Science in Political Agendas

Ethical conduct in human subjects research is primarily enforced by the federal government through regulations from agencies like the Food & Drug Administration or Department of Health and Human Services and the U.S. Congress. Throughout the 20th century, widely publicized events like the Tuskegee syphilis scandal and the diethylstilbestrol tragedy provided the impetus to create or improve research ethics regulations. However, increased regulation results in decreased probability of future triggering events from occurring; thus, the primary driver of research ethics policy is destined to fade over time. As less extreme triggering events fail to push legislators into action, research ethics policy will progress at an unacceptably slow pace. The field of bioethics has yet to establish a sustainable advocacy infrastructure meant to advance the recommendations of bioethicists in the field, but doing so is necessary to fill the void in political momentum left by extreme triggering events. Through a literature review and analysis of primary government documents, I evidence current dependence on triggering events and advocate for the creation of a new driver of progress, namely, a nonprofit research ethics advocacy organization. This entity would be able to provide proactive research ethics policy recommendations, thus allowing the federal government to better address issues in this area when triggering events do arise. Existing bioethics academic centers and professional organizations, such as the Hastings Center or the American Society for Bioethics and Humanities (ASBH), are best prepared to develop an advocacy group. Current policy stakeholders in the research ethics sphere are either institutions of higher education or medical interest groups, both of which have a broad array of interests that prevent them from regularly prioritizing improved ethics regulations in their advocacy efforts. A shift in this niche policy area is necessary in order to continue the push to improve human subjects protection policy going forward.Governmen

Writing Center: Impact analysis Fall 2014 to Fall 2018

The Utah State University (USU) Writing Center is dedicated to empowering students to express their knowledge and ideas in writing. Their approach promotes academic inquiry, critical thinking, and expressions of diversity. While research and evaluation suggest that the Writing Center significantly impacts student academic performance, the impact on student persistence is not yet clear. This report explores the association between USU’s Writing Center and students’ persistence toward graduation. METHODS: Students’ Writing Center use was captured through student log-ins at writing appointments. Students who had a record of using the Writing Center were compared to similar students who did not have a record of Writing Center use. Students were matched for comparison using prediction-based propensity score matching. Students were matched with non-users based on their persistence predication and their propensity to participate. FINDINGS: Students were 97% similar following matching. Participating and comparison students were compared using difference-in-difference testing. Students who used the Writing Center were significantly more likely to persist at USU than similar students who did not use the Writing Center (DID = 0.031, p \u3c .001). The unstandardized effect size can be estimated through student impact. It is estimated that Writing Center resources and services assisted in retaining 17 (CI: 3 – 32) students each year who were otherwise not expected to persist

The International Network for Evaluating Outcomes (iNeo) of neonates: evolution, progress and opportunities

Neonates born very preterm (before 32 weeks’ gestational age), are a significant public health concern because of their high-risk of mortality and life-long disability. In addition, caring for very preterm neonates can be expensive, both during their initial hospitalization and their long-term cost of permanent impairments. To address these issues, national and regional neonatal networks around the world collect and analyse data from their constituents to identify trends in outcomes, and conduct benchmarking, audit and research. Improving neonatal outcomes and reducing health care costs is a global problem that can be addressed using collaborative approaches to assess practice variation between countries, conduct research and implement evidence-based practices. The International Network for Evaluating Outcomes (iNeo) of neonates was established in 2013 with the goal of improving outcomes for very preterm neonates through international collaboration and comparisons. To date, 10 national or regional population-based neonatal networks/datasets participate in iNeo collaboration. The initiative now includes data on >200,000 very preterm neonates and has conducted important epidemiological studies evaluating outcomes, variations and trends. The collaboration has also surveyed >320 neonatal units worldwide to learn about variations in practices, healthcare service delivery, and physical, environmental and manpower related factors and support services for parents. The iNeo collaboration serves as a strong international platform for Neonatal-Perinatal health services research that facilitates international data sharing, capacity building, and global efforts to improve very preterm neonate care

Trends in Outcomes for Neonates Born Very Preterm and Very Low Birth Weight in 11 High-Income Countries

OBJECTIVE: To evaluate outcome trends of neonates born very preterm in 11 high-income countries participating in the International Network for Evaluating Outcomes of neonates. STUDY DESIGN: In a retrospective cohort study, we included 154 233 neonates admitted to 529 neonatal units between January 1, 2007, and December 31, 2015, at 24(0/7) to 31(6/7) weeks of gestational age and birth weight <1500 g. Composite outcomes were in-hospital mortality or any of severe neurologic injury, treated retinopathy of prematurity, and bronchopulmonary dysplasia (BPD); and same composite outcome excluding BPD. Secondary outcomes were mortality and individual morbidities. For each country, annual outcome trends and adjusted relative risks comparing epoch 2 (2012-2015) to epoch 1 (2007-2011) were analyzed. RESULTS: For composite outcome including BPD, the trend decreased in Canada and Israel but increased in Australia and New Zealand, Japan, Spain, Sweden, and the United Kingdom. For composite outcome excluding BPD, the trend decreased in all countries except Spain, Sweden, Tuscany, and the United Kingdom. The risk of composite outcome was lower in epoch 2 than epoch 1 in Canada (adjusted relative risks 0.78; 95% CI 0.74-0.82) only. The risk of composite outcome excluding BPD was significantly lower in epoch 2 compared with epoch 1 in Australia and New Zealand, Canada, Finland, Japan, and Switzerland. Mortality rates reduced in most countries in epoch 2. BPD rates increased significantly in all countries except Canada, Israel, Finland, and Tuscany. CONCLUSIONS: In most countries, mortality decreased whereas BPD increased for neonates born very preterm