MI Implementation in Juvenile Justice: A Case Report

Motivational interviewing (MI) is a communication style focused on enhancing clients’ own motivation towards change. In the justice system MI has evidence to support that it enhances communication and change behaviors in youth. As most MI training is designed for healthcare settings training and implementation of MI must be adapted to fit the juvenile justice model. This includes both rehabilitation and restorative justice. Here we describe the details that allowed one county small county in Pennsylvania to roll out MI training and initial skills review in less than 6 months. The case reviews the details of planning, trainings, and timing of activities. We then discuss what elements of those details fit into a greater implementation plan that may be applied elsewhere. Four key elements were instrumental to implementation: 1) appreciation of JPO time constraints, 2) cost containment 3) using blending to enhance JPO flexibility with MI use, and 4) policies that normalize use of MI. This outline may assist other courts in their own implementation efforts.     

Lawmaking and sentencing in rape and child sexual abuse cases in Poland – dead end or rational criminal policy?

Criminal Law Forum - Sexual offences have assumed crucial importance in Polish criminal policy in recent years. Several statutes have been enacted with a view to implementing a more appropriate...     

Factors Associated with Physician Discussion of Health Behaviors with Adolescents

Behaviors developed in adolescence influence health later in life. The purpose of this study was to investigate the frequency of health care provider's discussion of health behaviors with overweight and non-overweight adolescents and identify demographic and health behaviors related to exercise, hours of television viewing, and weight issues associated with these discussions. A Cross sectional survey of urban adolescents was conducted. Trained interviewers administered surveys over a three month period in 2001 at an urban academic pediatric and adolescent clinic. The 252 adolescents surveyed had a mean age of 15 with 49% categorized as being at risk for overweight/overweight and 51% as normal weight using the CDC percentiles for BMI. While 16% of the adolescents reported that their physician or nurse discussed the amount of television they watched, rates of discussion related to exercise (58%), and weight (54%) were much higher. In multivariate analyses, health care provider discussions with adolescents regarding exercise were more common for overweight (O.R.=2.42, 95% C.I. [1.28–4.57]) and at risk for overweight (O.R.=1.98, 95% C.I. [1.03–3.81]) adolescents, whereas physician discussion of television viewing was not associated with weight. Discussions of weight were more common for female (O.R.=2.18, 95% C.I. [1.21–3.95]), African-American (O.R.=2.53, 95% C.I. [1.40–4.57]), and overweight (O.R.=3.92, 95% C.I. [1.97–7.81]) adolescents. Even after adjusting for weight, race and gender strongly influenced the frequency of discussions about weight in physician offices. Although health care providers frequently address weight and exercise with adolescents, more discussions related to sedentary behaviors such as television viewing may be warranted to address adolescent obesity.Received PhD in Epidemiology from University of California, San Diego. Research interests include smoking prevention and cessation among adolescents and health promotion interventions.Received MD from University of Missouri-Kansas City and MPH from Johns Hopkins University. Research interests include health services research and research in support of measurable, systematic improvements in the quality of medical care.Received medical degree from Christian Medical College, Punjab, India and Master of Public Health from University of Kansas School of Medicine. Research interests include diet and physical activity behaviors, role of the environment in obesity and obesity prevention, especially among children and adolescents.Received MBBS from Allama Iqbal Medical College, Punjab University, Lahore, Pakistan and MPH from University of Kansas Medical Center. Research interests include smoking cessation, database design, implementation, data management and analysis, and use of information technology in health care settings.Director, Cancer Prevention, Control, and Population Sciences, Kansas Cancer Institute. Received MD/MPH from Tulane University and MS from Harvard School of Public Health. Research interests include disparities in healthcare; smoking cessation among underserved populations, specifically African Americans; diet, nutrition, obesity, and physical activity.     

Does sexual dimorphism in facial soft tissue depths justify sex distinction in craniofacial identification?

