional studies continues to encounter many hurdles, and promoting central review requires overcoming these challenges one at a time. The Ethical Guidelines for Medical and Health Research Involving Human Subjects will be revised in 2021 to require central review as a part of ethical reviews for non-interventional studies. In the future, central reviews of non-interventional studies will need to be of high quality and conducted efficiently, and this will require research institutions to utilize relevant central review guidelines and checklists.

Effectiveness of home-based rehabilitation program in minimizing disability and secondary falls after a hip fracture: Protocol for a randomized controlled trial.

INTRODUCTION: Hip fractures are a major health problem globally and are associated with increased morbidity, mortality, and substantial economic costs. Successful operative treatment of hip fracture patients is necessary for the optimization of post-op mobility and functional recovery of the patient. Rehabilitation after surgical stabilization of a hip fracture is crucial in order to restore pre-fracture function and to avoid long-term institutionalization. In particular ongoing exercise which targets balance can prevent up to 40% of falls. Therefore, we have designed a post-discharge home-based physical rehabilitation intervention program to minimize disability and falls in this high-risk elderly population. METHODS AND ANALYSIS: The study will be an open label, simple randomized controlled trial at a single hospital. The two arms will be equally allocated on a 1:1 ratio into intervention and control groups. The control arm will receive the usual standard postoperative rehabilitation. The intervention group will receive an extended home-based rehabilitation program twice a week continued for 3 months (12 weeks) after discharge. The Primary outcome of the study is occurrence of falls. Falls will be measured at 3, 6, 12, and 24 months by research-assistant follow-up telephone calls for both the groups. Mobility-related disability will be measured with a self-reported test at every routine follow-up for up to two years using a performance-based short battery tool. Negative binomial regression model will be used to compare number of falls in both the groups by computing incidence ratio rates. ETHICS AND DISSEMINATION: Approval for the conduction of this study has been taken from the Ethical Review Committee (ERC) of the institution. Evidences which will be obtained from this study will facilitate to propose changes in existing guidelines and policies for treating fall and hip fracture patients.Trial registrationThis trial is registered on clinicaltrials.gov ID: NCT04108793.

Exploration of the ethical review mechanism of serious adverse events in hospital clinical trials / 中华医学科研管理杂志

Objective To continuingly update the ethical review mechanism of Serious Adverse Events (SAE) in hospital clinical trials .Methods The definition of serious adverse events and the status quo of SAE review was analyzed ,considering the standard operating procedures of SAE review in our hospital ,as well as related measurements for improvement .Results At present ,there still exists some disadvantages in the report and ethical review of SAE ,which the ethical review committee should pay more attention .Conclusions It is important that the ethics committee review of SAE happened in clinical trial effec-tively and efficiently ,which helps to maximize the protection of the subject's health and rights .

Participación ciudadana en los comités éticos institucionales de investigación clínica y asistenciales de Cataluña / Participation of civilians in Catalonian clinical research and health care institutional ethical review committees / Participação dos cidadãos na pesquisa clínica institucional das comissões éticas e cuidado na Catalunha

Resumen: Objetivo: Conocer el nivel de participación de pacientes, usuarios y ciudadanos en los comités de ética de la investigación (CEI) y los comités de ética asistencial (CEA) acreditados en Cataluña. Material y métodos: Estudio descriptivo transversal en una muestra oportunista de 30 CEI y CEA. Se administró un cuestionario dirigido a los presidentes y al representante de los usuarios o ciudadanos (miembro lego). Para la interpretación de los resultados se analizó medias y desviación estándar. Las respuestas a las preguntas de texto abierto se analizaron mediante un análisis cualitativo del contenido. Resultados: Del total de los 30 comités de ética (CEI y CEA) contactados, 12 (40%) aceptaron participar. En total se realizaron 15 entrevistas (9 miembros de CEI y 6 miembros de CEA): 8 presenciales, 4 telefónicamente y 3 contestadas por correo electrónico. Resultados de los CEI: del total de 7 CEI entrevistados, 2 tenían representación ciudadana en su comité. El perfil correspondía a una mujer, de profesión administrativa y a un hombre de profesión auditor contable, ambos de más de 50 años. Resultados de los CEA: de los 5 CEA que participaron, 2 declararon tener representación de la ciudanía. El perfil correspondía a una mujer, de profesión administrativa y a un hombre de profesión profesor, ambos de más de 50 años. Discusión: Actualmente hay poca representación de la ciudadanía/pacientes en los comités éticos institucionales. Constituye un tema actual de debate la necesidad de incorporar el punto de vista del ciudadano/paciente, habiendo, sin embargo, un desconocimiento sobre el perfil más idóneo y en discusión su representatividad.

