The influence of "tradition", fear or resistance to change within the veterinary community was also widely mentioned, as well as concern about cultural differences between journals and between countries, the increased workload that could be caused, and economic factors.
Concern that trust may be affected by asking patients to take part in research is mentioned, as well as the concern for some clinicians that they risk feelings of ineptitude or rejection if they invite patients to take part in RCTs and they refuse.
Update, Friday 12 August: I have been reminded, rightly, that my reference to the crime and courts act mentioned, as far as publishers are concerned, only the stick and not the carrot.
KIIs confirmed that markets were relatively functional; with the exception of fuel shortages in some locations, availability of food and non-food items was not mentioned as a concern.
Where patient safety is mentioned as a concern, risks are often not explicitly identified or expanded upon.
With the exception of India, the cost and cost-effectiveness of PrEP were also frequently mentioned as key concerns.
Provider frustration with a perceived inability to affect change was also mentioned as a concern, stemming from a perception that providers are already aware of the issues but lack adequate resources to address them.
Gestational diabetes mellitus (GDM) and dystocia were also mentioned as a concern for Sub-Saharan African/Somali women (more than receiving-country-born women) in some studies [ 32, 34, 46].
Release of data to insurance companies or pharmaceutical companies was often mentioned as a concern, again leading to a more restrictive consent requirement [ 23, 26, 27, 42, 44, 45, 47].
The concerns that were most commonly mentioned as their "greatest" concerns were: 1) death during surgery, 2) having an irreparable fistula, and 3) marital discord.
