Glucose and lactate in vitreous humor compared with the determination of fructosamine for the postmortem diagnosis of diabetes mellitus

Diabetes mellitus is a chronic metabolic illness responsible for a great number of deaths. In postmortem diagnosis, because of the difficulty involved in interpreting blood glucose levels and relatively nonspecific pathologic features, biochemical markers in vitreous humor are useful. The aim of this study was to compare the results obtained for the combined determination of lactate and glucose with fructosamine levels recorded in the vitreous humor of two diagnostic groups (one diabetic and the other nondiabetic). The authors intended to ascertain the capacity of different markers measured in vitreous humor to diagnose diabetes mellitus. Fifty-one cadavers (mean age, 58.7 years; standard deviation, 17.09) were studied. The mean postmortem interval was 16.4 hours (standard deviation, 9.05). Cases were assigned to two diagnostic groups according to whether they were previously diagnosed as either diabetic or nondiabetic. Statistically significant differences for glucose, fructosamine, and the sum values of glucose and lactate were found between the two diagnostic groups. The highest levels were obtained in the group of cases with a previous diagnosis of diabetes mellitus. After the comparison of receiver operating characteristic curves, the sum values of glucose and lactate in vitreous humor is a better predictor of antemortem diabetes mellitus than the fructosamine.     

Contraceptive behavior in adolescence: A decision-making perspective

The contraceptive behavior of adolescent girls was viewed from a decision-making perspective. A semistructured interview protocol was used in interviewing 120 girls aged 12–19 in three clinics (Teen Family Planning, Prenatal, Pediatric Acute Care) at Michael Reese Hospital and Medical Center on (1) demographic in formation; (2) sexual and obstetric history; (3) contraceptive and sexual knowledge, attitudes, and practices; (4) environmental pressures; (5) personality factors; and (6) decision-making style. We found that the girls were generally poor contraceptors. They viewed the costs of contraception (in terms of safety) to be high; and they positively valued physical intimacy, opportunities for which come up unexpectedly and sporadically. These factors, along with their ambivalent views toward pregnancy and childbearing seemed to encourage their risk-taking behavior. Once pregnancy occurred, it was carried to term because of the strong internal and external pressures they felt to have and keep the baby. The peer-led intervention program that we are developing based on the survey findings will focus on (1) the teenagers' lack of accurate and complete knowledge about birth control and conception, (2) their limited sense of options concerning birth control and pregnancy outcomes, and (3) their poor understanding of and lack of insight into what motivates their behavior.This study is part of the investigation being conducted by the YADMAC (Young Adult and Adolescent Decision Making About Contraception) Project at Michael Reese Hospital and Medical Center, 2959 South Cottage Grove, Chicago, Illinois 60616. The authors are all members of the YADMAC research team.Received Ph.D. from the University of Chicago. Current interests are human sexuality and reproductive behavior. Currently at Department of Psychology, St. Xavier College.Received M.D. from the University of Michigan. Current interests are liaison child psychiatry and adolescent sexuality.Received Ph.D. from the University of Chicago. Current interests are early adolescent development issues.Current interests are puberty and sex differences.B. A. candidate in social work, Roosevelt University. Current interests are adolescent sexuality and contraceptive behavior.     

Thinking like a lawyer/acting like a professional: communities of practice as a means of challenging orthodox legal education

Increasingly, there is pressure upon law schools, in Australia and elsewhere, to impress upon students the significance of the ethical and professional obligations of legal practice. The recent Carnegie Report explicitly looked to law schools “to initiate novice practitioners to think, to perform, and to conduct themselves (that is, to act morally and ethically) like professionals”. Many law students, however, have little appreciation of legal ethics and any concept they may have of professionalism tends to be envisaged as applying only after graduation. In this paper, we explore the idea of a “community of practice”. Lave and Wenger, who coined the phrase, contend that “learning is conceived as a trajectory in which learners move from legitimate peripheral participant to core participant of the community of practice”. We will argue that law students should appreciate that they are entering the legal profession's community of practice and that all aspects of their conduct relevant to professionalism – not only academic integrity, but matters such as time management, teamwork, relationships with peers and staff – relate to this transition into a legal professional community. Such an approach may not only serve to impress upon students the significance of “professionalism” and ethics, but inculcate in them a sense of belonging to a professional community.     

A Call to Action—The Essential Role of Advocacy

Editor's Note: The Perspectives featured in this issue of Public Administration Review were adapted from May 2016 commencement addresses: Anna Maria Chavez, the CEO of the Girl Scouts of the USA, spoke on the 12th at Arizona State University's College of Public Service and Community Solutions; Nancy Pelosi, the Democratic Leader in the United States House of Representatives spoke on the 7th at New York University's Wagner School of Public Service; and Tommy Thompson, the former Governor of Wisconsin and Secretary of Health & Human Services, spoke on the 15th at the University of Wisconsin's La Follette School of Public Affairs. These Perspectives reaffirm the highest principles of American public administration: that by and large, government is NOT the problem, and quite often indeed holds the solution; that effective and helpful public policy depends on informed expert opinion and research; and that those who enter public service should do so with a commitment to the notion that America best fulfills its promise when we seek the well‐being of all people, including the least fortunate. We chose these messages from among a wealth of commencement speeches because while they come from leaders with quite different political views, background, and experience, taken together they offer a coherent and inspiring call to public service. Dan Feldman, Perspective and Commentary Editor