Compensation for Incarcerated Research Participants: Diverse State Policies Suggest a New Research Agenda

Research with prisoners is essential to understanding the incarceration experience and creating interventions to mediate its effects on individual and community health. Policies on research involving incarcerated participants can influence the extent to which researchers are able or willing to conduct prison studies. We attempted to collect data on inmate compensation policies from all 50 states, the District of Columbia, and the Federal Bureau of Prisons. We found that 44% of these jurisdictions allow compensation for inmates who participate in research, with wide variations in terms of the clarity of and ease of access to policy information. Anecdotal data suggest considerable administrative discretion in the implementation of these policies. Further study is needed on how compensation policies are formulated and enacted and their effects on research with prisoners.MORE THAN 2 MILLION PEOPLE are currently incarcerated in the United States.¹ Behavioral and social science research with prisoners is essential to understanding the incarceration experience and creating interventions and programs to mediate its effects on people''s lives. Collecting data from incarcerated participants can provide public health researchers with key information on health risks inside and outside of prison and jail, including drug use, violence, mental illness, sexual behavior, HIV, hepatitis, and tuberculosis.However, there are several challenges involved in conducting research with incarcerated participants. For instance, policies regulating inmate participation can be difficult and time consuming to navigate. Researchers must adhere to correctional facilities'' safety and inmate control procedures and ensure that prisoners'' confidentiality, autonomy, and right to consent to research are not violated.^2–5Clearly, the potential for coercion is magnified when participants are incarcerated. Federal regulations on research involving human participants designate prisoners as a “vulnerable population” and require that special protections be afforded to them.^6,7 However, state and local interpretations of these regulations vary, and researchers and institutional review boards (IRBs) are encouraged to consider the dynamics of the local environment and context when making decisions about research protocols involving human participants.^8,9We used the issue of compensation for individuals who volunteer to participate in behavioral or social science research while incarcerated to explore variations in prison research guidelines and the accessibility and clarity of these policies. Individuals living in the community are often compensated for their time when they participate in research. Less is known about whether and in what instances incarcerated participants can be offered remuneration. As mentioned, state and local interpretations of federal research guidelines vary, resulting in a range of different prison research regulations across the United States. Moreover, these variations are magnified by differences in administrative implementation and researchers'' access to and understanding of research policies.     

A profile of the online dissemination of national influenza surveillance data

Background  

Influenza surveillance systems provide important and timely information to health service providers on trends in the circulation of influenza virus and other upper respiratory tract infections. Online dissemination of surveillance data is useful for risk communication to health care professionals, the media and the general public. We reviewed national influenza surveillance websites from around the world to describe the main features of surveillance data dissemination.     

Effect of the dietary supplement Meltdown on catecholamine secretion, markers of lipolysis, and metabolic rate in men and women: a randomized, placebo controlled, cross-over study

Background

We have recently reported that the dietary supplement Meltdown^® increases plasma norepinephrine (NE), epinephrine (EPI), glycerol, free fatty acids (FFA), and metabolic rate in men. However, in that investigation measurements ceased at 90 minutes post ingestion, with values for blood borne variables peaking at this time. It was the purpose of the present investigation to extend the time course of measurement to 6 hours, and to include women within the design to determine if sex differences to treatment exist.

Methods

Ten men (24 ± 4 yrs) and 10 women (22 ± 2 yrs) ingested Meltdown^® or a placebo, using a randomized, cross-over design with one week separating conditions. Blood samples were collected immediately before supplementation and at one hour intervals through 6 hours post ingestion. A standard meal was provided after the hour 3 collection. Samples were assayed for EPI, NE, glycerol, and FFA. Five minute breath samples were collected at each time for measurement of metabolic rate and substrate utilization. Area under the curve (AUC) was calculated. Heart rate and blood pressure were recorded at all times. Data were also analyzed using a 2 (sex) × 2 (condition) × 7 (time) repeated measures analysis of variance, with Tukey post hoc testing.

