ONCE BITTEN TWICE SHY ''. (Chat échaudé craint l'eau froide). Chorégraphe: Lorna Cairns (Scotland) Novembre Danse en ligne: 32 Temps – 4 Murs. Once Bitten Twice Shy. 32 Count, 4 Wall, Improver. Choreographer: Lorna Cairns (UK) Nov Choreographed to: Gone Gone Gone by Robert Mizzell. PDF | On Dec 24, , J Marshall and others published Once bitten, twice shy.
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Free download of Once Bitten, Twice Shy by Linda Louise Rigsbee. Available in PDF, ePub and Kindle. Read, write reviews and more. PDF version of Once Bitten, Twice Shy by Linda Louise Rigsbee. Book One in the series, An Ozark dairy goat farm is an unlikely meeting place for a wealthy. “Once Bitten, Twice Shy”: Participant Perspectives in the Aftermath of an Early HIV Vaccine Trial Termination P.A. Newman*,a, S. Yima, A. Daleyb, R. Walissera, .
An example will emphasize the importance of implementation. Typically, a range of situational security measures targeted at preventing repeats by the same modus operandi were most efec- tive.
In contrast, education and advice do not necessarily trigger a strong preventive mechanism either if nothing substantive is implemented or if the measures conceived are weak and unlikely to have much efect.
However, it is important to note that, where there was no reduction in repeats, this does not repre- sent falsiication of the theory of preventing repeat victimization. Even where a pro- ject does not reduce crime, this does not invalidate the theory if the project had poor tactics or implementation.
Discussion and Conclusions here has been signiicant success to date in preventing repeat victimization. Gen- erally, the most successful eforts used appropriate situational crime-prevention measures that were comprehensively implemented.
When little or no crime was prevented, this was for two reasons. First, some prevention tactics were weak or inappropriate. Well-meaning advice and education will not prevent crime—unless it results in implementation of a strong prevention tactic—any more than sticky tape around a damaged door will prevent repeat burglary.
Second, a failure to ade- quately implement preventive tactics means nothing is in place to prevent further crime. While repeat victimization can be prevented, for the full potential of this crime-prevention strategy to be achieved, there needs to be signif- icant additional investment in research and development.
Problem-solving and action-research approaches that develop strong prevention tactics based on analysis of the crime problem should be developed. Figure It could be argued that policy is causing crime by failing to develop this area of crime-prevention strategy. Research on preventing repeat victimization should include greater eforts to prevent near repeats of various sorts. Hence, we conclude that further development of research and policy in this area would be to the signiicant beneit of society.
In addition, Wellsmith and Birks is the only study, to our knowledge, evaluating the prevention of near-repeat burglary, and they tentatively indicated some success. Related areas of crime concentration from hot products to hot spots are not included, though we suspect the time will come when such areas are more integrated.
Without doubling each s. Additional studies evaluating advice to victims of family violence and elder abuse have been conducted by Robert Davis and colleagues e. And while more work is needed to integrate that body of work, if its results seem less promising, we suspect this may be a result of what is assessed here as low implementation rates and weak crime-prevention mechanisms, particularly when prevention relies on education and advice rather than tactics with stronger situational mechanisms.
We recognize the need for further work and inter-rater reliability tests to conirm this preliminary typology of problems.
Crime Detection and Prevention Series Paper Bennett, Trevor, and Linda Durie. Police Research Series, Paper Bernasco, Wim. Bowers, Kate. Bowers, Kate J. A Test of the Boost Explanation. London: Home Oice. Breitenbecher, Kimberley Hanson, and Christine Gidycz. Queensland: Criminal Justice Commission. In Repeat Victimization. Cummings, Rick. Davis, Robert. National Institute of Justice, Research in Brief.
Unpublished report to the US Department of Justice. Farrell, Graham, and Ken Pease.
Welsh and David P. Dordrecht: Springer Press. Crime Prevention Unit Paper Gidycz, Christine A. Rich, Nichole L. Gregson, Mick. Nottingham, UK: York House. Grove, Louise E. Farrington, and Shane Johnson. Systematic Review of Preventing Repeat Victimization.
Hanson, Kimberley, and Christine Gidycz. Hindelang, Michael J. Gottfredson, and James Garafalo. Cambridge, MA: Ballinger. Laycock, Gloria. Lindstrom, Peter.
Marx, Brian P. Calhoun, Amy E. Wilson, and Lori A.
