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Given the rapid aging of the population in Egypt, efforts to slow down or prevent frailty. Virtual reality technology constitutes a promising rehabilitation strategy, but its effect on frailty in older adults remains inconclusive. A non-equivalent control pre, post, and follow-up test design was used with a sample of 70 prefrail or frail older adults. In 3 urbans affiliated to Dakahlia governorate, tools of data collection; Mini-Cog, Structured Interview Schedule, Survey of Health, Aging and Retirement in Europe of the Frailty Indicator (FI), Short Physical Performance Battery, and Falls Efficacy Scale. For each group, a significant improvement in frailty, physical performance, and falls from each measurement period to immediately after (p < 0.001), and within the 30-days study period while those in the control group were relatively stable over time and sometime worsen. The baseline characteristics and assessment results were similar between groups. We observed significant improvements in the intervention group in terms of frailty criteria, standing balance, gait speed, chair stand, and fear of fall. No improvements were observed in the control group, we anticipate a decrease in frailty index, and increase in standing balance, reinforcing the proven benefits of the exercise in this vulnerable population. [ABSTRACT FROM AUTHOR]

We undertook a qualitative e-mail survey of federally-funded principal investigators of their views of the US human subjects protection system, intended to identify the range of investigator attitudes. This was an exploratory study with a 14% response rate. Twenty-eight principal investigators responded; their comments were analyzed to show underlying themes, which are here presented along with supporting quotations.There was consensus that it is important to protect human subjects from research abuse, but disagreement over how well the IRB system is functioning. Some researchers felt that the system is effective and serves its purpose well. Of those who support the system, some endorse its methods, purpose, and daily functioning, as they experience it, without reservation. Others, while expressing some frustration, feel that the purpose is important and their local IRB does its best to make a difficult system work well.Those investigators who were more harshly critical commented on multiple flaws in the system, including (1) consent forms that are inappropriate and incomprehensible, (2) an emphasis on minutiae, and (3) concern with protecting the institution more than research subjects. Respondents told us that the IRB system is a particular burden for research in neurology, emergency medical conditions, repositories, and social sciences in general; a more comprehensive study might identify other problematic areas. Significant concern was expressed about the cost, inefficiency, and irrationality of IRB review. The IRB system works well for some researchers, but our results indicate that other investigators feel the costs outweigh the benefits.

Formal social participation significantly impacts health and well-being, potentially mitigating cognitive decline, although not consistently across all studies. Existing research often focuses solely on baseline participation levels, and age-related differences have primarily been explored among the Asian population. Therefore, this longitudinal study aims to assess the association between formal social participation and cognition across different age groups in individuals aged 50+ living in Europe and Israel, while capturing the dynamic nature of formal social participation. We use data from three waves (four, six, and eight) of the Survey of Health, Ageing, and Retirement in Europe (SHARE), comprising 85,601 respondents. Linear mixed-effects models were applied. The results show that participation in formal social activities mitigates cognitive decline in middle-aged and older adults, especially among those aged 70 to 79 and 80+. These findings support the need for social policies promoting formal social activities, for lasting cognitive health benefits. [ABSTRACT FROM AUTHOR]

Summary: Background: Since January 2022, assisted suicide (AS) in Austria is legal under certain conditions. One of these conditions is informative consultations with two physicians, one of whom must be qualified in palliative medicine. Patients who are thinking about AS can approach palliative care institutions. This study aims to assess the availability and nature of Austrian palliative care institutions' web-based statements about AS. Methods: In this qualitative study, the websites of all Austrian palliative care units (n = 43) and all Austrian inpatient hospices (n = 14) were searched for possible statements on AS once in February 2022 and once in August 2022 using the three search terms "suicide", "assisted", and "euthanasia". The findings were subsequently evaluated using thematic analysis and NVivo software. Results: Statements or texts that included positions on AS were found on the websites of 11 institutions (19%). The results covered three main themes 1) demarcation: denial of involvement and judgment about AS, 2) duty: handling of requests and describing the target group of care recipients, and 3) explanation: experience, values, concerns, and demands. Conclusion: The results of this study indicate that people in Austria who wish to have AS and who may use the internet as their first source of information largely find no relevant information. There is no online statement of a palliative care or hospice institution that endorses AS. Positions on AS are mostly lacking, while reluctant attitudes of Christian institutions are predominant. [ABSTRACT FROM AUTHOR]

