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.     

Health professionals' attitudes and practices in relation to Functional Capacity Evaluations

Functional Capacity Evaluations (FCE's) are part of practice in work injury prevention and rehabilitation, and are designed to define an individual's functional abilities or limitations in the context of safe, productive work tasks. Qualitative research methodology was used to investigate the attitudes and behaviours of health professionals in relation to FCE use. The study aimed to identify why health professionals chose a particular FCE, and to identify what factors influence health professionals' clinical judgements when providing results and recommendations for the individual being assessed. Five health professionals from the Hunter Region of New South Wales, Australia, participated in semi-structured, individual interviews using a phenomenological approach. Following inductive analysis of the data, four themes reflecting participants' attitudes and behaviours of FCE use emerged: i) referrals and expectations, including why and when the assessment is completed ii) outcomes, -- what the results aim to provide iii) workplace/practice/usage issues and iv) skills of the assessor. The results indicate the need for further research on the clinical utility of FCE's. A large scale quantitative study would allow results to be generalised to a wider community of FCE users.     

Differing Relationship Outcomes When Sex Happens Before,On, or After First Dates

While recent studies have suggested that the timing of sexual initiation within a couple's romantic relationship has important associations with later relationship success, few studies have examined how such timing is associated with relationship quality among unmarried couples. Using a sample of 10,932 individuals in unmarried, romantic relationships, we examined how four sexual-timing patterns (i.e., having sex prior to dating, initiating sex on the first date or shortly after, having sex after a few weeks of dating, and sexual abstinence) were associated with relationship satisfaction, stability, and communication in dating relationships. Results suggested that waiting to initiate sexual intimacy in unmarried relationships was generally associated with positive outcomes. This effect was strongly moderated by relationship length, with individuals who reported early sexual initiation reporting increasingly lower outcomes in relationships of longer than two years.     

From Health Crisis to Rights Advocacy? HIV/AIDS and Gay Activism in China and Singapore

The relationship between HIV/AIDS and gay activism has been primarily informed by the American experience and understudied in nondemocratic contexts. Drawing upon qualitative research on China and Singapore, we refine understanding of HIV/AIDS’ influence on the development of gay activism under authoritarian conditions, by examining the processes through which activist organizations interact with laws and regulations, political norms, HIV/AIDS funding, and government responses to both HIV/AIDS and collective organizing. We show how HIV/AIDS’ influence plays out in multiple patterns, depending on the strategic responses that gay activists select from a constrained range of options to shape their organizations’ destinies. Therefore, we provide insights for development agencies and international donors into whether and how international assistance intended to encourage activism and wider social change are mediated by political and legal controls on local activism.     

Fishing in Urban New Jersey: Ethnicity Affects Information Sources,Perception, and Compliance

Recreational and subsistence angling are important aspects of urban culture for much of North America where people are concentrated near the coasts or major rivers. Yet there are fish and shellfish advisories for many estuaries, rivers, and lakes, and these are not always heeded. This paper examines fishing behavior, sources of information, perceptions, and compliance with fishing advisories as a function of ethnicity for people fishing in the Newark Bay Complex of the New York–New Jersey Harbor. We test the null hypothesis that there were no ethnic differences in sources of information, perceptions of the safety of fish consumption, and compliance with advisories. There were ethnic differences in consumption rates, sources of information about fishing, knowledge about the safety of the fish, awareness of fishing advisories or of the correct advisories, and knowledge about risks for increased cancer and to unborn and young children. In general, the knowledge base was much lower for Hispanics, was intermediate for blacks, and was greatest for whites. When presented with a statement about the potential risks from eating fish, there were no differences in their willingness to stop eating fish or to encourage pregnant women to stop. These results indicate a willingness to comply with advisories regardless of ethnicity, but a vast difference in the base knowledge necessary to make informed risk decisions about the safety of fish and shellfish. Although the overall median income level of the population was in the $25,000–34,999 income category, for Hispanics it was on the border between $15,000–24,999 and $25,000–34,999.     

WOMEN AND THE INTERNET The natural history of a research project

This article represents a narrative, 'women and the internet', as a women and technology origin story with a fixed beginning, a contested centre, and an open ending. This article analyses our engagement with this narrative as a pilot study was conducted to look at women's perceptions of, and relationships to, the internet. Although this story felt like a coherent and persuasive narrative, this was questioned as the outcomes of the pilot study were reflected upon. Women coming to the 'net' led to a reconstruction of the questions that need to be addressed in researching gender and information technology. This article begins by describing and deconstructing the motivating story which was brought to this research project. Three genres are introduced-'the webbed utopia', 'flamed out' and 'locked into locality'-which are seen as forming the contested centre of this narrative. While each genre has its own narrative logic, all of them draw on a common tale of historical origins. From each of these perspectives 'Women and the internet' has an ending which is still open, but is rapidly closing. Three questions are then identified which have been raised by analysis: what do we mean by 'access'?; what do we mean by 'the internet'? and 'which women'? The seeming simplicity of these questions disguises serious difficulties which research in this area must address.     

“Want to Stay Over?” Demographic,Intrapersonal, and Relational Differences Among Those Who Date,Stay-Over,and Cohabit

This study explored the potential uniqueness of staying over, or spending the night with a romantic partner, as a relationship status. Using a recent sample of 2,304 individuals in romantic relationships, we explored how staying over might be associated with demographic, intrapersonal, and relational characteristics. Results suggested that individuals in “stay-over relationships” were similar to those in dating relationships and that cohabiters, defined as those who lived with a romantic partner in the same residence, were the most likely to differ from those in other types of relationships on demographic, intrapersonal, and relational assessments. Staying over in the absence of cohabitation was not associated with differences in relationship outcomes once controls were taken into account, but cohabiters who were not spending the night together did report lower relationship satisfaction compared with cohabiters spending most nights together.     

Principals' perceptions of benefits and barriers to school-based suicide prevention programs

Suicidal behavior among children and adolescents is a national problem and schools can be an effective context for suicide prevention and intervention efforts. School-wide screening programs are viewed as most effective from a public health standpoint, although they garner the least support from school administrators. The purpose of this article is to examine administrators' perceptions of three school-based suicide prevention models while also capturing opinions on barriers and benefits to implementation. Data were gathered through interviews with seven principals from one Midwestern state. Findings reveal agreement among principals that schools play a key role in suicide prevention, but they differ on which type of prevention approach is most appropriate. School principals believed the school-wide screening program included more barriers to implementation than either the in-service or the curriculum-based program, largely due to the likelihood of parental disapproval. Limitations of the study and implications for improving suicide prevention efforts are discussed.     

Neurobehavioral Consequences of Prenatal Exposure to Smoking at 6 to 8 Months of Age

Between 400,000 and 800,000 infants are born in the United States each year to women who smoked cigarettes during their pregnancy. Whereas the physical health consequences to infants of prenatal exposure to smoking are well established, the early neurobehavioral consequences are less well understood. This study investigated the neurobehavioral consequences of prenatal exposure to smoking using an epidemiologically derived sample of 454 infants who were drawn from a larger sample of 1,292 infants whose families were recruited at birth. Results indicated that, on average, infants who were exposed to higher levels of prenatal smoking exhibited less positive affect and greater irritability. Moreover, among male infants, elevated levels of prenatal exposure to smoking were associated with lower levels of approach, gross motor movement, reactivity, and attention. There was no evidence that the effects of prenatal exposure to smoking on infant neurobehavioral functioning were mediated by physical growth parameters (infant weight and head circumference) that are also known to be affected by prenatal exposure to smoking.