Abstract: Aim: To know the level of participation of patients, users and civilians in scientific ethical review committees (SERC) and health care ethical review committees (HCERC) accredited in Catalonian. Materials and methods: Descriptive transversal study using an opportunistic sample of 30 SERC and HCERC. A questionnaire was filled out addressed to presidents and consumer or civilian (lay member) representatives. For the interpretation of results means and standard deviations were analyzed. Answers to open texts questions were analyzed using qualitative content analysis. Results: 12 committees (40%) accepted to participate; 15 interviews were carried out (9 SERC members and 6 HCERC members): 8 person to person, 4 by phone and 3 by email. SERC Results: Of 7 SERC interviewed, 2 have a civilian representative in the committee. The profile was a woman of administrative profession and an auditor accountant man, both older than 50 years. HCERC Results: Of 5 HCERC participating, 2 declared having a civilian representative. The profile was a woman of administrative profession and a man teacher, both older than 50 years. Discussion: Currently, there is low civilian/patient representation in institutional ethical review committees. Today, the need to incorporate the point of view of the civilian/patient is a debatable issue, being unknown the suitable profile and their representativeness is under discussion.

Resumo: Objetivo: Conhecer o nível de participação de pacientes, usuários e cidadãos em comitês de ética de pesquisa (CEI) e as comissões de ética de cuidados de saúde (CEA) acreditados na Catalunha. Material e métodos: Estudo descritivo, transversal em uma amostra oportunista de 30 CEI e CEA. Um questionário dirigido aos presidentes e representante dos usuários ou cidadãos (membro de leigo) foi administrado. Para a interpretação dos resultados foi feita uma análise que incluiu as médias e o desvio-padrão. Analisaram-se as respostas às perguntas do texto aberto com uma análise qualitativa do conteúdo. Resultados: Do total dos 30 comitês de ética (CEI e CEA) contatados, 12 (40%) concordaram em participar. No total foram realizadas 15 entrevistas (9 membros do CEI e 6 membros da CEA). De todas as entrevistas realizadas, 8 foram presenciais, 4 foram realizadas por telefone e 3 foram respondidas por e-mail. Resultados da CEI: do total de 7 entrevistados da CEI, 2 tinham representação cidadã na sua Comissão. O perfil correspondia a uma mulher, de carreira administrativa e a um home de profissão auditor contábil, ambos com mais de 50 anos. Resultados da CEA: dos 5 CEA que participaram, 2 declararam ter representação cidadã. O perfil correspondente era de uma mulher, de carreira administrativa e a um homem professor, ambos com mais de 50 anos. Discussão: Atualmente há pouca representação dos cidadãos/pacientes em comitês de ética institucionais. A necessidade de incorporar o ponto de vista do cidadão/paciente constitui um tema atual de discussão, no entanto, falta conhecimento sobre o perfil mais adequado e discussão sua representatividade.

