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Article ; Online: Ethical guidelines for deliberately infecting volunteers with COVID-19.

Richards, Adair D

2020 Volume 46, Issue 8, Page(s) 502–504

Abstract: Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a ... ...

Abstract	Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods-that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.
MeSH term(s)	Betacoronavirus ; Biomedical Research/ethics ; Biomedical Research/methods ; COVID-19 ; COVID-19 Vaccines ; Coronavirus Infections/prevention & control ; Coronavirus Infections/virology ; Ethical Analysis ; Ethical Review ; Ethics Committees, Research ; Ethics, Research ; Guidelines as Topic ; Human Experimentation/ethics ; Humans ; Informed Consent ; Intention ; Pandemics/ethics ; Pandemics/prevention & control ; Pneumonia, Viral/prevention & control ; Pneumonia, Viral/virology ; Research Design ; Research Personnel ; Research Subjects ; SARS-CoV-2 ; Vaccination ; Viral Vaccines ; Volunteers
Chemical Substances	COVID-19 Vaccines ; Viral Vaccines
Keywords	covid19
Language	English
Publishing date	2020-05-27
Publishing country	England
Document type	Journal Article
ZDB-ID	194927-5
ISSN	1473-4257 ; 0306-6800
ISSN (online)	1473-4257
ISSN	0306-6800
DOI	10.1136/medethics-2020-106322
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Ethical guidelines for deliberately infecting volunteers with COVID-19

Richards, Adair D

Journal of Medical Ethics

2020 Volume 46, Issue 8, Page(s) 502–504

Abstract: Global fatalities related to COVID-19 are expected to be high in 2020–2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a ... ...

Abstract	Global fatalities related to COVID-19 are expected to be high in 2020–2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods—that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.
Keywords	Health Policy ; Arts and Humanities (miscellaneous) ; Issues, ethics and legal aspects ; Health(social science) ; covid19
Language	English
Publisher	BMJ
Publishing country	uk
Document type	Article ; Online
ZDB-ID	194927-5
ISSN	1473-4257 ; 0306-6800
ISSN (online)	1473-4257
ISSN	0306-6800
DOI	10.1136/medethics-2020-106322
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: Ethical guidelines for deliberately infecting volunteers with COVID-19

Richards, Adair D

J Med Ethics

Abstract	Global fatalities related to COVID-19 are expected to be high in 2020-2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods-that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #433431
Database	COVID19

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Book ; Online: Ethical guidelines for deliberately infecting volunteers with COVID-19

Richards, Adair D

2020

Abstract	Global fatalities related to COVID-19 are expected to be high in 2020–2021. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase II and phase III trials could take less long to conduct if they used human challenge methods—that is, deliberately infecting participants with COVID-19 following inoculation. This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approval processes so that they are in place when applications for trials are made.
Keywords	Current controversy ; covid19
Language	English
Publishing date	2020-08-01 00:00:00.0
Publisher	BMJ Publishing Group Ltd
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Ethical Guidelines for Deliberately Infecting Volunteers with COVID-19

Richards, Adair D

2020

Abstract: Global fatalities related to COVID-19 are expected to be high in 2020-21. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a ... ...

Abstract	Global fatalities related to COVID-19 are expected to be high in 2020-21. Developing and delivering a vaccine may be the most likely way to end the pandemic. If it were possible to shorten this development time by weeks or months, this may have a significant effect on reducing deaths. Phase 2 and Phase 3 trials could take less long to conduct if they used human challenge methods – that is, deliberately infecting participants with COVID-19 following inoculation.This article analyses arguments for and against such methods and provides suggested broad guidelines for regulators, researchers and ethics committees when considering these matters. It concludes that it may be possible to maintain current ethical standards yet still permit human challenge trials in a context where delay is critical. The implications are that regulators and researchers need to work together now to design robust but short trials and streamline ethics approvals processes so that they are in place when applications for trials are made.
Keywords	covid19
Publisher	Center for Open Science
Publishing country	us
Document type	Book ; Online
DOI	10.31235/osf.io/jb7gq
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Addressing critical knowledge and capacity gaps to sustain CRVS system development.

