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Global challenge-led research seeks to contribute to solution-generation for complex problems. Multicultural, multidisciplinary, and multisectoral teams must be capable of operating in highly demanding contexts. This brings with it a swathe of ethical conflicts that require quick and effective solutions that respect both international conventions and cultural diversity. The objective of this article is to describe the process of creating a toolkit designed to support global researchers in navigating these ethical challenges. The process of creating the toolkit embodied the model of ethical research practice that it advocates. Specifically, at the heart of ethical decision-making is consideration of the following: "Place," solutions must be relevant to the context in which they are to be used; "People," those impacted by the outcomes must be partners in co-creation; "Principles," ethical projects must be guided by clear values; and "Precedent," the existing evidence-base should guide the project and, in turn, the project should extend the evidence-base. It is the thesis underlying the toolkit that consideration of these 4Ps provides a strong basis for understanding ethical conflicts and allows for the generation of potential solutions. This toolkit has been designed in two phases of collaborative work. More than 200 researchers participated from more than 30 countries and more than 60 different disciplines. This allowed us to develop a model for contextual, dynamic analysis of ethical conflicts in global research that is complementary to traditional codes of ethics. It emphasizes the need to consider ethical analysis as an iterative, reflective, process relevant at all stages of the research journey, including, ultimately, in evaluating the legacy of a project. The toolkit is presented as an open access website to promote universal access. A downloadable "pocket guide" version is also now available in 11 languages.

At present, there is no internationally accepted set of core outcomes or measurement methods for epilepsy clinical practice. The International Consortium for Health Outcomes Measurement (ICHOM) convened an international working group of experts in epilepsy, people with epilepsy, and their representatives to develop minimum sets of standardized outcomes and outcome measurement methods for clinical practice. Using modified Delphi consensus methods with consecutive rounds of online voting over 12 months, a core set of outcomes and corresponding measurement tool packages to capture the outcomes were identified for infants, children, and adolescents with epilepsy. Consensus methods identified 20 core outcomes. In addition to the outcomes identified for the ICHOM Epilepsy adult standard set, behavioral, motor, and cognitive/language development outcomes were voted as essential for all infants and children with epilepsy. The proposed set of outcomes and measurement methods will facilitate the implementation of the use of patient‐centered outcomes in daily practice. [ABSTRACT FROM AUTHOR]

Malawi has a population of around 20 million people and is one of the world's most economically deprived nations. Severe mental illness (largely comprising psychoses and severe mood disorders) is managed by a very small number of staff in four tertiary facilities, aided by clinical officers and nurses in general hospitals and clinics. Given these constraints, psychosis is largely undetected and untreated, with a median duration of untreated psychosis (DUP) of around six years. Our aim is to work with people with lived experience (PWLE), caregivers, local communities and health leaders to develop acceptable and sustainable psychosis detection and management systems to increase psychosis awareness, reduce DUP, and to improve the health and lives of people with psychosis in Malawi. We will use the UK Medical Research Council guidance for developing and evaluating complex interventions, including qualitative work to explore diverse perspectives around psychosis detection, management, and outcomes, augmented by co-design with PWLE, and underpinned by a Theory of Change. Planned deliverables include a readily usable management blueprint encompassing education and community supports, with an integrated care pathway that includes Primary Health Centre clinics and District Mental Health Teams. PWLE and caregivers will be closely involved throughout to ensure that the interventions are shaped by the communities concerned. The effect of the interventions will be assessed with a quasi-experimental sequential implementation in three regions, in terms of DUP reduction, symptom remission, functional recovery and PWLE / caregiver impact, with quality of life as the primary outcome. As the study team is focused on long-term impact, we recognise the importance of having embedded, robust evaluation of the programme as a whole. We will therefore evaluate implementation processes and outcomes, and cost-effectiveness, to demonstrate the value of this approach to the Ministry of Health, and to encourage longer-term adoption across Malawi. [ABSTRACT FROM AUTHOR]

ABSTRACTCOVID-19 is compromising all aspects of society, with devastating impacts on health, political, social, economic and educational spheres. A premium is being placed on scientific research as the source of possible solutions, with a situational imperative to carry out investigations at an accelerated rate. There is a major challenge not to neglect ethical standards, in a context where doing so may mean the difference between life and death. In this paper we offer a rubric for considering the ethical challenges in COVID-19 related research, in the form of an ethics toolkit for global research developed at the University of Edinburgh in collaboration with more than 200 global researchers from around the world. This toolkit provides a framework to support confrontation of ethical conflicts through the integrated and iterative analysis of Place, People, Principles and Precedents, throughout the research journey. Two case analyses are offered to exemplify the utility of the toolkit as a flexible and dynamic tool to promote ethical research in the context of COVID-19. [ABSTRACT FROM AUTHOR]

This article addresses the issue of treatment delays for infantile epileptic spasms syndrome (IESS) in low- and middle-income countries (LMICs) and offers recommendations to address this problem. Challenges in LMICs include a high disease burden, delays in diagnosis, limited access to specialized care and diagnostic facilities, and socioeconomic barriers. The article suggests several recommendations, such as improving health literacy among parents, enhancing healthcare providers' knowledge and practices, utilizing telehealth services, and advocating for essential medicines to be included in government lists. These recommendations aim to improve the care and outcomes for children with IESS in LMICs. [Extracted from the article]