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Year 2 H+S > Block 12 H + S > Flashcards

Block 12 H + S Flashcards

1
Q

What is the importance of research-informed practice?

A

-Personal experience is biased in various ways
- Research reports findings for more patients than can hope to see in personal
experience
- Research involves the application of scientific method - Testing of hypotheses,
systematic data collection, analysis-designed to minimise bias
- Recommendations have been assessed for their clinical and cost effectiveness for
the NHS

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2
Q

What is the research cycle?

A
  1. Identify a clinical problem
  2. Basic research - Laboratory based
  3. Applied (clinical) research
  4. Clinical care
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3
Q

What is the implementation gap?

A

Gap between scientific understanding and patient care

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4
Q

What are the barriers to implementation of research-informed practice

A

-Characteristics of the recommendations - Easy to follow, compatible with existing norms, need for new skills, complexity of recommendations
- Characteristics of the adopters - Knowledge, attitudes, skills and abilities
 -Characteristics of the organisation - Limitations and constraints, organisational
culture
 -Characteristics of the environment - Social influence

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5
Q

What is quality improvement (QI)?

A

Facilitate the uptake and continuing use of evidence-based policy and practice, focusing on recurrent problems within system of care to improve:
- Performance
- Professional development
- Service-user outcomes

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6
Q

What does quality improvement involve?

A

-Engage participants across organisational levels
-Foster environment where improvement and innovation are viewed as normal
- Empowering staff to strive for change
- Provide knowledge and methods to implement change
 -Remove barriers to change

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7
Q

Give some examples of QI initiatives?

A

-Revision of professional roles
 Introduction of MDTs
- Change in skill mix, or in the setting of service
 -Facilitate audit and benchmarking cycles to identify variations in practice and
outcomes that may be targets for QI efforts
- Network recognition for high-quality practice
 -Promote inter-institutional communication and collaberation (and inter-institutioanl
competition)

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8
Q

What makes a QI initiative effective?

A

-Passive dissemination of information, such as distribution of educational materials or didactic lectures, is generally ineffective in driving change
- Mutlifaceted interventions that act of different levels of barriers to change are more likely to achieve improvements in policy and practice
- Key - Tailored to the key barriers, not just ‘the usual approach’

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9
Q

What is quality and outcomes framework (QOF)?

A

-Annual reward and incentive programme detailing GP practice achievement results
- Enables commissioners to reward excellence across key domains
- Aims to improve standards of care by assessing and benchmarking the quality of care
patients receive - Compares delivery and quality of care against previous years

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10
Q

Does QOF work?

A

-Improvements associated with financial incentives seem to be achieved at the expense of small detrimental effects on aspects of care that were not incentivised
- Following the removal of incentives, level of performance across a range of clinical
activities generally remain stable

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11
Q

What was the aims of national CQUINs 2014-15?

A
  • Friends and family test - Incentivise high performing providers
  •  Improvement against the NHS safety thermometer, particularly pressure ulcers
  •  Improving dementia and delirium care
  • Improving diagnosis in mental health
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12
Q

What is the incidence of falls in the elderly?

A

-35% of 65-79 year olds
- 45% of 80-89 year olds
 -55% of 90+ year olds

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13
Q

What are the possible consequences of falls?

A 
-Osteoporotic fractures
- Head injuries
- Contusions, lacerations
- Psychological problem - Fear of falling, social isolation, depression
- Increase in dependence and disability
- Impact on carers - Time and anxiety
- Institutionalisation
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14
Q

What are the risk factors for falls?

A

-Muscle weakness
- History of falls
- Gait deficit
- Balance deficit
- Visual deficit
 -Arthritis
- Impaired activities of daily living (ADL)
- Cognitive impairment
- Age - >80 years
- Medical conditions - PD, stroke, hypotension, depression, epilepsy, dementia,
arthritis, peripheral neuropathy, dizziness and vertigo

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15
Q

How can falls be prevented/decrease risk?

A 
-Increase activity - Diversity of physical activity
 -Weekly walk for exercise
- Strong family networks
- Multifactoral falls risk assessment
- Multifactoral intervention
- Education and information
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16
Q

What doesn’t help to reduce falls?

A

-Brisk walking
- Residential care setting - Increases!
- High intensity strength training - Increases injury
- Educational and behavioural alone

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17
Q

What is QALY?

