Dissemination to research subjects: operationalizing investigator accountability

Recent articles have argued from principles of bioethics for the right of research subjects to receive the results of the studies in which they have participated. We argue that accountability is a powerful tool of meso-level analysis appropriate to reasoning about answerability in research ethics, and that it captures the responsibility of researchers to disseminate study results to research subjects. We offer the following features of the research situation as relevant to the manner of dissemination to study subject, in addition to factors already proposed in the literature (risk and impact on health outcome): (a) features of the research subject in relation to identity, personal investment, disease, and community; (b) characteristics of the research study and field of inquiry in relation to certainty and significance; and (c) relationships among the research subjects and the healthcare workers involved in their care and in the research.     

Problems with Traditional Science Publishing and Finding a Wider Niche for Post-Publication Peer Review

Science affects multiple basic sectors of society. Therefore, the findings made in science impact what takes place at a commercial level. More specifically, errors in the literature, incorrect findings, fraudulent data, poorly written scientific reports, or studies that cannot be reproduced not only serve as a burden on tax-payers’ money, but they also serve to diminish public trust in science and its findings. Therefore, there is every need to fortify the validity of data that exists in the science literature, not only to build trust among peers, and to sustain that trust, but to reestablish trust in the public and private academic sectors that are witnessing a veritable battle-ground in the world of science publishing, in some ways spurred by the rapid evolution of the open access (OA) movement. Even though many science journals, traditional and OA, claim to be peer reviewed, the truth is that different levels of peer review occur, and in some cases no, insufficient, or pseudo-peer review takes place. This ultimately leads to the erosion of quality and importance of science, allowing essentially anything to become published, provided that an outlet can be found. In some cases, predatory OA journals serve this purpose, allowing papers to be published, often without any peer review or quality control. In the light of an explosion of such cases in predatory OA publishing, and in severe inefficiencies and possible bias in the peer review of even respectable science journals, as evidenced by the increasing attention given to retractions, there is an urgent need to reform the way in which authors, editors, and publishers conduct the first line of quality control, the peer review. One way to address the problem is through post-publication peer review (PPPR), an efficient complement to traditional peer-review that allows for the continuous improvement and strengthening of the quality of science publishing. PPPR may also serve as a way to renew trust in scientific findings by correcting the literature. This article explores what is broadly being said about PPPR in the literature, so as to establish awareness and a possible first-tier prototype for the sciences for which such a system is undeveloped or weak.     

An Analysis of Taiwanese Immigrants' Health Care Choice – Obamacare or Taiwan National Health Care

Due to recent policy changes in the USA and Taiwan, Taiwanese immigrants residing in the USA face a choice of continuing to receive health care in the USA or returning to Taiwan for treatment care. This study uses a quantitative survey to explore the association between recent health policy changes and the health care choice of Taiwanese immigrants residing in the USA. These findings indicate that there are statistically significant associations between a variety of factors and the Taiwanese immigrants' desire to return to Taiwan for health care under the new national health insurance plan (2nd NHIA). The variables positively associated with a desire to return to Taiwan for health care include the length of domicile and residence required to receive benefits, a nostalgic desire to return to Taiwan, the lower cost of health care in Taiwan, and if the respondents had come to the USA before 1996. The negatively associated variables include having a job in the USA, having a desire to return to Taiwan to live after retirement, the language preference in communications with a doctor, and a preference about the best place to receive dental treatment. The study reveals the dynamics behind the health care decision‐making of Taiwanese immigrants and particularly their choice of whether to seek care in the USA or in Taiwan.     