New York: Criminal Justice Press. Results showed that participants whose broker had failed regretted their decision and reported a lower intention to select the same broker again, even if she still had the best success rate.
Choice switching: experienced vs. The first one is a simple process, consisting in remembering that a particular option yielded a poor result in the past, thus avoiding it when faced with the same choice again direct effect of experienced regret, henceforth direct effect. According to the alternative explanation, the effect of experienced regret on subsequent choices is mediated by anticipated regret: A recent experience of regret could prime the anticipation of regret in the following choices, leading to increased regret aversion indirect effect of experienced regret mediated by anticipated regret, henceforth indirect effect.
The finding that the same neural circuitry mediates the experience of regret and its anticipation, emerged in brain imaging studies Coricelli et al. The current studies On the basis of the aforementioned considerations, the present studies were aimed at i providing further evidence of a non-adaptive choice switching behavior using real choices Study 1 , and at ii trying to shed light in the process that underpin this bias, by using a task in which the two hypothesized mechanisms direct effect vs.
Specifically, a first choice was followed by feedback about the respective outcomes of the chosen and non-chosen alternatives. The aim was to induce either regret i. Unlike previous studies on experienced regret, this experimental design made it possible to disentangle the specific effect of regret from a more general effect caused by disappointment for the negative outcome.
It was hypothesized that, if regret influences subsequent decisions, participants who receive the regret feedback should switch from a good decision to a non-optimal one in a subsequent choice, as opposed to participants receiving the disappointment feedback.
Participants were tested individually and were advised about the data retained and that anonymity was fully ensured, no sensitive data were collected. Procedure Participants played two rounds of a simplified computer-version of Blackjack against the computer-played dealer. To increase overall motivation and involvement in the game, each round had a 5-Euro prize.
Before beginning the first round, participants received instructions on Blackjack rules. We assumed that participants would have recognized that stopping was the optimal decision after having achieved the score of I was dumbfounded.
This is my first blood test and I just hope it comes out negative. But now I just feel like a sick person 35 y. Page 8 Two volunteers who had dropped out of the trial were among those who contacted research staff of the present study and were interviewed. After completion the interviewer provided contact information and urged them to follow up with the research clinic for their own NIH-PA Author Manuscript safety.
These volunteers indicated complete surprise upon hearing about the results: That information was never passed on to me. It was my understanding that Thus different perspectives emerged between participants and key informants regarding the nature of communication in the process of early termination and unblinding. Post-trial follow-up and support: Four participants described being left for long periods of time without contact from investigators.
After the initial roll-out of results, a participant reported that follow-up subsided: Did a lot of these people in this clinical trial actually contract HIV while they were doing the trial and what percentage? What's their life like now, are they being compensated or anything? Trial participants and key informants both discussed counseling for volunteers, beyond the traditional risk reduction counseling conducted in HIV prevention trials. A participant explained: A key informant also explained broader challenges and disappointment regarding post-trial dissemination of information in HIV vaccine and other biomedical prevention trials: Page 9 The information has not been in favor of big pharma or small pharma coming up with solutions…because of the trials not having the kind of outcomes that are appropriate to continue with.
Research is research. However the unforeseen termination of the study led four participants to specifically express mistrust of clinical trials: The pharmaceutical company, I think that they in many ways tied the hands of the researchers. NIH-PA Author Manuscript Another participant indicated fear, even after unblinding, that he may have actually received the test vaccine: Page 10 3. Willingness to participate: I am more aware of what can happen in a trial and the risks of it. It happened unfortunately to a lot of people who are going to have to deal with that n.
A participant articulated his complex feelings and ambivalence, reflecting the widespread NIH-PA Author Manuscript motivations based on altruism in conflict with fears for personal health and safety: I feel very conflicted now more so than when I started in the trial because I still rationally believe that these trials are important and I understand that they need to happen.
Alternately, 9 participants described ongoing motivations to participate in HIV vaccine trials based on altruism, the memory of a friend and a desire for new HIV prevention technologies. When asked whether they would consider volunteering for a future HIV vaccine trial or not, these participants responded: Participants also accurately articulated the need to include the results of the Step Study in future trial consent processes: Key informants described reservations about future HIV vaccine trials as well, and their increased scrutiny of experimental vaccines: Page 11 4.
