The social inclusion policy agenda in Australia: a case of old wine,new bottles?

The election of an Australian Labor Government in Australia in 2007 saw ‘social inclusion’ emerge as the official and overarching social policy agenda. Being ‘included’ was subsequently defined by the ALP Government as being able to ‘have the resources, opportunities and capabilities needed to learn, work, engage and have a voice‘. Various researchers in Australia demonstrated an interest in social inclusion, as it enabled them to construct a multi‐dimensional framework for measuring disadvantage. This research program resulted in various forms of statistical modelling based on some agreement about what it means to be included in society. The multi‐dimensional approach taken by academic researchers, however, did not necessarily translate to a new model of social policy development or implementation. We argue that, similar to the experience of the UK, Australia's social inclusion policy agenda was for the most part narrowly and individually defined by politicians and policy makers, particularly in terms of equating being employed with being included. We conclude with discussion about the need to strengthen the social inclusion framework by adopting an understanding of social inequality and social justice that is more relational and less categorical.     

Who to Serve? The Ethical Dilemma of Employment Consultants in Nonprofit Disability Employment Network Organisations

The Welfare‐to‐work policy, implemented in July 2006 by the Federal Government, imposed a new work and activity obligation on people applying for the Disability Support Pension. This requirement not only created a new obligation for people with disability but also for employment consultants working in nonprofit Disability Employment Network organisations to monitor the conduct of this new cohort on behalf of Centrelink. For many employment consultants traditionally drawn to the nonprofit disability sector for altruistic reasons, this has created an ethical dilemma between their duty to their employer, and acting in the best interests of their clients. Drawing on aspects of ethical theory we find that, although most employment consultants justify their actions in terms of duty to the organisation, some find themselves in an ethical dilemma of ‘who to serve’ when the interests of the organisation and the welfare of the client are mismatched.     

Iowa Case Management for Rural Drug Abuse

OBJECTIVE: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. METHOD: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. RESULTS: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to TAU did not improve substance use outcomes. CONCLUSION: Overall, the addition of case management did not significantly improve drug treatment as hypothesized by both researchers and clinicians. Some results were mixed, possibly due to the heterogeneous sample, wide range of case management activities, or difficulty retaining participants over time.     

Ordering and selecting components in multivariate or functional data linear prediction

Summary.  The problem of component choice in regression-based prediction has a long history. The main cases where important choices must be made are functional data analysis, and problems in which the explanatory variables are relatively high dimensional vectors. Indeed, principal component analysis has become the basis for methods for functional linear regression. In this context the number of components can also be interpreted as a smoothing parameter, and so the viewpoint is a little different from that for standard linear regression. However, arguments for and against conventional component choice methods are relevant to both settings and have received significant recent attention. We give a theoretical argument, which is applicable in a wide variety of settings, justifying the conventional approach. Although our result is of minimax type, it is not asymptotic in nature; it holds for each sample size. Motivated by the insight that is gained from this analysis, we give theoretical and numerical justification for cross-validation choice of the number of components that is used for prediction. In particular we show that cross-validation leads to asymptotic minimization of mean summed squared error, in settings which include functional data analysis.     

Exploring and validating surrogate endpoints in colorectal cancer

Sargent et al (J Clin Oncol 23: 8664–8670, 2005) concluded that 3-year disease-free survival (DFS) can be considered a valid surrogate (replacement) endpoint for 5-year overall survival (OS) in clinical trials of adjuvant chemotherapy for colorectal cancer. We address the question whether the conclusion holds for trials involving other classes of treatments than those considered by Sargent et al. Additionally, we assess if the 3-year cutpoint is an optimal one. To this aim, we investigate whether the results reported by Sargent et al. could have been used to predict treatment effects in three centrally randomized adjuvant colorectal cancer trials performed by the Japanese Foundation for Multidisciplinary Treatment for Cancer (JFMTC) (Sakamoto et al. J Clin Oncol 22:484–492, 2004). Our analysis supports the conclusion of Sargent et al. and shows that using DFS at 2 or 3 years would be the best option for the prediction of OS at 5 years.     

The issue of consent in research that administers drugs of addiction to addicted persons

In addiction, impaired control over drug use raises questions about the capacity of addicted persons to consent to participate in research studies in which they are given their drug of addiction. We review the case for doing such research, and the arguments that addiction does, and does not, prevent addicted persons from consenting to such research. We argue for a more nuanced view that acknowledges that while in some situations addiction impairs decision-making capacity, it does not eliminate such capacity. We conclude with some suggestions for recruiting addicted subjects and designing experiments in ways to obtain free and informed consent.