Perceptions of Academic Health Science Research Center Personnel Regarding Informed Consent Processes and Therapeutic Misconception

Introduction: Instrumentation exists to measure voluntariness and misunderstanding in informed consent processes. However, research personnel’s perspectives about using instrumentation to measure therapeutic misconceptions in research participants has not been reported. We designed a workshop to promote research personnel knowledge of emerging instrumentation and to study the perceptions of research personnel regarding such instruments.

Methods and Findings: Two nationally recognized experts who have developed psychometric instruments to measure aspects of informed consent presented their recent findings to research personnel of the Medical University of South Carolina at a one-day workshop. Following the presentations, workshop attendees divided into two focus groups and shared their perceptions regarding the presentation content. Inductive thematic analysis detected themes related to informed consent processes including: investigator/provider role clarity; investigator transparency; therapeutic misconception; and screening subjects for understanding.

Conclusion: Our findings suggest future directions in applied, proactive empirical research to better understand investigator perceptions and practices related to transparency in research, and to develop instrumentation to detect risks to the integrity of informed consent in order to promote voluntariness and autonomy and minimize therapeutic misconception in research practices.     

Perceived risk associated with apparel purchasing in discount stores

Consumer discount store patronage preferences for apparel are investigated using the concept of perceived risk. Apparel items are assigned a type and level of risk: low social, low economic; high social, low economic; and high social, high economic. Females (N=222) responding to a mail survey rate their willingness to purchase each item in a discount store on a scale ofprefer to buy, may buy, ornever buy. Results suggest that consumer preference for purchasing in discount stores declines more sharply when economic risk increases than when social risk increases.Teresa A. Summers is Associate Professor of the School of Human Ecology, Textiles, Apparel Design and Merchandising at Louisiana State University, Baton Rouge, LA 70803. She received her Ph.D. from Texas Woman's University. Her research interest includes rural/urban consumer responses to changes in the marketplace.Frances C. Lawrence is Professor of the School of Human Ecology, Family, Child, and Consumer Sciences at Louisiana State University, Baton Rouge, LA 70803. She received her Ph.D. from Florida State University. Her research interests include family financial decision-making and family time use.Janice L. Haynes is Assistant Professor of the School of Human Ecology, Textiles, Apparel Design and Merchandising at Louisiana State University, Baton Rouge, LA 70803. She received her Ph.D. from Texas Woman's University. Her research interest includes retail patronage of specialized consumer market segments.Patricia J. Wozniak is Associate Professor of the Department of Experimental Statistics at Louisiana State University, Baton Rouge, LA 70803. She received her Ph.D. from the University of Wisconsin-Milwaukee. Her research interests include survey methodology and rural families.     

Who is the victim anyway? The effects of bystander victim impact statements on mock juror sentencing decisions

Victim impact evidence was varied in a brief trial scenario given to 120 participants eligible for jury service. The scenario concerned the murder trial of a disgruntled employee accused of bombing his former workplace. Participants read either no victim impact evidence or one of three victim impact statements. For the victim impact statements, we varied the identity of the witness. The victim impact statement was given by either the wife of the victim, a coworker of the victim, or a firefighter called to the crime scene. Results revealed that only the victim impact evidence given by the coworker lead to harsher sentencing judgments. However, participants rated the suffering of the victim's wife as most severe, indicating that perceptions of suffering may not predict sentencing judgments in a straightforward manner. Implications for these findings for legal decisions such as Payne v. Tennessee (1991) are discussed.     

The effects of health and environment on exercise-class participation in older, urban women

This research investigated the effects of health and environmental factors on the dropout and intermittent nonattendance of an exercise program designed specifically for older, female, primary-care patients living in the inner city. Class-attendance records (n = 21,538) from a cohort 110 women were analyzed. Women who dropped out early had poorer perceived health and were more likely to report pain as an exercise barrier at baseline. Those who lived in a census tract where a larger percentage of workers walk to work were less likely to drop out early. Intermittent nonattendance was associated with adverse weather conditions including heat index above 90 degrees F, wind-chill index below 20 degrees F, overcast sky, and snow. Better attendance was associated with greater atmospheric pressure, as well as lower number of sunlight hours per day. This research highlights the need to better understand environmental barriers when promoting physical activities in older women.     

