Desafíos y oportunidades de financiación en la Acción Estratégica en Salud 2017-2020 para la investigación en cuidados / Challenges and opportunities in financing the 2017-2010 Strategic Health Strategy for care research

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Obtaining waivers of parental consent: A strategy endorsed by gay, bisexual, and queer adolescent males for health prevention research.

BACKGROUND: Requiring parental consent in studies with sexual minority youth (SMY) can sometimes be problematic as participants may have yet to disclose their sexual orientation, may not feel comfortable asking parents' permission, and may promote a self-selection bias. PURPOSE: We discuss rationale for waiving parental consent, strategies to secure waivers from review boards, and present participants' feedback on research without parents' permission. METHODS: We share our institutional review board proposal in which we made a case that excluding SMY from research violates ethical research principles, does not recognize their autonomy, and limits collection of sexuality data. DISCUSSION: Standard consent policies may inadvertently exclude youth who are at high risk for negative health outcomes or may potentially put them at risk because of forced disclosure of sexual orientation. Securing a waiver addresses these concerns and allows for rich data, which is critical for providers to have a deeper understanding of their unique sexual health needs. CONCLUSION: To properly safeguard and encourage research informed by SMY, parental consent waivers may be necessary.

Visibilización de la investigación en enfermería. Bases de Datos y Factor de Impacto / Nursing research visibility: databases and impact factor

En los últimos años, principalmente a raíz de la puesta en marcha de los diferentes procesos de acreditación de la actividad docente e investigadora, se está reflexionando más ampliamente acerca de la publicación en revistas de enfermería atendiendo al índice de impacto de las mismas o a su indexación en determinadas bases de datos, criterios básicos para la obtención de evaluaciones favorables en dichos procesos promovidos por las agencias de calidad. Atendiendo a esta problemática, se pretende analizar conceptualmente el soporte metodológico actual sobre el cual se sustenta el análisis de la calidad científica de la actividad investigadora en nuestra disciplina, así como las repercusiones para su visibilización y desarrollo (AU)

Nowadays, mainly as a result of the implementation of processes of accreditation of the teaching and research activity, there is discussion about the publication in journals of nursing according to the impact factor or their indexing in certain databases, basic criteria for obtaining favorable evaluations in these processes promoted by quality agencies. To response to this problem we are going to analyze conceptually the current methodological support on which is based the analysis of the scientific quality of the research in our discipline, as well as the impact on its visibility and development (AU)

Financial conflicts of interest in research: recognition and management.

Conflicts of interest (COIs) are of concern in research, and new regulations are in place to address financial COIs. Although not inherently wrong, a COI increases the risk of bias in research. The goal of the new regulation is to increase transparency to improve the public's trust in the research process. When a conflict is identified, it should be disclosed to the researcher's university, and if needed, a management plan is crafted to reduce the potential for bias.Management plans can include limiting a researcher's involvement in aspects of the research, disclosing this information to potential subjects, and reporting conflicts in presentations and publications. Addressing COI through education, disclosure, and management can protect investigators and all those involved in research and increase the integrity of the research process.

Mind the gaps in ethical regulations of nursing research.

The introduction of and the commitment to evidence-based nursing in all care settings have led to a rapid increase of intervention and outcome-based research programs. Yet, the topics of nursing research are not only affected by interventions and outcomes but also affected by the concept of caring derived from humanistic philosophy. Considering this twofold orientation of nursing science, nuanced ethical regulations for nursing research programs are called for. In addition to the different research approaches, further arguments for ethical regulations are as follows: first, the different degrees of contextualization and the variety of participation models regarding the target groups; second, the capacities and opportunities of participants; and third, the caring relationship between nurses and research subjects. To capture these special features of nursing science, four approaches to fill the gaps in existing ethical regulations for nursing research are proposed: (a) process orientation, (b) community orientation, (c) context orientation, and (d) relation orientation.

