The Management of Incidental Findings in Neuro-Imaging Research: Framework and Recommendations

This paper addresses the question of how incidental findings (IFs) in clinical research should be managed by researchers, focusing in detail on IFs discovered in neuroimaging research. It begins by engaging the larger research ethics issue of whether researchers have any obligations of clinical care to participants, and assesses the content and merits of one particular framework for answering this question, Richardson and Belsky's ancillary care model. From here the paper develops an organizational structure for integrating the ancillary care model with existing research ethics standards, with the aim of better understanding their respective domains. It makes a distinction between incidental findings that are anticipated by informed consent documents, and those that are unanticipated, arguing that this distinction is critical for evaluating researcher obligations. Finally, it takes on the issue of incidental findings in neuroimaging research, translating the standards discussed into recommendations for both unanticipated and anticipated findings.     

Revisiting the Concept of the Failed State: bringing the state back in

The policy and donor communities have placed great importance on fixing ‘failed states’. World leaders have cited failed states as one of the greatest threats to the global community. Nevertheless the concept of the failed state is currently subject to a backlash from the academic community. Scholars have criticised the failed states literature on theoretical, normative, empirical and practical grounds. We provide a brief overview of these main concerns and offer a more systematic method for measuring ‘state failure’. Coming up with better ways of assessing how states underperform will enhance our understanding of how institutional decay affects stability and development and, most importantly, will provide an improved system of early warning for practitioners.     

Are Family Meals as Good for Youth as We Think They Are? A Review of the Literature on Family Meals as They Pertain to Adolescent Risk Prevention

Regular family meals have been shown to reduce adolescents’ engagement in various risk behaviors. In this article, we comprehensively examine the literature to review the association between family meals and eight adolescent risk outcomes: alcohol, tobacco, marijuana and other drugs; aggressive and/or violent behaviors; poor school performance; sexual behavior; mental health problems; and disordered eating patterns. The majority of the studies reviewed found associations in the relationship between family meals and adolescents’ risk profiles. More specifically, studies reporting significant associations found that adolescents who frequently ate meals with their family and/or parents were less likely to engage in risk behaviors when compared to peers who never or rarely ate meals with their families. Additionally, the influence of family meal frequency on youth risk outcomes appears to be dependent on gender, with family meals being a protective factor for females and males differently, depending on the outcome examined. However, the studies available about family meals and adolescent risk only examined the effect of family meal frequency, and not other components of family meals that contribute to the protective effect, and, thus, hinder the understanding of the mechanisms unique to family meals’ protective characteristics. Regardless of these limitations, the studies examined indicate that family meals may be protective and, therefore, have practical implications for parents, clinicians, and organizations looking to reduce adolescent risk behaviors. However, further examination is needed to better understand the mechanisms that contribute to the protective effect afforded by family meal frequency on adolescents.     

Evaluation and quantification of nuclear DNA from human telogen hairs

Nuclear DNA was extracted from human telogen hairs from 60 individuals. Six to nine hairs from each individual were individually extracted. The amount of DNA recovered from each individual varied greatly, and most samples yielded a quantity of 550 pg or less per hair. A selective extraction buffer was used to remove epithelial cell DNA and the amount of exogenous DNA was determined. DNA was also quantified by real time PCR using three different sized amplicons targeting an Alu sequence. The results were used to determine the state of degradation of the extracted DNA. Different quantities of sample (<100 pg, 100-500 pg, >500 pg) were amplified with the Miniplex kits to determine the minimum DNA template required for successful amplification. DNA recovered from hair showed degradation; however, partial profiles were obtained for those samples containing at least 60 pg using MiniSTRs.     

Verdict selection processes in insanity cases

Judicial instructions (traditional American Law Institute vs. Guilty But Mentally Ill [GBMI]) were manipulated within an insanity defense vignette portraying a highly psychotic defendant. Construals were highly predictive of verdicts in both instructional conditions. Instead of influencing case construals, the GBMI option seems to operate by increasing respondents' decisional thresholds for insanity and guilty verdicts, creating a collapsing effect such that few such verdicts are rendered. Between-instruction comparisons reveal that the construals of respondents who choose insane and guilty verdicts are considerably more homogeneous and extreme under the GBMI conditions. Results suggest that many respondents intend their GMBI verdicts to signify diminished blame and punishment, indicating that such verdicts entail cognitive compromises that reflect both the thresholdraising effects and also probable confusion about the jurisprudential meaning of a GBMI verdict.This article is an expanded version of a paper entitled Insanity case construals are not simply verdict justification effects, which was presented at the 99th annual convention of the American Psychological Association at San Francisco, August, 1991. We would like to thank Linda Roberts, Norman Finkel, and the anonymous reviewers for their comments on an earlier version of this paper. Support for this research was provided in part by a grant from the Baldy Center on Law and Social Policy at the State University of New York at Buffalo.     