Results

No sex × condition interactions were noted for AUC for any variable (p > 0.05). Hence, AUC data are collapsed across men and women. AUC was greater for Meltdown^® compared to placebo for EPI (367 ± 58 pg·mL^-1·6 hr^-1 vs. 183 ± 27 pg·mL^-1·6 hr^-1; p = 0.01), NE (2345 ± 205 pg·mL^-1·6 hr^-1 vs. 1659 ± 184 pg·mL^-1·6 hr^-1; p = 0.02), glycerol (79 ± 8 μg·mL^-1·6 hr^-1 vs. 59 ± 6 μg·mL^-1·6 hr^-1; p = 0.03), FFA (2.46 ± 0.64 mmol·L^-1·6 hr^-1 vs. 1.57 ± 0.42 mmol·L^-1·6 hr^-1; p = 0.05), and kilocalorie expenditure (439 ± 26 kcal·6 hrs^-1 vs. 380 ± 14 kcal·6 hrs^-1; p = 0.02). No effect was noted for substrate utilization (p = 0.39). Both systolic and diastolic blood pressure (p < 0.0001; 1–16 mmHg), as well as heart rate (p = 0.01; 1–9 bpm) were higher for Meltdown^®. No sex × condition × time interactions were noted for any variable (p > 0.05).

Conclusion

Ingestion of Meltdown^® results in an increase in catecholamine secretion, lipolysis, and metabolic rate in young men and women, with a similar response for both sexes. Meltdown^® may prove to be an effective intervention strategy for fat loss, assuming individuals are normotensive and their treatment is monitored by a qualified health care professional.     

Predictors of periprocedural creatine kinase-myocardial band elevation complicating elective percutaneous coronary intervention

Limited data are available regarding the predictors of periprocedural creatine kinase-MB (CK-MB) isoenzyme increase after elective percutaneous coronary intervention (PCI) in the stenting era. We explored the predictors of periprocedural CK-MB increase in 882 consecutive patients with normal preprocedural CK-MB who underwent 919 angiographically successful elective PCIs with (n = 814) or without (n = 105) stenting. Patients were categorized into 3 groups based on their peak CK-MB levels after PCI: (1) normal CK-MB (n = 761), (2) minor CK-MB increase (CK-MB 1 to 3 times normal, n = 112), and (3) major CK-MB increase (CK-MB >3 times normal, n = 46). By logistic regression analysis, independent predictors for minor CK-MB increase included thrombus (odds ratio [OR] 5.09, p = 0.001), platelet IIb/IIIa antagonist use (OR 0.53, p <0.01), number of lesions treated (per additional lesion, OR 1.54, p <0.01), maximum balloon size (per millimeter increase, OR 1.57, p <0.05), American College of Cardiology/American Heart Association type C lesion (OR 1.68, p <0.05), sustained chest pain during procedure (OR 1.94, p <0.05), dissection (OR 2.05, p <0.05), and transient side branch occlusion (OR 4.54, p <0.05). Independent predictors for major CK-MB increase were chest pain at end of procedure (OR 9.66, p <0.001), type C lesion (OR 2.42, p <0.05), Canadian Cardiovascular Society angina class III to IV (OR 3.32, p <0.05), thrombus (OR 5.09, p = 0.001), and abrupt closure (OR 5.30, p <0.05). In conclusion, baseline clinical and angiographic characteristics and procedural complications were associated with minor and major CK-MB increases. Patients with chest pain at the end of the procedure were at the highest risk for major CK-MB increase.     

The changing landscape of interventional cardiology: A survival guide in the era of health system consolidation

Practice environments for interventional cardiologists have evolved dramatically and now include small independent practices, large cardiology groups, multispecialty groups, and large integrated health systems. Increasingly, cardiologists are employed by hospitals or health systems. Data from MedAxiom and the American College of Cardiology (ACC) demonstrate an exponential increase in the percentage of cardiologists in employed positions from 10% in 2009 to 87% in 2020. This white paper explores these profound changes, considers their impact on interventional cardiologists, and offers guidance on how interventional cardiologists can best navigate this challenging environment. Finally, the paper offers a potential model to improve the employed physician experience through greater physician involvement in decision making, which may increase jobs satisfaction.     

Parathyroid adenomas evaluated by Tl-201/Tc-99m pertechnetate subtraction scintigraphy and high-resolution ultrasonography

Thallium-201/technetium-99m pertechnetate subtraction scintigraphy of the parathyroid glands was performed in a prospective study of 33 patients who had undergone bilateral neck exploration for elevated serum calcium and serum parathyroid hormone levels. In 31 cases, the Tl-201/Tc-99m subtraction technique yielded an overall sensitivity of 81%, specificity of 99%, and accuracy of 94% for identifying solitary parathyroid adenomas. Tl-201/Tc-99m subtraction scintigraphy correctly identified 73% of parathyroid adenomas weighing less than 499 mg, 79% of those weighing 500-1,499 mg, and 100% of adenomas weighing more than 1,500 mg. In a subgroup of 24 patients with solitary parathyroid adenomas who underwent both scintigraphy and high-resolution sonography, the sensitivity, specificity, and accuracy of both procedures were similar.