东亚合作中的美国因素——以“泛太平洋伙伴关系协定”为例

中短期内,泛太平洋伙伴关系协定(Trans-Pacific Partnership,简称TPP)对于美国而言,只是其释放"重返亚洲"信号的工具之一,很难成为帮助美国进入东亚的有效手段。从中长期来看,基于战略安全和经济利益考虑,美国在东亚合作进程中将继续扮演"搅局者"的角色,而且其参与度会越来越高;与此同时,美国将继续以APEC或者类似于TPP的倡议为手段,积极倡导并推动跨区域的亚太区域合作,借以获得合法身份以维持其在东亚地区的存在。     

Age limits for participation in child protection court proceedings in Sweden

According to the UN Convention on the Rights of the Child and Swedish legislation, children have the right to participate in child protection proceedings. The aim of this paper is to describe and analyse the notion of age and maturity in child protection proceedings in order to elucidate how these aspects could influence children's rights to participate. We focus on the view of three groups of actors involved in child protection proceedings in Sweden—social workers, lawyers, and laypersons in social welfare boards and administrative courts—and on how children's age and maturity should be taken into consideration in decisions on their participation in court. The analysis is based on survey data. The study found that social workers, laypersons, and lawyers have different views on when children are old enough to have the right to litigate in court. Additionally, there is no consensus on how the maturity of the child can be assessed to inform the decision about participation. More discussion is needed about what competences a child needs to participate in court and to what extent this right should be limited by their age. Importantly, courts and decision‐making proceedings can be made more child friendly.     

Gender Issues Related to Group Social Skills Training

Social skills training helps group members to develop ways to behave competently in specific interpersonal situations. This paper identifies gender related issues in such training and describes a non-sexist response to them. Some of the issues dealt with are the status considerations women face in assuming many roles, the gender biases in tools used to assess social skills, and the way gender affects cognitive and emotional variables related to such skills. Another issue discussed is that in discriminatory situations women, in particular, should be helped to change such situations or to resist their detrimental effects. Workers must be helped to recognize and change their own biases in these respects.     

Consistency and Change in Children's Tattling on their Siblings: Children's Perspectives on the Moral Rules and Procedures of Family Life

Children's tattling on their siblings was observed in 39 families when children were 2- and 4- and 4- and 6-years of age. Tattling was more frequent among older siblings, and increased across time, despite a corresponding decrease in sibling transgressions against one another and an increase in parents' negative reactions to tattling. Tattling was largely truthful, implicit in form, and more likely to concern transgressions of what parents also regarded as more important standards. Among 4- and 6-year-olds, tattling was related to children's negative behaviour to one another and equally likely when children faced ongoing conflict issues and when they merely wished to inform parents of sibling wrongdoing. Parents generally allowed their children to tattle on one another, rarely reprimanded tattlers, but responded to the information contained in the tattlers' reports. The parents' responses were related to the quality of their children's tattling, but the children's tattling was unrelated to the likelihood that parents would react either positively or negatively to it. Results are discussed in terms of the place of tattling within the family system, with emphasis on the children's understanding of the implications of their parents' involvement in their own disputes.     

The Cognitive Basis of Future-oriented Prosocial Behavior

Two experiments examined the development of future-oriented prosocial behavior in relation to developing theory of mind and executive functioning. Children from 3;0 to 4;6 were given a series of trials in which they had to make a choice between immediate and delayed sticker rewards, where these rewards accrued either to self, to a play partner, or were shared. They also were presented with standard theory of mind tasks (in Experiment 1) assessing the understanding of belief and desire and an executive function task (in Experiment 2) in which the children had to inhibit pointing to a baited box in order to win the cookie within. Results showed that for 4-year-olds, the tendency to opt for delayed rewards in order to share with the partner was correlated with theory of mind. For younger 3-year-olds, the children's ability to inhibit pointing to the baited box was significantly correlated with the tendency to choose delayed over immediate sticker rewards. These results indicate that children's ability to show future-oriented prosocial or sharing behavior is linked developmentally both to the ability to imagine conflicting noncurrent mental states and the ability to inhibit responding to perceptually salient events.     

