bluuebunny/crossref_metadata_2025 huggingface dataset:
Concluding Thoughts and Recommendations
Authors: Youngner Stuart J , Schapiro Renie , Anderson Martha W
Published: November 2023

The preceding chapters present the first comprehensive examination of the tissue transplantation industry. From them emerges the picture of a rapidly developing health care enterprise at the cutting edge of biotechnological and commercial development. Equally apparent is the human dimension the hundreds of thousands of people who are helped through tissue trans plantation and the tens of thousands of families who make the generous gift of tissue from their newly deceased loved ones. The values of the market, the value of altruism in organ and tissue donation, and the Hippocratic values of healing are all very important in our society-and all are at play in the complex functioning of the tissue transplant industry.
Mental illness, substance dependence, And Suicidality: Secondary Data Analysis
Authors: Yeager Kenneth , Roberts Albert R
Published: November 2023

Mental illness, substance dependence, and suicide are three of the most prevalent social and public health concerns throughout North America. Recent estimates indicate that every 20 minutes somewhere in the United States or Canada a suicide occurs. In the United States alone there are 30,000 suicides per year (Bush, Fawcett,, Jacobs, 2003; Institute of Medicine, 2002). This chapter seeks to explain the contributing factors leading to rehospitalization and suicide risk among the psychiatric, substance abuse, and substance dependent populations. Data from a university medical center will be reviewed regarding characteristics of inpatient hospitalization and potential contributing factors increasing the individual’s risk of a suicide attempt following inpatient psychiatric/ substance dependence hospitalization. In 2001 approximately 15 million adults age 18 or greater were estimated to have suffered from a severe mental illness during the previous year. The population with the highest rate of severe mental illness was the 18-to-25-year-old age group (12 %). Persons ages 26-49 demonstrated a rate of approximately 8%, with the 50 or older age group demonstrating a rate of 5%. Females were more likely than males to have a diagnosis consistent with severe mental illness (9% female versus 6% male) (National Institute of Mental Health, 2001; Bush et al., 2003; Institute of Medicine, 2002).
Statistics For Human Service Workers
Authors: Almgren Gunnar
Published: November 2023

The basic purpose of this chapter is to provide a general overview of the fundamentals of statistical reasoning and analysis that are particularly applicable to the evaluation of human services practice. The audience for this chapter is assumed to include social workers and other behavioral practitioners who may have had a course in statistics that is but a distant and regrettable memory and practitioners who have not had a course in basic statistics. While it offers practitioners considerably enhanced opportunities to evaluate practice, the availability of highly sophisticated and user-friendly statistical software over the last decade brings with it the risk of extremely erroneous findings and conclusions that are ultimately far more detrimental to empirically based practice than the profession of honest uncertainty. In this chapter I will review the critical assumptions that are embedded in the application and interpretation of some of the more popular statistical tests employed in the evaluation of human services practice, as well as some of the common errors one can make in test selection and interpretation. Although this chapter will be more conceptual than mathematical, I will walk the reader through some equations essential to statistical reasoning. First, however, I will review some fundamental concepts and terminology.
Qualitative Research Ethics: Thriving Within Tensions
Authors: Antle Beverley J
Published: November 2023

Qualitative research methods emerge from a worldview that asserts that subjective experiences and the meanings assigned to those experiences intimately shape notions of reality. Embedded within this broad framework are the expectation that there are multiple perspectives on the same phenomenon, the belief that the values and perceptions of both the researcher and the researched are an integral part of the endeavor, and the application of an inductive approach to investigation that begins with the experiences of participants and moves to everincreasing layers of analysis and understanding (Cresswell, 1998; Maxwell, 1996; Strauss, Corbin, 1990). Traditional hierarchical barriers between the researcher and “the subject” are altered so that the expertise and subjectivity of both the researcher and the participant are acknowledged and viewed as an essential foundation for fostering a fuller and richer understanding of the phenomenon or issue being explored. These distinctions in worldview and researcherparticipant roles have considerable implications for the ethical dimensions of qualitative research, which are more contextually based and render themselves less amenable to a structured set of rules. An emerging body of literature reflects the unique ethical issues that qualitative researchers face (Brownlow, O’Dell, 2002; Burman, 1997; Denzin, 2002; Hadjistavropoulos, Smythe, 2001; Magolda, Weems, 2002; O’Connor, 2001; Punch, 1994; van den Hoonaard, 2001). By examining the reported experiences of qualitative researchers, the research community can become better informed about unintentional harm and unanticipated risks that emerge from this methodology (Boman, Jevne, 2000; O’Connor, 2001; Punch, 1994).
Setting The Stage For Accountability And Program Evaluation In Community-Based Grant-Making
Authors: Crusto Cindy A , Wandersman Abraham
Published: November 2023