The development and improvement of ethical review of multi-center clinical trial / 中华医学科研管理杂志

Objective Improve the ethical review models of multi-center clinical trial.Methods Analyze the ethical review models of multi-center clinical trial in China,and summarize advantages and disadvantages of the different methods.Then,clarify the development of ethical review methods of multi-center clinical trial in our hospital.Results Four methods were used to review the multi center clinical trial in China,including independent ethical review,central institutional ethical review,central review made by committee cooperation,collaborative review.Each method has its advantages and disadvantages.Collaborative review about multi-center clinical trial is adopted now in our hospital.Conclusions Using collaborative review model of multi-center clinical trial,the ethical review could achieve timely and uniformly.

Self-evaluation of ethical review committees functioning at Foundation University Medical College (FUMC) through structured constitution-practice-outcome (CPO) assessment model.

OBJECTIVE: To assess the operational efficiency of the ethical review committee of a medical college. METHODS: This study was conducted at the Foundation University Medical College, Islamabad, Pakistan, from 2012 to 2014. On the basis of literature review, methods for assessment of various features of ethical review committee were studied. A constitution-practice-outcome measurement model for evaluation of ethical review committee assessment process was developed. Data submitted to ethical review committee since its constitution was extracted and quantitatively analysed. RESULTS: The ethical review committee comprised 14 members, including 4(28.6%) permanent and 10(71.4%) rotating clinical, basic sciences and non-medical members. As many as 45 research protocols were submitted, with submission frequency of 8(17.8%), 12(26.7%) and 25(55.5%) per year respectively, and issued ethical approval certificates within a mean duration of 7.2±3.2 days from the time of first submission to final notification. Issues looked into were according to World Health Organisation guidelines. Standard review was done on 29(64.4%) studies and expedited on 16(35.5%). In addition, 24(53.3%) protocols needed resubmission. Only 2(4.4%) protocols were not approved. The number of issues raised for resubmission was 71. Main reasons for resubmission were found to be incomplete documents 26(36.6%), invalid informed consent forms 12(16.9%) and negligence in maintaining confidentiality of study participants 9(12.7%). CONCLUSIONS: Ethical review committee with its limited resources was fulfilling its founding objectives as depicted by constitution-practice-outcome model.

UN MARCO ÉTICO AMPLIO PARA LA INVESTIGACIÓN CIENTÍFICA EN SERES HUMANOS: MÁS ALLÁ DE LOS CÓDIGOS Y LAS DECLARACIONES: LA PROPUESTA DE EZEKIEL J. EMANUEL / A COMPREHENSIVE ETHICAL FRAMEWORK FOR SCIENTIFIC RESEARCH ON HUMAN BEINGS: BEYOND CODES AND STATEMENTS.: EZEKIEL J. EMANUEL'S PROPOSAL / UM REFERENCIAL AMPLO E ÉTICO PARA A PESQUISA CIENTÍFICA EM SERES HUMANOS: MAIS ALÉM DOS CÓDICOS E DECLARAÇÕES: A PROPOSTA DE EZEKIEL J. EMANUEL

El ejercicio de la ética de la investigación se apoya en la normatividad local vigente y en recomendaciones de carácter universal como el Código de Nüremberg o la Declaración de Helsinki. Sin embargo, estos documentos tienen una serie de falencias que no permiten la construcción de un marco ético completo para orientar la investigación en humanos, con miras hacia un mejor aprovechamiento de sus resultados y una construcción ética del conocimiento. Se propone así, un marco ético más amplio de acuerdo con la propuesta de Ezekiel J. Emanuel, en la cual, a partir de ocho principios fundamentales, se construye un espacio de evaluación, reflexión y debate alrededor de la investigación científica en seres humanos.

Ethics in research are norms for conduct based on local regulations and universal recommendations such as the Nuremberg Code or the Declaration of Helsinki. However, these documents have a number of shortcomings that thwart the construction of a comprehensive ethical framework to guide research on humans in an effort to make better use of research results and to provide for ethical construction of knowledge. A broader ethical framework is suggested in this article, consistent with Ezekiel J. Emanuel's proposal, specifically one that allows for evaluation, reflection and debate about scientific research on humans, based on eight fundamental principles.