A
  • Quality Adjusted Life Year
  •  1 QALY = 1 year in perfect health
  •  E.g. if an illness reduces quality of life by 20% (0.2) and this affects 10 people then 2 QALY are lost
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18
Q

What is the cost of falls?

A

£1.3 billion

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19
Q

What is the cost of hip fractures?

A
  • £12k per patient

-  Around £720 million per year

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20
Q

What is a common fracture in elderly people?

A

Fracture of the neck of femur

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21
Q

What are the two types of fracture of the neck of femur?

A

-Extracapsular - The bone outside the joint capsule breaks  Sliding hip screw, intramedullary nail
- Intracapsular - The bone within the joint capsule breaks  Internal fixation - Screws, nails, plates and rods

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22
Q

What is avascular necrosis?

A
  • Death of bone tissue due to lack of blood supply

-  Can lead to tiny breaks in the bone and the bone’s eventual collapse

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23
Q

What is the main risk factor associated with increased risk of fracture?

A

Osteoporosis

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24
Q

What are risk factors for hip fractures?

A

-Low bone mineral density (BMD) is associated with increased fracture riskAge - -Every 5 year increase doubles the risk
- Female gender
- Low body weight (correlates with bone density)
- Family history of hip fracture
- Prior history of fracture
- Smoking
- Ethnicity - Afrocarribeans have very low fracture risk
- Corticosteroid use
- Medications e.g. psychotripic drugs

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25
Q

How can hip fractures be prevented?

A
  • Fall prevention

-  Bone protection - Medication, hip protection

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26
Q

What is primary prevention?

A

Avoidance of disease before any signs or symptoms develop

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27
Q

What is secondary prevention?

A

Avoidance of progression or later problems, signs or symptoms present

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28
Q

What would be primary and secondary prevention in relation to stroke?

A
  • Primary - No history of stroke or TIA

-  Secondary - After either of these have occurred

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29
Q

What is the prevention paradox?

A
  • The majority of people who suffer a stroke are not at high risk of a stroke (e.g. 75% have ‘normal’ blood pressure).
  •  But if the whole population changes their health behaviour via public health mechanisms, this would lead to a much greater effect.
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30
Q

What are the effects of targeting population for prevention?

A

-Large potential benefit to community
- Low potential benefit to individual
- May be low perceived benefit to individual

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31
Q

What are the effects of targeting high risk groups for prevention?

A

-Larger potential benefit to individual
- Smaller effect on population rate of stroke
- Many of the conditions you treat are asymptomatic
- May of the treatments have side effects

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32
Q

Which group of people are at the highest risk from stroke?

A

-People who have already had one - Secondary prevention reduces risk in these people
- 1/5 people with stroke have another after 3 months

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33
Q

What medication is used for secondary prevention of strokes?

A
  • Ischaemic - Clipidogrel, statin, anti-hypertensive, anticoagulant if AF
  •  Haemorrhagic - Anti-hypertensives
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34
Q

What percentage of people who have strokes are under 50 years old?

A

<20%

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35
Q

What is the incidence in strokes in men and women?

A
  • Men are at a 25% higher risk of having a stroke and at a younger age compared to women
  •  However, as women tend to live longer there are more total incidences of stroke in women
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36
Q

What are the non-modifiable risk factors for strokes?

A

-Age
- Gender
- Race - South Asians with western lifestyle
- Family history - Rare congenital (in young people - CADASIL)

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37
Q

What are the modifiable risk factors for strokes?

A 
-High blood pressure - Biggest risk factor
- Diabetes
 -Atrial fibrillation
 -Smoking
 -Hyperlipidaemia
 -Obesity
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38
Q

What did the PROGRESS trial show?

A

Reducing blood pressure after stroke reduces risk of stroke recurrence

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39
Q

What are the barriers for initiating medical therapies for conditions with no obvious
symptoms?

A 
-Misinformed
 -Not caring
 -Side effects of tablets
- Forgetfulness
 -Depression
- Cognitive impairment
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40
Q

What is a confounding factor?

A
  • Distortion of the relationship between an exposure and outcome due to shared relationship with something else
  •  Confounders can either increase associated between exposure and outcome, or decrease association between exposure and outcome
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41
Q

How can we limit confounding factors and what are the effects?