Community-based organizations are increasingly being looked to and funded to address local social welfare, health care, and mental health needs. They are relied upon to develop and implement innovative programs to be delivered to individuals and communities they serve. However, the lack of staff and other resources available to these agencies often challenges their ability to develop high-quality grant proposals and programs to achieve desired outcomes. Moreover, few agencies have the capacity for evaluating the short- and long-term effects and impacts of their efforts (Morley, Hatry,, Cowan, 2002); therefore, in many instances the potential programmatic benefits remain unknown. In a study to explore foundation performance and effectiveness, foundation CEOs indicated that although the provision of nonmonetary assistance (e.g., management advice, advice about the field) to grantees during the course of the grant could contribute to grantee satisfaction and program impacts, this was rarely provided (Center for Effective Philanthropy, 2002b). Some foundations have attempted to build the capacity for achieving realistic grantee outcomes through creating a more trusting relationship between grant makers and grant seekers that allows for mutual learning (Center for Effective Philanthropy, 2002a). Building the capacity of potential grantees to develop high-quality grant applications and programs and to evaluate their programs is crucial to successful funding initiatives.
Measuring Skills And Reasoning Scientifically And Critically About Practice
Authors: Gibbs Len , Gambrill Eileen
Published: November 2023

Critical thinking skills should contribute to making well-reasoned decisions in practice regarding, for example, accurate assessments of client circumstances and presenting problems, assessing risk (e.g., new sex offense, violence), making generalizations about clients, and selecting effective methods. Research on cognitive biases in decision making (e.g., Baron, 2000; Hastie, Dawes, 2001; Nisbett, Ross, 1980) suggests that certain biases may result in faulty decisions across a broad array of contexts. Such errors and biases in thinking can be costly. Measures that test skills in spotting fallacies in newspaper reports, editorials, and debates may not be valid when applied to clinical situations. Tousignant and DesMarchais (2002) reported that selfassessments by medical students did not correlate well with performance on an oral examination. Their study involved 91 medical students enrolled in a problem-based learning program. Beck, Bennett, McLeod, and Molyneaux (1992) reviewed 13 studies that examined the relationship between clinical reasoning ability in nursing and scores primarily on the Watson-Glaser Critical Thinking Appraisal. They found mixed to negative results, suggesting that the WatsonGlaser test does not validly reflect clinical reasoning in nursing. Such findings support the need for measures of critical thinking about practice that are specific to practice.
The Implications Of Controlled Outcome Studies On Planned Short-Term Psychotherapy With Depressive Disorders
Authors: Bloom Bernard L
Published: November 2023

Depressive disorders are the major component of what are referred to in the DSM-IV-TR (American Psychiatric Association, 2000; see also Mays, Croake, 1997a, Chapter 4; Morrison, 1995) as mood disorders-periods of time when patients feel abnormally and pathologically happy or sad. The term depressive disorder is reserved to describe a person who has had multiple depressive episodes, periods of time of 2 weeks or longer when they feel depressed, cannot enjoy life, and have problems with eating and sleeping, guilt feelings, loss of energy, trouble concentrating, and thoughts about death. Most depressive disorders are recurrent and lifelong.
Dysthymic Disorder And The College Student: Evidence-Based Mental Health Approach
Authors: Walsh Joseph , Corcoran Jacqueline
Published: November 2023

This chapter describes the efforts of a clinical social worker to provide evidence-based interventions to a female college student with dysthymic disorder. This disorder is a relatively chronic (at least 2 years) low-grade depression that afflicts between 3% and 6% of the population (American Psychiatric Association[APA], 2000). Women are two to three times more likely to suffer from dysthymic disorder than men (APA, 2000). The disorder usually emerges in adolescence or young adulthood, although it can begin in middle age. Comorbidity is a significant issue for those suffering from the disorder, with three quarters having another medical or psychiatric problem. Common comorbid diagnoses include anxiety disorder (such as panic disorder and social phobia) and alcohol use disorders, but the most prevalent is major depressive disorder (Brunello et al., 1999).
Implementing Evidence-Based Practices In Opioid Agonist Therapy Clinics
Authors: Willenbring Mark L , Hagedorn Hildi
Published: November 2023

