The Therapeutic Misconception: A Threat to Valid Parental Consent for Pediatric Neuroimaging Research

Neuroimaging research has brought major advances to child health and well-being. However, because of the vulnerabilities associated with neurological and developmental conditions, the parental need for hope, and the expectation of parents that new medical advances can benefit their child, pediatric neuroimaging research presents significant challenges to the general problem of consent in the context of research involving children. A particular challenge in this domain is created by the presence of therapeutic misconception on the part of parents and other key research stakeholders. This article reviews the concept of therapeutic misconception and its role in pediatric neuroimaging research. It argues that this misconception can compromise consent given by parents for the involvement of their children in research as healthy controls or as persons with neurological and developmental conditions. The article further contends that therapeutic misconception can undermine the research ethics review process for proposed and ongoing neuroimaging studies. Against this backdrop, the article concludes with recommendations for mitigating the effects of therapeutic misconception in pediatric neuroimaging research.     

Research Articles in Australian Social Work from 1998–2007: A Content Analysis

Abstract

With the rise of evidence-based practice, there have been calls in social work for practice research that examines the efficacy of its interventions. For the present paper, the authors conducted a content analysis of all articles published in Australian Social Work in the period from 1998 to 2007 to examine the nature of published research and evaluation. Of the 313 articles, 138 (45%) reported on research findings. Of these, only six articles involved practice evaluation or testing of an instrument, but there were positive signs of a developing empirical research culture primarily utilising a qualitative approach or mixed methods studies. The authors suggest that there is a need for more research on social work interventions, a more conscious decision by the profession about its attitude to evidence-based practice (EBP), specific directions for research education, and greater rigour in reporting all types of research studies, but particularly qualitative studies.     

Judging Textbooks

Connecting wider economic, technological, or cultural trends to the everyday life of students can be a challenge. Food can serve as a course-long theme that helps students comprehend the essential connection between personal actions and national or international trends and develop skills of critical analysis. The author describes four activities that can be adapted to a wide variety of social studies courses and age groups. In the first two activities, students gain an understanding of their diet by exploring their food choices and the factors that affect those choices. These activities provide a point of comparison for subsequent units in which students examine food choices in a pre-industrial age and the impact of the technological advances of the Industrial Revolution on food production, preservation, and preparation.     

Rolling forward: addressing needs in the homeless community

ABSTRACT

The purpose of this pilot study was to use a bottom up, or grounded, approach to understand, from the perspective of the individuals living in the homeless community, what they feel would enable them to become housed and stay permanently housed. Organizations which serve homeless individuals often use a top down approach and implement programs without asking the homeless what they most need to find permanent housing. This project used intensive interviews to determine the needs of unhoused individuals in a mid-sized city with a tourist-centered economy in the south eastern United States. Working local homeless shelters, and various other intermediaries we collected data from 102 homeless individuals and 11 service providers. The major theme that emerged in our research is that the homeless individuals we interviewed were, for the most part, they were able to meet many of their basic needs, such as securing food, clothing, a place to bathe and wash their clothes, as well as obtain physical and mental care. However, they perceived lack of reliable and affordable transportation to be a significant barrier to obtaining and maintaining employment, making and keeping appointments, and maintaining their social support network.     

Becoming Parents

Ninety-six lesbian adoptive parents were part of a cross-sectional study to explore their adoption experiences, specifically focusing on their sources of consultation/information and possible bias, adoption timeframes and costs, and their satisfaction with the adoption experience. Questions within each of these domains were tested for significant differences across international, private domestic and child welfare adoption venues. While their overall experiences were positive, several key significant findings are discussed, with practice considerations suggested for adoption professionals and other lesbians seeking adoption. Lastly, a call for future research is made to further our understanding of lesbian mothers' transition to adoptive parenthood.     

Exposure,Resistance and Life Expectancy: Disease and Death During the Economic Development of Japan, 1900–1960

By 1900 Japan was still extremely poor, rural and predominantly agrarian: but it had achieved effective mortality parity with the more economically advanced and/or wealthier countries of Western Europe. As standards of living rose, life expectancy remained relatively stagnant until the end of World War II. Subsequently, in spite of the economy being still partially crippled by wartime destruction, life expectancy in Japan increased very rapidly. The analysis of these puzzling trends is undertaken by means of an historical model of mortality change in which life expectancy is interpreted as the function of both the relative overall resistance of the population to disease, and the degree to which it was protected from exposure to the leading causes of death. It is argued that the early and late Japanese achievement of relatively high life expectancy at relatively low levels of income rested on the government's efficient delivery of a very high level of protection from exposure to disease. The middle period, 1910 to 1940, represented a relative failure of protection due to the concentration of financial resources on the military sector; a failure which better diets etc. could not effectively counter. The post-war period involved a return to higher levels of investment in public health during a period of technological progress and structural shifts which enhanced the efficiency of such investment.     

Maximum likelihood estimation for the proportional odds model with mixed interval-censored failure time data

This article discusses regression analysis of mixed interval-censored failure time data. Such data frequently occur across a variety of settings, including clinical trials, epidemiologic investigations, and many other biomedical studies with a follow-up component. For example, mixed failure times are commonly found in the two largest studies of long-term survivorship after childhood cancer, the datasets that motivated this work. However, most existing methods for failure time data consider only right-censored or only interval-censored failure times, not the more general case where times may be mixed. Additionally, among regression models developed for mixed interval-censored failure times, the proportional hazards formulation is generally assumed. It is well-known that the proportional hazards model may be inappropriate in certain situations, and alternatives are needed to analyze mixed failure time data in such cases. To fill this need, we develop a maximum likelihood estimation procedure for the proportional odds regression model with mixed interval-censored data. We show that the resulting estimators are consistent and asymptotically Gaussian. An extensive simulation study is performed to assess the finite-sample properties of the method, and this investigation indicates that the proposed method works well for many practical situations. We then apply our approach to examine the impact of age at cranial radiation therapy on risk of growth hormone deficiency in long-term survivors of childhood cancer.     

The Costs of Environmental Regulation in a Concentrated Industry

The typical cost analysis of an environmental regulation consists of an engineering estimate of the compliance costs. In industries where fixed costs are an important determinant of market structure, this static analysis ignores the dynamic effects of the regulation on entry, investment, and market power. I evaluate the welfare costs of the 1990 Amendments to the Clean Air Act on the U.S. Portland cement industry, accounting for these effects through a dynamic model of oligopoly in the tradition of Ericson and Pakes (1995). Using the two‐step estimator of Bajari, Benkard, and Levin (2007), I recover the entire cost structure of the industry, including the distributions of sunk entry costs and capacity adjustment costs. My primary finding is that the Amendments have significantly increased the sunk cost of entry, leading to a loss of between $810M and $3.2B in product market surplus. A static analysis misses the welfare penalty on consumers, and obtains the wrong sign of the welfare effects on incumbent firms.