AN EPIDEMIC OF VIOLENCE?: CHANGING PATTERNS IN REPORTED RAPES IN VICTORIA

Victoria Police statistics show that, since the late 1980s, there has been a significant increase in reported rapes in that State. One interpretation of this trend is that there has been an increase in the underlying incidence of sexual violence in the community. An alternative explanation is that rape victims have become more willing to report to the police, in response to factors such as improved provision of support services to sexual assault victims, reforms to substantive and procedural law, and changes in police attitudes and procedures. In order to test these competing interpretations data were collected and analysed on the characteristics of rapes reported to the Victoria Police in the late 1980s/early 1990s. This analysis showed that: (1) most of the additional offences reported in the early 1990s were allegations of rapes committed by family members, spouses and other intimates; and (2) an increasing number of reports related to offences which had been committed at least one year prior to a report being made to the police. It is argued that these changing patterns are co nsistent with a significant increase in the reporting rate for rape. More generally, the research reported in this paper highlights the limitations of reported crime statistics as measures of the level of social violence, and points to the need for crime researchers to develop alternative methodologies for measuring and interpreting trends.     

Partnerships, Power and the "New" Politics of Community Participation in British Health Care

Multi–sectoral approaches to health improvement in its broadest sense have entailed an emphasis by the British government upon partnership working in and around community involvement in planning processes. New service planning and delivery organizations in the health service—primary care groups and primary care trusts—thus have to ensure that public and patient involvement strategies reflect a coordinated, if not integrated, multi–sectoral approach to such involvement. But how are these enforced partnership arrangements shaping the approach taken by primary care groups and trusts to the issue of public and patient involvement? More particularly, is the traditional dominance of health service managers and the medical profession in decision–making processes under challenge? This article draws on a study of primary care groups and trusts in three districts in order to gauge perceptions and calculations with regard to partnerships for involvement. Results appear to suggest that health service managers and practitioners continue to exercise considerable influence in comparison to that of patients and citizens. But, if the findings are viewed in the broader contexts of government managerialist strategies of surveillance and accountability and the growth of service–user and advocacy organizations, partnerships may offer significant scope for “lay” challenges to managerial and medical power.     

The thrill of bullying. Bullying,humour and the making of community

Humour can be utilised to mark out the boundaries of social groups, to produce and restore dignity, but also to produce contempt, marginalise and exclude. Humour and ridicule can be used to influence hierarchies and positioning among children in the classroom and it can have strong effects in school groups saturated with bullying practices. Ridicule appears to be widespread, very much feared, and not easily amenable to adult interventions. With this article, I look into the many and frequently subtle ways humour intertwines itself in relational practices among children, with a particular focus on children in groups plagued by bullying and social tension. I focus on the entanglement of humour in the complex manoeuvrings that characterise children's worlds, and the subtle mechanisms involved in the self‐regulation of their communities in and outside schools. The analyses and analytical understanding that I develop are grounded in qualitative data such as interviews with children and extensive observation in schools and in after school care.     

Migration, ageing and mental health: an ethnographic study on perceptions of life satisfaction, anxiety and depression in older Somali men in east London

This ethnographic study was carried out in the aftermath of an epidemiological investigation, the first of its kind, on the health and social status of Somalis aged 60 years and over living in Tower Hamlets, east London. The main aims of the study are to explore views on mental health and well-being and identify sources of stress and support so as to gain greater understanding of background factors of life satisfaction and depression in 'first-generation' older Somali migrants in Tower Hamlets (males). Face-to-face interviews were conducted among 28 males in Somali with the help of a bilingual interpreter from the same age, sex and cultural background of participants. Several factors were perceived to decrease life satisfaction and increase vulnerability to depression in male Somalis, in particular low family support in the face of increasing physical disability, loneliness, inadequate access to community services and inability to return home. Social isolation, low level of control over one's life, helplessness and social degradation – ageism, perceived racial/religious discrimination and, to a lesser extent, racial harassment – were common themes identified in people who said to be depressed. Family support was the main buffer against depression; other coping resources were represented by religious practices and reliance on Somali peers. Avoidance coping seemed to encompass denial of depression in participants who had low mood. The study revealed multiple reasons for ill-being, in particular in people who had high expectations about medical and social care. Low levels of distress were found in Somalis who felt supported by their families. There is a need for social workers and other health professionals to advance discussions of mental-health issues in the community and for service providers to promote greater access to culturally relevant medical and social services for Somali elders in Tower Hamlets and strengthen their informal support networks.     