Opioid agonist therapy (OAT) is a form of treatment for opioid (mainly heroin) dependence, in which counseling and other psychosocial services are coupled with provision of a daily dose of an opioid agonist medication. Currently, three agonist medications are available: methadone, levo-alpha acetyl methadol (LAAM), and buprenorphine. Opioid addicts often have persistent dysphoria and craving after withdrawal from opioids, so providing a daily dose of a long-acting opioid medication reduces or eliminates craving and illicit drug use. Unfortunately, rehabilitation treatments with goals of abstinence from both illicit opioids (such as heroin) and prescribed opioids (such as methadone) are effective for only a small percentage of addicted persons (Magura, Rosenblum, 2001; Sees et al., 2000). In contrast, compelling evidence accumulated over three decades demonstrates that OAT is the most effective treatment for opioid dependence, leading to improved patient outcomes, including reduced drug and alcohol use, fewer psychiatric symptoms and medical problems (e.g., reduced prevalence of HIV infection, AIDS, tuberculosis, and hepatitis CJ, less involvement in criminal activity, improved psychosocial functioning, a higher likelihood of employment, and reduced premature mortality (Ball, Ross, 1991; Ling et al., 1998; Marsch, 1998; Mclellan, Arndt, Metzger, Woody,, O’Brien, 1993; Newman, Whitehill, 1979; Sees et al., 2000; Zaric, Barnett,, Brandeau, 2000).
Validity And Reliability In Family Assessment
Authors: Franklin Cynthia
Published: November 2023

This chapter summarizes and discusses the reliability and validity of five measures of family assessment. Reliability is related to the consistency of a measure and is especially important when assessing measurement tools that will be used in clinical practice to guide the clinical decision-making process (Springer, Franklin, 2003). Reliability is established through four methods: test-retest, alternate form, split-half, and internal consistency. Validity addresses whether a tool measures what it is intended to measure. There are four types of validity: content validity, criterion validity, construct validity, and factorial analysis. Validity should be assessed in terms of the specific measurement tool and its intended use (Springer, Franklin, 2003). Managed behavioral health care and the subsequent demands for accountability in clinical practice require assessment tools and interventions that are known to be effective with clients and have well-established reliability and validity. Springer, Abell, and Hudson (2002) point out that despite an increase in accountability tools, the science of measurement and instrument development is very young. Much progress has been made on the psychometric development of valid and reliable assessment tools in the 25-to 30-year developmental period of marital and family therapy measures (Franklin, Jordan, 1999). The purpose of this chapter is to illustrate the importance of the development of psychometric measurement tools, which inform practice in marital and family therapy.
Statistical Methods For Estimates Of Interrater Reliability
Authors: Auerbach Charles
Published: November 2023

To assure interrater, or interobserver, reliability, much research in clinical fields relies on judges or raters who observe a common event. Bloom, Fisher, and Orme (1999) state that this type of reliability is used “to determine the extent to which two observers agree in their observations about whether, how often, or how long overt behaviors occur” (p. 48). Interrater reliability can be defined as the extent to which observations yield similar results from different judges. It is assumed that at least two judges independently rate a phenomenon. Orme and Gillespie (1986) suggest that a number of measures have been developed for the assessment of client problems. Often multiple observers of client problems use these measures. Ratings by consumers, providers, or other significant individuals are used to form consumer-specific sets of behavior. In these instances, there is a need to employ a method to rate the interobserver agreement. Interobservation is used widely in the research literature.
Locating Measurement Tools And Instruments For Individuals And Couples
Authors: Corcoran Kevin
Published: November 2023

One striking characteristic in the development of all sciences is how progress follows the lead first set by advances in measurement. Improvement in measures, it seems, is a predicate to other scientific development. In the behavioral sciences, measurement first allowed research to improve diagnoses and evidence the efficacy of theories for diagnostic-related groupings. Measurement has advanced to the current state where it is available for incorporation in the routines and procedures of everyday practice.
Outcome Measurement Scale With Families Of The Seriously Mentally III
Authors: Solomon Phyllis , Draine Jeffrey
Published: November 2023

Frequently, practitioners and evaluators are in a position where they need to evaluate targeted brief group interventions that address specific diseases or conditions (Sands, Solomon, in press). These may be educational or support groups (Toseland, Rivas, 2001) or socioeducational groups that combine educational, socialization, and support functions. These groups usually meet for 1 or 2 sessions or possibly as many as 10 to 12 sessions for about an hour or two (Brown, 1991). Given the highly targeted nature of these groups, frequently the objectives are to increase knowledge, a sense of self-efficacy in handling the problem or condition, and coping ability in cognitions and behaviors relevant to the particular condition. The intent of these programs is to improve the knowledge and ability of the participants in a defined area, such as children of alcoholics, various chronic medical conditions, or populations of family caregivers of an identified illness. Generally, there is little expectation that these brief interventions will improve participants' generalized self-efficacy or coping ability in all domains of living. Consequently, generalized measures of self-efficacy and coping cannot capture the expected effects of these interventions. Using these generalized measures would likely lead the evaluator to conclude that the groups are not effective in reaching their intended objectives.
Empowerment Evaluation
Authors: Fetterman David
Published: November 2023

Empowerment evaluation is the use of evaluation concepts, techniques, and findings to foster improvement and self-determination (Fetterman, 2001; Fetterman, Kaftarian,, Wandersman, 1996). It is guided by a commitment to truth and honesty (Fetterman, 1998). It is designed to help people help themselves and improve their programs using a form of selfevaluation and reflection. Program participantsincluding clients, consumers, and staff members-conduct their own evaluations; an outside evaluator often serves as a coach or additional facilitator, depending on internal program capabilities. By internalizing and institutionalizing self-evaluation processes and practices, a dynamic and responsive approach to evaluation can be developed.
Process Versus Outcome Evaluation
Authors: Smith Michael J
Published: November 2023