A

Restriction - Limit the participants of your study who have possible cofounders
 Means that you have less data and difficult with multiple confounders

- Matching - You create a comparison group that is matched on the possible confounder, make case and control group as similar as possible on the confounder and then ask about exposure status
 Used for strong confounders like age and sex
 Stratification - Analyse exposure:outcome association in different subgroups of the confounder, recombine data and use a weighted average of the strata

- Limitations - To take into account all confounders would require lots of strata and you may run out of data to fill all possible options in your strata

- Multiple variable regression - You can adjust for the effects of multiple confounders, try and produce a linear model between the outcome and the different exposures
 Allows for adjustment of estimates for confounding

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42
Q

What is standardisation?

A

Way to limit confounding, often used to control for differences in age groups when comparing rates of disease in two populations with different age structures

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43
Q

What is standardised mortality ratio (SMR)?

A

Ratio between the observed number of deaths in a study population to the number of expected deaths.
SMR = observed number of deaths / expected number of deaths

44
Q

What is direct standardisation?

A

Required we know the age-specific rates of mortality in all populations under study

45
Q

What is indirect standardisation?

A

Only requires that we know the total number of deaths and the age structure of the study population

46
Q

When is indirect standardisation preferable?

A

Small numbers in particular age groups

47
Q

Why do we have waiting lists?

A
  • There is a limitless demand for health, people can always ‘be more healthy’ which created high demand
  •  Limited resources - Supply of money, staff etc is finite
48
Q

Why are waiting times important to patients?

A

-The patient’s condition may deteriorate while waiting and in some cases the effectiveness of the proposed treatment may be reduced
- Experience of waiting can be extremely distressing in itself
- Patient’s family life may be adversely affected by waiting
- Patient’s employment circumstances may be adversely affected by waiting
- Excessive waiting times may be symptoms of inefficiencies in the healthcare system
and should be addressed as part of good management

49
Q

How can you measure waiting times?

A

-Average waiting time (mean or median)
- Proportion who waited longer than ‘x number of days’
 -Average wait of people currently on the list

50
Q

What are the theories of NHS waiting lists?

A

-The backlog - Implies a need for occasional emergency injection of funds
- Demand management - Waiting acts as a ‘price’ to deter frivolous use
- Allows NHS resources to be fully employed - Don’t want lots of spare capacity as this
is a waste
- Waiting lists are caused by underfunding and ineffieciency

51
Q

How can the NHS reduce waiting times?

A

-Manage demand - Ensuring each referral represents the most appropriate decision for the care of the individual patient
- Manage the queue - Ensuring waiting lists are well managed and patients are called for treatment in appropriate order
- Manage capacity - Providing efficient and effective services that meet the level of demand from appropriate referrals
- Provide leadership - Ensuring that all parts of the local NHS work together to achieve waiting time improvements in the best interests of patients.

52
Q

What was the 2000-2008 policy ‘targets and terror’?

A
  • Performance management of Trusts and PCTs based on achievement of target waiting times
  •  Hospitals receive an overall performance score and managers could lose their jobs if targets missed
53
Q

What was the pros of ‘targets and terror’?

A

-No inpatients waiting longer than 3 months
- Outpatients reduces, significant increased expenditure alongside this, however
funding has now remained constant meaning NHS is struggling despite increased demand

54
Q

What were the cons of ‘targets and terror’?

A

-Sacrifice of professional autonomy - Managers pressurising doctors, may be forced to treat less urgent due to waiting time
- Unmeasured performance sufferers - Things that don’t have a target may suffer
- Adverse behavioural responses e.g. emergency patients waiting in ambulances not emergency rooms, not classed as being in A&E until they are through the doors so
essentially cheating
- Data manipulation and fraud

55
Q

What is possible criteria for priority on a waiting list?

A 
-Clinical urgency
- Clinical severity
- Potential health gain
- Productivity and economic loss
- Equity waiting e.g. poverty
- Length of time waiting
56
Q

What are the social consequences of deafness?

A
  • Social impact - Difficult to have conversations, isolation, intimacy issues, problems at work
  •  Psychological impact - Anger, low confidence, frustration, depression, embarrassment
  •  Practical issues - Doorbells, phones, theatre and cinema, TV, alarms
57
Q

How can a stroke affect communication?

A
  • Aphasia (dysphasia) - Difficulty in the generation of speech and sometimes also in its comprehension
  •  Dysarthria - Difficult or unclear articulation of speech that is otherwise linguistically normal (due to weakness of muscles used to speak)
  •  Dyspraxia - Affects movement and coordination, cannot move muscles in the correct order and sequence to make the sounds needed for clear speech.
58
Q

What are the social consequences of speech and communication difficulties?