Investigators continue to debate whether the Dexamethasone Suppression Test (DST) reflects clinical severity or degree of melancholia ("endogeneity"). To evaluate this question, we studied 73 drug-free inpatients diagnosed with Schedule for Affective Disorders and Schizophrenia/Research Diagnostic Criteria (SADS/RDC) as having major depressive disorder (MDD). We compared absolute and dichotomous DST values (DST suppression versus nonsuppression) with absolute and dichotomous measures of endogeneity (as measured by operationally defined RDC items) and with Hamilton Rating Scale for Depression (HRSD) scores that were collected immediately prior to treatment. We found that degree of endogeneity correlated moderately (r = 0.27) but significantly (p = 0.02) with absolute DST values; DST nonsuppression increased proportionately with changes in categorical endogenous subtype (0% of the nonendogenous patients were nonsuppressives, 52% of probable endogenous, and 61% of subjects definitely endogenous); mean values for maximum DST concentrations increased steadily with categorical endogeneity (nonendogenous, 1.44 microgram/dl; probable endogenous, 7.65 micrograms/dl; definite, 10.93 micrograms/dl; p = 0.01); HRSD scores correlated more strongly (r = 0.45, p = 0.000) with maximum DST levels than did the degree of endogeneity. Age and weight changes did not account for the relationship of endogeneity to DST values. These data suggest that maximum postdexamethasone plasma cortisol levels reflect overall severity of depression and endogeneity and that endogeneity per se is highly confounded with severity.

Numerous ethical, legal, and social issues arise with biological sample sharing. The study explored the perspectives of genetic and genomic researchers on the sharing of biological samples in international collaborative research. Qualitative in-depth interviews were conducted with 15 researchers. Participants expressed positive attitudes towards biobanking and appreciated the benefits of cross-border sharing of biological samples but noted that this practice had adversely affected local capacity building efforts. There was limited understanding of the ethical and regulatory frameworks governing sample sharing. Researchers emphasized the importance of respecting cultural values in biobanking research. Issues concerning poor governance and inequitable benefit sharing were also raised. There is a need for fair and equitable international collaborations where all researchers are treated with respect and as equal partners. [ABSTRACT FROM AUTHOR]

Objectives : This study investigated whether physical and cognitive functioning predicts developing difficulties in basic or instrumental activities of daily living (ADL/IADL), and whether country-level factors moderated the associations. Methods : 69,227 adults aged 50+ from 19 countries were followed for up to 14 years. Cox regression and meta-regression analyses were used. Results : Higher grip strength was associated with a 45% lower risk of developing ADL limitations and a 47% lower risk of IADL limitations. The corresponding values were 22% and 23% for peak flow, 20% and 23% for word recall, and 20% and 24% for temporal orientation. The associations were similar and statistically significant in most countries, but some associations were weaker in countries with lower GDP and lower service coverage. Discussion : Good physical and cognitive functional capacity protects from ADL and IADL limitations consistently across Western countries. The associations may be stronger in countries with more resources. [ABSTRACT FROM AUTHOR]

Many European countries are facing the challenge of increasing the effective retirement age. Increasing the effective retirement age also requires that older employees are voluntarily willing to continue working. A worker who is willing to retire but is not allowed to retire might experience a negative impact on his or her well-being. This articles studies the determinants of the willingness to retire: the job, health, and financial situation of the older worker, and other socio-demographic characteristics. To do this, the micro data of the Survey of Health, Ageing and Retirement in Europe are used, which contains a binary question about willingness to retire. Based on the random effects logit estimator, we find that the job situation of the worker and the retirement of the partner are important drivers of the willingness to retire. Specifically, those willing to retire are more frequently employed in jobs that are mentally and physically demanding. They also feel less appreciated by the management or their colleagues and report to have fewer opportunities to get promotion. The willingness to retire is higher if the older worker has a retired partner. In the countries with the lowest rates of willingness to retire, the workers have better working conditions and are more easily able to make ends meet. [ABSTRACT FROM AUTHOR]