The field of program evaluation consists of broad concepts that are descriptive and overlapping, but nonetheless useful. The distinction between process and outcome evaluation is a case in point. So is the distinction between process evaluation and program monitoring, and outcome evaluation and impact assessment. The inconsistencies and overlap between these terms can be a source of confusion and annoyance for both the beginning student and the expert evaluator. Nevertheless, they provide a rich context and a way to organize your approach to evaluation.
Innovative Approaches To Risk Assessment Within Alcohol Prevention Programming
Authors: Holleran Lori K
Published: November 2023

Alcohol use by underage children is widespread. In 2001, about 10 million youth aged 12 to 20 (28.5% of this age group) reported drinking alcohol in the month prior to the survey interview (National Household Survey on Drug Abuse[NHSDA], 2001). Furthermore, there is a trend toward younger and younger ages of initiation, with 11% of teens reporting that they had their first drink before age 11 (American Academy of Pediatrics, 1998). The percentage of children reporting alcohol use in the past 30 days increased with age from youth to young adulthood, from 2% at age 12 to 65% at age 21 (NHSDA, 2001). The combination of youth and alcohol results in other risky and dangerous behaviors including cigarette use, violence, vandalism, high-risk sexual behavior, and drunk driving (Bonomo et al., 2001; McClelland, Teplin, 2001; NHSDA, 2001; Staton et al., 1999).
Qualitative Research With Battered Women: A Continuum Based on 501 Cases
Authors: Roberts Albert R
Published: November 2023

This study developed a new classificatory schemata for chronicity in battered women. It was developed from the narratives of 501 battered women. The goal was to describe different types of battering relationships, psychosocial characteristics of the victim and abuser, and the duration of abuse in order to enhance our understanding of the ways in which battering relationships occur and endure. Violence among current and former intimate partners is pervasive in American society. Every year an estimated 8.7 million women are abused by their partners (Roberts, 1998; Roberts, 2002). Two national studies have provided methodologically rigorous estimates of the prevalence of woman-battering. Tjaden and Thoennes (2000) said that 25% of their female respondents reported some form of violence. Straus and Gelles (1991) estimated that approximately 16 percent of American couples had encountered family violence incidents. Each year, for the past 20 years approximately 1.5 to 2 million women have needed emergency medical attention as a result of domestic violence (Roberts, 1998; Straus, 1986). Annual estimates indicate that approximately, 2,000 battered women are killed by their abusive partners, and the majority of these homicides take place after the victim has tried to leave, separate from, or divorce their batterer.
Using Qualitative Research To Enhance Practice: The Example of Breast Cancer in African American Women
Authors: Oktay Julianne S , Park-Lee Eunice Y
Published: November 2023

There has been a recurrent emphasis on the importance of utilizing research results to improve practice in social work and other health professions (Rosen, 1994; Rosen, 1996; Rosen, Proctor,, Staudt, 1999). However, advocates for a closer connection between research and practice tend to equate research with quantitative research, and the potential of qualitative research to improve practice has received little attention. This chapter discusses several ways that qualitative research can contribute to improved practice, using the example of breast cancer in African American women as an illustration. Specifically, qualitative studies are especially valuable in helping practitioners gain an in-depth understanding of new populations and new problems, design new interventions, and evaluate what is going on in existing programs.
Family Status And Soup Kitchen Use: Some Policy Considerations Based on Qualitative Research Findings
Authors: Chaiklin Harris , Lipton Marc
Published: November 2023

There have always been soup kitchens, but they usually do not surge in growth or get much attention until the economy is in decline. Their recent expansion only partly follows the historical trend. Contributing factors have been a recession, our productive economy’s changing nature, lack of housing, deinstitutionalization, the cutback in federal support programs, and the failure to make up for these cuts at the state and local levels. Over the last 20 years, soup kitchen use has increased, even when economic conditions were good.
A Cognitive-Behavioral Approach To Suicide Risk Reduction In Crisis Intervention
Authors: Weishaar Marjorie E
Published: November 2023