A
  • Not being able to express yourself clearly can be very isolating
  •  Depression
  •  Frustration
  •  May not be able to participate in activities they used to enjoy
  •  Tiring - Communicating may require a lot of effort
59
Q

What areas can medico-legal implications occur in a person with epilepsy?

A
  • Determination of fitness to drive and other similarly dangerous activities
  •  Determination of intent for alleged criminal actions
60
Q

What are the rules for whether people can drive with epilepsy?

A
  • Group 1 which applies to cars, motorbikes, and most other small vehicles - Need to be seizure free for 12 months
  •  Group 2 which applies to bigger vehicles such as lorries, heavy goods vehicles and other specialised types of vehicle - Unlikely to qualify for group 2 licence, need to be seizure free for 10 years and have not taken epilepsy medicines for 10 years

There are new rules relating to whether people can drive if:
- They have only had seizures while they sleep
- They have only had seizures that do not affect their consciousness
 -Their doctor changed their dosage or medication, but they have now gone back to
the original dosage or medication

61
Q

What are CAMs?

A
  • Complementary - Non-mainstream practice is used together with conventional medicine
  •  Alternative - Non-mainstream practice is used instead of conventional medicine
62
Q

What are the big 5 CAMs?

A
  • Acupuncture - Fine needles are inserted at certain sites in the body for therapeutic or preventative purposes
    - Chiropractic - Spinal manipulation aims to treat ‘vertebral subluxations’ which are claimed to put pressure on nerves
    - Herbal medicine - Medicines with active ingredients made from plant parts
    - Homeopathy - Based on the use of highly diluted substances, which practitioners
    claim can cause the body to heal itself
    - Osteopathy - Moving, stretching and massaging a person’s muscles and joints
63
Q

What is the underlying principle with CAMs?

A

-Self-healing is triggered
- Longer-term effects may be due to physiological (re-)learning and behavioural/life-
style changes integral to treatments
- Each therapy has its own mechanism(s) - Mostly poorly understood

64
Q

What percentage of CAMs are covered by the NHS?

A

10%

65
Q

What are the barriers to CAMs on the NHS?

A

-Regulatory issues
- Financial concerns in NHS
- Tribalism - Different medical specialties ‘hold on’ to their patch
- Inertia - Resistance to change
- Mixed evidence of effectiveness - Not all are properly evidence-based

66
Q

Why should CAMs be provided by the NHS?

A 
-Patient choice
- Preventative healthcare agenda
 -Commissioning changes
- Personal budgets
- Growing evidence base
67
Q

What is osteopathy used mainly to treat?

A

-Back pain
- Repetitive strain injury
- Changes to posture in pregnancy
- Postural problems caused by driving or work strain
- The pain of arthritis and sports injuries

68
Q

What do chiropractors mainly treat?

A

-Back, neck and shoulder problems
- Joint, posture and muscle problems
- Leg pain and sciatica
- Sports injuries

69
Q

What is acupuncture used to treat?

A 
-MSK patients
- Fertility/pregnancy - Has become much more popular
- Neurological pain
- Depression
- Eczema
- Chronic pain
70
Q

Why are people using acupuncture?

A

Effectiveness gap - A clinical area where available treatments are not fully effective or satisfactory for various reasons including lack of efficacy, adverse effects and acceptability to patients

71
Q

What is the evidence base for accupuncture?

A

-Acupuncture correlated with physiological parameters i.e. with decreases in brain flow
- Acupuncture can be seen as having an overall effect vs usual care
- Acupuncture is more effective than no treatment or sham treatment for lower back pain (indicate it is more than a placebo) but there are no differences in effectiveness
compared with other conventional therapies
- Acupuncture, osteopath and chiropractic shown to be effective when compared to
usual care
- As is the case with biomedicine, more and better research is needed

72
Q

What are the criticisms of acupuncture?

A

-Is the effect too small and not clinically relevant
- NSAIDs are commonly given for chronic back pain - NSAID vs placebo and
acupuncture vs placebo have similar effect for pain reduction

73
Q

What does the NICE guidelines state about acupuncture in lower back pain, osteoarthritis, and headaches?

A

-Low back pain - Consider manual therapy, do not offer acupuncture
- Osteoarthritis - Manipulation and stretching should be considered as an adjunct to
core treatments, do not offer acupuncture
- Headache/migraine - Consider a course of up to 10 sessions of acupuncture over 5-8 weeks

74
Q

What are the 5 categories for significant impaired decision making ability?