Prisons have been described as the final frontier for research on gangs and gang members. Criminological research in prisons is rare due to restricted access to facilities, concerns about harsh public scrutiny, and worries about security. There are added challenges for survey research involving prison gang members, as it is believed that gang norms inhibit reliable and valid responses and discourage participation in research. This article introduces the Study of Trajectories, Associations, and Reentry—the LoneStar Project—which involved interview-based surveys with 802 prison inmates in Texas, over 45% of whom were officially classified as gang members. We assess the prospect for conducting interview-based survey research with gang members in prison. We detail the planning and implementation phases of this study, assess whether gang members can be surveyed in prisons with fidelity, report descriptive statistics on gang and non-gang members, and identify five key operational lessons from this study. Our results revealed that gang members would not only participate in research, but that the methodological characteristics of their survey responses were indistinguishable statistically and substantively from those of non-gang prison inmates. We also determined that strong researcher-practitioner relationships, a nimble yet consistent research team, and a heavy emphasis on rapport building allowed this project to be carried out with few disruptions in a prison environment. These results are promising for future research in prisons, especially with gang members. [ABSTRACT FROM AUTHOR]

Fish and fish products contain high-quality protein of animal origin with essential bioavailable micronutrients such as iron, zinc, vitamins and omega-3 fatty acids. Although fish contribute to food and nutrition security, fish consumption per capita in Kenya is lower than Africa's and the world's average annual per capita consumptions. This study assessed fish farmers' attitudes and consumption behaviours for fish and value-added fish products in three Counties in Western Kenya. A cross-sectional study involving a mixed-method approach applying qualitative and quantitative techniques was used to collect data from one hundred and thirty-eight women with children aged 6 to 59 months. Participants were selected from a random sample of registered fish farmer groups representing vulnerable, marginalized and common interest groups within the study areas. Overall, most households consume fish as their main source of protein with the Nile tilapia being the most preferred fish species. A majority (64%) of the farmers had positive attitudes towards fish consumption and were interested in incorporating value-added fish products into their daily diets. In addition, availability of value-added fish products, knowledge of the existence of these products, skills in preparation and cooking, and socio-economic factors influenced consumption. The farmer's age ([Adjusted odds ratio, AOR = 2.83], [95% Cl: 1.23-6.52], p = 0.014), marital status ([AOR = 7.31], [95% Cl: 1.51-35.4], p = 0.014), monthly income ([AOR = 1.33], [95% Cl: 0.13-0.83], p = 0.019) and occupation of the household head ([AOR = 5.06, [95% Cl: 2.06-12.4], p<0.001) were positively associated with consumption of value-added fish products. However, education level ([AOR = 1.84, [95% Cl: 0.17-20.0], p = 0.617) was not associated with consumption of value-added fish products. Fish consumption patterns such as frequency and portion sizes significantly improved in the fish farmer households after they began fish farming. Furthermore, few farmers consumed value-added fish products due to low availability, lack of awareness and inadequate skills for preparation and cooking. In conclusion, awareness creation campaigns on fish value addition, nutrition education and behaviour change communication aimed at modifying nutrition behaviours are necessary to increase fish consumption, improve knowledge and skills, and ensure the availability of value-added fish products during all seasons. [ABSTRACT FROM AUTHOR]

