Race and Ethnicity in Medical Research: Requirements Meet Reality

Race and ethnicity are commonly reported variables in biomedical research, but how they were determined is often not described and the rationale for analyzing them is often not provided. JAMA improved the reporting of these factors by implementing a policy and procedure. However, still lacking are careful consideration of what is actually being measured when race/ethnicity is described, consistent terminology, hypothesis-driven justification for analyzing race/ethnicity, and a consistent and generalizable measurement of socioeconomic status. Furthermore, some studies continue to use race/ethnicity as a proxy for genetics. Research into appropriate measures of race/ethnicity and socioeconomic factors, as well as education of researchers regarding issues of race/ethnicity, is necessary to clarify the meaning of race/ethnicity in the biomedical literature.     

The United States Supreme Court and the death penalty: The struggle for fairness

In the ten years sinceFurman v. Georgia, the United States has recognized the right of states to adopt and follow different capital sentencing schemes so long as they protect the defendant from arbitrary and capricious imposing of the death sentence. The sentence may not be disproportionate to the crime. Sentencing may be done by a judge or jury. Prospective jurors may not be challenged for cause merely because their deliberations would be affected because a death penalty was possible, but only if they could not fulfill their oath. Habeas corpus petitions in capital cases are not open invitations to avoid finality of judgment and execution of the sentence, but are to find constitutional errors.     

" 'These Boots Are Made for Walking' ": A Reply

Erik Craft's comment on our 2000 article takes up a minor point,the impact of no-fault divorce on the gender of the spouse filingfor divorce. In the original article, we related the genderof the filing to rent exploitation during marriage, rent appropriationthrough divorce, and particularly child custody. We tested thehypotheses we generated using a sample of more than 46,000 divorcedecrees from the only four states collecting all the informationwe needed. The type of divorce ground was only a control variable,and not a strong one. We argue that Craft's comment misses ouressential point.     

Women's agency in Australia's first fertility transition: a debate revisited

The place of women's agency in the fertility transition of the late nineteenth/early twentieth century is a contested one. Some argue that the transition was achieved mainly through male methods of contraception. Others, including many arguing from an Australian perspective, contend that women's agency in fertility decline was significant. In this article, the authors revisit the issue of women's agency in Australia. Drawing on a range of archival sources and scholarship, they seek to demonstrate that women in Australia in the last quarter of the nineteenth century had access to contraception, albeit limited, and, where that failed, to abortion. The authors argue that the changing political and educational climate, which saw women gaining the vote in 1894 in South Australia and admission to secondary and higher education and paid work, provided the setting for women's changing status. Their increasing agency – an agency many women worked to secure – encouraged women to challenge many traditional practices.     

Fatal Fentanyl Patch Misuse in a Hospitalized Patient with a Postmortem Increase in Fentanyl Blood Concentration

Opioid‐related mortality happens, even in healthcare settings. We describe serial postmortem fentanyl blood concentrations in a hospital inpatient who fatally abused transdermal fentanyl. This is a single‐patient case report. A 42‐year‐old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. During the resuscitation attempt, a small square‐shaped film was removed from the patient's oropharynx. Femoral blood was collected 0.5 and 2 h postmortem, and the measured fentanyl concentration increased from 1.6 to 14 ng/mL. Study limitations include potential laboratory or collection errors and missing data. (i) Providers must be vigilant for signs of fentanyl patch abuse. (ii) Postmortem blood concentrations are not static postmortem, likely secondary to decreasing pH, increased aqueous solubility, and tissue redistribution, and are therefore unlikely to accurately represent antemortem blood concentrations.     

Supporting Accountability in the Field of Mediation

Over time, many fields of work - law, medicine, and teaching - matured from informal bodies of knowledge and skills, passed from one practitioner to another, into professions. In the process each began enumerating and affirming their intellectual and practical roots. Each also began testing practitioners to insure comprehension of relevant knowledge and an ability to demonstrate relevant skills. Family mediators in Canada have moved in this direction. In the United States, people who mediate interpersonal disputes also feel pressured to take additional steps to assure the quality of our work. This article summarizes what mediation organizations in the United States have done and could do to vouch for work in our field. But, taking additional steps calls for a clearer understanding of what a mediator should know and what they are expected to do. These two critical pieces of information remain nebulous. So, this article goes beyond describing ways of insuring accountability by also describing a recently completed job analysis, a tool frequently used in other fields of work to describe the skills and knowledge relevant to a particular job.