Collective Equipoise, Disappointment and the Therapeutic Misconception: On the Consequences of Selection for Clinical Research

Private information induces individuals to self-select as subjects into clinical research trials, and it induces researchers to select which trials they conduct. We show that selection can induce ex ante therapeutic misconception and ex post disappointment among research subjects; and it undermines it the rationale of collective equipoise as an ethical basis for clinical trials. Selection provides a reason to make non-trivial payments to subjects and it implies that researchers should not design experiments to maximize statistical power.clinical trials, therapeutic misconception, equipoise, selection

Adaptation to climate in widespread eucalypt species

AbstractThe long term success of revegetation efforts will depend upon the planted species’ resilience to climate change. Many widespread species grow across a range of climatic conditions and, thus, may possess adaptations that could be utilised to improve climate resilience of restored ecosystems. Species can achieve a widespread distribution via two main mechanisms; (1) by diverging into a series of specialised populations, or (2) through high phenotypic plasticity. The extent to which populations are specialised or plastic in response to climate will determine the seed-sourcing strategy required for optimal restoration outcomes under a changing climate. We examined genetic divergence and phenotypic plasticity in two widespread Eucalyptus species (E. tricarpa in southeastern Australia, E. salubris in southwestern Australia), to determine the nature of adaptation to climate in these species, and whether genomic screening might be a useful tool to assess climate adaptation.We examined nine populations of each species across climate gradients and, for E. tricarpa, trees originating from the same populations were also studied in two common garden field trials. We characterised responses in functional traits relevant to climate adaptation, including leaf size, thickness, tissue density, and carbon isotope ratio (δ13C). Genetic variation was assessed with genome scans using DArTseq markers, and ‘outlier markers’ were identified as being linked to regions of the genome that are potentially under selection.Evidence of both plastic response and genetic specialisation for climate was found in both species, indicating that widespread eucalypts utilise a combination of both mechanisms for adaptation to spatial variation in climate. The E. tricarpa common garden data suggested high plasticity in most of the measured functional traits, and the extent of plasticity in some traits (e.g. leaf size and thickness) varied among provenances, suggesting genetic variation for plasticity itself. In E. salubris, most functional traits showed little variation across the gradient. However, water use efficiency appeared highly plastic, as determined from the strong correlation between δ13C and recent precipitation (R2 = 0.83). Both species showed spatial partitioning of genetic variation across the gradient, and data for E. salubris revealed two distinct lineages. The genome scans yielded 16,122 DArTseq markers for “Lineage 1” of E. salubris, of which 0.1% were potentially adaptive ‘outlier loci’, and 6,544 markers for E. tricarpa, of which 2.6% were outliers. Canonical Analysis of Principal Coordinates (CAP) analysis showed that the outlier markers were correlated with climatic variables, and some were also strongly correlated with functional traits. An ‘Aridity Index’ was also developed from the CAP analysis that has potential as a tool for environmental planners to use for matching seed sources to target climates.Widespread eucalypts are likely to possess a capacity to respond plastically to a changing climate to some extent, but selection of seed sources to match projected climate changes may confer even greater climate resilience. Further study of the mechanisms of plasticity in response to climate may improve our ability to assess climate adaptation in other species, and to determine optimal strategies for ecosystem restoration and management under climate change

Las dimensiones de género en la investigación sobre turismo: Temas globales, perspectivas locales