Background: Breast implants are commonly placed postbreast cancer reconstruction, cosmetic augmentation, and gender-affirming surgery. Breast implant illness (BII) is a systemic complication associated with breast implants. Patients with BII may experience autoimmune symptoms including fatigue, difficulty concentrating, hair loss, weight change, and depression. BII is poorly understood, and the etiology is unknown. The purpose of this literature review is to characterize BII autoimmune disorders and determine possible causes for its etiology.Methods: The PubMed, Google Scholar, Embase, Web of Science, and OVID databases were interrogated from 2010 to 2020 using a query strategy including search term combinations of "implants," "breast implant illness," "autoimmune," and "systemic illness."Results: BII includes a spectrum of autoimmune symptoms such as fatigue, myalgias/arthralgias, dry eyes/mouth, and rash. A review of epidemiological studies in the past ten years exhibited evidence affirming an association between breast implants and autoimmune diseases. The most commonly recognized were Sjogren's syndrome, rheumatoid arthritis, systemic sclerosis, chronic fatigue syndrome, and Raynaud's syndrome. Explantation resulted in alleviation of symptoms in over 50% of patients, strengthening the hypothesis linking breast implants to BII. Studies have shown that silicone is a biologically inert material and unlikely to be the cause of these symptoms. This is supported by the fact that increased risk of autoimmune disease was also reported in patients with other implantable biomaterials such as orthopedic implants. Recent studies shed light on a possible role of bacterial biofilm and subsequent host-pathogen interactions as a confounding factor to this problem.Conclusion: BII could be dependent on biofilm infection and the microenvironment around the implants. The true pathophysiology behind these complaints must be further investigated so that alternative treatment regimens other than explantation can be developed. Translational significance of these studies is not limited to breast implants but extends to other implants as well. [ABSTRACT FROM AUTHOR]

Copyright of Salud Pública de México is the property of Instituto Nacional de Salud Publica and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

For decades, public opinion polls have shown that most Americans favor physician aid in dying (PAD) but little is known about those who support PAD ballot measures. With its emphasis on self-fulfillment, personal choice, and civic and political engagement, post-materialists would argue that adopting states tend to have younger, educated, and more secular populations. County-level votes on all nine ballot measures to legalize death with dignity were subjected to multiple regression analysis. The results largely confirm the hypotheses derived from post-materialist theory, namely that education, religion, and more problematically age significant indicators of PAD ballot measure voting. [ABSTRACT FROM AUTHOR]

Middle-aged adults are commonly confronted with the burden of paid work and multiple caregiving roles. This paper examines the relationship between weekly hours of unpaid caregiving and hours of work using data from the baseline survey of the China Health and Retirement Longitudinal Study. The analysis was conducted on a nationally representative sample of 3645 working-age Chinese adults aged 45–60 years who were not farming and had a young grandchild and/or a parent/parent-in-law. For women and men separately, we combined the use of a Heckman selection procedure and instrumental variables to estimate the relationship between weekly caregiving hours and hours of work. A caregiving threshold was also identified for women and men separately to allow for the testing of a kink and/or a discontinuity in this relationship. We found that for women, their working hours were initially unrelated to hours of caregiving before the threshold of 72 caregiving hours per week; then, their working hours experienced an almost two-fold increase at the caregiving threshold before falling by 2.02 percent for each additional hour of caregiving beyond the threshold. For men, their hours of work fell by 2.74 percent for each hourly increment in caregiving. Although a caregiving threshold of 112 h was identified for men, there was insufficient evidence for a statistically significant kink or discontinuity in this relationship. These findings provide support for a range of fiscal and human resource policies that target employed family caregivers in order to advance their well-being while also maintaining their work productivity. [ABSTRACT FROM AUTHOR]

While research on Institutional Review Boards (IRBs) has been conducted on issues ranging from quality, process, and effectiveness, gaps remain. Social science researchers have raised issues regarding decisions by IRBs applied to the social sciences based on biomedical research. To date, little is known about the experience of social scientists in criminology and criminal justice with IRBs and this research seeks to fill this gap. An online survey, including open- and closed-ended questions drawn from the validated IRB-Researcher Assessment Tool, was administered to members of the Academy of Criminal Justice Sciences and the American Society of Criminology about their experiences with IRBs. Results revealed that researchers report experiencing challenges with their IRBs including timeline delays of their research, bias against their research, and decisions that protect legal liability rather than human subjects ethics. Recommendations for improving IRB reviews of protocols and challenges unique to criminology and criminal justice are discussed. [ABSTRACT FROM AUTHOR]