An Enhanced Macroeconomic Approach to Long-Range Projections of Health Care and Social Security Expenditures as a Share of GDP

An enhanced two-sector economic growth model is created to project health care and Social Security expenditures as a share of GDP in the United States. Parameters used in the economic simulation model are based largely on consensus views in the literature. The main advantages of an economic model over the more commonly used actuarial models are: (1) explicit specification of underlying fundamental structures, (2) ability to investigate relationships in the entire economy, and (3) a fuller scope provided for policy analysis. Under the base model assumptions, that is, a continuation of current conditions for the production of, demand for, and financing of health care services, the economic model projects that the health care sector consumes 15.8 percent of national output by the year 2000 and 27.1 percent by the year 2040. The annual rate of increase in per capita consumption (less health spending) (“adjusted consumption”) falls from 1 percent in 2000 to 0.6 percent in 2025, and then increases to 0.8 percent in 2040, as the rate of increase in spending on health care for the elderly, and the capital investment required to support such spending, flow and ebb with the passing of the baby boom generation. Over the whole projection horizon, government spending on the health care of the elderly increases from a projected 3.8 percent of GDP in 2000 to 9.2 percent in 2040. Social Security expenditures for the elderly are projected to increase from 3.9 percent to 6.3 percent over the same period. More widespread HMO coverage is shown to lead to some small improvements in adjusted consumption. Over the long horizon, improved efficiency and productivity in the health sector and lower Social Security benefits assumed to cause an increased rate of savings and investment, however, actually cause the rate of growth in health spending to increase and adjusted consumption to decline, ceteris paribus. By contrast, an increase in sensitivity to health care prices leads to dramatically improved results, both in higher adjusted consumption and better finances for government programs of health care for the elderly.     

Gender,work, and childcare in Kazakhstan,Mongolia, and Russia

The current study seeks to understand the nature of gender relations within a post‐Soviet welfare model in Kazakhstan, Mongolia, and Russia. On the basis of the analysis of key labour market indicators, parental leave, and childcare policies, it finds that the welfare models in the three countries are hybrid, and neither authoritarianism in Kazakhstan and Russia nor democracy in Mongolia lead to substantive gender equality outcomes. Persistent gender inequality in these countries is underpinned by the neo‐liberal approach to welfare provision, conservative social norms, and limited agency of civil society to influence the policy agenda. Nonetheless, these states have distributed to the population with an emphasis on working mothers, and this policy choice has been driven by economic, demographic, and political considerations, which ultimately serve to support, rather than transform, the patriarchal power structure in these societies.     

Querulous Citizens: Welfare Knowledge and the Limits to Welfare Reform

Governments face pressures to improve services and (at the same time) to contain taxes and to ensure that their decisions are accountable to increasingly well‐informed and challenging citizens. The dilemma of “squaring the welfare circle” confronts New Labour in a particularly acute form, since the party has set ambitious targets for improvements in the NHS, education and elsewhere, and is also committed to economic prudence and transparency. This article uses new data from a major national survey to investigate knowledge and beliefs in the main policy areas. It shows that most people are generally strikingly well‐informed in some areas and ill‐informed in others. A government which wishes to pursue a progressive direction in redistribution, increasing taxation of the better‐off, or expanding provision for those on low incomes, faces real difficulties because many people hold inaccurate beliefs about policy impact and the policy context in these areas. However, NHS costs are more accurately perceived across the population, and the proposed expansion is likely to create less controversy. Current high‐profile policies appear to follow the contours of public knowledge reasonably accurately, but further policy development will require positive efforts to lead debates and improve public knowledge.     