La carpeta de aprendizaje. Innovación docente en relación de ayuda / Learning portfolio. Educational innovation in therapeutic relationship

La carpeta de aprendizaje es un instrumento metodológico recomendado por las autoridades educativas que adquiere protagonismo como estrategia para adquirir y/o evaluar aprendizajes. El proceso de elaboración y su contenido atiende a un paradigma reflexivo, de autoaprendizaje, centrado en el estudiante. En el curso 2008-2009, se inició el proyecto de implementación en la asignatura Relación de Ayuda, de la Diplomatura de Enfermería, con la finalidad de consolidar su uso en el futuro Grado. Los resultados de la primera experiencia fueron analizados al final de la asignatura realizándose modificaciones en el diseño y desarrollo en el curso 2009-2010. Se describe, por un lado, la experiencia piloto de la implementación y desarrollo del instrumento y, en segundo lugar, la percepción de aprendizaje y de la experiencia de los estudiantes y de la profesora, al final del segundo año. El resultado muestra una alta percepción de aprendizaje y satisfacción en el uso de la carpeta en la asignatura. A pesar de resistencias al cambio paradigmático, a las dificultades y al esfuerzo en la elaboración y seguimiento de la misma, las ventajas superan las desventajas. Es importante tener en cuenta las limitaciones para realizar los ajustes necesarios en función de las características del grupo y de la materia(AU)

The Learning Portfolio is a methodological tool recommended by the educational authorities who comes to the fore as a strategy to acquire and/or assess learning. The process of preparing and serving content to a paradigm reflective, self-learning, student-centered. During 2008-9, the project started its implementation in the Therapeutic Relationship, Course for the baccalaureate Nursing in order to consolidate its future use in the new Degree at European Space of Higher Education. The results of the first experience were analyzed at the end of the course, made modifications to the design and development in 2009-10. This article describes, first the experience of the implementation and development of the instrument and secondly the perception of learning and experience of students and teacher, at the end of second year. The result of the experience shows a high perception of learning and satisfaction with the use of the portfolio in the subject. Despite resistance to paradigmatic change, difficulty and effort in the development and monitoring of the portfolio, the advantages outweigh the disadvantages. It is important to note the limitations to make adjustments depending on the characteristics of the group and contents Programme(AU)

Transparency in research and its effect on the perception of research integrity.

Pharmaceutical companies routinely engage faculty from academic medical centers to participate in biomedical research. Faculty contribute expertise and research subjects and often receive considerable compensation for their efforts. Because the role of the researcher can be compromised by financial conflicts of interest, disclosure of such relationships is routinely required. The effect of such disclosure is not entirely clear, however, and studies have yielded inconsistent results on how those receiving financial disclosures perceive the integrity of the research. Reviewing the literature, we conclude there is little consensus on how the disclosure of a financial relationship with an industry sponsor affects confidence in the research. We also conclude that is it unclear whether the new Patient Protection and Affordable Care Act will substantially alter the landscape.

Benefits and challenges of electronic surveillance in nursing home research.

Cognitive impairment and frailty associated with dementia renders residents of long-term care (LTC) facilities particularly vulnerable to physical and emotional harm. Resident-to-resident violence affects not only the target of the aggression, but also the aggressor, as well as the formal and informal caregivers who must intervene. To date, little research has been conducted on resident-to-resident violence despite preliminary but emerging evidence that it is a common (and likely growing) problem in LTC settings. Exploration of this phenomenon presents multiple pragmatic and ethical challenges. This article presents a rationale for implementing newer technological methods to collect data in investigations of resident-to-resident violence associated with dementia. The advantages and disadvantages of electronic surveillance in LTC research and the ethical principles involved are discussed, and an argument is developed for using electronic surveillance in both the shared, as well as private, spaces of the facility.

Nurse research and the law in competent adults.

This article is a summary of issues which nurses face when carrying out research involving competent adults. A recent case of a nurse in Teeside who was struck off as a result of irregularities in conduct during a clinical research trial highlights the importance of standards of care in research being met. The authors focus on two aspects of research - the problems of the consent procedure and the different obligations that might arise from involvement in research. Nurses have a very important role to play in the conduct of research. They, like any other health-care professionals, must make sure that they conduct themselves in accordance with the standards of care of their profession and are accountable for their research conduct.

Barriers and strategies for recruiting study participants in clinical settings.

Recruiting participants for research studies is often a challenging task. Recruitment requires careful planning, collaboration, and flexibility on the part of researchers and health care providers at the recruitment sites. This article describes six major barriers to recruiting study participants as identified from a review of the literature and from the coauthors' research experiences. These barriers include challenges related to regulations of the Health Insurance Portabililty and Accountability Act (HIPAA), health care providers' work burden, providers' financial disincentives, competition, health care provider concerns regarding research, and provider protection of patients. Each barrier is described, and specific strategies are suggested based on the empirical literature. In some instances, the coauthors' experiences are also shared.