Personal income and assets are sensitive topics to discuss. This phenomenon is reflected in high rates of nonresponse to financial questions in surveys. In face-to-face surveys, item nonresponse is influenced by interviewers. Although interviewers are trained to conduct standardized interviews, some obtain a higher number of item nonresponses than others. This study examines interviewer effects on nonresponse to questions about household income, bank balances, and interest and dividend income in the Survey of Health, Ageing and Retirement in Europe (SHARE). It first investigates the extent to which interviewers affect nonresponse to income and asset questions and second whether interviewers' prior expectations regarding respondents' likelihood to provide information about their income predict actual nonresponse rates. Results of multilevel modeling show that interviewer influence on nonresponse to the income and asset questions was significant at the five percent level. In addition, interviewer expectations were significantly correlated with "don't know" responses and "refusals." These results indicate that interviewer expectations matter in the context of income and asset questions and that survey practitioners should take this into account when designing interviewer training. [ABSTRACT FROM AUTHOR]

Objectives: Assess whether education moderates associations between discrimination and depression risk within a southern Black/African American cohort in a labor market shifting from manufacturing and farming to education-intensive industries, such as health care and technology. Methods: Data are from the Pitt County (NC) Study (n = 1154) collected in 2001. Depression risk was assessed with the Center for Epidemiologic Study-Depression (CES-D) scale. Discrimination was measured using a subset from the Everyday Discrimination Scale. Education was categorized as completion of less than high school (HS), HS/GED (General Educational Development), or any college. Results: Completing any college mitigated the association between discrimination and CES-D among men (b = −1.33, 95% CI = −2.56, −0.09) but not women (b = −0.19, 95% CI = −1.36, 0.98). Conclusions: Education is protective for depression risk related to discrimination for men but not women. Recent macroeconomic changes placed a premium on higher levels of education in 2018, as in the 1990s. Because racial discrimination remains a stressor in the everyday lives of African Americans regardless of education level, the health benefits of higher education for working-aged African Americans in shifting labor markets warrants further investigation. [ABSTRACT FROM AUTHOR]

Purpose: This paper aims to discuss whether alignment between corporate real estate strategy and corporate strategy exists for non-property companies listed on the Johannesburg Securities Exchange and what effects alignment has on the firms' financial performance. Design/methodology/approach: The study was both qualitative and quantitative in nature, with a specific focus on non-property firms listed on the Johannesburg Securities Exchange. The qualitative part of the study involved the analysis of the firms' annual reports to determine the presence and use of corporate real estate strategies and their alignment to corporate strategy and the extraction of financial indicator data. The quantitative portion of the study involved the use of multivariate analysis, to distinguish and quantify the relationship, if any, between corporate real estate strategy and the identified financial performance indicators. The independent variables were the CRE strategies employed and the dependent variable was the share price. The methods used in this study have been applied before in European and Asian studies; this assisted in ensuring that validity and reliability was achieved. Findings: The study finds that the most used strategy by firms (47%) is that which facilitates production, operation and service delivery. The Consumer Goods, Healthcare and Telecommunications sectors appear to demonstrate the highest level of alignment. Return on Shareholder Funds has a strong significant positive correlation with share price. Flexibility as a corporate real estate strategy also has a significant positive coefficient, which indicates a positive relationship with share price. Research limitations/implications: Although consistent with results of studies conducted in Europe and Asia, the results of this research may not be applicable to privately held non-listed firms, state-owned enterprises, non-profits and educational institutions. This study also ignores the dynamic external environment in which firms operate and the necessity of firms adjusting their corporate real estate strategy to their changing business strategy. Practical implications: These results suggest that the incorporation of corporate real estate strategy in the firms' corporate strategy formulation has the potential to enhance shareholder value for South African firms. Real estate developers, landlords and owner occupiers would benefit from better understanding the strategic requirements of corporations to ensure that the solutions they provide increase the likelihood of maximizing shareholder return. Originality/value: The role of corporate real estate strategy in the firms' corporate strategy formulation has the ability to enhance shareholder value. This research adds to the scant literature on corporate real estate management in South Africa. [ABSTRACT FROM AUTHOR]

