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This approach had been approved by the ethical committees of the Izhevsk Medical Academy and the London School of Hygiene & Tropical Medicine, on the basis that in Russia there remains a substantial reluctance to sign any official document for fear of it leading to the individual being subsequently held to account by the authorities for what they said.
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In line with meaning centred approaches [ 31], this work argues that assessing the particularities of the manner in which the substantial continued reluctance towards testing for HIV was expressed and where treatment was available is of substantial value in understanding what is at stake in an HIV testing context.
At the same time, all types of TV distributors have lost substantial ground in their reluctance to pay broadcasters like ABC and Fox the same kind of fees they pay cable-only channels like ESPN and TNT.
There are plenty of other threats, including Washington's reluctance to make substantial concessions on its cotton payments (recently held to be illegal by a W.T.O. panel) before an overall deal is struck.
Mr. Bush has had to contend not only with Pentagon reluctance to commit substantial numbers of troops to Liberia at a time when the military is already stretched thin, but also with nervousness among Republicans in Congress about putting American lives on the line in Africa.
Barry Knapp, United States equity strategist at Barclays, said big business was engaging in a "capital strike" — a reluctance to commit substantial sums for long-term projects "until the results of the election are known, and it's clear that the fiscal cliff can be averted".
Investors and speculators were so badly hurt in the yen's violent recovery toward the end of 1998 (from August until October in 1998 the dollar crashed from ¥147 to ¥111) that they still have a general reluctance to build up substantial short yen exposures.
As for Washington, its reluctance to recognize that nothing substantial could come of the autonomy talks led to many years of diplomatic foot-dragging.
Some propositions also regarded political cooperation and democratisation, yet those were rather of auxiliary character and furthermore, Nazarbayev's sincerity in their regard may be generally called into question given his reluctance to carry out any substantial political reforms in Kazakhstan (see below).
However, the department, and the commissioner, has come in for substantial criticism, in part because of their apparent reluctance to embrace fully the idea of recycling.
Validation of the questionnaire was limited by participants' reluctance to present for physician review, substantial delays in doing so and major self-selection bias among those who did.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com