Change in treatment has no relationship with subsequent re-offending in U.K. domestic violence sample: a preliminary study

In this study, data is presented from a sample of 52 male domestic violence offenders who were court mandated to attend a profeminist psycho-educational rehabilitation program in the West Midlands. The extent of both statistically and clinically significant psychological change achieved across a variety of measures (pro-domestic-violence attitudes, anger, locus of control, interpersonal dependency) assessed pre- and post-treatment, and their association with post-treatment re-offending within an 11-month follow-up period is examined. The results indicate that program completers achieved limited significant psychological change. However, the level of psychological change achieved had no association with re-offending.     

Acts of Childhood Sexual Abuse: An Empirically Derived Typology

A clinical sample of 165 women survivors in outpatient therapy was surveyed about whether their childhood sexual abuse (CSA) included each of 17 sexual acts. Factor analysis of these acts was conducted. A typology of CSA acts consisting of three factors emerged. Inspection of the acts loading on each factor suggested that they differed primarily in terms of the type of abuse of power implied by them rather than in the nature of the sexual behavior involved. The three factors were named Coerced Complicance (Coercion), Subjugation and Humiliation (Subjugation) and Invasive Objectification (Objectification). Implications for research, theory, and clinical practice, and the need for evaluating the generalizability of the typology to other subpopulations of survivors, are discussed.     

Homicidal ethylene glycol intoxication: a report of a case

We report a case of a 75-year-old hypertensive, diabetic man who presented to the emergency room with symptoms and signs of nausea, acute intoxication, significant alteration in mental status with rapid neurologic deterioration, and blunt impact injuries sustained during a recent altercation with a 36-year-old female companion-caretaker. He denied a history of ethanol abuse or other recent toxic ingestion and had not been diagnosed with or treated for depression. Hospital laboratory tests revealed a metabolic acidosis and a negative urine toxicology screen. He was diagnosed with toxic encephalopathy with metabolic acidosis secondary to metformin. Despite treatments including hemodialysis, he expired after approximately 28 hours of hospitalization. A postmortem anatomic examination revealed recent blunt-impact injuries and cardiac and renal pathology. A subsequent histologic examination revealed the presence of calcium oxalate crystals in the kidneys and brain, in addition to cardiac and renal pathology. Comprehensive forensic toxicologic testing was performed on antemortem and postmortem samples and revealed lethal levels of ethylene glycol. The cause of death was as a result of acute intoxication by ethylene glycol with another condition of multiple blunt impacts to the head, trunk, and extremities. The manner of death was ruled as homicide. A trial by jury, involving the female companion-caretaker, resulted in her conviction, and she was sentenced to 23 years to life in prison. In this report, we present an unusual case of homicidal ethylene glycol intoxication in which legal proceedings have occurred.     

The Return of ‘Social Europe’: Ideas and Positions of German Parties towards the Future of European Integration

Politics in Eastern Europe. By George Schöpflin. Oxford: Blackwell, 1993. £12.99 pb.

Eastern Europe since 1945. By Geoffrey Swain and Nigel Swain. Basingstoke and London: Macmillan, 1993. £10 pb.

Revolution in East‐Central Europe. The Rise and Fall of Communism and the Cold War. By David S. Mason. Boulder, San Francisco and Oxford: Westview Press, 1992. £9.50 pb.

Surge to Freedom: The End of Communist Rule in Eastern Europe. By J.F. Brown. Twickenham: Adamantine Press, 1991. £18.40 pb.

The New Democracies in Eastern Europe. Party Systems and Political Cleavages. Edited by Sten Berglund and Jan Åke Dellenbrant. Aldershot: Edward Elgar, 1991. £39.95 hb.

Developments in Eastern European Politics. Edited by Stephen White, Judy Batt and Paul G. Lewis. Basingstoke and London: Macmillan, 1993. £11.99 pb.