Adair, Tim / Richards, Nicola / Streatfield, Avita / Rajasekhar, Megha / McLaughlin, Deirdre / Lopez, Alan D

BMC medicine

2020 Volume 18, Issue 1, Page(s) 46

Abstract: Background: Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the ... ...

Abstract	Background: Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the workforce has the skills and knowledge to assess the quality of, and analyse, CRVS data using demographic and epidemiological techniques. While longer-term measures to improve data collection practices must continue to be implemented, it is important to build capacity in the cautious use of imperfect data. However, a lack of training programmes, guidelines and tools make capacity shortages a common issue in CRVS systems. As such, any strategy to build capacity should be underpinned by (1) a repository of knowledge and body of evidence on CRVS, and (2) targeted strategies to train the CRVS workforce. Main text: During the 4 years of the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne, an extensive repository of knowledge and practical tools to support CRVS system improvements was developed for use by various audiences and stakeholders (the 'CRVS Knowledge Gateway'). Complementing this has been a targeted strategy to build CRVS capacity in countries that comprised two approaches - in-country or regional training and a visiting Fellowship Program. These approaches address the need to build competence in countries to collect, analyse and effectively use good quality birth and death data, and a longer-term need to ensure that local staff in countries possess the comprehensive knowledge of CRVS strategies and practices necessary to ensure sustainable CRVS development. Conclusion: The Knowledge Gateway is a dynamic, useful and long-lasting repository of CRVS knowledge for countries and development partners to use to formulate and evaluate CRVS development strategies. Capacity-building through in-country or regional training and the University of Melbourne D4H Fellowship Program will ensure that CRVS capacity and knowledge is developed and maintained, facilitating improvements in CRVS data systems that can be used by policymakers to support better decision-making in health.
MeSH term(s)	Data Collection ; Health Knowledge, Attitudes, Practice ; Humans ; Registries ; Vital Statistics ; Workforce
Language	English
Publishing date	2020-03-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1741-7015
ISSN (online)	1741-7015
DOI	10.1186/s12916-020-01523-y
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Addressing critical knowledge and capacity gaps to sustain CRVS system development

Tim Adair / Nicola Richards / Avita Streatfield / Megha Rajasekhar / Deirdre McLaughlin / Alan D. Lopez

BMC Medicine, Vol 18, Iss 1, Pp 1-

2020 Volume 6

Abstract: Abstract Background Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the ... ...

Abstract	Abstract Background Improving civil registration and vital statistics (CRVS) systems requires strengthening the capacity of the CRVS workforce. The improvement of data collection and diagnostic practices must be accompanied by efforts to ensure that the workforce has the skills and knowledge to assess the quality of, and analyse, CRVS data using demographic and epidemiological techniques. While longer-term measures to improve data collection practices must continue to be implemented, it is important to build capacity in the cautious use of imperfect data. However, a lack of training programmes, guidelines and tools make capacity shortages a common issue in CRVS systems. As such, any strategy to build capacity should be underpinned by (1) a repository of knowledge and body of evidence on CRVS, and (2) targeted strategies to train the CRVS workforce. Main text During the 4 years of the Bloomberg Philanthropies Data for Health (D4H) Initiative at the University of Melbourne, an extensive repository of knowledge and practical tools to support CRVS system improvements was developed for use by various audiences and stakeholders (the ‘CRVS Knowledge Gateway’). Complementing this has been a targeted strategy to build CRVS capacity in countries that comprised two approaches – in-country or regional training and a visiting Fellowship Program. These approaches address the need to build competence in countries to collect, analyse and effectively use good quality birth and death data, and a longer-term need to ensure that local staff in countries possess the comprehensive knowledge of CRVS strategies and practices necessary to ensure sustainable CRVS development. Conclusion The Knowledge Gateway is a dynamic, useful and long-lasting repository of CRVS knowledge for countries and development partners to use to formulate and evaluate CRVS development strategies. Capacity-building through in-country or regional training and the University of Melbourne D4H Fellowship Program will ensure that CRVS capacity and knowledge is ...
Keywords	Capacity-building ; Civil registration and vital statistics ; Courses ; Evidence ; Fellowship ; Sustainability ; Medicine ; R
Subject code	020
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: The Effect of Ground Poles and Elastic Resistance Bands on Longissimus Dorsi and Rectus Abdominus Muscle Activity During Equine Walk and Trot.