O exercício da ética da pesquisa se apoia na normatividade local vigente e em recomendações de caráter universal, como o Código de Nuremberg ou a Declaração de Helsinki. Contudo, esses documentos têm uma série de carências que não permitem a construção de um referencial ético completo para orientar a pesquisa que envolve humanos com vistas a um melhor aproveitamento de seus resultados e a uma construção ética do conhecimento. Assim, propõe-se um referencial ético mais amplo de acordo com a proposta de Ezekiel J. Emanuel, na qual, a partir de oito princípios fundamentais, constrói-se um espaço de avaliação, reflexão e debate sobre a pesquisa científica em seres humanos.

[Bioethics in clinical practice]. / La bioética en la práctica clínica.

Bioethics has grown exponentially in recent decades. Its most important schools include principlism, casuistry, virtue ethics and the ethics of care. These schools are not exclusive. Within bioethics, clinical ethics addresses the inherent clinical practice ethical problems, problems which are many and very varied. Bioethics training is essential for clinicians to address these bioethics' problems. But even the professionals are trained, there are problems that cannot be solved individually and require advisory groups in clinical ethics: clinical ethics committees. These committees are also responsible for education in bioethics in health institutions. Clinical bioethics is a practical discipline, oriented to address specific problems, so its development is necessary to improve the decision making in such complex problems, inevitable problems in healthcare.

La bioética ha tenido un desarrollo exponencial en las últimas décadas. Entre sus escuelas más importantes destacan el principialismo, el casuismo, la ética de la virtud y la ética del cuidado, las cuales no son mutuamente excluyentes. Dentro de la bioética, la ética clínica aborda los problemas éticos de la práctica clínica, problemas que son numerosos y muy variados. La formación en bioética es fundamental para que los clínicos aborden adecuadamente estos problemas. Pero aunque los profesionales estén formados, existen problemas que precisan del concurso de grupos asesores en ética clínica: los comités de ética para la asistencia sanitaria. Estos comités son además los responsables de la formación en bioética en las instituciones sanitarias. La bioética clínica es una disciplina práctica, orientada a dar respuesta a problemas concretos, por lo que su desarrollo es necesario para mejorar la toma de decisiones ante estos complejos problemas, inevitables en la asistencia sanitaria.

Caracterização de riscos em protocolos submetidos a um comitê de ética em pesquisa: análise bioética / Characterization of risks in search of an ethics committee in research protocols: bioethical analysis

Estudo descritivo realizado com o objetivo de identificar como os pesquisadores descreveram os riscos e as medidas de proteção/prevenção de suas pesquisas submetidas à análise por um comitê de ética em pesquisa. Foram incluídos 175 protocolos de pesquisa de um comitê de ética em pesquisa da cidade de Divinópolis, Minas Gerais. Como resultado, encontrouse que somente 38 (24,7%) pesquisadores descreveram os riscos nos formulários e 36 (23,5%) no termo de consentimento. Entretanto, 110 (62,9%) descreveram as medidas de prevenção nos formulários e 143 (93,5%) as descreveram no termo de consentimento. Concluiu-se que, embora os pesquisadores tenham identificado as medidas de prevenção, não descreveram quais seriam propriamente os riscos de suas pesquisas. É possível que tenham certa dificuldade em descrever os riscos por associá-los a danos...

Estudio descriptivo con el fin de conocer cómo los investigadores describieron los riesgos y las medidas de protección/prevención de sus investigaciones sometidas a análisis por un comité de ética en investigación. Se evaluaron 175 protocolos de investigación de un comité de ética en investigación de la ciudad de Divinópolis, Minas Gerais. Como resultado sólo 38 (24,7%) de los investigadores describieron los riesgos en los formularios y 36 (23,5%) en el término de consentimiento informado. Sin embargo, 110 (62,9%) describieron las medidas de prevención en los formularios y 143 (93,5%) en el término de consentimiento informado. Se concluye que aunque los investigadores han identificado las medidas de prevención, no describieron exactamente cuáles son los riesgos de sus investigaciones. Es posible que tengan alguna dificultad en la descripción de los riesgos por asociarlos a daños...