Patterns of Informal Help and Caregiving in Sweden: A Thirteen-Year Perspective

This article analyses informal help and caregiving in Sweden with a focus on the scope and trends of change over time. The discussion is based on the results of three national surveys and of one survey conducted in the county of Stockholm. The results indicated that informal help and caregiving was common throughout the period under study. In the 1990s, the figures were fairly stable, while from the late 1990s to 2005 there seems to have been a dramatic increase in the prevalence of such support. Two interpretative perspectives are used to discuss this pattern. One locates its point of departure in recent welfare state changes and in the substitution argument, according to which cuts in welfare services put more pressure on people to provide informal help and care. The second perspective relates to the present debate on civil society and to its possible role in contemporary society. According to the civil society perspective, an increase in the prevalence of informal help and caregiving might be interpreted as an expression of growing civic involvement 'in its own right', without a straightforward and simple relationship to changes in the welfare state. It is argued in the article that the two frames of interpretation should not be viewed as mutually exclusive, but rather that they represent two partly complementary approaches to the understanding of the complex dynamics of unpaid work in contemporary Swedish society.     

Environmental hazards and the health status of women and children in a riverine community in Nigeria: Nikrowa in Edo State

Nikrowa is a riverine village located in Ovia North-East Local Government Area of Edo State. This paper examines the relationship between the environment and the health status of women and children in the village. Data used in this essay were obtained mainly in focus groups from a study of women and health service utilization in Nikrowa. Women in Nikrowa farm, fish, collect water and firewood, and process and prepare food. They also bear many children. Their hard physical labor causes them to suffer continuous body aches and pains. Environment-related illnesses such as malaria, measles, dysentery, and diarrhea are prevalent among children. The geographical isolation of Nikrowa limits access to modern health care facilities, so traditional therapies are used to treat prevailing illnesses. It is suggested that women have access to fertilizers in order to improve soil fertility and agricultural yields. Fuelwood and adequate and safe water supplies should be made readily available to women. Moreover, access roads to rural areas should be improved to facilitate transport to modern health care facilities, and rural primary health care facilities should be helped to provide efficient services by providing trained staff and ensuring regular supplies of drugs.     

近代以来台湾的留日教育

日据台湾时期,大批台湾学生竞相赴日留学,至抗战胜利之际,其总数达六七万人之多,形成一个人数不菲的留日学生群体。台湾光复后,国民政府接管台湾留日学生,并召回大批台湾学生,将其分送至台湾或大陆相应学校续学;对于尚未返台者,给予一定补助,然此补助直至国民党败退台湾后才实施,且附有强烈的政治色彩。新中国成立伊始,党和政府感召包括台籍学生在内的留日学生回国,并无条件发放救济金资助其完成学业。部分台湾留日学生在民族大义和统一大业面前做出理性选择,成为抗日运动先锋或祖国统一的拥护者。     

Pragmatics of Self- and Other-Reference in Young Children

During the first years of life, children come to understand and talk about a self separate from others. This study examined self- and other-reference and communicative intents expressed by children and parents in dyadic interaction at 14, 20 and 32 months. Research questions included whether children's early use of self- and other-reference pronouns occurred for expression of particular communicative intents, how use changed with age, and whether parent and child pragmatic expressions of self and other were similar. Results showed that children's early explicit reference to self tended to take the form of I rather than me/my/mine, and was used primarily in making statements about their intended actions, in making requests or proposals to their parents and in stating propositions about the world around them. Children during this developmental period were only beginning to refer to the present other with the pronoun you and these instances occurred primarily in making requests or proposals. Despite age-related increases in pronominal forms and intents, a small set of intents continued to provide the context for most self- and other-reference pronouns. In the communicative contexts in which they explicitly refer to self and other, children did not appear to exclusively mirror those which were observed in parental speech.