Aligning Ethics with Medical Decision-Making: The Quest for Informed Patient Choice

Clinical evidence suggests that many patients undergo surgery that they would decline if fully informed. Failure to communicate the relevant risks, benefits, and alternatives of a procedure violates medical ethics and wastes medical resources. Integrating shared decision-making, a method of communication between provider and patient, into medical decisions can satisfy physicians' ethical obligations and reduce unwanted procedures. This article proposes a three-step process for implementing a nationwide practice of shared decision-making: (1) create model integration programs; (2) provide legal incentives to ease the transition; and (3) incorporate shared decision-making into medical necessity determinations.     

A study on the false positive rate of Stegdetect

In this paper we analyse Stegdetect, one of the well-known image steganalysis tools, to study its false positive rate. In doing so, we process more than 40,000 images randomly downloaded from the Internet using Google images, together with 25,000 images from the ASIRRA (Animal Species Image Recognition for Restricting Access) public corpus. The aim of this study is to help digital forensic analysts, aiming to study a large number of image files during an investigation, to better understand the capabilities and the limitations of steganalysis tools like Stegdetect. The results obtained show that the rate of false positives generated by Stegdetect depends highly on the chosen sensitivity value, and it is generally quite high. This should support the forensic expert to have better interpretation in their results, and taking the false positive rates into consideration. Additionally, we have provided a detailed statistical analysis for the obtained results to study the difference in detection between selected groups, close groups and different groups of images. This method can be applied to any steganalysis tool, which gives the analyst a better understanding of the detection results, especially when he has no prior information about the false positive rate of the tool.     

Retrospective ideological representation and its impact on democratic satisfaction*

Congruence between government policies and citizen preferences is a key element that increases the quality of democracy. While scholars have shown that governments generally adopt ideological positions and propose policies close to citizen preferences, they have neglected to consider whether citizens respond to promises or to actual enactments. The paper addresses this gap in two ways. First, we propose a new measure that captures how close a citizen is on average to the policies enacted by the incumbent government, namely retrospective ideological representation – the ideological distance between the position of a respondent and the incumbent government at the end of its term in office. We show that this measure captures retrospective information associated with governments’ actions and in particular whether the government increases or decreases social spending during its mandate period. Second, we show that retrospective ideological representation has a substantial impact on citizens’ democratic satisfaction and greater than prospective ideological representation – an established measure of congruence – which is the ideological distance between the positions of a respondent and the elected government after an election.     

Pathways from Childhood Adversity to Problem Behaviors in Young Adulthood: The Mediating Role of Adolescents’ Future Expectations

Adverse childhood experiences and pessimistic future expectations about college attendance or mortality are established risk factors for problem behaviors among youth. Data were from the National Longitudinal Study of Adolescent to Adult Health (N?=?14,800; 49?% female). Participants were 11–17-years-old at baseline and 24–32-years-old at outcome. Adolescents’ college expectations and fatalistic expectations mediated the effect of childhood adversity on violent behavior in young adulthood. Neither college nor fatalistic expectations were significant mediators in models predicting substance use and nonviolent antisocial behaviors. Although observed mediational effect sizes were small, they survived models that included multiple controls designed to rule-out alternative explanations. Intervening on adversity-exposed adolescents’ college and fatalistic expectations may reduce risk for violent behaviors.     

Americans’ Knowledge of Their Local Judges

What do Americans know about their local judges and how do they know it? One of the central arguments in the debate over judicial elections is whether voters know enough about judicial candidates to make an informed democratic choice. The vast majority of criminal and civil matters in the U.S. begin with and filter through the local state courts. But judicial scholars know little about what explains the variance in voters’ knowledge of their courts and judges. This paper draws on survey data from the 2012 Cooperative Congressional Election Study to investigate the origins of voter knowledge of local judges. A central finding of this study is that rural voters are a lot more knowledgeable about their local judges than are urban voters, ceteris paribus. This finding has significant consequences for the debate over the ways in which states structure their elections for local judges.     

Introduction to queer circuits: Critical performance and digital praxis

This introduction situates the articles making up this special issue within four thematic clouds, positing queer theorization as broadly relevant for critically engaging with computational technologies and culture. These sub-themes offer suggestions for future queer inquiry and praxis and reflect key terms in performance studies and queer theory that have undergone transformation with the ubiquity of digital technology.