Working with suicidal patients can be anxietyprovoking for even the most experienced clinician because of the perceived responsibility for another person’s life, the difficulty predicting the likelihood and timing of an individual’s suicide based on population models, and the particular reliance on the therapy relationship when collaboration may be difficult. Suicide is the 11th leading cause of death overall in the United States (Minino, Arias, Kochanek, Murphy,, Smith, 2002). Among adolescents, it accounts for a greater proportion of deaths than for the nation as a whole (McIntosh, 2000). Despite these facts, there is a paucity of well-designed research on treatments to reduce suicidality (i.e., suicide, suicide attempts, and suicide ideation; Linehan, 1997). Clinicians need empirically validated treatments or will continue to rely on methods that are unproven and perhaps ineffective. This chapter presents a summary of the research literature on randomized controlled trials to reduce suicide risk, descriptions of cognitive-behavioral treatments that have demonstrated efficacy, and guidelines for implementing cognitive and behavioral interventions with suicidal individuals.
Community Reintegration Prerelease Research Exemplar: Applying Theory to Practice-Based Research
Authors: Chaiklin Harris
Published: November 2023

Practice theory explains behavior and suggests interventions to maintain or change it. This chapter will show how data from the Community Reintegration Project, a prison prerelease program, were used to explicate the intervention component in practice theory. The practice concerned helping offenders prepare for release from prison. The program was designed to identify needs, to facilitate family and other social connections, and, where appropriate, to make referrals to community resources. The aim· was not to develop new theory but to make existing theory useful for practice. Tallman (2002) says that theory and not data provides a rationale for intervention and that data are not the basis for “building a cumulative body of knowledge” (p. 228). This does not mean the data are irrelevant, but, as Merton (1957) says, the abstractions of middle-range theory “are close enough to observed data to be incorporated in propositions that permit empirical testing” (p. 39). Middle-range practice theory helps avoid what Mills (1959) called “abstracted empiricism” and the rejection of rationality in dealing with human affairs.
Water and Salt
Authors: Piantadosi Claude A
Published: November 2023

Water is critical to the ability of plants and animals to acclimatize and survive in extreme environments, whether on the seas, in deserts, or in the high mountains. Dehydration is the most important cause of death from exposure to heat and may contribute to death during other types of extreme exposures. Lack of potable water is much more rapidly dangerous to human survival than lack of food. Furthermore, the popular notion that the human body acclimatizes to water deprivation is unfounded biologically. This misconception, or some twist on it, has caused the deaths of many a hardy but poorly informed explorer.

The misunderstanding about water stems from the fact that the human body adjusts to low water intake by conserving water. Although the body curtails its loss of water and salt in the first few days of exposure to hot climates, no scientific evidence has shown that minimum daily water requirements decrease with acclimatization. A hallmark of heat adaptation is actually an increase in the rate of water loss from sweating. Indeed, the old adage about conserving water by seeking shade in the day and walking only at night in the desert has much to recommend it. Nothing on Earth substitutes for potable water, and without an adequate supply death is inevitable.
Endless Oceans of Sand
Authors: Piantadosi Claude A
Published: November 2023

Despite the tropical origin of human beings, the hot, dry deserts of the world are no place for ill-prepared adventurers. Through the centuries thousands of ill-fated explorers have underestimated the amount of water required for long desert treks. This miscalculation has led to many deaths by dehydration. Slightly more fortunate sojourners have stumbled across the hot sands for days only to find water in the nick of time or to be saved from certain death by hardy rescuers. The environment of the arid desert is indeed formidable.

The world’s largest desert, the Sahara, covers one-third of the African continent, an area the size of the United States (see Figure 8.1). Its temperatures range from 130°F during the day to 20°F at night. Rainfall averages only three to five inches and in the driest areas may be as little as one-sixteenth of an inch a year. Desertification of the Sahara has been one of the most dramatic climatic events since the end of the last Ice Age, some 10,000 years ago. As recently as 3000 B.C.E. much of the region was still arable, but the size of the Sahara continues to expand today.
On the Perceptual Reality of Synesthetic Color
Authors: Blake Randolph , Palmeri Thomas J , Marois René , Kim Chai-Youn
Published: November 2023

Synesthesia, the mental mixture of real and illusory sensory experiences, is incredibly fascinating to read or hear about but frustratingly complex to study. Those of us who are not synesthetes are spellbound by the accounts of those who are, but at the same time we are mixtures would occur. As the chapters in this volume document,investigation of synesthesia has rapidly developed into an area of great interest and debate within cognitive neuroscience, and our group at Vanderbilt University is among those seeking to understand this fascinating phenomenon.
Malaria: Killing Mosquitoes and Anophelines ( 1915-1935)
Authors: Farley John
Published: November 2023

From the start, the possibility of taking on malaria had been discussed by members of the Rockefeller Foundation. At the time, experts were divided on how best to attack the disease. Some favored campaigns against mosquito larvae; others supported the use of medications, particularly quinine, against the malarial parasite. Depending on the dosage, quinine was assumed to act either as a prophylactic to prevent further infection or as a sterilizer to remove the parasite from the blood. Additionally, houses could be screened to keep out mosquitoes. The Health Board began testing for the most effective method of attack.
Yellow Fever Vaccines: A Slap in the Face
Authors: Farley John
Published: November 2023

