Functional Neuroimaging of Symptom Validity Testing in Traumatic Brain Injury

The Word Memory Test (WMT) is a commonly used symptom validity test (SVT) that assesses recognition verbal memory. The task has been adapted for use within a functional magnetic resonance imaging (fMRI) paradigm so the neural correlates of WMT activation patterns can be studied. In the current investigation, performance on the delayed recognition subtest of the WMT was examined in two patients who sustained severe TBI and compared to ten healthy controls. The patients underwent comprehensive neuropsychological evaluations and structural MRI. All participants completed two versions of the WMT: full-effort and simulated poor effort conditions. Despite extensive structural brain damage, the fMRI activation patterns during full-effort WMT performance were somewhat similar in the two TBI patients and likewise, somewhat similar to controls. The fMRI activation pattern in both patients demonstrated intact activation of the basic neural structures necessary to perform the WMT. Dissimilar patterns of activation were obtained during the simulated poor effort condition of WMT performance suggesting that fMRI techniques may be sensitive in demonstrating non-credible cognitive performance. The results of our study represent the first fMRI investigation of normal and simulated poor effort SVT performance in individuals with documented brain damage. The implications of fMRI techniques in SVT research and their clinical application are discussed.     

Legislating for Your Own Good: Criminalising Moral Choice. The Modern Echoes of the Victorian Vaccination Acts

Victorian vaccination legislation has important echoes for the present age in the dilemma over how to promote compliance with government-endorsed scientific and medical public health strategies for the welfare of the community in a context of growing popular mistrust of such initiatives, in terms of their likelihood to confer benefits as well as their possible negative impacts on individuals. Victorian experience of dealing with the issue of ‘conscientious objection’ to policy initiatives seen as intruding into the area of individual moral choice, especially parental choice for children, is invoked to suggest better ways of comprehending the present resistance to take-up of the MMR vaccine, and its wider implications; as well as commenting on the role of the media.

State-Local Relations in Policy Implementation: The Case of Highway Transportation in Iowa

This article examines relationships between state agencies andlocal communities, using survey and interview data from a casestudy of the Iowa Department of Transportation. It argues thatthese relationships often parallel the agency-clientele relationshipsobserved by public administration scholars. The agency derivessimilar benefits from local government support as from privateclientele support, namely, an independent power base that helpsto preserve its flow of resources and its administrative autonomy.IDOT possesses formidable political resources in the breadthand intensity of its clientele, but the key to IDOT's successis the skillful utilization of those resources through an administrativestrategy stressing the development of widely accepted technicaldecision-criteria and an administrative style emphasizing accessibility,responsiveness, and flexibility. A survey of mayors and localbusiness leaders shows that this strategy has generated widespreadpositive perceptions of the department among these clientelegroups.     

The tools to understand: community as co-researcher on culture-specific protective factors for Alaska Natives

A collaborative research process engaging Alaska Native communities in the study of protective factors in Alaska Native sobriety and the design of a preventative intervention using its findings is described. Study 1 was discovery oriented qualitative research whose objectives were identification of protective factors and development of a heuristic model. Study 2 involved quantitative survey methods to develop and test ameasure of protective factors identified by the qualitative study. Empirical data from these studies is presented, and the role of Alaska Native co-researchers who did not possess specialist research training is described in the design and implementation of the study, interpretation of findings, and design of the intervention model and tools. Benefits that emerged from co-researcher involvement in this process, to the community and to the co-researchers themselves, are described.