Several longitudinal studies show that over time the American public has become more approving of euthanasia and suicide for terminally ill persons. Yet, these previous findings are limited because they derive from biased estimates of disaggregated hierarchical data. Using insights from life course sociological theory and cross-classified logistic regression models, I better account for this liberalization process by disentangling the age, period, and cohort effects that contribute to longitudinal changes in these attitudes. The results of the analysis point toward a continued liberalization of both attitudes over time, although the magnitude of change was greater for suicide compared with euthanasia. More fluctuation in the probability of supporting both measures was exhibited for the age and period effects over the cohort effects. In addition, age-based differences in supporting both measures were found between men and women and various religious affiliations. [ABSTRACT FROM AUTHOR]

There is limited literature on the opinions and perspectives of researchers on the ethical issues in biobank research in South Africa. This study aimed to explore researchers' perspectives on informed consent and ethical review of biobank research in South Africa. An online survey was conducted among researchers and scientists at Stellenbosch University and the University of Kwazulu-Natal. The majority of researchers opined that broad consent is appropriate for biobank research. However, there was no consensus on the necessity for re-consent. Researchers were also in agreement that issues concerning informed consent and future use of samples require thorough discussions during the ethical review process. Overall, the attitude of researchers on informed consent and ethical review of biobank research was positive and ethically informed. [ABSTRACT FROM AUTHOR]

Joint pain is a common experience among adults aged 65 and over. Although pain management is multifaceted, medication is essential in it. The paper examines the use of medication among older adults with joint pain in Israel and asks whether socioeconomic factors are associated with this usage. The data, harvested, from the Survey of Health, Aging and Retirement in Europe (SHARE), include 1,294 randomly selected community‐dwelling individuals aged 65 and over in Israel. Bivariate analysis and logistic regression are used to identify factors associated with the presence of joint pain medication use. About 38% of respondents report experiencing joint pain and 45% of those who so report are not taking prescription medication. Back pain is the most common location, reported by 64% of individuals who report joint pain. Taking medication is independently associated with younger age (OR = 0.965, 95% CI = 0.939–0.991), more education (OR = 1.044, 95% CI = 0.998–1.091), and better ability to cope economically (OR = 1.964, 95% CI = 1.314–2.936). However, older age and ability to cope economically are independently associated with women (OR = 0.964, 95% CI = 0.932–0.998 and OR = 2.438, 95% CI = 1.474–4.032, respectively) but not with men. It is suggested that socioeconomic inequality exists in healthcare access among adults aged 65 and over. Since income and gender are strongly associated with taking pain medication, physicians should follow‐up on women and less affluent people to ensure that medication prescribed has been obtained. Policymakers should consider programs that would facilitate better access to pain medication among vulnerable older individuals. [ABSTRACT FROM AUTHOR]

Copyright of Turkiye Klinikleri Journal of Medical Ethics-Law & History / Türkiye klinikleri tıp Etiği, Hukuku ve Tarihi Dergisi is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lengthy review times for institutional review boards (IRBs) are a well-known barrier to research. In response to numerous calls to reduce review times, we devised “Real-Time IRB,” a process that drastically reduces IRB review time. In this, investigators and study staff attend the IRB meeting and make changes to the protocol while the IRB continues its meeting, so that final approval can be issued at the meeting. This achieved an overall reduction in time from submission to the IRB to final approval of 40%. While this process is time and resource intensive, and cannot address all delays in research, it shows great promise for increasing the pace by which research is translated to patient care. [ABSTRACT FROM AUTHOR]

Many innovative, new sampling plans that have been proposed for use in "resource limited" settings use GIS, GPS and Google Earth technology. In this issue of JSSAM, Chen, et al. describe a GIS/GPS-assisted area probability sampling method and its application to an epidemiological study designed to investigate the relationship between social capital and HIV risk behaviors among rural immigrants to the city of Wuhan, China. The following discussion examines the strengths and weaknesses of the Chen et al. sampling plan and related applications of GIS/GPS/ Google Earth technology to area probability sampling of household target populations. The aim is to stimulate additional methodological research on GIS/GPS-assisted area probability sample designs, focused on the real constraints that exist in resource limited settings but with an eye to opportunities that the GIS/GPS and Google Earth technology provide to construct designs that are optimal under those constraints. [ABSTRACT FROM AUTHOR]