In 1928, with the acquisition of two small rooms in the Rockefeller Institute’s animal house in New York to serve as a yellow fever laboratory, the production of a vaccine to protect the laboratory workers became the number one priority. By 1937 the Health Division had developed such a successful vaccine that the U.S. army turned to them for assistance on the outbreak of World War IL In 1942 disquieting news began to be heard which led to what became the most embarrassing episode in Health Division history.
Northern Lights: London and Toronto
Authors: Farley John
Published: November 2023

In the 1920s, the Health Board endowed two schools of hygiene, one in London and the other in Toronto, which they regarded as model institutions, sharing with Johns Hopkins the distinction of being centers of research with the very highest standards-and so recipients of by far the most funding. At the same time, it turned its back on Rio and hospital schools of nursing, deciding instead to endow university schools of nursing, none more important than that at the University of Toronto. The Brazilian experiments were not to be repeated. Initially, both London and Toronto were seen as schools of the British empire, the former the central home and the latter serving Canada and the British Caribbean. Once the idea that schools should be opened in the poorer countries had seemingly been abandoned, London and Toronto would have seemed the logical next step where colonial nationals could be trained in first-class institutions. But such a smooth transition did not occur. European schools that had no link with the tropics predated the Health Board’s endowments of London and Toronto, although the European schools were never to attain the same status as Toronto and London. And in the end, the Health Board seemed more concerned with opening schools of hygiene in London and Toronto to serve the health needs of the British and Canadians than in creating centers of colonial training. Clearly, the Health Board’s attention was turning northward away from the problems of the tropical and colonial countries where they had started.
Adams vs. Jefferson
Authors: Ferling John
Published: November 2023

It was a contest of titans: John Adams and Thomas Jefferson, two heroes of the Revolutionary era, once intimate friends, now icy antagonists locked in a fierce battle for the future of the United States. The election of 1800 was a thunderous clash of a campaign that climaxed in a deadlock in the Electoral College and led to a crisis in which the young republic teetered on the edge of collapse. Adams vs. Jefferson is a gripping account of a true turning point in American history, a dramatic struggle between two parties with profoundly different visions of how the nation should be governed. Adams led the Federalists, conservatives who favored a strong central government, and Jefferson led the Republicans, egalitarians who felt the Federalists had betrayed the Revolution of 1776 and were backsliding toward monarchy. The campaign itself was a barroom brawl every bit as ruthless as any modern contest, with mud-slinging--Federalists called Jefferson "a howling atheist"--scare tactics, and backstabbing. The low point came when Alexander Hamilton printed a devastating attack on Adams, the head of his own party, in "fifty-four pages of unremitting vilification." The election ended in a stalemate in the Electoral College that dragged on for days and nights and through dozens of ballots. Tensions ran so high that the Republicans threatened civil war if the Federalists denied Jefferson the presidency. Finally a secret deal that changed a single vote gave Jefferson the White House. A devastated Adams left Washington before dawn on Inauguration Day, too embittered even to shake his rival's hand. Jefferson's election, John Ferling concludes, consummated the American Revolution, assuring the democratization of the United States and its true separation from Britain. With magisterial command, Ferling brings to life both the outsize personalities and the hotly contested political questions at stake. He shows not just why this moment was a milestone in U.S. history, but how strongly the issues--and the passions--of 1800 resonate with our own time.
Pulmonary Surfactant, Cell Culture, and Tissue Regeneration as Models for Understanding the Evolution of Developmental Physiology
Authors: Daniels Christopher B , orgeig sandra
Published: November 2023

Recently there have been substantial advances in our understanding of the ontogeny of the control and regulation of developmental processes in animals. It is clear that a particular system is generally composed of similar cells and tissue types and often demonstrates a similar overall structural pattern across a range of vertebrate groups. In many cases, it is the same groups of genes that control the morphology, biochemistry, and development of a structure. However, the function of these structures can differ dramatically between species. Therefore, a subset of often highly conserved genes can create spectacular phenotypic diversity. How has this functional diversity evolved, and how do evolutionary forces control the developmental processes to create the functional diversity in anatomical structures? Hence, the big question in developmental biology (especially from an evolutionary viewpoint) is: “If the genes controlling development are conserved, then how do these systems demonstrate such phenotypic diversity?”
A Physiological Approach to Heterochrony
Authors: Spicer John I
Published: November 2023

One way in which Aristotle defined comedy was as an event out of place and out of time but without danger or damage (Halliwell 2000). Though it is less humorous, the definition could also be extended to the subject of this chapter, physiological heterochrony. This is defined as altering the timing of the development of physiological traits (be they systems or components of that system) in one species relative to an ancestral species. Heterochrony is seen by many as one of the key developmental processes that couples ecology to development and development to evolution (Gould 1977; McKinney 1988; McKinney and McNamara 1991; Raff 1996; Hall 1999). That being so, it is perhaps surprising that heterochrony currently seems to have little or no role at all in the developing fields of evolutionary physiology (Garland and Carter 1994; Feder et al. 2000) and ecological physiology (Spicer and Gaston 1999), or the most recent marriage of these two disciplines to genomics, evolutionary and ecological functional genomics (Feder 2001 and chapter 11, this volume; also see .
The Nazi Medical Experiments
Authors: Weindling Paul J
Published: November 2023