Organização e funcionamento dos Comitês de Ética em Pesquisa do Município de Belo Horizonte, Minas Gerais / The organization and functioning of Intitutional Review Board of the city of Belo Horizonte

INTRODUÇÃO: De acordo com a Resolução 196/96 do Conselho Nacional de Saúde brasileiro, Comitês de Ética em Pesquisa (CEP) visam a segurança e proteção de sujeitos de pesquisa. Devem ter condições mínimas para o funcionamento descritas em resoluções brasileiras e complementares, entretanto há carência de informações sobre os perfis destes órgãos no cenário brasileiro para que se busquem meios de aperfeiçoá-los. OBJETIVO: Analisar a organização e funcionamento dos comitês do município de Belo Horizonte(BH). Foram considerados somente os CEP cadastrados no Sistema Nacional de Ética em Pesquisa com situação regular junto à Comissão Nacional de Ética em Pesquisa. METODOLOGIA: Estudo seccional e descritivo, realizado com coordenadores de 23 CEP no município de BH em 2012. Questões relacionadas à infraestrutura, composição, processo de instalação e funcionamento dos CEP foram coletadas por meio de um questionário. Os resultados foram analisados através de estatística descritiva. RESULTADOS: Quanto à infraestrutura, 78,3% dos CEP possuem espaço físico e computador exclusivo e 100% têm acesso à internet. Em relação à composição, são constituídos na grande maioria por médicos, 100% possuem membros da comunidade no colegiado e 52,2% ofereceram algum curso sobre ética e bioética. Foram fundados entre 1996 e 2006, 100% possui regimento interno e ata de reuniões e 52,2% dos entrevistados relataram que os CEPs que coordenam precisam de algum pessoal de apoio. DISCUSSÃO: A maioria dos colegiados têm se dedicado para cumprir o seu papel, apresentando características que são adequadas às resoluções brasileiras. Entretanto, nenhum comitê está isento de aperfeiçoamento. A maioria dos pontos passíveis de melhorias estão relacionados ao apoio institucional. CONCLUSÃO: A organização e funcionamento dos CEP de BH possuem pontos de aperfeiçoamento importantes para a realização de sua função com qualidade. Faz-se necessário a realização de trabalhos que perpassam...

INTRODUCTION: According to Resolution 196/96 of the Brazilian National Health Council, an Institutional Review Board (IRB) has the aim of protect research subjects thus keeping their safety. For its operation as described in the Brazilian resolutions and complementary, minimum pre-establish requirements must be archived. However there is scarcity of information about the profiles of these organs in the Brazilian scenario whose knowledge is essential to their improvement. OBJECTIVE: Analyze the organization and functioning of IRBs of the city of Belo Horizonte. Were considered only the IRBs registered in the National System of Research in Ethics, and with regular status in the National Research in Ethics Council. METHODS: Sectional and descriptive study, conducted with coordinators / deputy coordinators of 23 IRBs in the city of Belo Horizonte in the year 2012. Issues related to infrastructure, composition, process of installation and operation of the IRBs were investigated through a questionnaire. The results were analyzed using descriptive statistics. RESULTS: All the IRBs evaluated were founded between 1996 and 2006, 100% has bylaws and minutes of meetings and 52.2% of the interviewed reported needing some support staff. The vast majority of the member is composed of medical doctors, 100% have community members in the collegiate and 52.2% offered a course on ethics and bioethics; and 78.3% of the IRBs have their own physical space and an exclusive computer, with internet access. .DISCUSSION: Most boards have dedicated themselves to play their role, showing characteristics that are in agreement to the Brazilian resolutions. However, no IRB is exempt improvements, mostly related to the institutional support. CONCLUSION: The organization and operation of the IRBs of the city of Belo Horizonte have important points of improvement in order to perform its function with excellence. Beyond the analysis of the facts, works that have direct impact in the work done...

