Mass screening in low-income populations: the challenges of securing diagnostic and treatment services in a national cancer screening program

Funding for many mass screening programs for low-income and uninsured populations provides resources for screening tests, yet only rarely does it provide coverage for necessary follow-up diagnostic and treatment services. The National Breast and Cervical Cancer Early Detection Program (NBCCEDP), a federally funded initiative that provides cancer screening to low-income uninsured and underinsured women, covers some diagnostic follow-up tests and no treatment services. We conducted in-depth case studies of seven state programs participating in the NBCCEDP to investigate the strategies and approaches being used to secure diagnostic and treatment services. The results suggest that the program relies on a patchwork of resources--at state and local levels--to provide diagnostic and treatment services. This includes a number of components of local safety nets, all of which are unstable and have uncertain futures. Public health disease-screening initiatives need to reconsider the feasibility of continued reliance on case-by-case appeals to the local safety net for diagnostic follow-up and treatment services.     

The co-offender as counterfactual: a quasi-experimental within-partnership approach to the examination of the relationship between race and arrest

Journal of Experimental Criminology - Estimate the relationship between race and arrest within co-offending partnerships using a quasi-experimental framework. More specifically, this study argues...     

Fatal acute intracranial injury, subdural hematoma, and retinal hemorrhages caused by stairway fall

We describe an infant with an acute subdural hematoma, a fatal head injury, and severe hemorrhagic retinopathy caused by a stairway fall. His cerebral and ocular findings are considered diagnostic of abusive head trauma by many authors. Our literature search of serious injuries or fatalities from stairway or low-height falls involving young children yielded 19 articles of primary data. These articles are discrepant, making the classification of a young child's death following a reported short fall problematic. This case report contradicts the prevalent belief of many physicians dealing with suspected child abuse that low-height falls by young children are without exception benign occurrences and cannot cause fatal intracranial injuries and severe retinal hemorrhages. The irreparable harm to a caregiver facing an erroneous allegation of child abuse requires physicians to thoroughly investigate and correctly classify pediatric accidental head injuries.     

Images of illness: how causal claims and racial associations influence public preferences toward diabetes research spending

Despite the salience of health disparities in media and policy discourse, little previous research has investigated if imagery associating an illness with a certain racial group influences public perceptions. This study evaluated the influence of the media's presentation of the causes of type 2 diabetes and its implicit racial associations on attitudes toward people with diabetes and preferences toward research spending. Survey participants who viewed an article on genetic causation or social determinants of diabetes were more likely to support increased government spending on research than those viewing an article with no causal language, while participants viewing an article on behavioral choices were more likely to attribute negative stereotypes to people with diabetes. Participants who viewed a photo of a black woman accompanying the article were less likely to endorse negative stereotypes than those viewing a photo of a white woman, but those who viewed a photo of a glucose-testing device expressed the lowest negative stereotypes. The effect of social determinants language was significantly different for blacks and whites, lowering stereotypes only among blacks. Emphasizing the behavioral causes of diabetes, as is common in media coverage, may perpetuate negative stereotypes. While drawing attention to the social determinants that shape these behaviors could mitigate stereotypes, this strategy is unlikely to influence the public uniformly.     

Rights of Self-delimiting Peoples: Protecting Those Who Want No Part of Us

While in recent years new charters and government actions have boosted the collective and individual rights enjoyed by “Fourth-World” indigenous peoples such as the Inuit, another set of indigenous peoples has not experienced such protection: “self-delimiting” peoples. Their rights go largely unprotected because of deliberate ambiguities in the word “indigenous”; because these peoples generally avoid all contact with the larger society, and so are unknown by it and have no voice in it; and because charters and institutions generally require validation of an indigenous people as bona fide—such as a history of contact and of evident land occupation—in order for the group to enjoy full rights protections. Both practice and theory may militate against the extension of full protection. This paper argues that theory, institutions building upon it, and practice realizable from theory and institutions must be reconsidered in terms of the particular circumstances and needs of these peoples if their rights are to be fully respected and maintained. Clear, special protection for these peoples’ rights to their culture must be established.     