Discussion This mixed methods investigation examined in depth the experiences and perspectives of NIH-PA Author Manuscript volunteers, largely gay men, at one site of the Step Study Phase 2b HIV-1 vaccine trial upon the early termination of the trial. The experimental vaccine was not efficacious and a subgroup of test vaccine recipients were unexpectedly placed at increased susceptibility to HIV infection [7,9]. The most striking disparity was simultaneously what participants identified as the most troublesome aspect of their trial experience: Over half of participants interviewed went so far as to retroactively doubt the NIH-PA Author Manuscript integrity of the informed consent process given the unexpected adverse effects of the test vaccine; however, many expressed acceptance of the fact that a clinical trial involves inherent uncertainties and reported that they had understood the possible risks of participation.
Nevertheless, participants questioned and were upset by perceived delays and gaps in communication, particularly in waiting for the trial to be unblinded and in first hearing about the results from the media rather than from investigators. Furthermore, what may constitute quick, efficient and transparent communication and decision-making in the complex world of clinical trials, among trial sponsors, data safety monitoring boards and investigators, may seem like protracted periods of uncertainty among participants.
As participants may continue to engage in similar risk behaviors to those that initially made them eligible for the trial, they may understandably harbor reality-based fears that the test vaccine rendered their even unchanged level of risk behaviors more dangerous. The fact that the present sociobehavioral study succeeded in recruiting two participants who had NIH-PA Author Manuscript previously dropped out of the trial and was the initial conduit for informing them of the overall trial results suggests that relatively low-cost community outreach efforts may help to mitigate loss to follow-up and enhance communication of results.
However, increasing integration of social science research, including both qualitative and quantitative methods, as an ongoing component of HIV vaccine trials may generate 1Note: A follow-up observational study HVTN  that was implemented to monitor Step Study volunteers suggests that enhanced susceptibility to HIV infection due to adenovirus AD5 immunity may have waned over time, but uncircumcised men who have sex with men who received the experimental vaccine continue to show increased risk .
Page 12 evidence to improve our ability to successfully explain challenging concepts to trial participants. Facilitating increased volunteer comprehension of concepts such as random assignment and investigational vaccines may help to mitigate therapeutic misconception and NIH-PA Author Manuscript undue expectations of the success of investigational products [11,14,24,25].
Nevertheless, this also raises questions as to how much detail researchers should include in the informed consent process. Limitations to this study include the small sample of participants from one Canadian site of a larger international HIV vaccine trial. Additionally, the subgroup that participated in post- trial interviews may not be representative of the larger trial population; and in adhering to NIH-PA Author Manuscript strict confidentiality guidelines we were unable to match baseline survey data with post-trial interviews.
It is possible that participants in the post-trial interviews may differ from those who did not participate: However, the variety of nuanced perspectives expressed, neither unilaterally critical nor supportive, suggests we were successful in recruiting participants with a range of perspectives and opinions.
Future social science investigations in the context of large-scale HIV prevention trials are needed to assess the generalizability of the present findings.
Implications This investigation has several implications for interventions to enhance participant experiences as well as for recruitment and retention in future HIV vaccine trials: Overall, this study suggests that we might conceptualize the interim data analysis that is routinely conducted in clinical trials as an opportunity to assess psychosocial and behavioral indices e.
Similarly, trial endpoints might be consistently structured to comprise psychosocial measures in addition to risk behavior assessment , including evaluations by participants of the conduct i. Page 13 of clinical trials [27,28]. Extensive human and financial resources will be needed to support HIV vaccine and other biomedical HIV prevention trials for the foreseeable future.
Systematic implementation of integrated i. Incorporating social science research in HIV vaccine trials also may help us to prepare for the monumental challenges of future HIV vaccine dissemination [34,35].
We gratefully acknowledge all participants for sharing their experiences and for their contribution to HIV vaccine development, and all staff at the Maple Leaf Medical Clinic. We also thank Dr. Mike Robertson and Merck, the trial sponsor, for allowing us to conduct this study and for reviewing the manuscript.
References 1. N Engl J Med. Michael, N. RV Update: Abstract Presented February 18, ; http: Barouch DH. Challenges in the development of an HIV-1 vaccine. Dolin R. HIV vaccine trial results--an opening for further research. Reasons for declining to enroll in an HIV vaccine trial. Newman PA. Social and behavioral challenges of HIV vaccines: A double-blind, randomised, placebo- controlled, test-of-concept trial.
News release. Available at: STEP Study volunteers to be informed whether they received vaccine or placebo. Post-step modification for research on HIV vaccines.
HIV vaccine trial participation among ethnic minority communities.