La perspectiva de género en los Estudios de Turismo ha evolucionado desde un enfoque de «añádanse mujeres y agítese» a estudios diversos que se apoyan en la teoría feminista plasmada en una fértil literatura internacional. En este artículo empezaré revisando y atendiendo a los diferentes significados en disputa de género en tanto que concepto que sigue inspirando la teorización sobre las relaciones entre los hombres y las mujeres, sus identidades y sus actividades. Veremos cómo las intersecciones del género con otras formas de categorizar las diferencias como la etnicidad, la edad, la clase, la sexualidad o la nacionalidad se manifiestan en diseños complejos de ideas culturales y relaciones sociales. En nuestro campo, los investigadores analizan los entornos del turismo sexuado y la construcción de relaciones de poder en función del género en los sistemas de turismo. Nos estamos enfrentando a cuestiones que tienen que ver con la ética en el turismo sexual, las desigualdades en la producción, marketing y consumo del turismo y su disfrute sexuado en función de las ideas sobre la masculinidad y la feminidad. Estas preguntas urgentes sobre la equidad de género se plantean en los contextos de temas globales como la acumulación de capital, el movimiento de la población, los recursos medioambientales naturales, la tecnología de la información, la cultura popular y la seguridad. Las percepciones de género locales ofrecen bases para analizar pormenorizadamente estudios de caso y para realizar investigaciones comparativas. A partir de ideas relativas a la encarnación, un término bastante frecuente aunque a menudo oscuro, ha ido emergiendo un enfoque fructífero. Los cuerpos representan lo local por excelencia. Aquí, las tensiones globales y locales se codifican y representan en un espacio individual. El artículo termina con una discusión sobre lo que una teoría sobre el cuerpo puede suponer para la producción de conocimiento en los estudios de turismo, siendo también nosotros investigadores corpóreos.Gender research in Tourism Studies has evolved from an «add women and stir» approach to nuanced studies that draw on feminist theory written into a rich international literature. I’ll begin this paper with an overview, looking at contested meanings of gender as a concept that continue to inspire theorizing about women’s and men’s relationships, identities and activities. We study how intersections of gender with other ways of categorizing people’s differences such as ethnicity, age, class, sexuality, and nationality play out in complex patterns of cultural ideas and social relations. In our field, scholars are investigating gendered tourism environments, and the construction of gendered power relations in tourism systems. We are grappling with questions about ethics in sex tourism, inequalities in tourism production, marketing, and consumption, and gendered enjoyment shaped by ideas of masculinity and femininity. Our urgent inquiries about gender equity are located in the contexts of global issues such as capital accumulation, population movement, natural environmental resources, information technology, popular culture, and security. Local gender perceptions provide bases for fine-grain analysis in case studies and comparative analyses. One useful approach has grown out of ideas on embodiment, an often used but often obscured term. Bodies are as local as one can get. Here global and local tensions are encoded, acted out in individual sites. I’ll end this paper with a discussion of what theory about the body may mean for the production of knowledge in tourism studies, by us the embodied researcher

Collective Equipoise, Disappointment and the Therapeutic Misconception: On the Consequences of Selection for Clinical Research

Private information induces individuals to self-select as subjects into clinical research trials, and it induces researchers to select which trials they conduct. The authors show that selection can induce ex ante therapeutic misconception and ex post disappointment among research subjects, and it undermines the rationale of collective equipoise as an ethical basis for clinical trials. Selection provides a reason to make nontrivial payments to subjects, and it implies that researchers should not design experiments to maximize statistical power

What Works in Writing

For this self-study, I developed and presented a series of authentic writing experiences and corresponding mini-lessons for fourth graders. This study looks at my journey through the early stages of implementation of a literacy program based on writer\u27s workshop. The goal of this study was to answer the questions of which teaching methods best engage and motivate students, whether the implementation of some components of writing workshop leads to differentiated, individualized instruction in support of all students\u27 writing, and how to balance grammar instruction with workshop practices. By evaluating my lesson plans, student work, writing conference transcripts and field notes, I find that student-teacher writing conferences are especially useful, both for differentiating instruction and for developing positive attitudes about writing. The results highlight the importance of explicit instruction of the writing process in order to teach the skills needed to create an effective writers\u27 workshop