A
  • Lack of insight - Person suffers from some disability but seems unaware of the existence of their disability
  •  Cognitive impairment - e.g. Dementia
  •  Presence of psychosis
  • Severe depressive symptoms
  •  Learning disability
75
Q

Why is it important to support patients decision making?

A
  • Patients generally happier if can make decisions
  •  Enables patients to have self-determination, autonomy
  •  Likely to facilitate other positive goods - Good doctor-patient relationship
  •  A professional requirement (GMC)
  •  A legal requirement - Mental capacity act (2005)
76
Q

How might doctors assist patients in making decisions?

A

-Using a different form of communication
- Providing information in a more accessible form
- Treating a medical condition affecting the person’s capacity
- Having a structured programme to improve a person’s capacity

77
Q

Which act are capacity determinations governed by?

A

Mental capacity act (MCA) 2005

78
Q

According to the MCA, when does a person lack capacity?

A

A person lacks capacity if they are unable to:
- Understand information that may be relevant to the decision, including the consequence
- Retain information, even for a short time
- Use or weigh information to make decisions
- Communicate decision

79
Q

What are the 5 key principles of the MCA?

A
  • Presumption of capacity - A person must be assumed to have capacity until otherwise established. Assumption can be over-ridden if shows to lack capacity for that decision at that time.
  •  Right to be supported to make their own decisions - Use different forms of communication, provide information in different formats, treat a condition that is impacting capacity thus restoring capacity
  • Right to make eccentric or unwise decisions - A person is not to be treated as unable to make a decision merely because it is an unwise one
  •  Best interests - A decision made under the MCA for someone lacking capacity must be done in their best interests
  •  Least restrictive intervention - Before the decision is made you should explore other less restrictive options
80
Q

How might dementia first present?

A
  • Patient noticing changes - Forgetfulness, difficulty with names and finding the right word, embarrassment in social situations
  •  Family or friends noticing changes - Repetitive, forgets social arrangements, skills deteriorating, withdrawing
  •  Delirium - Acute confusion with fluctuating level of consciousness, agitation, hallucinations etc
  •  Social crisis - E.g. death of a spouse reveals cognitive dysfunction and impairment
81
Q

What is the impact of diagnosis of dementia on a patient?

A
  • Denial (with or without insight) - Patient attributes all problems to old age, often accompanied by anger at the suggestion that there is anything wrong
  •  Grief reaction - Similar reaction to receiving diagnosis of any serious illness
  •  Acceptance/positive coping strategies - Need to reconsider the future
82
Q

What determines the response of the patient to the diagnosis?

A
  • Insight and stage of illness - Ability to remember and process information
  •  Type of dementia
  •  Previous personality, relationship, and support
83
Q

What is the impact of diagnosis on the carers?

A
  • Confirmation of something they have long suspected
  •  Fear
  •  Anger
  •  Grief
84
Q

What determines the response of the carer to the diagnosis?

A

-Understanding of illness
- Patients reaction
-Nature of relationship with patient and what else is happening

85
Q

What are the benefits of diagnosis?

A

-Know what it is that you are dealing with
- Access to treatments
- Access to support services
- Information/education
- Planning for the future - financial affairs etc
- Assess and manage risks e.g. driving

86
Q

Describe the effect of dementia on the patient, spouse/partner, children and carers?

A

-Patient - Loss of self-esteem, may find communication difficult, loss of independence and autonomy, change in social roles and relationships, impact on ADLs
- Partner - Relationship becomes skewed, practical, emotional, financial, strained relationship with family/friends
- Child - Role reversal, competing demands, conflict between family members, effect on young children, previous relationship
- Carers - Stress, physical care, poor sleep, constant vigilance, loss of support, unable to take time off sick

87
Q

Why are people with dementia at high risk of elder abuse?

A

-More vulnerable
- May struggle to discuss their feelings and experiences or remember what happened
to them
- Can be hard to detect abuse

88
Q

What are examples of advanced care planning?

A
  • Advanced statement of wishes - Wishes and preferences about treatment/care they would like (NOT legally binding hence can use best interests judgement)
  •  Advanced decisions/directives - A decision to refuse treatment (LEGALLY BINDING so should always be followed)
89
Q

What are advanced directives?

A

-Extends patients autonomy to apply in situations where they don’t have capacity as defined under the MCA 2005.
- A valid AD that refuses treatment should always be followed
- ADs allow patients to refuse future treatment but not to demand treatments

90
Q

When are advanced directives valid and applicable?