Are Peripapillary Intrascleral Hemorrhages Pathognomonic for Abusive Head Trauma?*

Abstract: The American Academy of Pediatrics’ Committee on Child Abuse and Neglect, Section on Ophthalmology, acknowledges that searching for retinal hemorrhages (RHs) in infants only in cases of suspected of abuse creates selection bias. However, they also recommend that postmortem eye removal might not be indicated “in children who have clearly died from witnessed severe accidental head trauma or otherwise readily diagnosed systemic medical conditions.” Although infrequently described in the child abuse literature, peripapillary intrascleral hemorrhages (bleeding in the sclera at the optic nerve insertion)—putatively from severe repetitive acceleration/deceleration forces with or without blunt head trauma—have been considered essentially pathognomonic for abusive head trauma (shaken baby syndrome). We present two neonates who sustained accidental, severe in utero head injuries and had associated extensive RHs and optic nerve sheath hemorrhages with peripapillary intrascleral hemorrhages detected at autopsy. Neither neonate had a documented clinical fundal examination in the intensive care unit.     

The role of personnel migration in the introduction of innovations

The study examined the extent of transfer of aerospace management techniques that accompanied the movement of personnel. Sixty individuals who were formerly employed in aerospace were questioned regarding the management techniques they had introduced into their current workplace. In some instances, the information given by the respondent was validated by nonaerospace colleagues. The results clearly demonstrated that the movement of personnel may act as a mechanism for transfer. For all respondents, the mean number of techniques introduced was greater than five. In 13 cases, 100 per cent of the aerospace management techniques currently used were introduced by the respondent; in 15 cases, at least 50 per cent currently in use were introduced by the respondent. The process of introduction was also examined. The managers reported using several steps to encourage transfer including familiarization with the environment, introduction of new goals, adaptation of the technique, persuasion, coercion, and the hiring of co-workers with similar attitudes. The results also indicated that successful innovators were self-confident, had a detailed knowledge of the innovation, were convinced of its value, and were frequently in positions of authority. Finally, results indicated that the introduction was more likely to be adopted in smaller and/or newer institutions, where “discipline” and a team concept existed in management, and when superiors were supportive. Recommendations were made for future research.     

Is Species Integrity a Human Right? A Rights Issue Emerging from Individual Liberties with New Technologies

Currently, some philosophers and technicians propose to change the fundamental constitution of Homo sapiens, as by significantly altering the genome, implanting microchips in the brain, and pursuing related techniques. Among these proposals are aspirations to guide humanity’s evolution into new species. Some philosophers have countered that such species alteration is unethical and have proposed international policies to protect species integrity; yet, it remains unclear on what basis such right to species integrity would rest. An answer may come from an unexpected angle of rights issues: Some cultures have indicated that they want no part of our technological culture, preferring to retain their practices. Yet, rights documents do not explicitly establish that any individual has a right to species integrity. Careful interpretation of rights documents nonetheless reveals that such a right to species integrity is implicit. Interpreting these so as to reveal this needed right is also necessary to retain the foundations of rights documents and institutions. Further, acknowledging a right of species integrity could mean, because of practicalities, a limit to the freedom of proponents to implement proposals to manipulate the species.     

Stereotypical Hate Crimes and Criminal Justice Processing: A Multi-Dataset Comparison of Bias Crime Arrest Patterns by Offender and Victim Race

Many hate crimes are not reported and even fewer hate crimes result in an arrest. This study investigates patterns of victim reporting and arrest for hate crimes in two parts. First, using data from the National Crime Victimization Survey, we find that, controlling for offense severity, hate crimes are less likely than non-bias crimes to be reported to the police and that the police are less likely to take further action for hate crimes, compared to non-hate crimes. Second, we use data from the Pennsylvania Human Relations Commission and the National Incident-Based Reporting System to compare differences between types of hate crimes in the likelihood of crime clearance. We find that those hate crimes most likely to result in arrest are those that fit the profile of a “stereotypical” hate crime: violent incidents, incidents committed by hate groups, and incidents involving white offenders and black victims.