Shaw, Karen / Ursini, Tena / Levine, David / Richards, Jim / Adair, Steve

Journal of equine veterinary science

2021 Volume 107, Page(s) 103772

Abstract: Core strengthening and postural stability are desired outcomes of certain therapeutic exercises performed in horses. This study aimed to quantify changes in muscle activation at a walk and trot in horses traveling over eight consecutive ground poles ... ...

Abstract	Core strengthening and postural stability are desired outcomes of certain therapeutic exercises performed in horses. This study aimed to quantify changes in muscle activation at a walk and trot in horses traveling over eight consecutive ground poles evenly spaced (at 30 inches for walk and 48 inches for trot) in parallel fashion in a straight line, and with hindquarter and abdominal elastic resistance bands applied at 25% stretch. Surface electromyography (sEMG) data were collected for the longissimus dorsi and rectus abdominus muscles in six horses. A 2 × 2 repeated measures ANOVA was performed for each muscle to test for significant differences in differences in normalized average rectified values and maximum low pass signals. Within subject effects were reported, followed by post-hoc pairwise comparisons to evaluate differences between the conditions of with or without ground poles or elastic resistance bands. The use of ground poles at a walk resulted in a significant (p < .05) increase in the maximum low pass value bilaterally in the longissimus dorsi and rectus abdominus muscles, with an increase in the average rectified value bilaterally in the rectus abdominus muscles and right longissimus dorsi muscle. The use of ground poles at a trot resulted in a significant increase in the maximum low pass value bilaterally in the rectus abdominus muscles. The hindquarter and abdominal elastic resistance bands resulted in a respective 27% and 27.2% increase in the mean average rectified value of the left and right RA muscles; however this only reached statistical significance in the left RA (p < .05). These findings provide support regarding changes in muscle activation when using ground poles to increase core and epaxial muscle engagement. While a significant effect on core muscle activation was identified with the elastic resistance bands at a trot, further research is needed in this area to further characterize their effects on muscle activation.
MeSH term(s)	Abdominal Muscles ; Animals ; Electromyography ; Gait ; Horses ; Rectus Abdominis ; Walking
Language	English
Publishing date	2021-09-17
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2102631-2
ISSN	1542-7412 ; 0737-0806
ISSN (online)	1542-7412
ISSN	0737-0806
DOI	10.1016/j.jevs.2021.103772
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Where there is no hospital: improving the notification of community deaths.

Adair, Tim / Rajasekhar, Megha / Bo, Khin Sandar / Hart, John / Kwa, Viola / Mukut, Md Ashfaqul Amin / Reeve, Matthew / Richards, Nicola / Ronderos-Torres, Margarita / de Savigny, Don / Muñoz, Daniel Cobos / Lopez, Alan D

BMC medicine

2020 Volume 18, Issue 1, Page(s) 65

Abstract: Background: Globally, an estimated two-thirds of all deaths occur in the community, the majority of which are not attended by a physician and remain unregistered. Identifying and registering these deaths in civil registration and vital statistics (CRVS) ...