Separation of male and female soft tissue depths into discrete groups for craniofacial identification implies that males and females differ enough from each other, with respect to this application, for this distinction to be useful. In this study, previously published soft tissue depth data were analyzed for sex separation. It was found that the variation within each sex was large while the variation between the sexes was small. Often the value of two standard deviations of the measurement for either sex was larger than the difference displayed between the means of each sex. Furthermore, opposite sex overlap in regions defined to be close to the male or female mean were found to be large and the amount of variance explained by sex was small (less than 6% on average). These results indicate that while male and female means at single craniofacial landmarks may differ slightly, and even at statistically significant levels, individual male and female soft tissue depths are often the same or very similar. On average, soft tissue depths of the face do display some sexual dimorphism but it is not marked and of little practical meaning for craniofacial identification where a single individual must be independently considered. Thus, there is little use in separate reporting of data for males and females and data should be combined to increase sample sizes.     

Predicting mouth width from inter-canine width--a 75% rule

It has been suggested that inter-canine width plus 57% of the cumulative distance between the lateral aspect of the canines and the pupil centers can be used to estimate mouth width. Evidence also suggests that the distance between the medial irises approximates actual mouth width fairly well. However, these soft tissue prediction guidelines are limited because they rely on accurate medio-lateral positioning of the pupils within the orbits, for which no systematic empirical evidence appears to exist at this stage. It would, therefore, be more appropriate to use only known hard tissue landmarks in mouth width prediction. This study reports the results of using inter-canine width as a percentage of mouth width for its prediction. This method seems favorable in comparison to the other guidelines because it is as accurate, uses known hard tissue landmarks, and does not rely on assumptions concerning pupil location. Estimating mouth width by using the canines alone, therefore, seems the best guideline to use in facial approximation techniques, at least given knowledge existing at this stage.     

Detection of deception with fMRI: Are we there yet?

A decade of spectacular progress in functional magnetic resonance imaging (fMRI) technology and systems neuroscience research has so far yielded few changes in our daily lives. The dearth of clinical applications of this prolific and academically promising research tool began raising the eyebrows of the public and the research funding agencies. This may be one of the reasons for the enthusiasm and interest paid to the growing body of literature suggesting that blood oxygenation level‐dependent (BOLD) fMRI of the brain could be sensitive to the differences between lie and truth. The word ‘differences’ is critical here since it refers to the often‐ignored core concept of BOLD fMRI: it is only sensitive to differences between two brain states. Thus, available studies report using fMRI to discriminate between lie and truth or some other comparative state rather than to positively identify deception. This nuance is an example of the extent to which applied neuroscience research does not lend itself to the type of over‐simplification that has plagued the interpretation of fMRI‐based lie detection by the popular press and the increasingly vocal academic critics. As an early contributor to the modest stream of data on fMRI‐based lie detection, I was asked by Dr Aldert Vrij to write a piece in favour of fMRI‐based lie detection, to be contrasted with a piece by Dr Sean Spence presenting an opposite point of view ( Spence, 2008 ). This seemingly straightforward task presented two hurdles: having to respond to the popular as well as scientific view of what lie detection with fMRI is and present a wholly positive view of evolving experimental data.     

An unusual case of high-voltage electrocution of a truck driver due to inadvertent contact of the truck with an overhead wire

Electrocution deaths are mostly accidental. However, reconstruction of events in unusual electrocution death is challenging. This article reports an accidental death due to electrocution in a highly unusual circumstance, in which a truck driver reversing his vehicle was electrocuted when his truck inadvertently touched an overhead high-voltage wire. The electric injury marks were present over the sole of the right foot. The scene investigation revealed that the high-voltage wire was loose and was below the level of the prescribed height. The truck was passing over an elevated area made up of dirt and stone. The interior of the cabin of the truck revealed a few non-insulated metallic areas over the floor of the truck, between the accelerator and the brake, which were attributed as the sources of entry of electricity into the body. The electric injury marks were different than those usually seen in high-voltage electrocution as there was an intermediate object (truck) involved, and the contact period between the truck and the electric wire was minimal. This fatality was attributed to the non-proper insulation of the interior of the truck, the negligent driving of the truck driver over the elevated surface, and the loose high-voltage wire without proper maintenance.