Legal parameters of alternative-complementary modalities in nursing practice.

Complementary and alternative healing modalities are increasing in popularity. Partially in response to client demand and partially because of a strong history in providing care encompassing the whole person, nurses have responded by incorporating selected alternative therapies within select professional services. There are questions, however, as to whether some or all of these modalities are within the boundaries of nursing practice. Because most professional practice acts are vague in relation to specific therapies, a model for legal analysis is presented.

Enfermagem de bordo: análise da legislação e normatização de proteção à saúde do trabalhador de enfermagem aquaviário / Nursing services on board: legislation and standardization analysis to waterway nursing workers' health protect

Este estudo tem como objetivo introduzir um debate sobre as questões relacionadas à legislação voltada para o trabalhador de enfermagem aquaviário, com ênfase na proteção da saúde deste trabalhador de enfermagem inserido em plataformas e navios de exploração de petróleo da costa brasileira. O método utilizado é a análise documental. É característica da pesquisa documental definir a fonte de coleta de dados, que deve estar restrita a documentos, escritos ou não, constituindo o que se denomina de fontes primárias. Analisou-se, inicialmente, como fonte primária, os seguintes documentos jurídicos da legislação trabalhista: as Normas Regulamentadoras do Trabalho Urbano (NR – 30 e NR – 32), a Resolução COFEN-146 e o Decreto N° 2.671, DE 15 DE JULHO DE 1998 do COFEN e a NORMAM. Ainda, como fontes internacionais, destacam-se as Convenções 164 e 147 da OIT. Constatou-se que dezesseis das normas estudadas (72,7 porcento) têm sua vigência definida a partir dos anos noventa, embora existam desde 1910, conforme a Convenção Internacional para Unificação de Certas Regras em Matéria de Abalroamento, Assistência e Salvamento Marítimo – Bruxelas (23 de setembro de 1910). Contudo, a maioria absoluta destes dispositivos não se refere ao trabalhador de enfermagem aquaviário, à exceção do Código Brasileiro de Ocupações, uma norma complementar que define apenas algumas competências do enfermeiro de bordo. Concluiu-se que existe escassez de instrumentos legais para este setor e a necessidade de mobilização para a criação de normas mais específicas para o enfermeiro aquaviário e, conseqüentemente, relativas à proteção da saúde deste profissional...

This study aims to introduce a debate on issues related to legislation focused on the worker of nursing aquaviário, with emphasis on the protection of the health of workers in nursing inserted into platforms and ships of oil exploration of the Brazilian coast. The method used is the document analysis. It is characteristic of desk research to define the source of collecting data, which should be limited to documents, written or not, is what is called primary sources. Examined is, initially, as primary source, the following legal documents labor legislation: the Rules Regulamentadoras Labor Urban (NR-30 and NR-32), the resolution COFEN-146 and Decree No. 2671, of 15 July 1998 of COFEN and NORMAM. Still, as international sources, it is the Conventions 164 and 147 of the ILO. It was noted that sixteen of the standards studied (72.7 percent) have defined his life from the nineties, although there since 1910, according to the International Convention for Unification of Certain Rules in Respect of Abalroamento, Assistance and Rescue Marine-Brussels ( on September 23, 1910). However, the absolute majority of these devices does not refer to the worker of nursing aquaviário, with the exception of the Brazilian Code of Occupations, a standard that defines only a few complementary skills of the nurses board. It is concluded that there is a shortage of legal instruments to this sector and the need to call for the creation of more specific rules for the nurses aquaviário and, consequently, on the protection of the health of this training...

Being a research participant: the nurse's ethical and legal rights.

Nurses and their patients/clients are increasingly being approached to participate in research projects conducted in the clinical setting. However, such research involving human participants raises many ethical and legal concerns. This article provides nurses with an overview of their rights when asked to participate in such research. The ethical and legal principles that must be respected when such research is being conducted are presented and questions to ask of the researcher suggested. The role of the nurse, as required by their professional duty of care, to protect patients' rights during research in the clinical setting is highlighted.