Gratitude, Warm Glow, and the Role they Play in the Pay-it-Forward Model

Prosocial interventions encourage voluntary actions that benefit others to achieve medical and/or public health outcomes. Pay-it-forward is a prosocial approach that includes offering an individual a gift (an STD test) and then asking if that individual would like to give a gift to another person. This approach has shown promising results among gay, bisexual, and men who have sex with men (GBMSM) in China, but there is limited understanding about the participant experience and how this intervention works. This study aims to understand prosocial behavior, recipient gratitude and warm glow, and the impact these behaviors can have on an individual’s health. Aim 1 synthesizes the peer reviewed literature on prosocial interventions used to promote public health and medical outcomes using a systematic review. Aim 2 and 3 explore the experience of the participant in pay-it-forward specifically by describing their experience when they receive a gift and the warm glow feeling that people feel when they give to others (Aim 2) and determine whether receiving a gift from pay-it-forward is associated with transient feelings of gratitude and changes in a biomarker, oxytocin (Aim 3). Our systematic review was informed by the Cochrane handbook, and the data extraction and synthesis consisted of three parts: a transformation of quantitative and mixed methods results to qualitative narratives, a data based convergent synthesis, and a meta-aggregation interpretation.Our analysis of pay-it-forward was conducted using data from a two-armed study comparing pay-it-forward to a free test as part of a research study. In aim 2 we conducted a qualitative thematic analysis to identify facilitators and barriers of implementing pay-it-forward. In aim 3 we conducted confirmatory factor analysis, difference-in-difference models, and regression analysis to compare demographic differences between the two groups and individual oxytocin changes.The systematic review found that individual interests and community connectedness are vital aspects of prosocial interventions. Informed by the systematic review, the qualitative analysis found that the pay-it-forward approach highlights the need for connection, support, and health services for gay men in China. The quantitative analysis found insignificant results but determined that the STD clinic environment itself may alter the biomarker.Doctor of Philosoph

Decision aids can support cancer clinical trials decisions: Results of a randomized trial

BACKGROUND. Cancer patients often do not make informed decisions regarding clinical trial participation. This study evaluated whether a web-based decision aid (DA) could support trial decisions compared with our cancer center’s website. METHODS. Adults diagnosed with cancer in the past 6 months who had not previously participated in a cancer clinical trial were eligible. Participants were randomized to view the DA or our cancer center’s website (enhanced usual care [UC]). Controlling for whether participants had heard of cancer clinical trials and educational attainment, multivariable linear regression examined group on knowledge, self-efficacy for finding trial information, decisional conflict (values clarity and uncertainty), intent to participate, decision readiness, and trial perceptions. RESULTS. Two hundred patients (86%) consented between May 2014 and April 2015. One hundred were randomized to each group. Surveys were completed by 87 in the DA group and 90 in the UC group. DA group participants reported clearer values regarding trial participation than UC group participants reported (least squares [LS] mean = 15.8 vs. 32, p < .0001) and less uncertainty (LS mean = 24.3 vs. 36.4, p = .025). The DA group had higher objective knowledge than the UC group’s (LS mean = 69.8 vs. 55.8, p < .0001). There were no differences between groups in intent to participate. CONCLUSIONS. Improvements on key decision outcomes including knowledge, self-efficacy, certainty about choice, and values clarity among participants who viewed the DA suggest web-based DAs can support informed decisions about trial participation among cancer patients facing this preference-sensitive choice. Although better informing patients before trial participation could improve retention, more work is needed to examine DA impact on enrollment and retention. IMPLICATIONS FOR PRACTICE: This paper describes evidence regarding a decision tool to support patients’ decisions about trial participation. By improving knowledge, helping patients clarify preferences for participation, and facilitating conversations about trials, decision aids could lead to decisions about participation that better match patients’ preferences, promoting patient-centered care and the ethical conduct of clinical research

Editorial: Education Leadership and the COVID-19 Crisis

This research topic presents important developments in the field of education as the COVID-19 crisis ripples across the world. Not only have educators everywhere had to take extraordinary measures to deal with the health and safety threats they have encountered on a daily basis since the onset of this pandemic, but they have also had to learn new technologies, and respond to multiple demands as the landscape of teaching and learning shifted under their feet. The 20 articles in this collection, which capture early responses to the pandemic, highlight the complex, disruptive nature of this ongoing global challenge. While many of the authors have found hopeful ways to understand what educators have been experiencing, they also chronicle the harsh realities of loss and interrupted learning that weigh heavily on teachers, administrators, parents and students