Principais falhas na elaboração do TCLE dos projetos tramitados no CEP-FHEMIG nos últimos 24 meses / The most commons flaws on the elaboration of the informed cosent of the projects that were auditioned in CEP-FHEMIG in the last 24 months

INTRODUÇÃO: O Termo de Consentimento Livre e Esclarecido (TCLE) é peça fundamental na elaboração de uma pesquisa envolvendo seres humanos e expressa para o participante todas as garantias éticas e humanas do pesquisador junto ao voluntário. Por sua importância o TCLE é fonte de atenção detalhada dos Comitês de Ética em Pesquisa (CEP) e é determinante para aprovação do início das pesquisas. OBJETIVOS: Levantar as principais falhas detectadas na elaboração do TCLE dos projetos apreciados pelo CEP-FHEMIG, nos últimos 24 meses. MATERIAL: Trata-se de um estudo retrospectivo, no qual foram analisados os projetos de pesquisa que tramitaram no CEP-FHEMIG no período de setembro de 2008 a agosto de 2010. RESULTADOS: Foram analisados 193 projetos de pesquisa, sendo que 39,9% deste receberam o parecer de pendências por diversos motivos, porém a causa mais comum de pendências foram as inadequações do TCLE (38%). As principais falhas na elaboração do TCLE foram: Linguagem inadequada (23%), não disponibilização de contatos telefônicos para esclarecimento de dúvidas (15%), não apresentavam os riscos e benefícios da pesquisa (13,9%), projetos sem envio do TCLE (13,4%), não esclareciam o objetivo do estudo (7,5%), não mencionavam no TCLE os procedimentos a serem realizados (6,4%), falha não relatada no parecer (6,4%), erros de formatação (5,9%), não relatavam no TCLE as garantias do sujeito da pesquisa (5,9%) e sem relato de custo ou remuneração para o voluntário (2,7%). CONCLUSÕES: As principais causas de pendência estão diretamente relacionadas a falhas encontradas no TCLE, em especial as falhas presentes na linguagem do documento.(AU)

The informed consent is a fundamental piece on the elaboration of research with human beings and it contains all the ethics safeties and guaranties for the voluntaries chosen to participate in the project. Because of its importance, the informed consent is given a special attention by the Research Ethics Committee (REC) and is required for the approval of the project. OBJECTIVES: This study aims to assess the aspects of the research projects sent to CEP-FHEMIG, especially the difficulties related to the informed consent. MATERIALS: This is a retrospective study in which the research projects in CEP-FHEMIG were evaluated from November 2008 to August 2010. RESULTS: 193 research projects were analyzed, 39.9% of those were held up for various reasons. However the most common hold up was related to problems on the informed consent (38%). The most common mistakes related to the informed consent were: inappropriate grammar and language (23%) , did not have the phone info necessary to clear possible doubts (15%), did not show the risks and benefits of the research (13.9%), did not send the informed consent (13.4%), did not explain the objectives of the project (7.5%), did not mention the procedures of the research in the informed consent (6.4%), did not have the exact problem identified on their files (6.4%), were not properly formatted (5.9%), did not included the rights of the subject of the research (5.9%) and did not show that there was no costs or payment to the patients (2.7%). CONCLUSIONS: Most hold ups are related to flaws encountered on the informed consent, mainly on the grammar and language of the document.(AU)

Perfil dos projetos de pesquisa submetidos ao Comitê de Ética em Pesquisa da Fundação Hospitalar do Estado de Minas Gerais nos últimos 12 meses / Patterns of research projects submitted to the Research Ethics Committee of the Fundação Hospitalar do Estado de Minas Gerais in the last 12 months