Hitler’s racial state and racial war provided German doctors and their associates with the opportunity to inflict unparalleled medical atrocities. These involved not only research but also using medical knowledge and resources for a race-based program of public health and genocide. The Nazi government imposed no mandatory professional standards on the conduct of experiments— although Germany had earlier adopted such standards—and no international humanitarian or medical agency intervened to protect the victims. German physicians experimented to advance medical and racial science, and to contribute to the German war effort. They exploited bodies, used body parts and internal organs for research, and drained the blood of Jews and Slavs for use as a cell culture medium and to support transfusion. The exploitation of human beings for medical research occurred within the broader context of how the Nazis harvested hair, gold fillings, and any other usable body parts from victims of the Holocaust.
The Jewish Chronic Disease Hospital Case
Authors: Arras John D
Published: November 2023

During the summer of 1963, Chester M. Southam and Deogracias B. Custodio together injected live, cultured cancer cells into the bodies of 22 debilitated patients at the Jewish Chronic Disease Hospital ( JCDH) in Brooklyn, New York. Custodio, a Philippineborn, unlicensed medical resident at JCDH, was participating in a medical experiment designed by Southam, a distinguished physician-researcher at the Sloan-Kettering Institute for Cancer Research, an attending physician at Memorial Hospital in New York City, and associate professor of medicine at Cornell University Medical College. The purpose of the research was to determine whether the previously established immune deficiency of cancer patients was caused by their cancer or, alternatively, by their debilitated condition. Southam thus looked to a group of noncancerous but highly debilitated elderly patients who might bear out his guiding hypothesis that cancer, not old age, was the cause of the previously witnessed immune deficiency. Importantly, he believed on the basis of long experience that the injection of cultured cancer cells posed no risk to these patients, and that all of the cells would eventually be rejected by their immune systems. Although Southam’s professional credentials were impeccable, and although his work was deemed by his peers to be of the utmost scientific importance, the JCDH experiment soon erupted in a major public controversy. Critics denounced Southam’s methods as being morally comparable to those of the Nazi physicians tried at Nuremburg, whereas his defenders countered that he was a distinguished physician-researcher, and by all accounts an honorable man, who merely had the bad luck to be caught in the shifting rip tides of history.
The Tuskegee Syphilis Experiment
Authors: Jones James H
Published: November 2023

The Tuskegee Syphilis Experiment, commonly called The Tuskegee Study, was a peculiarly American tragedy, and it ultimately played a key role in creating the institutions and practices that today govern the use of human volunteers in U.S. biomedical research. From 1932 until 1972, the U.S. Public Health Service (PHS), aided and abetted by a number of partners, conducted a nontherapeutic study of the effects of untreated syphilis on more than 400 black men in Macon County, Alabama, in and around the county seat of Tuskegee. Although PHS officers and other participating physicians performed a variety of tests and medical examinations on the men over the years, the Tuskegee Study in essence was a 40-year deathwatch. Only men with advanced cases of syphilis were selected for study, and the men were left largely untreated. Instead, the Tuskegee Study’s basic procedures called for periodic blood tests and routine autopsies to supplement the information obtained through regular clinical examinations. The fact that only men with advanced syphilis were selected for the study indicated that the PHS officers were eager to learn more about the serious complications that the disease inflicts on its victims. To comprehend the magnitude of the risks to the men from denying them adequate treatment, it is useful to know a few basic facts about the disease.
HIV Research
Authors: Jr. John Y Killen
Published: November 2023

In the 26 years since its first recognition, the AIDS epidemic has had a profound impact on human history. The Joint United Nations Programme on HIV=AIDS estimates that in 2006 there were 39.5 million people worldwide living with HIV, 4.3 million became newly infected, and 2.9 million died. “In addition to the untold grief and human misery caused by AIDS, the epidemic is wiping out development gains, decreasing life expectancy, increasing child mortality, orphaning millions, setting back the situation of women and children, and threatening to undermine national security in highly-affected societies”
The Nuremberg Code
Authors: Annas George J , Grodin Michael A
Published: November 2023

The Nuremberg Code is a primary foundational document informing all ethical codes on research with humans. Many consider it the most authoritative legal and human rights code on the subject of human experimentation. Its significance cannot be appreciated without a basic knowledge of its historical origins: It is a legal and ethical code promulgated by U.S. judges at the trial of the Nazi doctors at Nuremberg after World War II.
The Council of Europe
Authors: Zilgalvis Pēteris
Published: November 2023