Abstract	Background: Globally, an estimated two-thirds of all deaths occur in the community, the majority of which are not attended by a physician and remain unregistered. Identifying and registering these deaths in civil registration and vital statistics (CRVS) systems, and ascertaining the cause of death, is thus a critical challenge to ensure that policy benefits from reliable evidence on mortality levels and patterns in populations. In contrast to traditional processes for registration, death notification can be faster and more efficient at informing responsible government agencies about the event and at triggering a verbal autopsy for ascertaining cause of death. Thus, innovative approaches to death notification, tailored to suit the setting, can improve the availability and quality of information on community deaths in CRVS systems. Improving the notification of community deaths: Here, we present case studies in four countries (Bangladesh, Colombia, Myanmar and Papua New Guinea) that were part of the initial phases of the Bloomberg Data for Health Initiative at the University of Melbourne, each of which faces unique challenges to community death registration. The approaches taken promote improved notification of community deaths through a combination of interventions, including integration with the health sector, using various notifying agents and methods, and the application of information and communication technologies. One key factor for success has been the smoothing of processes linking notification, registration and initiation of a verbal autopsy interview. The processes implemented champion more active notification systems in relation to the passive systems commonly in place in these countries. Conclusions: The case studies demonstrate the significant potential for improving death reporting through the implementation of notification practices tailored to a country's specific circumstances, including geography, cultural factors, structure of the existing CRVS system, and available human, information and communication technology resources. Strategic deployment of some, or all, of these innovations can result in rapid improvements to death notification systems and should be trialled in other settings.
MeSH term(s)	Autopsy ; Bangladesh ; Cause of Death ; Colombia ; Data Collection ; Hospitals ; Humans ; Myanmar ; Papua New Guinea ; Vital Statistics
Language	English
Publishing date	2020-03-09
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ISSN	1741-7015
ISSN (online)	1741-7015
DOI	10.1186/s12916-020-01524-x
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Electromyography of the Multifidus Muscle in Horses Trotting During Therapeutic Exercises.

Ursini, Tena / Shaw, Karen / Levine, David / Richards, Jim / Adair, Henry Steve

Frontiers in veterinary science

2022 Volume 9, Page(s) 844776

Abstract: Thoracolumbar pain has been identified in both human and equine patients. Rehabilitation and conditioning programs have focused specifically on improving trunk and abdominal muscle function (1-5). Equine exercise programs routinely incorporate ground ... ...

Abstract	Thoracolumbar pain has been identified in both human and equine patients. Rehabilitation and conditioning programs have focused specifically on improving trunk and abdominal muscle function (1-5). Equine exercise programs routinely incorporate ground poles and training devices for the similar goals of increasing spinal and core stability and strength (6-8). The multifidus muscle has been an area of focus due to atrophy associated with disease (9). To date, there have been no reports on the activity of the multifidus muscle in horses in relation to therapeutic exercises. Our objectives were to use electromyography to determine the average work performed and peak muscle activity of the multifidus in horses trotting, trotting over ground poles, trotting while wearing a resistance band-based training device and trotting while wearing the training device over ground poles. We hypothesized that ground poles and the training device would each increase average work performed and peak multifidus muscle activity. Right and left cranial thoracic locations showed significant increased muscle work and peak activation when horses were trotted over ground poles versus without. The peak activation was significantly greater in horses trotting over poles in both lumbar regions, but there was no significant change in peak activation in either location due to the training device. When the influence of the training device was investigated without ground poles, left caudal thoracic muscle work and peak activity, and right lumbar muscle work were significantly lower when using the training device, as compared to without. When the training device was combined with trotting over ground poles, both left and right caudal thoracic regions showed significantly lower muscle work and peak activity when the device was used. There was no significant difference between with and without the device in either left or right lumbar muscle work. In conclusion, implementing ground poles can be an effective strategy to increase the activation of the multifidus muscle, however, caution should be taken when incorporating the use of a resistance band training device as muscle work and peak activation were significantly reduced in most locations. Further study should be performed in regards to the training device to determine its effects on epaxial musculature.
Language	English
Publishing date	2022-05-27
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2834243-4
ISSN	2297-1769
ISSN	2297-1769
DOI	10.3389/fvets.2022.844776
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