Introdução: A Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) é uma rede composta por 20 hospitais públicos e possui o seu Comitê de Ética em Pesquisa (CEP) desde 1999, seguindo as normas da Resolução 196/1996 do Ministério da Saúde. Objetivos: Este estudo teve como objetivo avaliar o perfil dos projetos de pesquisa encaminhados ao CEP-FHEMIG, enfocando os tipos de pesquisa, pareceres, causas de pendências, padrões de pesquisadores e instituições envolvidas. Métodos: Trata- se de um estudo retrospectivo, no qual foram analisados os projetos de pesquisa que tramitaram no CEP-FHEMIG no período novembro de 2008 a outubro de 2009. Resulta- dos: Foram analisados 119 projetos de pesquisa, o tempo de tramitação até o primeiro parecer foi de 19,6 ± 11,2 dias. O resultado do primeiro parecer foi de: 52,1% projetos aprovados, 45,4% pendências e 2,5% reprovados. As causas mais comuns de pendência foram inadequações no Termo de Consentimento Livre e Esclarecido (TCLE) (35,8%), metodologia (24,6%) e orçamento (13,4%). A maior parte dos projetos foi encaminhada por profissionais de medicina e 63,0% dos projetos foram prospectivos e 37,0% retros- pectivos, apenas 13,4% contavam com financiamento externo. Conclusões: Entre os projetos analisados as principais causas de pendências foram inadequações ou dúvidas em relação ao Termo de Consentimento Livre e Esclarecido, metodologia e orçamento. Palavras-chave: Bioética, Ética em Pesquisa, Temas Bioéticos, Comitê de Revisão Ética, Pesquisa.

Introduction: The Fundação Hospitalar do Estado de Minas Gerais (FHEMIG) is a network of 20 public hospitaIs and has its Research Ethics Committee since 1999, following the norms of 196/1996 Resolution of the Health State Department. Objectives: The aim of this study was to evaluate the profile of the research projects referred to the research ethics committees of the FHEMIG, focusing on the types of research, verify the reasons for rejected projects, patterns of researchers and institutions involved. Methodology: Is a retrospective study that evaluated research projects involving human beings. Research projects were submitted in November 2008 to October 2009 to the Research Ethics Com- mittee of the FHEMIG. Results: One hundred nineteen research projects were submitted to the ethics committee and the average time for evaluating the research projects and related documents until a final decision was reached was 19.6 ± 11.2 days. The result of the first opinion was 52.1% of projects approved, pending 45.4% and 2.5% disapproved. The main reasons for returning the projects to the researchers were the use of inadequate informed consent form (35.8%), doubts regarding methodological (24.6%) and lack of information on financial support (13.4%). Most of the projects were referred by physicians and 63.0% of projects were prospective and 37.0% retrospective, only 13.4% relied on external financing. Conclusion: Among the research projects that were returned for additional clarification, the main reasons were inadequacies or doubts about the informed consent, methodology and financial support.

My Opinions on the Accreditation and Recognition of Institutional Ethical Review Committee / 中国医学伦理学

This brief article argues that if institutional ethical review committee is established and functioned in conformity with the Interim Rules on Ethical Review of Biomedical Research Involving Human Subjects promulgated by the Ministry of Health,it will be legitimate and meet quality requirement.If some institutes attempt to seek accreditation and recognition from oversea organization,the accreditation and recognition will be both illegal and ineffective.

European Ethical Review Committee: the experience of an international ethics committee reviewing protocols for drug trials.

An international ethics review committee, founded seven years ago, has several unusual features: it selects its own members, who are independent of the drug industry; it includes members with no medical or paramedical background, such as lay people and lawyers; and it reviews protocols together with the study's sponsor. Membership of 31 from nine European countries enables frequent meetings and there is a full meeting of the committee every year to review progress and consider policy. Of the first 294 protocols for phase I, II, or III trials reviewed, 37 were admitted outright, 243 were amended (usually during the discussion of the protocol), and 14 were rejected. It is suggested that, to overcome the problem of ethics review in smaller institutions, regional health authorities in Britain might consider establishing similar committees.