BackgroundInformed consent is an ethical and legal requirement for research involving human participants. However, few studies have evaluated the process, particularly in Africa.Participants in a case control study designed to identify correlates of immune protection against tuberculosis (TB) in South Africa. This study was in turn nested in a large TB vaccine efficacy trial.The aim of the study was to evaluate the quality of consent in the case control study, and to identify factors that may influence the quality of consent.Cross-sectional (...) study conducted over a 4 month period.MethodsConsent was obtained from parents of trial participants. These parents were asked to complete a questionnaire that contained questions about the key elements of informed consent (voluntary participation, confidentiality, the main risks and benefits, etc.). The recall (success in selecting the correct answers) and understanding (correctness of interpretation of statements presented) were measured.ResultsThe majority of the 192 subjects interviewed obtained scores greater than 75% for both the recall and understanding sections. The median score for recall was 66%; interquartile range (IQR) = 55%–77% and for understanding 75% (IQR = 50%–87%). Most (79%) were aware of the risks and 64% knew that they participated voluntarily. Participants who had completed Grade 7 at school and higher were more likely (OR = 4.94; 95% CI = 1.57 – 15.55) to obtain scores greater than 75% for recall than those who did not. Participants who were consented by professional nurses who had worked for more than two years in research were also more likely (OR = 2.62; 95% CI = 1.35–5.07) to obtain such scores for recall than those who were not.ConclusionNotwithstanding the constraints in a developing country, in a population with low levels of literacy and education, the quality of informed consent found in this study could be considered as building blocks for establishing acceptable standards for public health research. Education level of respondents and experience of research staff taking the consent were associated with good quality informed consent. (shrink)

Perhaps no work which describes the American people is so comprehensive as Toqueville's Democracy in America. Bellah et. al. rely heavily upon Toqueville in Habits of the Heart in exploring how the mores of the American people have helped to shape national character. More particularly, they are interested in how Americans attempt “to preserve or create a morally coherent life” (p. 275). But unlike Toqueville for whom the issue of equality was central, Bellah and his co-authors focus their attention on (...) American individualism which “may be destroying those social integuments that Toqueville saw as moderating its more destructive potentialities” (p. viii). (shrink)

Placebo cures. Global warming. Extraterrestrial life. Psychokinesis. In a time when scientific claims can sound as strange as science fiction--and can have a profound effect on individual life or public policy--assessing the merits of a far-out, supposedly scientific idea can be as difficult as it is urgent. Into the breach between helpless gullibility and unyielding skepticism steps physicist Robert Ehrlich, with an indispensable guide to making sense of "scientific" claims. A series of case studies of some of the most controversial (...) (and for the judging public, deeply vexing) topics in the natural and social sciences, Ehrlich's book serves as a primer for evaluating the evidence for the sort of strange-sounding ideas that can shape our lives. A much-anticipated follow-up to his popular Nine Crazy Ideas in Science, this book takes up issues close to readers' everyday reality--issues such as global warming, the dangers of cholesterol, and the effectiveness of placebos--as well as questions that resonate through (and beyond) civic life: Is intelligent design a scientific alternative to evolution? Is homosexuality primarily innate? Are people getting smarter or dumber? In each case, Ehrlich shows readers how to use the tools of science to judge the accuracy of strange ideas and the trustworthiness of ubiquitous "experts." As entertaining as it is instructive, his book will make the work of living wisely a bit easier and more reliable for scientists and nonscientists alike. (shrink)

In Segmented Worlds and Self, Yi-Fu Tuan is sensitive to the fact that “the isolated, critical and self-conscious individual is a cultural artifact” whose development “is closely tied to the evolution of aworld that is progressively more complex, specialized, and segmented.” (p. 139) He argues that in the West this process of segmentation began at the end of the Middle Ages when communal forms of life started to disintegrate and gave way to more individualistic modes of experience and perception. Tuan (...) explores certain manifestations of this process, particularly how the increasing preoccupation with individuality, privacy, and interiority is mirrored in the transformation of eating habits, living arrangements, and the nature of the theatre. (shrink)

Few works of social criticism about contemporary America have elicited so much response as The Culture of Narcissism. There Christopher Lasch argued that the traditional American emphasis on individualism has degenerated into a narcissistic preoccupation with the self. He explained this transformation by pointing to the psychological consequences resulting from changes in the nature of production, consumption, and socialization. Of particular importance was the shift from handicraft to factory modes of production and the subsequent takeover of workers' knowledge by a (...) managerial elite. Rarely encouraged to be self-sufficient, today's individual is asked to rely too often on professional experts, who provide certified answers for every aspect of life — a process which unwittingly duplicates the conditions of infancy in which we are all dependent on the adult world. (shrink)