Founded in 1949, the Council of Europe is an intergovernmental organization with a pan-European mandate to foster political, legal, and cultural cooperation between its 46 member countries. Its Convention and the protocols that have been negotiated under its aegis form a set of legally binding treaties addressing a wide variety of topics at the international level. The Council is distinct from the 25-nation European Union (EU), although all EU member countries are also members of the Council of Europe. Its aims, as specified by its Statute, are to protect human rights and strengthen pluralist democracy, to enhance European cultural identity, and to seek solutions to the major problems of our time such as the bioethical problems addressed by the Convention on Human Rights and Biomedicine.
The European Community Directives on Data Protection and Clinical Trials
Authors: Beyleveld Deryck , Sethe Sebastian
Published: November 2023

The two legislative instruments of the European Community (EC) with the greatest impact on medical research are Directive 95=46=EC, the “Data Protection Directive,” and Directive 2001=20=EC on good clinical practice in clinical trials, the “Clinical Trials Directive” Although Directive 95=46=EC had to be implemented by October 1998, there has as yet been no case law at the EC level on its requirements in relation to medical research. The deadline for implementation of Directive 2001=20=EC was May 2004, and, again, no case law about it has yet emerged. This renders it difficult to make definitive legal statements about many aspects of these directives. Consequently, our analysis is to a degree speculative and tentative, and some of the statements we make might be controversial.
Exploitation in Clinical Research
Authors: Wertheimer Alan
Published: November 2023

Some writers on research ethics have argued that the principle “minimize exploitation” is a rationale—even the rationale—for many of the oft-mentioned principles of ethical research. The four canonical principles of bioethics (nonmaleficence, beneficence, respect for persons, and justice) do not invoke the language of exploitation, nor do some of the standard principles of research ethics, such as social value, scientific validity, fair participant selection, favorable risk-benefit ratio, and respect for human research participants. Still, it can be argued that many or all of these principles are based on a more general principle: minimize exploitation. For example, it can be argued that research that has no social value or is not scientifically valid is exploiting research participants because they are being “used” for no good end. Similar things can be said about research that involves unfair participant selection or that does not have a favorable risk-benefit ratio.
Research With Biological Samples
Authors: Wendler David
Published: November 2023

The collection and storage of human biological samples has become integral to health research. The number of stored samples, estimated to be in the hundreds of millions, if not billions, increases daily as researchers and clinicians routinely obtain samples and store them for research purposes.1 To identify an appropriate consent process for research with human biological samples, commentators have relied largely on theoretical considerations. Not surprisingly, this approach has led to divergent practices and conflicting recommendations.
Research With Ethnic and Minority Populations
Authors: Lo Bernard , Garan Nesrin
Published: November 2023

Egregious misconduct in clinical research has often centered on ethnic and minority populations. The Nazi “experiments” involved disregard for the lives of Jewish, Gypsy, and other subjects whom the Nazis considered racially inferior. The Tuskegee study was flagrantly unethical because of its lack of informed consent, its deception, and its exploitation of poor, often illiterate African Americans. The legacy of Tuskegee persists today among many African Americans, who are largely mistrustful of medical research and often unwilling to participate in clinical trials. Specifically, a number of studies show that African Americans are more likely than people from other ethnic backgrounds to believe that researchers would lie to them about research and would expose them to unnecessary risks. In addition, African Americans tend to believe that to give informed consent for research is to sign away their rights. Furthermore, African Americans view research in the context of broader concerns about racism and remain skeptical that research would provide any benefits to them as a group.
Research Involving Those at Risk for Impaired Decision-Making Capacity
Authors: Rosenstein Donald L , Miller Franklin G
Published: November 2023

Medical conditions that impair a person’s ability to make decisions (e.g., dementia, stroke, schizophrenia) are devastating for affected individuals and their families. Too often, modern medicine provides only modest symptomatic improvement for patients with these disorders. Much-needed progress in the diagnosis, treatment, and prevention of these illnesses depends on clinical advances through research. However, the conduct of research exposes these individuals to the possibility of exploitation precisely because they may not be able to make informed decisions about participation. This chapter employs a process-oriented and practical approach to the ethics of research with adults who may not be able to provide informed consent because of impaired decision-making capacity (DMC). Neither emergency research nor research with children will be addressed. The chapter is organized into the following sections: a brief history of ethical aspects of research with those who are decisionally impaired; our conceptualization of DMC as it relates to the ethics of clinical research; a review of empirical data on research subjects who have, or are at risk for, impaired DMC; policy and study design implications; and unresolved empirical issues regarding the ethics of DMC and clinical research. Throughout the chapter, we emphasize the integral relationship between research methodology (i.e., subject selection, the nature of the proposed research interventions, and specific protocol details) and the ethical analysis of a given research proposal.