My student body: a high-risk drinking prevention web site for college students

The authors investigated the efficacy of an interactive Web site, MyStudentBody.com: Alcohol (MSB:Alcohol) that offers a brief, tailored intervention to help heavy drinking college students reduce their alcohol use. They conducted a randomized, controlled clinical trial to compare the intervention with an alcohol education Web site at baseline, postintervention, and 3-month follow-up. Students were assessed on various drinking measures and their readiness to change their drinking habits. The intervention was especially effective for women and persistent binge drinkers. Compared with women who used the control Web site, women who used the intervention significantly reduced their peak and total consumption during special occasions and also reported significantly fewer negative consequences related to drinking. In addition, persistent heavy binge drinkers in the experimental group experienced a more rapid decrease in average consumption and peak consumption compared with those in the control group. The authors judged MSB:Alcohol a useful intervention for reaching important subgroups of college binge drinkers.     

Availability of caregiver support services: implications for implementation of the National Family Caregiver Support Program

This study examines the scope and range of existing resources for family caregivers from the perspective of the Area Agencies on Aging (AAAs), which are charged with implementing Title III-E of the reauthorized Older Americans Act. California is used as a case example because of its substantial experience in providing caregiver support services. In particular, we examine the extent and adequacy of resources available in California corresponding to each of the five Title III-E service areas, utilizing data from AAAArea Plans, a follow-up survey of AAAs, and an Internet search. AAAs identified more than 276 providers of caregiver support services, and our Internet search identified another 195. Nearly two-thirds of these programs offer access to respite care, while other support services (e.g., counseling, training, support groups) are less often available. Service gaps most frequently identified included culturally and linguistically appropriate caregiver services, transportation, respite care, financial assistance, and services in rural areas. These findings suggest the need for enhanced efforts to improve the service network for supporting family caregivers, as states implement the National Family Caregiver Support Program.     

Managed care and the rationalization of mental health services

Managed care represents a response to the wider institutional demand for technical rationality and efficiency, and it may be in conflict with professionally generated logics of mental health care which emphasize the delivery of quality care, as well as providing services to all who need care. The organizational and policy conundrum is to balance conflicting institutional demands for efficiency (cost savings) and effectiveness (access and quality). This paper examines managed care in one public sector mental health care system that has attempted to incorporate the principles of managed care into a community based system of care and to overcome the potential contradictions between demands for efficiency and professional logics of care. Both qualitative and quantitative data are used to examine changes in organizational structure and service offerings; providers' experience of managed care, and the effect of managed care on working conditions and work experiences, and changes in the goals of the organization as measured by the specification of client outcomes. I find that, while increased performance accountability and outcome assessment (in keeping with demands for efficiency) have the potential to improve mental health care services, in fact, providers report that the primary effect of managed care has been an emphasis on cost containment, and there has been a corresponding de-emphasis on the provision of community based services for clients with long term care needs. However, there is potential for professional logics to be maintained by larger institutional forces demanding quality care.     

Child abuse and neglect: Perspectives on a national emergency

Hundreds of thousands of children are being abused and neglected in the United States annually. The structures devised to respond to this abuse and neglect have been unsuccessful. The United States government continues to spend billions of dollars on programs to deal with the effects of these unsuccessful responses. Child abuse and neglect in the United States now represent a national emergency. In this article, we will provide a historical, cultural, and contemporary perspective on child abuse and neglect. This perspective throws light on the complexity of the national emergency and provides a context for further exploration of the issue.     

"LEARNING TO LEARN" AND THE FAMILY SYSTEM: NEW PERSPECTIVES ON UNDERACHIEVEMENT AND LEARNING DISORDERS

A new frontier for family therapy is emerging from recent studies of under-achievement in school, learning disabilities and parental communication. Although poor school performance is frequently the presenting problem (or an associated symptom) in family therapy, this topic still lacks a coherent conceptual framework. An ecological model is proposed for understanding child and adolescent achievement problems. Four dimensions of a family's learning environment are suggested as foci: (a) family communication deviances; (b) family structure; (c) family attributions; and (d) family achievement values. The metaphor of the family as "primary classroom" is offered as a way to think about learning styles across home and school contexts, and some treatment guidelines are suggested.