Signalong Indonesia (SI), a key word signing approach, was created to support the development of Indonesian inclusive schools. A mixed methods approach collected data about teacher’s beliefs and experiences regarding SI from the first two schools to pilot it. Thirty-two teachers completed questionnaires, followed by interviews with nine teachers. Three themes emerged: understanding the nature of SI, the stigmatisation of signers and its reporting by teachers, and the nature of happiness in inclusive pedagogy. The latter reveals, for the first time, the importance of Suka as a culturally mediated intrinsic part of Indonesian inclusive pedagogy. The findings suggest recommendations about SI materials and training, and indicate a new research area regarding inclusive pedagogies within different cultures. [ABSTRACT FROM AUTHOR]

Participants often do not read consent forms in social science research. This is not surprising, especially for online studies, given they do not typically offer greater risk than what is encountered in daily life. However, if no one is reading, are participants really informed? This study used previous research to craft experimentally manipulated consent forms utilizing different visual presentations (e.g., greater use of line spacing, bullets, bolding, diagrams). Participants (n = 547) were randomly exposed to one of seven form variations. Results found no significant differences between forms in reading or comprehension. Open-ended questions asked participants why they do not read consent forms and what would influence them to read the forms. Participants most frequently stated forms need to be shorter, and important information needs to be highlighted. We suggest improvements to informed consent forms, including removing much of the information that is constant across forms, and only including unique aspects of studies. [ABSTRACT FROM AUTHOR]

The link between greater wellbeing and longevity is well documented. The aim of the current study was to test whether this association is consistent across individualistic and collectivistic cultures. The sample consisted of 13,596 participants from 11 European countries, each of which was assigned an individualism score according to Hofstede et al.'s (Cultures and organizations: software of the mind, McGraw Hill, New York, 2010) cultural dimension of individualism. We tested whether individualism moderated the cross-sectional association between wellbeing and self-rated health or the longitudinal association between wellbeing and mortality risk. Our analysis revealed a significant interaction between individualism and wellbeing such that the association between wellbeing and self-rated health or risk of mortality from cardiovascular disease was stronger in more individualistic countries. However, the interaction between wellbeing and individualism was not significant in analysis predicting all-cause mortality. Further prospective studies are needed to confirm our finding and to explore the factors responsible for this culturally dependent effect. [ABSTRACT FROM AUTHOR]

Research activities often involve enrolling human subjects as volunteers to participate in research studies. Federal regulations mandate that research institutions are responsible for protecting the ethical rights and welfare of human subjects from research risks. This is usually accomplished by requiring approval of research protocols by an institutional review board (IRB) through a review process that is often complicated and time-consuming. The aim of this research was to reduce the time to obtain IRB approval/denial decisions for research protocols. Through a case study, this research addressed this issue within a leading public research university using the Lean Six Sigma methodology, a structured, problemsolving approach for improving process performance. Analyzing the IRB review process and implementing solutions to address the root cause(s) of lengthy processing times helped to streamline this process, which enhanced investigators' ability to conduct their research in a timely manner, while also ensuring compliance with federal regulations for human subject research. [ABSTRACT FROM AUTHOR]

Ethical oversight of clinical research is one of the primary means of ensuring that human subjects are protected from the natural bias of researchers and research institutions in favor of experimentation. At a minimum, effective oversight should ensure that risks are minimized and reasonable in relation to anticipated benefits, protect vulnerable subjects from potential coercion or undue influence, ensure full and informed consent, and promote the equitable distribution of the risks and benefits of research. Because these assessments often involve value judgments for which there are no agreed-upon objective standards, we rely on deliberative procedures thought to have the greatest likelihood of producing the right or best outcomes. Concerns about the potential for improperly functioning IRBs to waste scarce human and institutional resources and impede biomedical progress have motivated a surge in empirical research assessing their procedures and outcomes. Yet within this literature, there has been minimal attention paid to the social scientific evidence regarding how individuals and deliberating groups make decisions, nor how those data might inform IRB practice. This essay seeks to fill that gap, locating recent empirical data on IRB composition and process within the context of data regarding what I call "deliberative pathologies," or instances when deliberation fails to live up to one or more aspect of the deliberative ideal because of systematic biases in the ways participants interact. The paper goes on to make evidence-based recommendations to reduce the vulnerability of IRB deliberations to the kinds of pathologies discussed and indicate directions for future research. [ABSTRACT FROM AUTHOR]

