Conflicted medical journals and the failure of trust

Journals are failing in their obligation to ensure that research is fairly represented to their readers, and must act decisively to retract fraudulent publications. Recent case reports have exposed how marketing objectives usurped scientific testing and compromised the credibility of academic medicine. But scant attention has been given to the role that journals play in this process, especially when evidence of research fraud fails to elicit corrective measures. Our experience with The Journal of the American Academy of Child and Adolescent Psychiatry (JAACAP) illustrates the nature of the problem. The now-infamous Study 329 of paroxetine in adolescent depression was negative for efficacy on all eight protocol-specified outcomes and positive for harm, but JAACAP published a report of this study that concluded that "paroxetine is generally well tolerated and effective for major depression in adolescents." The journal's editors not only failed to exercise critical judgment in accepting the article, but when shown evidence that the article misrepresented the science, refused either to convey this information to the medical community or to retract the article.     

The practice of deliberative policy analysis in the context of political and cultural challenges: lessons from Thailand

ABSTRACT

This article draws upon insight from a study of those involved in introducing deliberative policy analysis in Thailand at the city scale and presents lessons for both policy practitioners and scholars. The design of each deliberative forum differed, depending on lessons learned from previous forums and the consensus that emerged as a result of deliberation amongst forum facilitators. The underlying principle of this kind of deliberative design is to make deliberative processes authentic, by avoiding coercion, inclusive, by engaging stakeholders who bring forth different ideas, and impactful. To make these forums more exciting, deliberative practices are often linked to other attractive discourses, such as those surrounding smart cities, creative spaces and inclusive development. The case of Thailand sheds light on emerging challenges involved in the practice of deliberative policy analysis in the context of both national political regimes that are not democracies and those in the East.     

Guided by ethics: religion and spirituality in gerontological social work practice

This random national survey anonymously explored 299 gerontological social workers' attitudes about spirituality and the use of spiritual interventions in practice. Respondents support the inclusion of religion and spirituality in education and practice as a diversity component, as part of holistic assessment, and as a fundamental aspect of human life. Nearly 70% of respondents report little or no preparation on spiritual issues during their schooling and only 24.5% report satisfaction with their educational preparation on this topic. While respondents' personal spirituality correlates positively and weakly with the use of spiritual interventions, it is ethical attitudes toward spiritual interventions that predict the use of spiritual interventions by gerontological social workers.     

Cognitive-behavioural interventions for adolescents in residential child care in Scotland: an examination of practice and lessons from research

This paper sets out to examine the basis and use of cognitive‐behavioural interventions with adolescents in residential child care. The paper outlines the results of a survey of the use of cognitive‐behavioural interventions in Scotland. The survey indicates that such interventions are used widely in residential schools and secure units in Scotland. The paper then reviews some of the studies relating to cognitive‐behavioural interventions, which appear to be most relevant to residential child care. The review revealed many of the positive outcomes of cognitive‐behavioural interventions. However, there are some cautionary notes highlighted by the survey and the review. These relate to issues about generalization of learning and the meaning of the intervention for the young person and for the staff. The paper discusses the importance of other factors in determining the success of cognitive‐behavioural interventions. These factors include the importance of accurate assessment, the role of staff training and the need to ensure that interventions are always in the best interests of the child.     

Perceptions concerning research integrity and the practice of data audit in the biotechnology industry

A survey was conducted in order to evaluate the responses of biotechnology executives concerning their perceptions of the frequency of questionable R & D studies performed in their companies and to assess the extent to which their companies voluntarily conducted data audits. Data audit was found to be commonly practiced on a voluntary basis by biotechnology companies, in contrast to its almost lack of practice by universities. However, public companies were more likely to practice data auditing than privately held companies. Moreover, the likelihood that managers suspected or detected questionable studies in their companies was significantly increased if the company practiced data auditing.     

Launching a family-centered, neighborhood-based human services system: lessons from working the hallways and street corners

The author describes Contra Costa County's efforts to implement Healthy Families 2000, the County's vision of neighborhood-based, family-centered, comprehensive integrated services in two of the county's unincorporated areas, North Richmond and Bay Point. Contra Costa County is one of six bay area counties, northeast of San Francisco. It has nearly 800,000 residents and is home to some of the wealthiest communities in the state as well as some of the poorest neighborhoods. This article provides a systematic review of the process and a discussion of the operating practices and principles guiding Contra Costa's significant effort to change its service delivery approach, anticipating that this experience might be helpful to others as they develop a neighborhood-based human services partnership with community leaders and residents.     

Transforming child and family services in urban communities in South Africa: lessons from the South

Post‐apartheid, South African agencies have been required to shift their services in fundamental ways, including offering services in previously un‐resourced areas, honouring the rights of children and families, ensuring that users, staff and governing bodies are representative of the population and providing developmental social welfare services in place of child protection‐oriented interventions only. A study of urban South African child welfare agencies provides insight into the complex task of managing and leading change. In view of overloaded change agenda and resource constraints, managers focused on effecting incremental change and prioritized the most ‘rewarding’ change efforts. Transforming practice towards a developmental approach was less successful. Structural interventions were also not prioritized. Child welfare agencies internationally face demands to transform in response to the effects of local change and globalization. The study's insights might resonate with agencies working for change in other societal contexts.     

Teenagers in foster care: Issues,themes, and debates from and for practice and policy

The task of fostering adolescents is unique, requiring skills, qualities, and information that acknowledge each young person's particular needs. This editorial summarises a range of research in this special issue covering parenting styles, transitions out of care, child sexual exploitation, and the needs of LGBTQ and separated teenagers. Three themes emerging from the papers are discussed: autonomy and control; risk, resilience, and trauma; and relationships, identity, and stigma.     

Practices of activation in frontline interactions: Coercion,persuasion, and the role of trust in activation policies in Germany

Following Michael Lipsky's well‐known argument that policy is made in the daily encounters between street‐level bureaucracy and citizens, a growing body of research emphasizes that actors and organizations delivering social and labor‐market policy play a crucial role in welfare‐state politics. Using qualitative data collected at three local employment agencies in Germany, this article explores worker‐client relations as a crucial mechanism through which activation policies are translated into practice. The analysis investigates how caseworkers define their role and their relationships with clients. The findings show that it is essential for caseworkers to achieve client compliance. In such a context, building relationships of trust is a strategic instrument in overcoming possible barriers to co‐operation in the caseworker‐client interaction. Caseworkers develop strategies to create the impression of trustworthiness and to motivate both unemployed clients and employers to become trust‐givers in the caseworker‐client relation. While research has often stressed the dichotomy between disciplining and enabling elements of activation policies, our explorative study shows that persuasion and trust‐building are a further important dimension of the frontline delivery of activation policies. These strategies reflect the importance of emotional aspects of frontline work.