Rethinking the therapeutic misconception: social justice, patient advocacy, and cancer clinical trial recruitment in the US safety net.

BackgroundApproximately 20% of adult cancer patients are eligible to participate in a clinical trial, but only 2.5-9% do so. Accrual is even less for minority and medically underserved populations. As a result, critical life-saving treatments and quality of life services developed from research studies may not address their needs. This study questions the utility of the bioethical concern with therapeutic misconception (TM), a misconception that occurs when research subjects fail to distinguish between clinical research and ordinary treatment, and therefore attribute therapeutic intent to research procedures in the safety net setting. This paper provides ethnographic insight into the ways in which research is discussed and related to standard treatment.MethodsIn the course of two years of ethnographic fieldwork in a safety net hospital, I conducted clinic observations (n=150 clinic days) and in-depth in-person qualitative interviews with patients (n=37) and providers (n=15). I used standard qualitative methods to organize and code resulting fieldnote and interview data.ResultsFindings suggest that TM is limited in relevance for the interdisciplinary context of cancer clinical trial recruitment in the safety net setting. Ethnographic data show the value of the discussions that happen prior to the informed consent, those that introduce the idea of participation in research. These preliminary discussions are elemental especially when recruiting underserved and vulnerable patients for clinical trial participation who are often unfamiliar with medical research and how it relates to medical care. Data also highlight the multiple actors involved in research discussions and the ethics of social justice and patient advocacy they mobilize, suggesting that class, inequality, and dependency influence the forms of ethical engagements in public hospital settings.ConclusionOn the ground ethics of social justice and patient advocacy are more relevant than TM as guiding ethical principles in the context of ongoing cancer disparities and efforts to diversify clinical trial participation

An RF Circuit Model for Carbon Nanotubes

We develop an rf circuit model for single walled carbon nanotubes for both dc and capacitively contacted geometries. By modeling the nanotube as a nano-transmission line with distributed kinetic and magnetic inductance as well as distributed quantum and electrostatic capacitance, we calculate the complex, frequency dependent impedance for a variety of measurement geometries. Exciting voltage waves on the nano-transmission line is equivalent to directly exciting the yet-to-be observed one dimensional plasmons, the low energy excitation of a Luttinger liquid.Comment: 4 pages, 4 figures. To be published in the proceedings of IEEE-NANO 200

Common trends, cointegration and competitive price behaviour

This article describes a characterisation of competitive market behaviour using the concepts of cointegration analysis. It requires all (n) rms to set prices to follow a single stochastic trend (equivalently the vector of n prices should have cointegrating rank n - 1). This implies that, in the long run, prices are driven by the shocks that impact on all companies, ruling out the possibility that the price set by any one rm is weakly exogenous

Arbitrage, market definition and monitoring a time series approach

This article considers the application to regional price data of time series methods to test stationarity, multivariate cointegration and exogeneity. The discovery of stationary price differentials in a bivariate setting implies that the series are rendered stationary by capturing a common trend and we observe through this mechanism long-run arbitrage. This is indicative of a broader market definition and efficiency. The problem is considered in relation to more than 700 weekly data points on gasoline prices for three regions of the US and similarly calibrated simulated series. The discovery of a single common trend is consistent with competitive pricing and a broad market definition, but the finding of a single weakly exogenous variable affects this conclusion

Long-run equilibrium price targetting

This is the post-print version of the Article. The official published version can be accessed from the link below - Copyright @ QASS 2011This article describes a characterisation of competitive market behaviour using the concepts of cointegration analysis. It requires all (n) firms to set prices to follow a single stochastic trend (equivalently the vector of n prices should relate to cointegrating rank n- 1). This implies that, in the long run, prices are driven by the shocks that impact on all companies, ruling out the possibility that the price set by any one firm is weakly exogenous for the set of cointegrating vectors