As informed consent forms continue to lengthen, are these lengthening forms helping to create better informed participants? The aim of this research was to determine whether the length of consent forms affected reading frequency and comprehension, and to provide recommendations on how to improve consent forms in the social sciences so they are more likely to be read. A quasi-experiment was conducted using actual consent forms at two liberal arts schools, one requiring a long form (463 words, n = 73) and one requiring a shorter form (236 words, n = 57). Participants exposed to the shorter form reported fully reading, or at least skimming the form more frequently than those exposed to the longer form. Those exposed to the shorter form also comprehended more of the form’s information. The majority of participants indicated consent forms need to be shortened if researchers want future participants to be more likely to read these forms’ contents. Additional recommendations are discussed. [ABSTRACT FROM AUTHOR]

The central claim of this paper is that American states' use of so-called "triggering conditions" to regulate surrogate decision-making authority in end-of-life care leaves unresolved a number of important ethical and legal considerations regarding the scope of that authority. The paper frames the issue with a case set in a jurisdiction in which surrogate authority to withdraw life-sustaining treatment is triggered by two specific clinical conditions. The case presents a quandary insofar as the clinical facts do not satisfy the triggering conditions, and yet both the appropriate surrogates and the care team agree that withdrawal of life-sustaining treatment is in the best interest of the patient. The paper surveys applicable law across the 50 states and weighs the arguments for and against the inclusion of such triggering conditions in relevant legal regimes. The paper concludes by assessing the various legal and policy options states have for regulating surrogate decision-making authority in light of the moral considerations (including epistemic difficulties), and notes the possibility for conflict within ethics teams arising from the potential tension between prudence, risk-aversion, and moral obligation. [ABSTRACT FROM AUTHOR]

This article compares the doctor-patient communication styles of the United States with those of three Asian countries: Pakistan, Japan, and Thailand. Based on intercultural comparisons drawn between those countries, this analysis reveals that, overall, the United States has very little in common with the philosophical, cultural, societal, and communicative approaches to the traditional doctor-patient communication styles used in these three Asian nations. However, major similarities have been found across all three Asian nations. Although the doctor-patient relationship has been studied extensively in the United States and most of the Western world, rarely do those studies integrate, concurrently within their doctor-patient communication framework, dimensions such as power distance, individualism-collectivism, and communication styles. These are three important concepts in this analysis; they improve our understanding of what constitutes effective doctor-patient communication across dissimilar cultures. [ABSTRACT FROM PUBLISHER]

As part of an ongoing effort to better understand barriers to academic research, we reviewed and analyzed the process of research ethics applications, focusing on ethics approval time, within the Department of Medicine from 2006 to 2011. A total of 1,268 applications for approval to use human subjects in research were included in our analysis. Three variables, risk category (minimal vs. non-minimal risk), type of funding, and year of submission, were statistically significant for prediction of ethics approval time, with risk status being the most important of these. The covariate-adjusted mean time for approval for minimal risk studies (35.7 days) was less than half that of non-minimal risk protocols (76.5 days). Studies funded through a for-profit sponsor had significantly longer approval times than those funded through other means but were also predominantly (87%) non-minimal risk protocols. Further investigations of the reasons underlying the observed differences are needed to determine whether improved training for research ethics board (REB) members and/or greater dialogue with investigators may reduce the lengthy approval times associated with non-minimal risk protocols. [ABSTRACT FROM PUBLISHER]

Companies purchase computer systems to make their processes more efficient through automation. Some academic medical centers (AMC) have purchased computer systems for their institutional review boards (IRB) to increase efficiency and compliance with regulations. IRB computer systems are expensive to purchase, deploy, and maintain. An AMC should expect a positive return on investment from the purchase of an IRB system. An IRB system should decrease the processing time for IRB applications and affect the number of IRB staff members necessary to adequately handle IRB processes. This study examined these and other factors at AMCs to determine the value of IRB computer systems. [ABSTRACT FROM AUTHOR]