A
  • Patient is 18+ - Note MCA is for 16+ but only 18+ can refuse treatment
  •  Patient lacks capacity at the time of treatment but had capacity at time of making AD
  •  Properly informed patient and statement is clear and applicable to current situations
  • ADs can be used to refuse life-saving treatments but cannot be used to refuse basic care e.g. food/water.
91
Q

What is the Ulysses arrangement?

A

Advanced directive for bipolar disorder

92
Q

What are the pros of advanced directives?

A

-Respect patient autonomy
- Encourages forward planning
- Patient will be less anxious about unwanted treatment
- May lower healthcare costs as people opt out for less aggressive treatments

93
Q

What are the cons of advanced directives?

A

-Difficult to verify if the patient’s opinion has changed since making AD
- Difficult to ascertain whether the current circumstances are what the patient
foresaw when making AD
- Possibility of coercion on behalf of the patient
- Possible wrong diagnosis
- Can patients imagine future situations sufficiently vividly to make their current
decisions adequately informed?

94
Q

What are some of the research atrocities in history?

A

-Nazi medical experiments (Nuremberg trials)
- Willowbrook study - Injected vulnerable children with Hep B to develop vaccine
- Tuskegee sphilis study - African-american men given syphilis but not given
antibiotics, researchers wanted to see disease progression
-Alder Hey - Retaining childrens organs without consent
- Wakefield - MMR scandal (autism)

95
Q

What is the Nuremberg Code (1947)?

A

The Nuremberg code resulted from the Nuremberg trials. It was an early code for research ethics principles, including:

  •  Need for voluntary consent
  •  Avoid all unnecessary physical and mental suffering and injury
  •  Conducted only by scientifically qualified persons
96
Q

What is the Helsinki Declaration (1964)?

A

Includes requirement that any human research is subject to independent ethical review and oversight by properly convened committee.

97
Q

What are some research ethics principles?

A

-Usefulness - Valid, good method, hasn’t been done before, strong justification
- Necessity - Does it need to be done this way?
- Risks - Risks should be as low as possible, sometimes balance minimal risk with
benefits
- Consent - Valid (competent, voluntary, informed), deception is sometimes needed
e.g. psychological studies
- Confidentiality - Respect patients information
- Fairness - Who benefits? Will it favour particular population group?
- Approval - From research ethics committee

98
Q

What is valid consent?

A

Voluntary, informed, patient is competent

99
Q

What does voluntary consent mean?

A

-Not putting pressure on patients or volunteers
- Not offering inappropriate (financial) inducements
- Not threatening/imposing sanctions if they don’t take part

100
Q

What should patients be given to facilitate consent?

A 
-Information sheets
- Presentation of information - No jargon, easy to understand
 -Summary of key points
- Opportunity to ask questions
- Time to decide - At least 24 hours
101
Q

What is confidentiality and why is it important?

A
  • Confidentiality is the state of keeping or being kept secret or private
  •  It is important for patient trust and for ensuring valid results
  •  All patient information is confidential
102
Q

How can we increase the level of confidentiality?

A

-Limit access to identifiable information
- Securely store data documents
- Assign security codes to computerised records
- Properly dispose, destroy or delete study data/documents
- Encrypt identifiable data

103
Q

What is an ethics committee?

A

Body responsible for ensuring that medical experimentation and human research are carried out in an ethical manner in accordance with national and international law

104
Q

Why do we need ethics approval?

A

-To protect participants
- Make sure no harm to researchers
- Researcher will not be covered is a claim regarding the research is made against
them
- Many publications will not accept research that was not ethically approved
- Funders will not provide financial support without ethical approval

105
Q

When is ethics approval needed?

A
  • Research involves humans
  •  Research involves confidential information
  •  Research involves biological material (embryos, stem cells, etc)
106
Q

What are some of the types of research ethics committees?

A

-NHS Research ethics committees
- Higher Education Institution (HEI) research ethics committees
 -Gene therapy advisory committee
- Social care research ethics committee
 -Ministry of defence research ethics committee

107
Q

What does the human tissue act (2004) state about research?

A

-Consent for storage and use of tissue for ‘scheduled purposes’ is required for tissues from living or deceased persons
- These purposes include research in connection with disorders, or the functioning of the human body
- However, consent is not required to use tissue obtained from living patients if the tissue is anonymous to the researcher and the project has research ethics approval

Year 2 H+S (14 decks)

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